I’m finding it increasingly hard to look after myself - what are my options?
Depending on your level of need, your options may include:
- remain in your own home or live with family, and consider
- having modifications made to your home to improve safety and accessibility;
- getting additional home support (e.g. from help with housework through to food preparation or bathing) from family members or a provider;
- moving to a place which provides the support you need.
The Seniorline website has information about the range of services available to older people, to help you stay independent. You might also like to get a copy of the booklet Where from here. He ara whakamua. Essential information for older people. Your local CAB may have copies, or you can contact Care Publications by phone (03 388 1204) or email for a copy.
Back to top
What support services are available to help me at home?
There are many support organisations and agencies that provide home support for older people and people with disabilities to help them manage as safely and independently as possible. Home support services can include:
- help with showering, dressing, taking medication
- help with cleaning, meal preparation
- equipment to help with safety at home
- help for the person’s carer
Publicly-funded home support
For people who qualify, home support services are funded by the Ministry of Health or the District Health Board and are available through approved providers.
To apply for publicly-funded support services you can either talk to your GP about a referral, or contact your local Needs Assessment and Service Co-ordination (NASC) agency directly. The NASC will assess the person's eligibility and needs and, if appropriate, arrange for suitable home support services through a contracted provider. The assessment is free.
The Ministry of Health has information about the assessment process for people aged 65 and over, and for people with disabilities.
If you are not eligible for publicly funded home support, or want home support services that you cannot obtain through the NASC, you will need to organise and pay for the services yourself. The cost of home support will vary depending on the provider and on what services you require. In this case you can choose from a range of home support providers i.e. you wouldn't be limited to providers who have a contract with the NASC.
You can search for a home support provider on the internet using terms such as elder care, home care, home support, senior care; and search the Home and Community Health Association (HCHA) online directory of providers. Your local CAB can also help you find a suitable provider.
Back to top
What is a needs assessment and why do I need one?
You can make your own arrangements for home help, house modifications or move into a rest home.
However if you want your care to be publicly funded you’ll need to get an assessment done by a Needs Assessment Service Coordination agency (NASC).
NASC will visit you and work with you to assess what your needs are; this will include taking into consideration any help that you receive from other people (eg family members who live with you). They will discuss what support services are available and can tell you whether you qualify for funded services. If you have high needs they may talk to you about long term care in a rest home.
You can find more information about government-funded home help in this Ministry of Health booklet.
Back to top
How do I arrange for a needs assessment?
To locate your nearest NASC agency you can ask your doctor, call your local DHB or search the directory on the New Zealand Needs Assessment Service Co-ordination Association website.
Back to top
How do I choose a suitable rest home?
If the needs assessor has determined that you need residential care (i.e. in a rest home), they can discuss with you what you’ll need to look for in a rest home so that you find one that best suits your needs. They may be able to provide you with a list of rest homes in your area, which are contracted to your DHB to provide the services that you need.
Some factors to consider when choosing a rest home include:
- location (eg will friends and family be able to visit you easily if they rely on public transport?);
- staffing levels – the ratio of staff to residents varies depending on the provider, and on the level of care being provided to you (eg dementia care, hospital level care);
- how often the rest home’s GP is available;
- what facilities are included in the residents’ rooms;
- whether the provider can accommodate your food preferences and dietary requirements;
- whether outings and other recreational activities are regularly offered;
- if English is not your preferred language, whether it has staff who speak your preferred language.
Below are some resources to help you know what questions to ask and what look out for:
You might also need to consider the rest homes’ fees (see the next question), especially if you aren’t eligible for financial assistance.
Back to top
How much will it cost to move into residential care?
The cost of residential care will vary depending on:
- whether you have been assessed as needing to be in residential care
- what level of care will be provided (e.g. rest home care, long term hospital care, dementia care)
- whether the provider is a private business or a not-for-profit organisation
- whether you are willing to pay for extra services or for a “premium” room
- whether the provider has a contract with your local DHB to provide these services
- your eligibility for financial assistance (see the next question).
If you are eligible for financial assistance and can move into a rest home that has a contract with the DHB then most of the cost will be paid for by the government (though you might be charged more if you have requested extra optional services).
If you move into a rest home that has a DHB contract but have to pay the costs yourself, it will be up to a maximum amount set by the DHB (though you might be charged more if you have requested optional extras).
Even if you are eligible for the subsidy, it pays to check the admission agreement (between you and the rest home) as this specifies exactly what services will be provided to you and how much you will have to pay for them.
