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(2012) Ageing in Place in Golden

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(2012) Ageing in Place in Golden 'Ageing in Place' in Golden Bay: An investigation of the ageing population in Golden Bay and what they need to be able to ‘Age in Place’ By Dr. Bjarne Vandeskog, Abbi Vandeskog and Dr. Linda Liddicoat Commissioned by Golden Bay Work Centre Trust Financed by Lottery Community Sector Research Fund © Golden Bay Work Centre Trust and Dr. Bjarne Vandeskog January 2012 ACKNOWLEDGEMENTS We would like to thank all the people who made this research possible; the organisations providing services to older people, individuals we interviewed and those who took the time and effort to answer the questionnaire. Thanks also to Dr. Jeff Sluka and Dr.Trisia Farrelly who provided valuable feedback on the research proposal as part of the ethics approval process. Dr Mike Milstein and Dr. Annie Henry have read through parts of the report and provided important comments. Lottery Community Sector Research Fund financed the research and without their support it would not have happened. Thank you to all of you. CONTENTS Executive Summary p.1 1. INTRODUCTION p.3 Why do this Research? Golden Bay – a remote rural community The New Zealand Positive Ageing Strategy Nelson Marlborough District Health Board (NMDHB) Annual Plan 2011/12 How to study an ageing population Ageing in Place in Golden Bay Our research questions and how we investigated them The structure of the report 2. RELEVANT LITERATURE p.12 Definitions of old age Age: decline or resilience Ageing in Place Literature on Ageing and rural 3. DESIGN AND METHODS p.20 Design Interviews with service providers Interviews with residents over the age of 55 Questionnaire Ethical issues 4. FINDINGS p.24 Overview - Service Providers Issues identified through interviews with service providers Volunteer situation Transport situation Home Support worker situation Rest Homes and Dementia care Bureaucratic standardisation vs. pragmatic delivery Planning for the future Issues identified through interviews with individuals aged 55 and older Choice of place to become old Sense of belonging Medical Care Aging at home Not wanting to become old in Golden Bay Not having made a choice Health Finances Partner, Family and Social network Transport and mobility Planning for old age Findings from Questionnaire answered by the General Public Demographics “Where would you like to live as you get older?” “Is your current home suitable for ageing in?” “If unable to live independently, where would you prefer to live?” Income and debt Work and retirement Transport Health Social network Degrees of wellbeing Volunteering Access to services and future improvements 5. DISCUSSION p.50 What factors influence people’s choices about the place where they want to become old? What factors influence people’s ability to get old in the place they prefer? Home and Property Social network Finances - Income and debt Health and home support Transport Degrees of wellbeing Organisations dependent on volunteers Access to services; future needs CONCLUSION p.62 BIBLIOGRAPHY p.66 APPENDIX 1 Questionnaire p.69 APPENDIX 2 Comments to questionnaire p.74 EXECUTIVE SUMMARY The demographic situation in Golden Bay is characterised by a relatively rapid increase in the proportion of older people. As of 2011 43.1% of the population is 50 years or older and one third (33.8%) have seen their 55th birthday. Due to a number of reasons, primarily lack of employment and affordable housing, many young people are leaving Golden Bay and few are arriving, further contributing to the over-representation of older people. There are no signs that this trend will change, and Golden Bay is facing a future where, in ten to twenty years, close to half of the population will be of retirement age. The New Zealand Positive Ageing Strategy outlines the National Government’s aims and actions to enable people in rural areas to age in the place of their choice. The present study has investigated the factors that influence Golden Bay resident’s decisions about where that place is, and their ability to actually grow old there. The study found that the great majority of residents in Golden Bay want to Age in Place in Golden Bay, and preferably in their present home. A majority of Golden Bay residents already live in homes that are adequate, but one third of the population over 55 years of age report that their houses are not adequate for old age as they require too much maintenance, are too big or located too far from town. This research found that people want to grow old in Golden Bay because of its beauty, the leisure activities it affords and their sense of identity and belonging to the land, the community, to family and to friends. It also found that the quality of people’s accommodation (house and section); their financial situation, the quality of their social network and their health are the main issues contributing to their ability (or not) to Age in Place in Golden