​Teachers say more and more new entrants are turning up to school without the language skills they should have for their age group. 
 
Too many five-year-olds start school unable to talk coherently, teachers say, and they blame Covid-19 and excessive screen time.
 
Teachers of new entrant school children and early childhood teachers report seeing more children than ever with poor language skills, research by the Education Review Office published today shows.
 
More than a quarter of teachers in schools in poor neighbourhoods said most of their pupils had oral language below the level expected of them, compared to just 3 percent of new entrant teachers in schools in rich neighbourhoods.
 
School teachers said some children could not talk in sentences of more than four or five words, spent a lot of time on devices and had little interaction with books.
 
"There is a complete lack of positional language, pronouns, and simple grammar tenses. A 6-year-old might say 'Me go pee' instead of 'I need the toilet' …", a new entrant teacher told the study.
 
"I have been teaching for 24 years and have never seen this low level of oral language."
Another said: "They have difficulty both with understanding what is said to them and with formulating responses. They often fail to understand what teachers say, [and] miss important points in class."
 
Early childhood teachers told the study they were spotting problems before children start school.
 
"The children want to communicate and try, however, they will often use the same simple words or incoherent sounds to communicate regardless of different contexts and situations," one early learning teacher told the study.
 
"Some of our 4-year-old tamariki like to tell long stories, but it mostly comes out as gibberish, much like an infant babbling," said another.
 
The ERO study said research showed 80 percent of five-year-olds had good oral language, but a significant group of children were behind and Covid-19 had made this worse.
"Covid-19 has had a significant impact. Nearly two-thirds of teachers (59 percent of ECE teachers and 65 percent of new entrant teachers) report that Covid-19 has impacted children's language development.
 
"Teachers told us that social communication was particularly impacted by Covid-19, particularly language skills for social communication. International studies confirm the significant impact of Covid-19 on language development," the report said.
 
Children's vocabulary at the age of two was strongly linked to their literacy and numeracy at age 12, the ERO report said.
 
"Delays in oral language in the early years are reflected in poor reading comprehension at school," it said.
 
However, it also said children's oral language varied a lot up to the first two years of primary school because children's development varied.
 
Quality early childhood education a solution – report
 
International studies showed quality early childhood education supports language development and could accelerate literacy by up to a year, especially for children from poor communities, the report said.
 
It recommended removing barriers to increase enrolments of children from poor families in early learning and increasing the quality of early education available to them through ERO reviews and Ministry of Education interventions.
 
While most qualified school and early childhood teachers know how to help children improve their oral language, some were not confident, the report said.
 
It recommended ensuring the school and early childhood curriculums provide clear progress indicators for oral language.
 
 
Reference:
 
https://www.rnz.co.nz/news/national/525811/more-5-year-olds-starting-school-with-low-speaking-skills-teachers

Code of Health and Disability Services Consumers’ Rights
 
The Health and Disability Commissioner Act 1994 established a Health and Disability Commissioner to oversee this act.  As part of their role they have developed a code of rights.  The act and the code are currently under review.
 
Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996
 
1. Consumers have rights and providers have duties:​
 
(1)     Every consumer has the rights in this Code.
(2)     Every provider is subject to the duties in this Code.
(3)      Every provider must take action to:
             (a)    inform consumers of their rights; and
             (b)    enable consumers to exercise their rights.
 

2. Rights of consumers and duties of provider

The rights of consumers and the duties of providers under this Code are as follows:
 
Right 1
Right to be treated with respect
 
(1)    Every consumer has the right to be treated with respect.
(2)    Every consumer has the right to have his or her privacy respected.
(3)    Every consumer has the right to be provided with services that take into account                                  the needs, values, and beliefs of different cultural, religious, social, and ethnic                                         groups, including the needs, values, and beliefs of Māori.
 
Right 2
Right to freedom from discrimination, coercion, harassment, and exploitation
 
Every consumer has the right to be free from discrimination, coercion, harassment, and sexual, financial or other exploitation.

Right 3
Right to dignity and independence
 
Every consumer has the right to have services provided in a manner that respects the dignity and independence of the individual.
 
Right 4
Right to services of an appropriate standard

(1)  Every consumer has the right to have services provided with reasonable care and                                 skill.
​
(2) Every consumer has the right to have services provided that comply with legal,                                 
(3) Every consumer has the right to have services provided in a manner that                                               minimises the potential harm to, and optimises the quality of life of, that consumer.                                
(4)  Every consumer has the right to co-operation among providers to ensure quality and                           continuity of services. 
 
 
Right 5
Right to effective communication
 
(1)   Every consumer has the right to effective communication in a form, language, and                 
        manner that enables the consumer to understand the information provided.                                          Where necessary and reasonably practicable, this includes the right to a competent                             interpreter.

 (2)    Every consumer has the right to an environment that enables both consumer and               
​          provider to communicate openly, honestly, and effectively.

 Right 6
Right to be fully informed
 
(1)  Every consumer has the right to the information that a reasonable consumer, in                                     that consumer's circumstances, would expect to receive, including:
        (a)    an explanation of his or her condition; and
        (b)   an explanation of the options available, including an assessment of the expected                                 risks, side effects, benefits, and costs of each option; and
        (c)     advice of the estimated time within which the services will be provided; and
        (d)     notification of any proposed participation in teaching or research, including                                            whether the research requires and has received ethical approval; and
        (e)     any other information required by legal, professional, ethical, and other                                                    relevant standards; and
        (f)      the results of tests; and
        (g)     the results of procedures.
 