Back to top
Is there financial assistance to help with the cost of residential care?
The Residential Care Subsidy is available if you:
If you qualify for the subsidy, you will still need to contribute towards the cost of your care (e.g. from your NZ Superannuation), but the subsidy will make up the difference and is paid directly to the rest home or hospital.
Note that your family home (where you normally live) is usually included in the asset test unless your partner (who does not require residential care) or dependent child still lives there (more about this here).
More information about income and asset testing for the Residential Care Subsidy is on the Ministry of Health website and the Work and Income website.
It’s worth noting that even if you do not pass the eligibility criteria for the Residential Care Subsidy when you first move into a rest home, you can apply again if your financial circumstances change (e.g. if your savings decrease after having paid for your care for a period of time).
Back to top
I am not eligible for the Residential Care Subsidy. What are my options?
You may be eligible for the Residential Care Loan through Work and Income if you still own your former home. This is an interest-free loan that can be paid back when the home is sold, or six months after the borrower passes away, whichever happens first. The money is paid directly to the residential care provider. You may be eligible if the value of your assets (excluding your home) is no more than $15,000 (if you are single) or ($30,000 if you have a partner).
To apply for the loan, you will need to apply for the Residential Care Subsidy so that your financial situation can be assessed, and also complete the section of the form that relates to the loan. This includes providing the contact details of your solicitor.
For more information about the Residential Care Loan, visit the govt.org.nz website or call the Residential Subsidy Unit on 0800 999 727 or send them an email.
Back to top
My spouse is moving into a rest home but I’m staying at home in the house we own – does this affect their eligibility for the Residential Care Subsidy?
The asset threshold for receiving the subsidy is different depending whether the person going into care is single or has a partner, and - in the latter situation - whether the partner is also in care.
In your case, your spouse (or the person who has Enduring Power of Attorney for them) can choose not to have the family home and car included in the financial means assessment. If your home and car will not be included in the assessment then in order for your spouse to be eligible for the subsidy your other assets have to be valued at less than the threshold of $123,025.
If your home and car are included in the assessment the asset threshold is $224,654.
More details are on the Work and Income website.
If your spouse is not eligible for the subsidy, you may qualify for a Residential Care Loan depending on the value of the house and of your joint assets.
Back to top
I’ve gifted a lot of assets to family members over the years. Will the value of these gifts be included in the asset test for my Residential Care Subsidy application?
If you have given away (‘gifted’) assets they may be counted in your asset assessment. For assets gifted more than five years prior to applying for the Subsidy, if you gifted more than $27,000 per year it may be counted in the financial means assessment. For gifts made within the five years prior to the application, any gifts with a total value of $6000 or more per year must be included in your asset assessment.
If you’ve gifted up to $6000 per year to someone (not your partner or dependent child) who has been caring for you (but not receiving government funding for this) for more than 12 months, this can be excluded from the financial means assessment. More about this is on the Work and Income operational manual website.
More details about gifting in relation to the Residential Care Subsidy are on the Work and Income website (under the Gifts of money or assets heading).
Back to top
Why am I being charged more than the “maximum contribution” for my rest home care?
If your rest home has a contract with the local District Health Board then the rest home can only charge you more than the maximum contribution, if you have asked for additional services or a “premium” room.
Examples of what might be considered extra services (but this will depend on the provider) include:
- personal toiletries
- visits by a specialist, and other healthcare not prescribed by a GP
- provision of books or magazines
- recreational activities that are not part of the normal programme
A premium room may:
- be larger than the other, “standard”, rooms
- have an en-suite bathroom where the other rooms don’t
- have better access to the garden
- have a better view
- have its own phone while other residents may have to share a phone in the common area
- have Sky television
All of these charges should be specified in the individual rest home’s “Admission Agreement” (the contract between the rest home provider and the resident), and it’s important that you are clear on what you are paying for before you sign the agreement.
Back to top
What can I do if I’m not happy with the care that the rest home is providing?
If you have concerns about the quality of care provided by a rest home, you should first bring it up with them. Check the admission agreement (the contract between provider and resident) so that you know what services were agreed to and what the complaints process is. Generally you would address your complaint to the manager of the facility, via a complaint form.
If this doesn’t lead to the problem being fixed satisfactorily, or if your complaint is about the management, you can discuss the matter with your needs assessment coordinator, social worker, your local Age Concern or a health and disability advocate.
If you are still unsatisfied after having completed the rest home’s complaints process, you can contact:
You could also contact the professional association that the care provider is a member of: