The loneliness epidemic is now known to be a major public health issue, impacting both
​mental and physical health.  But there are ways to protect ourselves. Angela Mathews explains

After a lifetime spent caring for the poorest of the poor and looking after people suffering from sicknesses diverse as leprosy, tuberculosis, cholera and HIV/AIDS  Mother Teresa famously said, “Of all the diseases I have known, loneliness is the worst”.
 
Several decades later US Surgeon General, Vivek Murthy, identified the “epidemic of loneliness’ as a public health issue.  In 2023 he described mental health as the defining public health crisis of our time but identified loneliness as being at the heart of that crisis (Murthy 2023).
 
Loneliness is the state of distress or discomfort which results from the perceived gap between one’s desire for social connection, and their experiences of social connection. (Psychologytoday.com. 2025).  While loneliness can affect anyone, those aged 65 and over are particularly vulnerable.  In fact the General Social Survey carried out by Statistics NZ showed the percentage of people aged 65 had over who felt only increased form 27% in 2018 to 36% in 2021, a massive 9% increase in only three years!
 
In November 2024, Age Concern Auckland, in conjunction with the CHT Aged Care Fund,    published a report examining loneliness and social isolation among older adults in Auckland and the Bay of Plenty.  Their research found that 59% of  participants had recently felt lonely or socially isolated, and 30% felt that way often or all for the time (Breaking Barriers: Understanding the Socal Connection Challenges of Older Adults, Age Concern Auckland).

Among the report’s findings were some surprising insights. For example, 63% of those who reported feeling lonely could still drive, proving that it is not so much your driving status which is important but rather having a meaningful destination to drive to where you can meet others and connect over common in interests. And 42% of married older adults reported feeling lonely or isolated, showing that marriage alone is not a protection against loneliness.
 
The problem with loneliness is that it is not only diminishes joy and quality of life but also impacts physical health. Beyond the obvious correlation between loneliness and mental health  challenges, it has also been linked to an increased risk of cardiovascular disease, hypertension, diabetes and a host of other health issues. Put simply, for the sake of your mental and physical health it is wise to do your utmost to come up with a plan to try and avoid loneliness and           social isolation.  This like many other things in life is more easily said than done.  Whilst the 20th century saw rapid urbanisation in New Zealand, the 21st century has brought a new wave of globalisation for the New Zealand population. Over the last century people have become increasingly mobile which means families are less likely to live in the same town, city or even country.  At the time of the 2023 census an estimated one million New Zealand citizens lived abroad, this represents an astonishing 19% of the population.  That same census showed that over 28% of New Zealand’s resident population were born overseas.  The result of all this mobility is an increasing number of older adults living in different countries or cities than their adult children, and their grandchildren. Visits have changed from regular  pop-ins from children and grandchildren to catch ups online punctuated by occasional in-person visits.
 
The Age Concern study also highlighted that particularly in Auckland, there is a growing group of older migrants who feel isolated due to language barriers and their adult children being unable to support them during the day as they are out at work.
 
The Age Concern study found that the health system also contributed to the rise in loneliness and social isolation.  Delays in accessing non-urgent medical treatment affected some participants mobility, making it harder for them to get out into the community and participate in activities and connect with others.  This was especially true for those who were less financially secure as they didn’t have the option to pay for private medical care and extra support.
 
 
 
 
 
 
Ironically, while technology and social media have made us more connected than ever, many people feel more alone. Age Concern found that an astonishing 75% of survey participants who reported feeling lonely were social media users. However older New Zealanders are also rightly wary of scams which can make us feel insecure and hesitant about connecting online.  I think we can all conclude after living through covid lockdowns, that nothing is quite as good as catching up in person and connecting over a cup of tea or shared interest.
 
So what can we do to protect ourselves from loneliness?  The Age Concern study suggested that retirement planning needs to be more than financial but should also include a plan to live life with purpose and remain socially connected, whether that be through part time employment, volunteering or developing a new hobby.  Of course retirement villages often come with a huge   plethora of activities or clubs to get involved in which offer plenty of options to connect socially but for those people who aren’t living in a village and whose social life was tied up with work there may be a need to plan ahead for your post-work social life!! If possible, make sure that plan doesn’t hinge around one person or group but has lots of variety and options. As well as developing existing friendships this could include joining a new club or interest group.  To find local clubs and groups in your area check out www.seniors.org.nz/clubs.
 
Lesley who lives in Christchurch found that her life was a bit more lonely when her husband  moved into care.  She said while it was easy to stay busy and connected during the day it was at the ‘bookends’ of the day, the mornings and evenings, that she really noticed the change.  One thing she really missed was having someone to discuss problems with so she didn’t feel like she was carrying the load alone, and it was at these times she really appreciated being connected to the community around her and having neighbours and friends to talk things through with over a cup of tea or a glass of wine.  Fortunately Lesley is someone who has spent years helping others out in the neighbourhood so those community connections were already well established when she needed them.
 
Vivek Murthy, the US Surgeon General who identified the epidemic of loneliness, would agree with Lesley’s approach.  He encourages us to focus on building caring and supportive relationships and community networks to strengthen our social connections.  He also encourages each person to take 15 minutes a day to reach to someone and to support them in some way, in doing so we forge a connection with another human and we remind ourselves of our own value. What a great way to reduce loneliness!!
​ 
Ref:  NZ”s Best - Seniors Org NZ Edition 2026
 
 

Keeping fit when older is important and takes more effort the older we get.  Fifty per cent of those over 75 are sedentary (sit most of the time) and 25% of those over 85 aren’t active at all.  Habitual activity makes up a large part of all activity.  Housework makes up more than half of an older woman’s activity.
 
As we get older, fitness is more Important than weight, so relax about your shape and concentrate on fitness.
 
So how fit are you? 
 
What walking distances can you comfortably do?
 

• walk across the road
• walk around the house
• walk in your garden

• walk in the street – one block
• walk in the street – two blocks
• walk more than four blocks

 
Being unable to walk round the block is one indicator you have an increased risk of falling.
 
Test your fitness with the “Get up and go test” – using a dining chair.  
Record how long it takes you to stand; walk three metres (10 feet); turn; walk back; sit down again.
 
After a month of exercising, test yourself again. A change more than four seconds can indicate a change in the level of mobility eg six seconds slower indicates slower/less confident mobility or six seconds faster indicates stronger/more confident mobility.
 
Below are some moderate intensity realistic exercise ideas for you to improve your fitness: 

In 1987 Clare O’Hagan, the founder of Therapy Professionals Ltd attended the World Congress of Physical Therapy and heard a lecture by Carol Davis on Transdisciplinary Teamwork.  From that moment Clare wanted to develop such a team.  It wasn’t until 1997 when she got the opportunity.  It was a slow process to start with as the disciplines were struggling to work in a multidisciplinary way.  By the early 2000’s the team was humming and her dream was realised.
 
Below is Carol Davis’s article on transdisciplinary teamwork.
 
 
Philosophical Foundations of Interdisciplinarity in caring for the Elderly:  or, the willingness to change your mind.
 
Carol M Davis, Ed. D Associate Professor
Department of Physical Therapy, Sargent College, Boston University, Boston, MA 02215, USA.
 
INTRODUCTION
 
Medicine alone rarely, if ever, meets all of most patients’ needs. Other health professionals assume the responsibility of caring for patients’ multiple other needs with a common goal of the highest level of independent function, thus the greatest quality of life possible, for each person.
 
When health professionals from many disciplines attempt to work together in caring for the elderly patient, the end product of this effort can have various characteristics.  This paper examines the characteristics of various outcomes, and describes what factors enhance the process.  Finally the suggestion is made that the processes of interdisciplinary or transdisciplinary result in the best possible outcome of care for the patient.
 
THE CONTINUUM TOWARD TRANSDISCIPLINARITY
 
Few health care professional students in the United States receive adequate training in learning how to work well with others for the good of patients.  Indeed, young beginning practitioners often feel more than stressed in simply maintaining access to their own professional knowledge and skill.  Learning to work with others takes place on a continuum of growth that can be described in the following model:
 
Unidisciplinary
Feeling confident and competent in one’s own discipline
 
Intradisciplinary
Believing that you and other fellow professionals in your own discipline can make an important contribution in care
 
 
Multidisciplinary
Recognising that other disciplines also have important contributions to make
 
Interdisciplinary
Willing and able to work with others in the joint evaluation, planning and care of the patient
 
Transdisciplinary
Making the commitment to teach and practice with other disciplines across traditional disciplinary boundaries for the benefit of the patient’s immediate needs. (United Cerebral Palsy 1.)
 
The increasing effectiveness of each of these processes can be illustrated with the help of the following case example.
 
An 85-year-old patient is admitted to the geriatric evaluation unit with a cerebral vascular accident with right hemiplegia, hemianopsia, and aphasia.  He is accompanied by his 78-year-old wife.  They had been living together at home prior to his stroke one month ago.  Since that time the patient was in the hospital for resolution of his acute problem, then transferred to a nursing home for careful nursing care until he stabilised.
 
Mr Walker was a tailor and lives on a modest social security income.  His wife receives no social security.  Their finances are assisted by monthly cheques from their son who lives in another state 1000 miles away.  Mr Walker is diabetic.  Mrs Waker is quite well but very lonely without her husband of 60 years.  They were active in the Methodist church but were driven to church each Sunday before Mr Walker’s stroke, as neither could drive any longer.
 
Mr Walker’s physician illustrates unidisciplinarity and intradisciplinarity as he evaluates the patient upon admission to the hospital. He believes that his discipline of internal medicine is very suited to the care of this patient, but his area of expertise in gastrointestinal cancer restricts his confidence that he can uncover and treat Mr Walker’s circulatory problem to resolve it adequately.  Thus, he requests his colleague in internal medicine who is a cardiac specialist to see the patient as well.
 
Multidisciplinarity occurs as he writes the order for the patient to be seen by the physical therapist, occupational therapist, speech therapist, the psychologist, the social worker and the nutritionist.
 
When this group of practitioners evaluate the patient and plan their care, all separate from each other, communicating only by way of the patient’s record, they are practicing multidisciplinarity.  Just as in a ‘jar of jelly’ beans, the end product of care is no more than the sum total of all the parts.
 
Patients complain about multidisciplinary care when they say, “I’m not answering that question one more time!”.  Or, “I’ll only give blood once today – you people get together and figure out which one of you is going to stick me and when.”
 
Practitioners complain about multidisciplinary care when the goal of the physical therapist to increase Mr Walker’s endurance in ambulation is thwarted by the nurse who ties him in bed so he cannot get up and walk around for he might fall.
 
Interdisciplinarity can be recognised as superior to the aforementioned when it’s working well.  In the Journal of Medicine and Philosophy Maurice de Wachter offers five steps to interdisciplinarity (De Wachter 2):
 
1)        One starts by accepting the “methodological epoch”.
Each person agrees to abstain from approaching the topic along the lines of his  or her       monodisciplinary method alone.
 
2)        The entire team tries to formulate, in an interdisciplinary way, the global question, acknowledging all aspects of the patient’s problem and all disciplines required to solve it.
 
3)        One translates the global question into the specific language of each participating discipline.
 
4)        Answers to this global question (translated to each discipline) are constantly  checked for relevance with regard to the overall global question.
 
5)        One agrees upon a global answer, which must not be produced by any one  particular discipline but rather integrates all particular answers available.
 
Thus, interdisciplinary process is composed of more than just several health professionals gathered around a table to discuss Mr Walker.  Each sits down and, in essence, brackets his or her professional-discipline identity, places it to the side and assumes the new identity of “team member.”

This act of bracketing is critical to the success of interdisciplinarity.  Just as in algebra or language analysis, brackets serve the purpose of setting aside, without destroying, what is bracketed.  In other words, identity as a physical therapist, for example, is available to me and, indeed, informs my contribution to the team, but I do not allow it to keep me from hearing the reports of other team members and helping to decide on a team goal and plan of care for this patient.  In short, each of us sits down at the table and listens to the others with a willingness to allow others to change our minds.  In this way the very best of all possible plans is agreed upon.  Unlike the “jar of jelly beans”, the product of this effort is larger than the sum of all the parts.  Indeed, ideally professional boundaries are transcended and flow into each other with ease, much like the colours of a rainbow.

Finally, transdisciplinarity represents the highest progression in the process of patient care.  Hospice care illustrates this process quite adequately.  Health professionals teach each other, the patient and the patient’s family how to perform aspects of care reaching beyond professional boundaries with the immediate need of the patient being foremost.  If the physical therapists arrives to work with a patient at home and learns she has not yet taken her pain medication, she doesn’t wait for the nurse to arrive to give it, nor the husband to make the toast to take with it. She does it herself.  Likewise she teachers the nurse, husband and volunteers how to help the patient move about in bed and walk to the bathroom.
 
Integrated, smooth, coordinated congruent care with the patient’s immediate needs at the centre of the effort marks transdisciplinary care.  Individuals come together without territorial professional boundary needs to guide their role and responsibilities.  This is what makes it the highest form of care.
 
Transdisciplinary care is a mature and humble way of being in the world.  Factors which interfere with interdisciplinary and transdisciplinary care include:
 
·         lack of personal commitment in the process
·         lack of personal commitment to accepting the risk of bracketing one’s professional role
·         feelings of insecurity that are revealed in the need for clear territorial boundary roles
·         lack of shared values
·         lack of skill in interpersonal interaction
·         perception of threat from other team members (Darling 3)
 
Factors that enhance interdisciplinarity and transdisciplinarity are the opposite of these limiting factors.  Central to these two processes is a mature, secure, self-confident practitioner with excellent skills in communication and teaching who primarily values that the patient’s needs be met regardless of who meets them.  The making of such persons takes time and commitment to the beauty and value of the rainbow.
 
 
 
 
 
 
 

For most of us handwriting is a task we take for granted.  We don’t consider how much goes in to it, nor do we think about the implications of not mastering this skill.
 
Handwriting is a complex process.  It involves:
 

• quickly transferring a thought into words
• accessing memory to choose the correct letters that make up a word (symbols)
• holding and directing the pen
• feeling the page and coordinating eyes to form the letters on the page.

 
Today with technology we increasingly use typing in place of handwriting.  Although typing and technology are useful tools handwriting has many benefits.  According to research three areas of the brain light up in a highly coordinated way when a person is handwriting and no such activity is observed with typing.
 
The physical act of handwriting helps improve:
 

• reading and writing
• reading comprehension
• memory and recall
• critical thinking and conceptual development
• creativity
• calming the body and nerve ends
• managing depression and anxiety
• problem solving
• organising and processing information
• focusing on tasks.

 
Children who struggle to write by hand often avoid it or are encouraged to type instead.  Unfortunately they then miss out on all the benefits derived from handwriting and from gaining help for the underlining cause of their difficulty, which may include problems with:
​

• fine motor weakness or weak hands
• poor coordination between hands
• poor core muscle strength or posture control
• poor eye hand co-ordination
• poor processing of their senses

 
These functions are necessary for many other life skills and activities, eg tying shoe laces, using a knife and fork, dressing and grooming
 
Occupational Therapists are experts in improving handwriting and hand skills.  If you know a child who is struggling with their handwriting contact us at Therapy Professionals as our friendly Occupational Therapist can help.  Just contact us:
 
                        Phone:            03 377 5280               
                        Email:             admin@tpl.nz
                        Website:         www.therapyprofessionals.co.nz

​The government is cutting transport subsidies for elderly and disabled people from 75 percent to 65 percent.

The Total Mobility scheme provides discounted taxis and public transport fares for those with long-term impairments.

Transport Minister Chris Bishop and Disability Minister Louise Upston said when the previous Labour government boosted the scheme from a 50 percent subsidy in 2022, it did not account for increased demand.

The number of registered users had increased from 108,000 to 120,000 between 2022 and 2024/25, and the number of trips increased from 1.8 million in 2018 to 3 million in 2024/25.

Bishop said the increased demand now meant the scheme was close to exceeding the funding provided by $236m sometime over the five years to 2030.

"The subsidy is split between the government and public transport authorities - local councils and the NZ Transport Agency (NZTA) - and provides an important service for the people who use the scheme," he said.

"This is yet another fiscal cliff left to us that we are having to correct and fix. Today, the government is announcing decisions to stabilise the Total Mobility scheme so that the disability community is supported in a financially sustainable way, by all funding partners."

This would be done by reducing the subsidy from 75 percent to 65 percent, something the Transport Agency would work towards.

The reduced costs to the Crown would be recycled back to public transport authorities to reduce the 2025 to 2030 shortfall, with the government also providing $10m.

Upston said they wanted to "stabilise" the scheme's funding pressures "in a way that ensures financial sustainability, consistency in how the service is delivered, and fairness across New Zealand".

She said the government would release a discussion document to consult on further changes to the scheme "to ensure fairer, consistent and more sustainable access to services for people with the greatest need".

Labour's Priyanca Radhakrishnan says today's changes mean disabled New Zealanders paying more to get to work, attend appointments or see loved ones.

She said the government was making life harder and more expensive for disabled New Zealanders by making the cuts in a cost-of-living crisis.

"Slashing subsidised transport at a time when people are already struggling is out of touch especially from a government that promised to ease the cost-of-living and has instead made it worse.

"Disability communities feel betrayed. First came the overnight cut to flexible funding. Then restrictions on residential care with no warning. Then Whaikaha was gutted and disability support shifted to the Ministry of Social Development. Now, the transport subsidy many rely on to live independently has been cut."
​
She said affordable transport was not a nice-to-have for many disabled New Zealanders, but a lifeline that meant independence, dignity, and the ability to participate in everyday life - which was why Labour had increased the subsidy in 2022.
 
Ref: RNZ 16 December 2026
https://www.rnz.co.nz/news/political/581995/transport-subsidies-for-elderly-and-disabled-people-reduced

 Many of us experience changes in our sleeping as we age.  We may find it hard getting to and staying asleep, or waking early unrefreshed, making us feel sleepy and sluggish during the day.  Research suggests most of the sleep problems among the elderly are because of physical and psychological health problems and the medications used to treat them.  Lack of sleep contributes to falls, car accidents, sensitivity to pain and a poor quality of life.
 
The amount of sleep required by each person varies from 7-9 hours.  It’s not the time sleeping that matters, it’s how you feel when you wake that’s important.  There are a number of stages to sleep, dreamless periods of light sleep and deep active dreaming sleep (REM sleep). This cycle is repeated several times during the night and although total sleep time tends to remain constant, as we age we spend more time in the lighter stages of sleep than in deep sleep, which is more refreshing. This contributes to wakefulness during the night.  Generally as we age we go to bed earlier and wake earlier.
 
Here are a few tips to improve your sleep
 
1)         Go to bed and get up about the same time every day.
2)         Ensure you have a comfortable bed and bedding.
3)         Have a bed time ritual that’s relaxing eg reading, deep breathing, listening to music, having a
             hot bath or shower.
4)         Have a cool, dark and quiet bedroom to sleep in. 
5)         If your partner snores wear earplugs.
6)         Keep your bedroom for sleep and sex only (no screens).
7)         Stop looking at screens (TV and computers) about an hour before going to bed (the light
             tricks your mind into believing it’s day time).
8)         Eat dinner at least three hours before bed. If you need a light snack avoid sweet snacks and
            those containing caffeine, instead have crackers and cheese or milk.
9)         Don’t drink after dinner and go to the loo before bed so you don’t need to go through the
             night
10)      Stop your caffeine intake at lunch time (coffee, fizzy drinks and chocolate).
11)      Reduce your alcohol intake and stop at dinner time.  If you’re having a great deal of trouble
           with sleeping stop drinking alcohol.
12)      Get some vigorous exercise during the day, early afternoon is best and not in the evening, as
            this will keep you awake.
13)      Vitamin D helps with sleep. Ensure you get enough from sunlight, your diet or supplements.
14)      If you have a bad night’s sleep don’t worry, just try and go to bed at your usual time the next
​            night.  This will help keep your circadian rhythm on track.
15)      If you are still awake after 20 minutes get up and do something quiet like reading. Keep light
           to a minimum and return to bed when you feel sleepy.
16)      If you need a nap during the day, do so early in the afternoon and for about 20 minutes.
17)      Reduce the stress in your life and don’t do anything that upsets you before bed.
18)      Take any medication as and when prescribed.
19)      If you have a health problem that interferes with your sleep eg Arthritic pain, reflux or a
​            breathing problem, discuss this with your Doctor.
 
 
Still not sleeping
 
If after trying these tips for some weeks you’re still not sleeping well talk to your Doctor as you may:

• need a review of your current medication
• have a sleep disorder like sleep apnoea or restless leg syndrome 
• need better control of an existing physical or mental health issue
• need greater assistance with sleep from medication or cognitive behavioural therapy .

 
Sleeping is important for our overall functioning, so take the time to think about your sleeping habits.
 
Happy sleeping from the team at Therapy Professionals Ltd.
 
    
References:
 
Lecture by Dr Alex Bartle “Sleep Disorders In the Elderly”
 
https://www.helpguide.org/articles/sleep/how-to-sleep-well-as-you-age.htm?pdf=13837
 
 

The Supreme Court has ruled two parents who care full-time for their disabled children are, in fact, employees of the government, and should receive the same benefits and protections.

Under the New Zealand Public Health and Disability Act 2000, family members who provided support services could receive payment for their care of their disabled family members.

Christine Fleming, who cares full-time for her disabled son Justin, and Peter Humphreys, who cares full-time for his disabled daughter Sian, had their case heard by the Supreme Court in April.

The decision was released on Tuesday, in favour of recognising both Fleming and Humphreys as ministry employees.

Jurisdiction for disability funding has transferred since court proceedings began from the Ministry of Health, to the Ministry of Social Development.

For carers not to be recognised as employees meant they weren't entitled to things like holiday pay and protection against unfair treatment - and during the April hearing, lawyers said the issue could potentially affect thousands of family carers.

Fleming's and Humphreys' individual cases had initially been won in the Employment Court, but were overturned by the Court of Appeal.

The Court of Appeal ruled Fleming wasn't a homeworker after she turned down the health ministry's offer of funding through a programme called Funded Family Care, which would only have funded her initially for 15.5 hours, and later, 22 hours, for what was actually round-the-clock care for Justin. She decided she was better off on a benefit.

The court ruled separately that Humphreys was classified as a homeworker during the six years he received Funded Family Care, which meant he was technically an employee of Sian - but when the funding scheme was replaced by a new one, called Individualised Funding, in 2020, his status changed and he was no longer considered an employee.

He argued in court nothing had changed for him, or for Sian, and it was unfair that his status as an employee had disappeared.

On Tuesday, the Supreme Court - in reasons laid out by justice Dame Ellen France - has reinstated both Fleming's and Humpheys' employee statuses.

It also ordered costs worth $50,000 to be paid by the Attorney-General to Humphreys, but left the working out of costs for Fleming to the Employment Court.

In making its decision, the court had to consider the definition of "work".

It found: "We consider the appellants are subject to constraints and responsibilities and that what they do is of benefit to the Ministry as their employer. They are working when caring for Justin and Sian, at least for some of that time."

It also had to consider the concept of "engagement" as an employee.

In Humphreys' case, it found he could still be considered "engaged" as a "homeworker" even though he had not been formally selected - that is, he was acting as caregiver without being hired to fill that role by the ministry.

In Fleming's case, the judgment noted that without his mother's care, the government would have had some obligations for Justin's care itself, adding weight to her status as a "homeworker".

While the Supreme Court left the matter of costs for Fleming to the Employment Court, for the purposes of "assist[ing] resolution by the parties" it noted, "it is accepted that Justin needs full-time care for the 24-hour period each day of the week.

"In these circumstances it is difficult to see, on application of the factors in Idea Services, how Ms Fleming would not be working a 40-hour week".

'Over the moon'

Humphreys, who watched the reading of the judgment on Tuesday afternoon via video link, told RNZ he was "over the moon" with the decision.

"It's been a long six years," he said.

"I don't really know where we go from here, other than we've got the same rights as other workers, and that's what we've been trying to do all the way through, really."

"[Family members] do the work the same as other [care] workers," he said.

For him, the fight began when he asked for government support to renovate their bathroom, to make it more accessible for Sian.

"They said there was just minimal support and you will have to be means-tested. My question was, I'm the employee, why should I have to provide a bathroom for my employer?"

The mixed messages continued when they lost the appeal, so to have a definitive answer from the Supreme Court had been a long time coming for the families.

"It feels like closure," Humphreys said.

"Today's decision means a great deal to me and my whānau. The care I provide for my daughter is not only an act of love, but it is also skilled, demanding work that deserves to be recognised and fairly rewarded. This work goes beyond love alone. It involves dedication, knowledge and responsibility that meets the same standards expected in professional care settings," he said in a statement.

The judgment made it clear that when the government relied on family carers it must also respect their rights as workers "with fair pay, proper protections, and dignity", he said.

He described the six-year court process to reach this point as "exhausting, stressful, and often disheartening" with many carers feeling "invisible and undervalued".

"No family should have to endure such a lengthy legal battle just to have their work recognised and respected."

Independent disability advocate Jane Carrigan, on behalf of Fleming, agreed.

"It's seven years, seven months since I filed for Christine in the Employment Court," she told RNZ on Tuesday.

"These issues have really been before the courts for the last two-plus decades. But this is the first time we've ended up in the Supreme Court, so we've finally got a decision the government aren't going to be able to ignore."

She said the decision could affect thousands of families - not just those of family members with disabilities, but aged care, health and mental health carers as well.

She confirmed Fleming would be seeking costs, but couldn't give details yet.

She said considering the Employment Court acknowledged that employment rights were human rights, she was hopeful for a good outcome there.

Ministry declines to comment

The Ministry of Health declined to comment, and Anne Shaw, deputy chief executive of disability support services at the Ministry for Social Development, said they would be carefully considering the court's decision.
​
"We would like to reassure the disabled people, their family, whānau and carers that existing care arrangements continue while this consideration takes place."
 