(2)     Before making a choice or giving consent, every consumer has the right to the                                      information that a reasonable consumer, in that consumer's circumstances,
          needs to make an informed choice or give informed consent.
 
(3)      Every consumer has the right to honest and accurate answers to questions
           relating to services, including questions about:
             (a)     the identity and qualifications of the provider; and
             (b)     the recommendation of the provider; and
             (c)     how to obtain an opinion from another provider; and
             (d)     the results of research.
 
(4)        Every consumer has the right to receive, on request, a written summary of
             information provided.
 
Right 7
Right to make an informed choice and give informed consent

(1)       Services may be provided to a consumer only if that consumer makes an informed
            choice and gives informed consent, except where any enactment, or the common
            law, or any other provision of this Code provides otherwise.

(2)      Every consumer must be presumed competent to make an informed choice and
           give informed consent, unless there are reasonable grounds for believing that the
           consumer is not competent.

(3)       Where a consumer has diminished competence, that consumer retains the right                                  to make informed choices and give informed consent, to the extent appropriate to                                his or her level of competence.

 (4)      Where a consumer is not competent to make an informed choice and give                                            informed consent, and no person entitled to consent on behalf of the consumer is                                available, the provider may provide services where:
             (a)   it is in the best interests of the consumer; and
             (b)   reasonable steps have been taken to ascertain the views of the consumer;  and
             (c)   either:
                    (i)   if the consumer's views have been ascertained, and having regard to those                                             views, the provider believes, on reasonable grounds, that the provision of 
                           the services is consistent with the informed choice the consumer would                                                 make if he or she were competent; or
                    (ii)  if the consumer's views have not been ascertained, the provider takes into                                             account the views of other suitable persons who are interested in the welfare                                       of the consumer and available to advise the provider.
 
(5)       Every consumer may use an advance directive in accordance with the common law.
 
(6)        Where informed consent to a health care procedure is required, it must be in writing if:
                (a)   the consumer is to participate in any research; or
                (b)   the procedure is experimental; or
                (c)  the consumer will be under general anaesthetic; or
                (d)  there is a significant risk of adverse effects on the consumer.
 
(7)         Every consumer has the right to refuse services and to withdraw consent to                           
              services.
 
(8)          Every consumer has the right to express a preference as to who will provide services                          and have that preference met where practicable.
 
(9)          Every consumer has the right to make a decision about the return or disposal of any                           body parts or bodily substances removed or obtained in the course of a health care                             procedure.
 
(10)        No body part or bodily substance removed or obtained in the course of a health care                           procedure may be stored, preserved, or used otherwise than
               (a)   with the informed consent of the consumer; or
               (b)   for the purposes of research that has received the approval of an ethics committee; or
               (c)    for the purposes of 1 or more of the following activities, being activities that are  each                          undertaken to assure or improve the quality of services:
                         (i)  a professionally recognised quality assurance programme:
                         (ii) an external audit of services:
                         (iii) an external evaluation of services.

Right 8
Right to support
 
Every consumer has the right to have one or more support persons of his or her choice present, except where safety may be compromised or another consumer's rights may be unreasonably infringed.
 
Right 9
Rights in respect of teaching or research
 
The rights in this Code extend to those occasions when a consumer is participating in, or it is proposed that a consumer participate in, teaching or research.
 
 
Right 10
Right to complain
 
(1)   Every consumer has the right to complain about a provider in any form appropriate to the     
         consumer.
(2)    Every consumer may make a complaint to:
           (a)     the individual or individuals who provided the services complained of; and
           (b)     any person authorised to receive complaints about that provider; and
           (c)      any other appropriate person, including:
                      (i)  an independent advocate provided under the Health and Disability                                                            Commissioner Act 1994; and
                       (ii)  the Health and Disability Commissioner.
 
(3)      Every provider must facilitate the fair, simple, speedy, and efficient resolution of
           complaints.
 
(4)      Every provider must inform a consumer about progress on the consumer complaint
            at intervals of not more than 1 month.
 
(5)      Every provider must comply with all the other relevant rights in this Code when dealing with 
           complaints.
 
(6)      Every provider, unless an employee of a provider, must have a complaints procedure                           that ensures that:
           (a)   the complaint is acknowledged in writing within 5 working days of receipt,                       
                    period; and
           (b)    the consumer is informed of any relevant internal and external complaints                                             procedures, including the availability of:
                   (i)  independent advocates provided under the Health and Disability                                                               Commissioner Act 1994; and
                    (ii)  the Health and Disability Commissioner; and
           (c)    the consumer's complaint and the actions of the provider regarding that                                                    complaint are documented; and
            (d)    the consumer receives all information held by the provider that is or may be                                           relevant to the complaint.
 
(7)        Within 10 working days of giving written acknowledgement of a complaint, the                                     provider must:
                (a)  decide whether the provider:
                       (i)   a ccepts that the complaint is justified; or
                       (ii)    does not accept that the complaint is justified; or
                 (b)  if it decides that more time is needed to investigate the complaint:
                       (i)   determine how much additional time is needed; and
                       (ii)  if that additional time is more than 20 working days, inform the consumer of  that
                              determination and of the reasons for it.
 
(8)        As soon as practicable after a provider decides whether or not it accepts that a. complaint
             is justified, the provider must inform the consumer of
              (a)   the reasons for the decision; and
              (b) any actions the provider proposes to take; and
              (c) any appeal procedure the provider has in place.

​My Health Passport

The Commissioner has also developed a Health Passport to assist, those of us with disabilities and those of us who have interactions with health services.
 
My Health Passport is a booklet where you can write down information about how you want people to communicate with you and support you when you receive a health or disability service.  Available in a variety of accessible versions.
 
What is My Health Passport?
 
My Health Passport is a booklet that you can carry with you when you visit health and disability services. The booklet has information about how you want people to communicate with you and support you when you use health or disability services.
My Health Passport is not a tool to help doctors diagnose or monitor patients. It is not a substitute for a patient’s medical records.
 
 
The above information has been sourced from the Health and Disability Commissioner website www.hdc.org.nz December 2024

Why do we get corns or bunions and what can be done about it? Should you tackle your own ingrown toenail? And socks, cotton or wool?
 
Christchurch podiatrist Simon Wheeler is the man in the know about how to look after our feet.
 
Toenails
A little but often is his trimming advice.
 
“Rather than once in a blue moon and trying to cut them right back, aim just to cut them straight across the free edge.”
 
Buying the right shoe
Wearing a properly fitted shoe with support and cushioning, is important, and Wheeler suggests supporting your local shoe shop is the way to go.
 
“The trend at the moment is purchasing online, but it’s quite hard to buy footwear online. I think it’s best to actually be fitted at a shop.”
 
Socks and foot hygiene
They need to be changed daily, he says.
 
“Some people sweat more than others, some people will have to change socks more often than daily, particularly if you have gone out and done some sport or activity.
 
“You want to make sure you've got moisture wicking socks. Thin cotton socks do not move moisture away from the skin. You end up sitting in a pool of sweat or moisture.”
 
Go for woollen socks, he says.
 
Toenails as we age
Toenails, like skin and bone, are living and respond to load or to irritation, he says.
 
“They generally thicken because they suffer from trauma. And obviously the older, the longer we live, the more trauma they suffer.
 
“So that's why they thicken up. The most common reason that could be like a one-off trauma, you dropped a hammer on it a cricket ball or whatever.”
 
 
Toenail fungus
“It's common, it's hard to treat. It gets into the nail bed and then in the nail,” he says.
 
Treatments include prescription medication which can “have some quite harsh side effects.”
 
Laser treatment is also an option, but prevention is the best method, he says.
 
“Foot hygiene, first signs of fungal skin infections, athlete's foot, get onto a fungal cream really quickly.”
 
Over the counter anti-fungal creams are highly effective, he says.
 
“The creams for skin infection are 100 percent very effective. Once it starts to get into the nails the more in depth it is in the nails the harder it is to treat.”
 
In-growing toenails
The condition is often hereditary, he says.
 
“They're quite often present in their early teenage years as we start to sweat a bit and the feet are growing.

“And then again, it can be as a result of trauma. You've got to trim them straight across and the risk of you cutting them back yourself is that you introduce a portal for infection, or you miss some of it and you make it a hell of a lot worse.
 
“If you've got an ingrowing toenail with what looks like a skin infection, I would seek podiatry help immediately, as quick as you can.

 
Listener questions:
 
The soles of my feet are covered in coarse, scaly skin and underneath red weeping skin, it's very itchy. I'm desperate.
 
“That sounds like a skin infection of some sort. And so, you should seek medical attention for that. So, a GP or potentially your local podiatrist.”
 
What do I do about thick, yellowing skin that’s become painful?
 
“This is known as a callus, the skin is a living tissue, it responds to what load you put through, the thickened skin or the calluses is its way of protecting itself.
 
“However, often that goes too far. And that yellow thickened skin becomes quite uncomfortable to stand on so often a podiatrist would debride that and take that skin away, which provides instant comfort.”
 
I have damp skin splits that happen between my toes is that athlete's foot?
 
Yes, skin hygiene; natural fibre socks, so we're getting moisture wicking, and antifungal cream, over the counter from the pharmacist.”
 
 Is it important to wash and dry feet when you're in a shared space like a gym shower?
 
“You probably want to wear some real simple, rubber old-school jandals in the shower. And definitely dry thoroughly. So, they're not damp when you're putting them into footwear particularly in the winter.
 
“Otherwise, they're just moist going into that warm, damp environment.
 
“Some people are prone to it, there's no doubt about that. Like some people just seem to get athlete's foot at the sniff of going to a shared shower
 
“If you’re prone you can use the creams for prevention, use sprays these help and anti-fungal talcum powder that you can pop your socks or shoes.”
 
Another listener suffered from painful cracked heels
 
“People that are prone to heel fissures tend to get them again and again, so if you get them, you're going to get them in the future.
 
A regular moisturiser, and you can get cracked heel balm which is a bit thicker. It’s really good to use regularly, especially at the first sign of the crack.”
 
What's your advice for the management of bunions to reduce pain and prevent worsening?
 
“There's, different types of orthotics. Prefabricated ones, but you can get custom made ones which, are probably significantly dearer. But they do a phenomenal job.”
 
Should I pop my blisters?
 
“Probably not, it does give pain relief, but also potentially leads to infections. So salt-water bathing maybe, you’ve got to keep them clean.”

https://www.rnz.co.nz/news/national/516641/schools-failing-autistic-and-other-neurodivergent-children-report​

​A report warns schools and early childhood centres are failing autistic and other neurodivergent children on an epic scale.
The Education Hub study said devastating testimony from 2400 people showed the education system was broken and heading for a major crisis.
It was calling for more funding and a law change to force the Education Ministry and schools to provide support for all children with disabilities and learning needs.
 
The Education Hub is a non-profit organisation that connects teachers with education research.
Its report said 15-20 percent of the population was neurodivergent, meaning they had conditions including autism, ADHD, dyslexia and anxiety.
The school system was supposedly inclusive, with schools required by law to enrol local children regardless of their abilities, it said.
However, inclusion was not the reality for many neurodivergent children.
"Inclusion is all but an illusion for too many of our young people, with no specific education
legislation in New Zealand regarding specialist provisions or supports for children with special educational needs," it said.
"Many parents gave heart-rending accounts of the mental health impacts they witnessed in their neurodivergent children during the time they attended school, describing trauma responses, clinical depression, anxiety, self-harm and suicidal ideation from as young as the age of six."
​The education system focused more than $600 million a year on children with the highest needs, which meant neurodivergent pupils who did not have challenging behaviours tended to miss out, the report said.
"In addition, at some schools, accommodations for neurodivergent students are being arbitrarily denied or discouraged."
When support was provided, it was often inadequate, the report said.
Education Hub founder Nina Hood said it was clear there were big problems.
"The system is completely broken. There's very little that is working particularly well.
"There are significant issues with funding. It's really, really hard for many neurodivergent students to get access to any publicly funded services and those young people who are getting access to public services, in most cases it's not enough support."
There were too few specialists working with neurodivergent children - and teachers needed more help, Dr Hood said.
"They are having to bear a huge burden trying to support these neurodivergent students and for many teachers they want to be doing the best by their students but it is incredibly hard."
More funding was part of the answer, she said.
But the law needed to change so that all children with disabilities had an absolute right to the support they needed.
"Neurodivergent children ... have the right to attend school but at the moment they don't actually have the right to receive the resourcing and support they need in order to actually succeed and thrive at school," Hood said.
 
Frustrated and exhausted
Tami Harris from Acorn Neurodiversity, a trust helping neurodivergent children and young people in Auckland, said the report accurately reflected what many families were going through.
"Families feel like a burden to their school and, in fact, are often discouraged from enrolling their child at the school directly and feel like they're constantly needing to fight to get the things that their child needs."
The situation was "incredibly bad" and New Zealand's neurodivergent children were much worse off than children in other countries, she said.
"The access that our families would have if they lived across the pond in Australia or really anywhere else, they would be getting a suite of comprehensive services if they had a disability or some form of learning challenge."
Rebecca, the mother of a child with autism and ADHD, said trying to get support for her daughter was exhausting.
"I've been out of work, in work, out of work purely to spend time advocating, ensuring my daughter's needs are met, ensuring I'm at home when she's been sent home. Yes, it's been a real roller-coaster."
Many people tried their best to help, but the system was too difficult to navigate, she said.
"Individuals [are] working within a system that's convoluted, complex and just doesn't have enough to meet the basic needs of children with learning needs."

​University student Annabelle said she teared-up when she read the report.
Going through school with undiagnosed ADHD and autism was tough, because even with supportive teachers, the system made neurodivergent students feel like failures, and seemed to provide help for students only after they had failed, rather than supporting them to succeed, she said.
"It's not acceptable for the students and it's not acceptable for the teachers. It's not acceptable for the leaders, it's not acceptable for anyone working in schools.
"Trying to navigate a system that's built like an ambulance at the bottom of a cliff is ridiculous."
​
Hostile environment
In the report, several respondents said the situation in schools was so bad they would be better off home-schooling their children.
A school's special education coordinator told the study: "If I had a learning support child I would seriously homeschool my child. At times I suggest to parents the same. The New Zealand school system currently cannot support these students."
Many respondents were especially unhappy with so-called modern learning environments, which have large, open, shared spaces for teaching.
Most said teachers' lack of knowledge about neurodivergent children was a big problem.
And schools that did a good job tended to attract more neurodivergent children, a teacher told the researchers.
"It is a concern to me that the schools/staff that have embraced better approaches to supporting neurodiverse students (and others with special needs) often are flooded with those students.
"This is unfair, does not always come with extra funding/resources, and allows those who are deliberately blind to remain that way."
Another respondent said specialists were burnt out and every Education Ministry speech therapist they knew was looking for another job.
 
 
 
Author: John Gerritsen
Sourced from Radio New Zealand website:
https://www.rnz.co.nz/news/national/516641/schools-failing-autistic-and-other-neurodivergent-children-report
 

Type 2 Diabetes prevalance and risks
 
17 per cent of New Zealanders over 65 have Type 2 Diabetes (around 135,221).  This is an alarming statistic due to the complications Type 2 Diabetes can cause for a person’s overall health.  Type 2 Diabetes is a disorder of the endocrine system.  It’s an impairment in the way the body uses and regulates glucose in the blood.  Subsequently too much glucose is circulating in the blood and can lead to disorders of the nervous, immune and circulatory systems.
​Nutrition as a simple intervention in the aged care setting
 
Low carbohydrate nutrition has been researched, with good outcomes, as a therapeutic measure for those with Type 2 Diabetes.  This can be of significant use in the aged care setting, as a simple measure for improving the quality of life for those with Type 2 Diabetes.  Particularly where other lifestyle measures such as exercise may be limited due to mobility, nutrition is a simple daily measure that can be used to treat Type 2 Diabetes and reduce clinical costs.
 
Here is some practical advice around implementing this and monitoring residents.  Individual advice for each resident should be sought from a Registered Clinical Nutritionist trained in low carbohydrate nutrition and the residents medical professional (GP or Diabetic Care Nurse).
 
Positive effects of Low Carbohydrate Nutrition on blood sugar, lipids and body weight reduction
 
Type 2 Diabetes is linked to obesity and elevated blood lipids.  In one study following 64 obese subjects with elevated blood glucose, it is interesting to note that not only a drop in blood glucose has occured but also a drop in body weight and a decrease in blood lipid markers for these patients.  The study was conducted over a period of 56 weeks.  Thus showing a really beneficial effect long term for adherence, blood glucose reduction, body weight reduction and blood lipids.
 
Monitoring in the initial period and ongoing
 
If a resident is prescribed insulin for their Type 2 Diabetes diagnosis it is really important to monitor blood glucose levels closely when embarking on a low carbohydrate lifestyle due to the high risk of hypoglycaemia.  In this instance the care facility staff should moitor blood sugars four times daily (before meals and before bed or as recommended by their registered health professional) and work closely with the resident’s doctor as to when the insulin should be reduced and/or ceased.
 
The risk of hypoglycaemia with diabetic prescription medications is low and whether or not a patient stays on these as blood sugars lower can be discussed with the resident’s doctor on an individual basis.  If a resident is prescribed anti-hypertensives for high blood pressure, then blood pressure should be moitored closely when embarking on a low carbohydrate diet.  The high blood pressure insulin levels can cause sodium retention, and this is often quickly resolved with a low carbohydrate diet.
 
How to implement a low carbohydrate lifestyle
 
From a practical perspective keeping it simple is best.  A diet consisting of 10 per cent carbohydrate, 25 per cent protein and 65 per cent fat across total calories for the day is a good start for most.  Essentially following a low carbohydrate diet is eating eggs, meat, fish, chicken, nuts, seeds, low to no lactose dairy, low sugar fruit and plenty of green vegetables (above ground), and cutting out sugar, highly processed packaged foods, starchy carbohydrates and grains.  Nutrient dense, wholefoods should be consumed predominantly.  Packaged foods tend to be over processed, contain added refined sugar and industrially produced oils that can lead to inflammation.  If you are using any packaged foods check the ingredients first for either of these.  Make sure you know what it is in the food provided.
 
Protein should be prioritised at each meal.  Amino acids contained in protein are the building blocks of the body and increasingly important across the lifespan.  As the aging process occurs the body naturally works against itself by way of a process called sarcopenia (muscle wastage).  You can combat this for residents by ensuring they eat at least 1.8gms of protein per kg (note this is not the weight of the actual food but the weight of the protein content in the food) of bodyweight daily and get at least a little exercise (resistence is best for this and should be appropriate to the resident) daily.

Foods high in protein include eggs, fish, meat, and chicken etc.  Protein powders may also be used where a resident cannot or is struggling to consume enough protein from other sources.  Bone broth and whey protein powders have the best amino acid profile.  Plant based pea protein powders can be used if dairy is not tolerated.  Protein powders are a convenient way to add in protein by way of a smoothie as a snack or a complete meal with the right additions.  Low to no lactose dairy includes full fat yoghurt, butter and cream.  This is of course only appropriate to those who tolerate dairy.
​
In terms of carbohydrates, low sugar fruit consists of berries.  As it is an accumulation of carbohydrate across a day it may be appropriate at times to include a small amount of vegetables such as carrots, pumpkins and onions etc.  Variety will of course improve nutrient consumption also and this should be a priority.  Healthy fats include cold pressed oils, and good quality dairy.
 
 
Ref: Aged Care New Zealand Issue 02 2022
Author:  Rosie James, Registered Clinical Nutritionist

In April 2024 stricter rules for Carer Support payments and Equipment Management Services (EMS) through Enable, were made, to manage Whaikaha’s projected 10% budget overspend. This prompted the Government to review Whaikaha’s performance.  The Independent Review was released on 28 June 2024.
 
The review’s recommendations were:

1. Budgets for Needs Assessment and Service Co-ordination (NASC’s), Enabling Good Lives (EGL) sites and Equipment Management Services (EMS) providers – to be fixed.  Monitoring and reporting requirements to be developed.
2. Freeze funding for residential care - to maintain the current levels of funding for facility based care for 2024/25 pending a review of contract and pricing models. Have a panel to review and approve packages over $105,000.
3. Take no action on price increases for providers in 2024/25.
4. Monitor NASC and EGL performances.
5. Update the assessment and allocation settings – to be implemented by MSD.
6. Establish Flexible Funding criteria and review guidelines - to improve clarity and consistency.
7. Strengthen how agencies work together – Ministry of Health (MOH),  Ministry of Social Development (MSD), and Health NZ.

 
In addition to these recommendations the Government transferred the responsibility for Disability Support Services (DSS) from Whaikaha to the Ministry of Social Development (MSD) in September 2024.
 
In 1993 the responsibility for Disability Support Services was taken away from MSD’s predecessor and transferred to the Ministry of Health where the funds were ring fenced. The move was made because disabled people were not being served well under MSD. The move back to MSD seems to be a retrograde step.
 
Whaikaha was established in response to disabled people requesting a specific department for their issues and to help streamline a system which had become complex and hard to navigate. Not two years into Whaikaha’s existence, this rushed and scathing review of its performance has been done, with barely any input from consumers, their families or providers.
 
Was this fair when for the past six years Whaikaha and formerly the Ministry of Health’s Disability Support Services, ran over budget by about 10% per year?  This wasn’t due to mismanagement by these government agencies, it was the result of chronic underfunding over decades, the growing demand and the ageing population they serve.
 
Effectively these recommendations are a way of rationing services to keep spending within an unrealistically low budget. The recommendations don’t recognise the increasing demand for services is growing yearly as a result of:

• the increased life expectancy of those with disabilities,
• greater survival rates for premature babies and babies born with disabilities
• Autism being added to DSS responsibilities in 2014 with no additional budget allowance.

 
The New Zealand Disability Support Network “estimates a 10.4% increase in funding is needed just to keep pace with rising demand and costs in the disability sector, with 24% in total needed to make up for historic underfunding. Additionally, the Government must fund the stalled Pay Equity settlement for carers and support workers”.
 
The Disability sector supports the most vulnerable New Zealanders and the people who work in the area are either unpaid or paid a low wage to do demanding and very challenging work. Currently nearly all the funding in the sector goes to “frontline” services. Without a realistic increase in funding there will be cuts to “frontline” services even though the Government promised there won’t be cuts to “frontline” services. The government’s defence is they aren’t cutting frontline services they are just asking the sector to stay within budget.
 
The majority of those using DSS have limited ability to advocate for themselves because of their disability and the level of deprivation they live in. This population needs our help to ensure our government looks after this vulnerable group of people by increasing the budget to account for the historic underfunding, and have a system to adjust the budget for the growing demand and the ageing population.
 
 
Shonagh O’Hagan
Therapy Professionals

​I feel like Goldilocks. I spend my entire life saying: The venue is too loud, can you turn it down?
This speaker is too soft, can you turn it up?  I rarely get the – Ah, this is just right!
 
I am lucky enough to be able to programme my own hearing aids, but as I am getting older It seems I need to make more changes.  Part of it is the changes in my brain. The brain is the biggest part of hearing.  The ear provides the raw data, but the brain needs to make sense of it all.  Add in bits that are missing take out bits that should not belong there, and make sure everything is in the right order.

​All hearing aids, even the ones 10 years old, have the ability to make billions of changes to sounds.  Soft sounds can be made louder, speech can be made clearer, and loud sounds reduced.  There are billions of changes that can be made on hearing aids and unless there is a list of specific hearing issues that need to be addressed it is hard to know which change is right for you.
 
Our hearing is as individual as our fingerprints.  Everyone likes to hear differently. Some people are Classical, some are Country and Western, some are Rap and some are Techno, the list goes on. Hearing aids are designed to self-adjust hundreds of times a second based on what they have been programmed to do, and it can take several visits to an audiologist to get the programming right.  
 
Sometimes it isn’t easy even getting to the audiologist’s office, as COVID has demonstrated.  But fortunately the majority of hearing aids are less than six years old and have the ability to remote programme and there is an app for that, which is great news!  It does take some    technical skill to do but it is reasonably easy to learn.  It is something the tech-savvy generations can do easily.  
 
What hearing aids cannot do is take hearing back to what it once was.  Hearing loss is typically caused by damage to the nerves in the ear.  The greater the damage, the less the hearing aids can restore hearing.  Everyone, regardless of hearing capabilities, misses things and needs to ask for repetition or clarification. If your hearing is good, you can usually understand the second time, and it takes very little effort.  Perhaps this is the underlying reason why some people with good hearing get so frustrated with those who don’t. They think we are not trying hard enough, not paying enough attention.  They do not realise the amount of effort that needs to be put into even a simple conversation.  Hearing aids are great, but they aren’t a panacea for hearing loss, they are an aid.               
 
Perhaps we can blame the hearing aid marketing campaigns.  All those smiling people running around laughing and hearing effortlessly.  I even remember one Siemens hearing aid campaign from about 15 years ago that promised their aid could make you hear like you were 18 again. Well,  possibly they can because to be fair, I cannot remember what I could hear when I was 18.  Although, I do remember that I was invincible and knew everything.

​Getting your hearing aids working just right for your individual hearing can be complicated and may take several visits, but it’s worth it.  So while hearing aids can’t return your hearing to its previous levels, and we need to ask for music to be turned down – ALL THE TIME!  We can get best out of our hearing aids by going back to your audiologist with a list – the more information on what your personal listening needs and preferences are.  This way your hearing aids will work better for you and be much more comfortable for you to use.
 
Your audiologist would appreciate the opportunity to get your hearing aids programmed into that Goldilocks zone for you, where it is – Ah just right, and many of you have already prepaid for the visits in the cost of hearing aids.
 
Hearing NZ is New Zealand’s longest serving organisation for the Hard of Hearing and we’d love to hear from you.
 
To have conversations with others in the New Zealand Hard of Hearing Community follow this link to join us on:  www.facebook.com/groups/1760516034138598
 
Reference:     
 
Article written by Dr Lisa Seerup, President of Hearing New Zealand, audiologist, and a hearing aid wearer.   Aged Care New Zealand Issue 02 2022

However, many illnesses and impairments that may affect driving capability tend to increase with age, such as dementia or impaired vision.  There is a demand for balance between maintaining the quality of life for seniors and ensuring their safety and the safety of others on the road.  Fortunately, there are many other options available to get out and about.

​Retaining a driver’s licence
 
For those seniors who can drive, retaining a driver’s licence can be a crucial way to maintain independence and avoid feeling lonely.  A survey conducted by the New Zealand Automobile Association (AA) revealed that 34 per cent of members over 75 would feel frustrated if they could no longer drive and 28 per cent said they would feel lonely.  For seniors living in rural areas where public transport is not widely accessible, maintaining a driver’s licence is particularly important to avoid isolation.
 
Coping without a car
 
Having personal freedom and mobility is important to everyone and having to surrender a driver’s licence could be extremely difficult for some.  Fortunately, there are many other options available to reserve these freedoms without a car.
 
Public transport offers many advantages that can be a positive outlook when faced with surrendering a licence.  Often using public transport is cheaper than running a vehicle and allows time for other activities while travelling such as reading or writing.  Public transport also takes the stress out of driving and can even be social, especially if travelling with friends.  It can also improve a person’s health if they must walk to the bus stop and will contribute to improving the environment by reducing pollution.
 
Types of public transport for seniors
 
Free off-peak public transport is available to all seniors 65 and over with a SuperGold card.  Many taxi companies will also offer a discount.
 
There are also options available for taxi, companion driving services, or share ride services.  It is worth investigating which services are provided in the local area.  If a senior is not able to use public transport easily or has mobility impairments, they can apply for a Total Mobility card which offers discounted transport fares.  An assessment facilitator will have to assess whether an application is eligible.  

​Community transport services are another transport option which provide a service specifically for seniors and charge by time not distance.  This service also offers assistance in areas like help unloading shopping or help with wheelchairs.  Many also offer companion services such as taking seniors on scenic routes or spending time with them out and about.
 
Having personal freedom and mobility can be a crucial factor to support wellbeing as we age.  It is important that our senior population maintain their independence whether that is through retaining their driver’s licence or becoming familiar with the many public transport options available to them.
 
 
 
Ref: Aged Care New Zealand Issue 02 2022

Older people are more digitally savvy, but aged care providers need to keep up
 
Senior citizens are an important consumer group which is only going to increase in number in the future.  The time has come for aged care operators and the technology industry to engage in meaningful efforts to meet their needs.

​Older adults are more digitally connected than ever, even though their uptake of internet-based technologies remains lower than for younger aged groups.
 
Today’s senior citizens are likely to spend their spare time tweeting about their social lives and face-timing their grand kids.  This is good news because research shows that social interactions benefit us.
 
The drive to join the digital community is no doubt influenced by social media becoming an important platform for news and information, sharing experiences and connecting with friends and family. Nevertheless, age related gaps in digital engagement (“the digital divide”) still exist.  And research shows people who live in aged care environments are at risk of being excluded  from the digital world.

​A digital community
 
Moving into aged care can affect a person’s ability to remain connected to their local community.  The facility might be some distance away from the neighbourhood in which they have lived. They may be unable to travel to maintain relationships. 
 
Low levels of social connectedness and participation are related to poor health and higher mortality risks as well as a significant reduction in quality of life.  Family can provide an important source of social contact and support, but geographic distance can again make frequent visits difficult.
 
Digital engagement in later life might not always be desired or possible.  But access to online resources can enhance older adults’ well-being through improved access to information and ore frequent social interactions.
 
The social internet
 
An early study reported psychosocial benefits from providing computer training in internet use for aged care residents.  These include improvements in life satisfaction and lower levels of depression and loneliness.  In another study, a once weekly video conference with a family   member had a positive impact on loneliness and perceived social support.
 
But there is little information on informal and unstructured use of the internet by residents because the use of digital technologies in aged care remains largely invisible.  Residents are omitted from many surveys and reports.
 
In a recent Swiss study, where all residents in a facility were offered wi-fi access, 14 percent used the internet.  This percentage is similar in that age group living in the community

​Staying connected
 
In a recent survey of telephone interviews with over 70 members of the public who had a family member or friend living in residential aged care, researchers spoke to family and friends rather than seniors because they wanted to hear about residents who had physical and mental challenges, as well as healthy seniors who tend to volunteer for research.  To reduce the risk of bias, they did not mention that they wished to talk to people about technology use.
 
The research highlighted the enthusiasm with which many older people have adopted digital technologies.  Nearly half of the 80 or so residents spoken about owned a computer or smart phone.  The average age of residents was 86 years, and the oldest was 102. Sometimes the  family had purchased a device for the resident specifically to make communication easier. 
 
Mobile phone calls, texts and emails were the most common methods of communication using these devices.  Technology not only enabled residents to interact with family and friends they seldom saw (for example, those overseas), but also resulted in increased interactions with those who visited more often.  While dementia and other serious health issues reduced the likelihood of uptake, the frequency of personal visits was not affected by technology use.

Family help
 
Importantly family members were essential to residents’ digital connectedness.  They often bought the device, set up software and troubleshooted any technical problems.  They were also involved in the day-to-day use of technology.  For example, some residents used video conferencing but needed assistance to initiate the call.
 