Bay. The results of the statistical survey revealed that for 4/5 of the Golden Bay population the situation looks positive on all variables influencing their ability to age in the place of their choice. This means, on the other hand, that at any given time approximately one in five is vulnerable on one or several parameters. A large number of organisations, both governmental and NGO’s, provide services contributing to making Golden Bay an attractive place to grow old, and enabling people to age well in this area. All these organisations and the services they provide are important contributors to the sustainability of the Golden Bay community and maintaining its viability as a Place to Age. As the number and proportion of older people increase, it is likely that they will experience an increase in the demand for their services. This research shows that the issues and areas that need to be addressed in preparation for the increase in older people are: • Social network – community fabric. People chose to Age in Place in Golden Bay because of the positive qualities of their social networks and the community. These factors also contribute, in a fundamental way, to their ability to age in this place. The future of people’s social networks and the community are highly uncertain and precarious because of the exodus of younger people and very low recruitment rates. Lack of employment opportunities and unaffordable housing are some of the main contributors to this problem. 1 • Appropriate accommodation. A range of solutions are needed, from retirement/eco-villages, via more easy-care, smaller units close to own, to allowing several buildings on the same section. • Transport. Some forms of alternatives to private cars that also enable Golden Bay residents to take advantage of the transport subsidies available in urban areas, are needed. • Home Support. This service is essential to enable people to keep living at home as their health declines. Whilst carers in Golden Bay enjoy a very good reputation, the organisational model upon which the service is built seems to be sub-optimal. The present organisational model does not seem well suited to delivering the highest quality of service, nor for looking after the carers as a human resource asset. • Volunteers. A large number of services for older people rely on volunteers, and all volunteer organisations report increasing difficulties recruiting new volunteers, particularly for executive positions. Lack of volunteers undermine the sustainability of these organisations and every organisation plays an important part in maintaining Golden Bay as a good and viable Place to Age. Younger people in Golden Bay express a willingness to become more active in volunteering the future, but this willingness needs to be channelled into action. 2 INTRODUCTION The “Ageing in Place in Golden Bay” project investigates the factors that influence people’s decisions about where to grow old and the factors that influence their ability to get old in the place of their choice. The project builds on two central concepts, ‘Ageing’ and ‘Ageing in Place’, both of which need clarification. ‘Ageing’ can be defined in many different ways and it is easy to assume that functional decline is a necessary characteristic of ageing. We have made a conscious effort to avoid that assumption because we believe that people’s level of functioning is something we should discover rather than assume a priori. Consequently we have chosen a ‘neutral’ definition of ageing, a definition that only brackets off a category of people of the same age. The cut off point for when a person should be considered old is obviously open to debate and varies between countries and cultures. An indicator of this variation is the age that defines a person as eligible for superannuation. In New Zealand that age is e.g. 65, in Austria 58 and in Norway 67. We will not discuss the relative merit of the various cut off points here, but have decided to adopt the same understanding of ‘old’ as the one underpinning the New Zealand superannuation scheme, i.e. people enter into the category ‘old age’ when turning 65, noting that many have as much as 1/4 of their lives ahead of them at this age. In order to say something about the future and those who will reach ‘old age’ during the next decade, we have included people over 55 years of age in this project. In the questionnaire we also included people between 18 and 55 to learn about similarities and differences between younger and older residents. ‘Ageing in Place’ can also be defined in many different ways and the most intuitive definition is ‘getting old at home’. Essentially we subscribe to this definition as well, but recognise that it is slightly too vague because it begs the question ‘What is a home?’ The New Zealand Positive Ageing Strategy (Ministry of Social Policy, 2001) defines ‘Ageing in Place’ as: “people’s ability to make choices in later life about where to live, and receive the support to do so” (p.
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