Ref: RNZ
https://www.rnz.co.nz/news/national/581306/full-time-carers-appeal-for-employee-status-upheld-by-supreme-court

For people with disabilities, even daily life can require some workarounds - let alone a natural disaster.

With this in mind, the Wellington Region Emergency Management Office (WREMO) has launched a new emergency preparedness guide developed by, and for, disabled people.

Renee Patete, who's been blind since birth, said most things were easier at home, in the house she'd known for the past 24 years.

"In an emergency, it's important to know where you are, and what you have around you, and who you have around you," she said.

She told RNZ she knew where all the exits were and where to drop during an earthquake to avoid falling objects, and the house was well-stocked with food.

But that was not always the reality - a natural disaster could strike at any time.

"I suppose the best thing to do is to be able to clearly communicate your needs to anyone else," she said. "Having in mind how you're going to quickly and efficiently communicate what you need to strangers is really important."

This, and other advice designed with the input of people with all kinds of disabilities, was included in WREMO's new guide.

Patete, who was an intern in the National Emergency Management Agency's communications team through the Whaikaha/Ministry for Disabled People's summer intern programme, had been a part of the creative process.

She said the result was a practical resource for planning ahead and preparing well for a disaster, "no matter the individual's ability".

"We talk a lot about what everyone should do, or what we should all do," Patete said. "But that doesn't necessarily always apply to everyone."

She explained advice like drop-cover-hold was not very useful for someone in a wheelchair - instead, they might prefer to lock, cover, hold - locking their wheels and curling over.

It was the first step in a wider project responding to long-standing evidence that disabled people face disproportionate impacts in disasters, based on a framework designed at the University of Sydney which emphasised the input of people with disabilities themselves.

It recognised the expertise disabled people already used to manage daily life.

"Centering it on the person is a really big step forward," Patete said. "We talk a lot about the people that help, the other people that can support you and what we need from other people, but actually this guide is about what can you do, what are your strengths, what can you do to solve these problems?"

WREMO's project lead Renee Santos has an invisible disability.

"Controlled well by medication now, but when I started working on this guide, I was really struggling with mobility, so I came in and I was like, 'What can I do to improve outcomes for my community?'"

WREMO's adaptation of the Sydney guide was shaped by groups of disabled people at national, regional and local levels, who were paid for their time like any other contractor.

The work was backed by Whaikaha - Ministry of Disabled People, and the National Emergency Management Agency. They were now developing a national version, including in alternate formats like braille or audio.

Santos said the plan was to create peer-led workshops to go with the guide, and then, she hoped, forums to bring emergency services, emergency management, and disabled people together.
​
"I think that's where the real change will come in the system."
 
Ref: RNZ

A Speech Language Therapist is trained in the area of swallowing and in the development of communication speech, and language.  The reason they are trained in both these areas is many of the same muscles, nerves and body parts are used in both communication and swallowing.
 
Communication is a complex activity that involves us understanding and being understood and includes:

• non-verbal communication
• facial expression
• gestures/sign language
• body language
• symbols (writing, drawing picture)
• technology
• verbal communication - speech
• language or understanding words and sentence
• social rules
• considering others people’s views
• recognising non verbal clues
• taking turns, eye contact, personal space
• staying on topic
• adapting communication for different situations and audiences.

 
Swallowing or dysphagia is a common consequence of many health conditions, head and neck surgery and ageing, affecting over 20% of over 50 year olds.  Signs of swallowing problems may include:
 
•       coughing while eating or drinking
•       choking while eating and drinking
•       repeated chest infections
•       taking longer to eat or drink
•       reduced appetite
•       unplanned weight loss
•       problems eating/drinking in public
•       food sticking in your throat
•       difficulty chewing tough foods
•       dribbling
•       food/fluid coming out of your nose
•       spilling food from mouth while eating
•       wet or gurgly sounding voice after eating or drinking
•       problems with drinking enough fluid

What does a Speech Language Therapist do?
 
Communication
 
Speech Language Therapists give practical solutions to improve your communication, such as:
 

• Ways to use and/or enhance your current communication skills
• Exercise to help all areas of speech, language and voice
• Use of gestures, signs, symbols and/or technology

 
With you, and those supporting you, they will:
 

• Tailor a plan for you and help you put it into action
• Review plan if required
• Recommend equipment and its funding

Swallowing (Dysphagia)
 
Speech Language Therapists will give practical solutions to improve your eating and drinking, such as:
 
•       swallowing exercises
•       the best position to eat and drink
•       advice on special cutlery or cups to make eating and drinking easier
•       advice on food and fluids and how to make them so they are safe to swallow
•       advice on the ways to feed when eating and drinking is no longer safe

With you, and those supporting you, they will:
 
•       tailor a plan for you and help you put it into action
•       review plan if required
•       recommend equipment and its funding
 
 
Who does a Speech Language Therapist work with?
 