Interviewees endorse the use of digital devices if they were used to supplement social contact, rather than supplanting it.  The majority reported that they were not aware of computers being available for residents in common areas of the facility they visited.
Aged care operators do not generally provide Wi-Fi access to residents.  They have to arrange this with their own internet provider.  These deficits are of concern because residents don’t always have family or friends to help them become digitally connected.
 
Devices were often criticised for their small keys and buttons which are difficult to manage for arthritic hands and by people with vision impairments.  Older users, it seems, must try to adapt their abilities to devices to devices that have been designed for younger people.
 
Senior citizens are an important consumer group which is only going to increase in number in the future. The time has come for aged care operators and the technology industry to engage in meaningful efforts to meet their needs.
 
 
 
Author:  Dr Wendy Wrapson, Senior Research Fellow, Auckland University of Technology
 
Ref:  Aged Care NZ issue 02 2012

An individualised approach to one’s wellbeing is especially important during stressful times when there have been plenty of eventful, unprecedented changes around us.  Our physical, mental, emotional and spiritual wellbeing all need support, and a one size fits all approach is not always helpful.
 
Entering the senior phase of one’s life journey is such a privilege – but it brings with it a range of unique challenges.  For some, they’re fortunate enough to have their physical bodies and minds remain strong and vital.  While for others physical strength becomes a challenge, and their mental clarity is not what it used to be.
 
Many of the elderly find it increasingly more difficult to cook for themselves – they find themselves on their own after decades of looking after a family – and it becomes just too much work to cook for one person.
 
Despite these individual differences, the common thread among most people in their senior  years is that everything is slowing down.

In this article I would like to address three easy ways to ensure that eating a healthy plate of food is both affordable and manageable in most circumstances.

The first way to ensure that one is eating a balanced meal is to look at your hand – the palm to be precise.  A handy little measuring guide is to imagine the piece of chicken, fish, beef, lamb or vegetable protein fitting nicely inside the palm. This general guide will ensure that a person is getting sufficient protein into their body every day.
 
Eating too little protein happens more often as one gets older. For many people it’s due to expense, dental changes or health conditions that make swallowing difficult.  However, the need for adequate protein is important for the build and repair work that happens every day on our bodies.
 
Some easy and affordable options to ensure that one is eating sufficient protein is to include scrambled eggs at breakfast rather than cereal.  Protein at breakfast is always a good choice as it helps to regulate blood sugars and gives individuals a solid start to their day.  Over time, combining protein and a good fat such as butter on a whole wheat slice of toast will provide an added bonus of improved energy.
 
If a nice warm bowl of oats porridge is preferred for breakfast, one can add some protein by mixing in a teaspoon of chia seeds, half a mashed banana and honey to sweeten.   Do remember however, to add extra water/milk when you cook the porridge as the chia seeds absorb the liquid and swell.
 
Another idea is to drink a daily smoothie made with raw nuts, half a banana, a three quarter cup of milk of your choice (plant based/nut-based milks can be used), a quarter teaspoon of ground cinnamon and a teaspoon of honey.  Blend with two to three ice blocks and you have a delicious, creamy breakfast/lunch or dinner.  This recipe makes enough for one adult.

An individualised approach to one’s wellbeing is especially important during stressful times when there have been plenty of eventful, unprecedented changes around us.  Our physical, mental, emotional and spiritual wellbeing all need support, and a one size fits all approach is not always helpful.
 
Entering the senior phase of one’s life journey is such a privilege – but it brings with it a range of unique challenges.  For some, they’re fortunate enough to have their physical bodies and minds remain strong and vital.  While for others physical strength becomes a challenge, and their mental clarity is not what it used to be.
 
Many of the elderly find it increasingly more difficult to cook for themselves – they find themselves on their own after decades of looking after a family – and it becomes just too much work to cook for one person.
 
Despite these individual differences, the common thread among most people in their senior  years is that everything is slowing down.

In this article I would like to address three easy ways to ensure that eating a healthy plate of food is both affordable and manageable in most circumstances.

The first way to ensure that one is eating a balanced meal is to look at your hand – the palm to be precise.  A handy little measuring guide is to imagine the piece of chicken, fish, beef, lamb or vegetable protein fitting nicely inside the palm. This general guide will ensure that a person is getting sufficient protein into their body every day.
 
Eating too little protein happens more often as one gets older. For many people it’s due to expense, dental changes or health conditions that make swallowing difficult.  However, the need for adequate protein is important for the build and repair work that happens every day on our bodies.
 
Some easy and affordable options to ensure that one is eating sufficient protein is to include scrambled eggs at breakfast rather than cereal.  Protein at breakfast is always a good choice as it helps to regulate blood sugars and gives individuals a solid start to their day.  Over time, combining protein and a good fat such as butter on a whole wheat slice of toast will provide an added bonus of improved energy.
 
If a nice warm bowl of oats porridge is preferred for breakfast, one can add some protein by mixing in a teaspoon of chia seeds, half a mashed banana and honey to sweeten.   Do remember however, to add extra water/milk when you cook the porridge as the chia seeds absorb the liquid and swell.
 
Another idea is to drink a daily smoothie made with raw nuts, half a banana, a three quarter cup of milk of your choice (plant based/nut-based milks can be used), a quarter teaspoon of ground cinnamon and a teaspoon of honey.  Blend with two to three ice blocks and you have a delicious, creamy breakfast/lunch or dinner.  This recipe makes enough for one adult.