Funding in-home care for aged parents
Australia lets old people pick the people paid to come into their homes to help them bathe, dress and toilet, and New Zealand should follow suit, says Mark Jeffries.
The government spends over $1billion a year on home care, and that's going to rise to around $1.3b after a landmark deal which will see care workers' pay rise.
Following Australia would empower to families trying to help their aged relatives age in their homes, says Jeffries, it could also save taxpayers up to 25 per cent an hour on home care costs.
"The savings to the government could fund the extra services that are going to be needed for the ageing population."
Jeffries has a personal and professional interest in how New Zealand families find, and pay for, the care their older relations need to stay independent in their own homes, rather than go into expensive means-tested residential care.
He's the founder of MyCare, an online marketplace where families can find and manage local self-employed caregivers for their aging parents.
But Jeffries is also a "sandwich generation" son who learned how home care worked when his parents, both now deceased, needed help to stay in their home as his mother's sight worsened, and his father developed dementia.
Currently, when someone is assessed as needing in-home care, which is not means-tested, the carers come from large companies contracted by the likes of the district health boards.
It's an efficient "corporate" contracting model that came in in the 1980s, when state services were privatised.
It made some people very rich, but left many care workers on low wages, and the aged with no choice about who comes to their homes.
Jeffries recalls the experiences of his parents, including not knowing who would show up at their door, and not liking some of those who did.
"My mum had three different carers in a week," Jeffries said.
She told him: "I'm opening the door to somebody I have never seen before and they are about to bathe me, or your father. I know I should be grateful, but I just don't like it."
And, in one case, words to make a son's heart bleed: "I don't like the way she handles me."
Currently, MyCare exists on the fringes with families using it to find and manage carers to cover the "gap" between their parents' real needs, and the needs identified by the state assessments, which are needed before state funding becomes available.
Often that care is paid for by the family.
MyCare lets families locate carers (who are identity and police-checked) in their area that want work, and manage their employment online, including the payments, worksheets and monitoring, so it care can even be managed from overseas.
Feedback from families means caregivers have a direct incentive to provide professional, caring service.
Australia started heading down the choice path in 2015, driven by the desire to let people choose carers they wanted, trusted and liked.
Less formally, and less publicly, some New Zealand agencies are tentatively taking steps in that direction, but it is not yet the rule, rather than the exception, as in Australia.
MyCare has been lobbying MoH and many DHBs to talk about individualised funding and home care choice, says Jeffries.
Families sometimes find individualised funding is available, and several ACC clients have begun to manage their own care through MyCare.
But as yet, it's not the choice revolution taking place in Australia.
MoH said some DHBs already provided some individualised funding.
CARER BECOMES 'INVALUABLE' PART OF FAMILY
Tracy Martin is the mother of a disabled high-needs child, and the daughter of a mother diagnosed with Alzheimer's, who's using a carer found through MyCare.
"As Mum's condition progressed, I came to the realisation that despite my best efforts I wasn't able to keep up," she said.
"I was struggling with trying to keep everyone happy, waking up throughout the night with everyone's needs."
She could care for her daughter, but not manage everything her mother needed to be happy at home.
"Mum really loved walking. She missed her two hour walks and I just didn't have the time to take her," she says.
She found Marlene Burrows, who she says is now an invaluable part of the family.
"We've all formed a genuine relationship with her."
Burrows herself turned to MyCare to get away from the low wages paid by care companies.
"I hadn't done all my training to get paid minimum wage," she says.
Instead of $15.75 an hour, MyCare workers commonly command pay of $20-$25.
That's because there isn't a company taking a large cut. MyCare does get paid, but Burrowes says the cut it takes is a lot less, and in return MyCare handles her tax, administration and liability insurance.
Being directly employed by families enables her to form a deeper relationship with them than was ever possible while working for a corporate carer.
"I'm like an extended family member, and I'm treated as such. It's very good."
Higher wages should attract better people to the caring sector as the workforce expands to cope with the ageing population, she says.
"Honestly, some of the people I have seen working in this industry. It's horrendous."
She would like to see it become standard for families with members needing care to be given individual funding, and be able to employ people like her directly.