HEALTH OF OLDER PEOPLE

COMMUNITY & HOME BASED SUPPORT SERVICES

REVIEW PROJECT

Working Group Meeting Minutes for 27th July 2007 from 12noon to 1.30pm

Present:Marie Hull-Brown, Miriam Horgan, Emsie Walters, Andrea McLeod, Manjula Sickler, Margaret Thompson, Rebecca Ruwhiu Collins, Lucy Westbrooke, Jo Wright, Sandi Millner, Matthew Parsons, Philippa Neads, Hilda Fa’aselele, Hillary Birch.

Apologies: Kitty Chiu, Indu Bajaj, Barbara Stevens

Matters / Discussion / Action / Responsibility / Due Date
Welcome to the HOP Community and HBSS Project
Introductions /
  • Jenny welcomed new representatives to the working group and provided a general overview of the project and outlined minutes of the last meeting.
/ ALL / ALL
Minutes Previous Meeting / Minutes of the last meeting – were accepted to be true and correct.
Presentations / Jenny reminded members that the website was up and running.
Presentations were provided by
Sandi Milner – A+ Links
8 years ago A+ Links embarked on a similar project. A+ Links was formed by an amalgamation of four in-patient wards with strong linkages.
  1. Orthopaedic cases(#NOF)follow a pathway, from PACU go directly to rehab ward.
  2. Orthopaedics is linked to medical and regular wards.
  3. General medicine has three physicians who are also geriatricians.
  4. GiNOA portfolio is discussed.
  5. The in-patient and community services – geriatricians rotate working in the wards and home visiting.
  6. Day assessment - organised integrated days with interdisciplinary teams.
  7. CNS/Neurology services – in the process of developing larger stroke services (issues of memory).linked to day assessment programme
  8. Adult services. In home health not all funding is HOP funding. A+ Links funded by a number of funding sources.
For the sector to be collaborative and to maximise resources, CNS positions funded for the residential sector. We need to reflect the diversity of consumer needs.
Lucy Westbrooke (on behalf of Barbara Stevens) – PHO perspective
Themes from the presentation were:
  • The need for single point of entry for access
  • simple pathways.
Emsie Walters (on behalf of Kitty Chiu) – Asian health perspective
Set up of Chinese day care programme led by Chinese volunteers.
Key issues:
  • transportation
  • health continuum for the Chinese older person.
Suggest early intervention health promotion.
Matthew Parsons – NZ wide Home Based provider training
  • Currently running training for 11 DHBs.
  • Common interface of NASC and providers. NASC leads the process, holds the control and works with the providers.
  • The turnover of homecare coordinators is higher than the workers.
  • Comment – flexible packages do not mean more money.
Andrea McLeod – Home Based support services sector feedback
Waiheke Home Based support services have their own unique needs. Within the Auckland there is a wide variety of provider/ADHB contracts. There are also ACC rehab contracts.
Strengths:
  • large pool of providers
  • high level of satisfaction
  • strong relationship
  • commitment to NZQA and upskilling of workers
  • commitment to quality standards.
Gaps:
  • issues of boundaries
  • access to specialists
  • duplication
  • prescriptive nature of support services
  • no movement of auditing processes
  • fee for services
  • transport issues
  • recruitment retention issues
  • traffic jams
  • hazard problems
  • lack of duty to provide
  • knowledge of different cultures.
Future service provision – providers would like to manage low needs, early screening based on need not demand.
Hilda Fa’aselele – Pacific Health perspective
Day care services for older persons health called Tua Sina Sina.
Issues:
  • older abuse
  • isolation
  • culture specific issues and language issues.
Currently there are church-led groups that support the older persons health needs. This is a family centred approach which is ethnic-specific and culturally appropriate.
Rebecca Ruwhiu Collins – Maori Health perspective
Issues
  • Cultural behaviour issues when dealing with whanau. The whanau wants to take over and care for the older person. Training is given to Maori whanau however there is resistance to training as they are caring for family members.
Note:
  • provide more cultural content for homecare provider’s training especially in family violence and elderly abuse
  • ensure that boundary areas are covered in this training
  • a whanau approach is necessary for the Maori client.
Jenny divided the group into smaller groups to discuss the themes from the survey
Health of Older Persons
Home Based Support Services
Community Quality Initiative Project
Themes:
  1. Flexible Funding
  2. Integration
  3. Flexible packages of care
  4. “Declinicalising” DHB services
  5. Client needs for intimacy and sexuality
  6. Active case management
  7. Empowerment model
  8. Robust Referral pathway
  9. Older Persons Mental Health
  10. Carers issues
  • formal
  • informal
The discussion from these themes will continue on the 10th August 2007

The meeting closed at 1.30pm

Next meeting: to be held 10 August 2007 from 1200 - 1330 at AlexanderRoom. Level 8, Building 13, Greenlane Clinical Centre

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