Adults and children with a variety of communication and or swallowing difficulties.
 
Conditions that may require help from a Speech Language Therapist include:
 
Developmental
 

• Learning (Intellectual) Disability
• Developmental Delay
• Chromosomal Disorders eg  Down Syndrome
• Dyspraxia
• Autism
• Cerebral Palsy
  
• Reading and writing difficulties

 

Health and wellbeing
 

• Deafness/hearing impairment
• Ageing          
• Oral cancer
• Stuttering/fluency

 
 
Neurological
 

• Stroke (CVA)
• Parkinson’s
• Multiple Sclerosis (MS)
• Dementia
• Motor Neurone Disease
• Huntington’s
• Muscular Dystrophy
• Brain/head injuries
• Specific language impairment
• Stuttering
• Abnormalities of head or neck

 

How does a Speech Language Therapist work?
 
The way in a Speech Language Therapist works is determined by the individual needs of the client and may include one or a combination of the following approaches.
 
Consultation and Monitoring
 
Consultation is an effective way of working with a person to improve their communication wherever they live, work play or learn. Therapists work together with the Significant Others, who are in the best position to carry out ideas on a day- to-day basis.
 
The Speech Language Therapist can provide support and regular review.
 
Direct/Hands On Intervention
 
The therapist carries out a programme on a regular basis, in a one-to-one or group setting.
 
Transdisciplinary Team Approach
 
People we work with may require support from a range of therapists including occupational therapists, physiotherapists, dietitian, and music therapists. At Therapy Professionals Ltd we work within a transdisciplinary team and are able to provide support one another’s programmes when appropriate.
 
If you think you or someone you know needs a speech language therapist Therapy Professionals Ltd’s friendly Speech Language Therapist can help, just contact us:
 
   Phone:           377 5280                  Fax:                377 5281                   Email:             admin@tpl.nz
 
 
 

Swallowing difficulties (Dysphagia) are a common consequence of many health conditions, and head and neck surgeries, however swallowing difficulties can also be associated with ageing.  Estimates suggest up to 20% of all adults over 50 may be affected.
 
Changes might include such things as reduction in muscle strength for chewing, taste and smell, dental issues, dry mouth or throat, or recurrent illness such as pneumonia.
 
These changes may result in poor nutrition and hydration, unintended weight loss, avoidance of eating in public, loss of enjoyment in previously enjoyed food, and/or a risk of food/fluid entering the lungs (aspiration) leading to pneumonia and chronic lung disease.
 
What might you notice?

• Difficulty or reluctance swallowing food or fluid  
• Regularly coughing during or after eating or drinking
• Regularly choking on food, fluid or medication
• Persistent drooling of saliva
• The sensation of food being stuck in the throat or chest.
• Bringing food back up through the mouth or nose
• Gurgly voice after eating and/or drinking
• Recurrent chest infections or pneumonia
• Difficulty chewing tough or stringy foods such as meat
• Taking longer than 20-30 minutes to eat a meal

Suggestions to help:

• Eat when you are feeling comfortable and relaxed.
• Reduce distractions and keep conversation to between mouthfuls of food.
• Have smaller meals or snacks more frequently throughout the day instead of three larger meals.
• Chop or grate harder textured foods, and/or add sauces and gravies to keep food moist and easy to swallow.
• Take your time to eat
• Make sure you have swallowed everything in your mouth before taking another bite or sip.
• Drink a glass of water after eating to wash down any residual food.
• Remain upright for at least 30 minutes after eating and drinking.
• Ensure dentures fit well. Use of a denture paste may assist.

 
Who can you talk to?

• General Practitioner: For medical assessment and advice.
• Pharmacist: About difficulties swallowing medications
• Dentist: to check dentures for fit and function.
• Dietitian: to give advice to improve and maintain nutrition and hydration
• Speech Language Therapist: for assessment and treatment of swallowing difficulties

 
 
For further information or advice please contact Therapy Professionals Ltd as follows:
           
            Phone                         (03) 3775280,
            Email:                          admin@tpl.nz
            Website:                      http://www.therapyprofessionals.co.nz
 
Our Dietitian or Speech Language Therapist will be happy to help.