Insights into Care Models

Churchill Report Highlights New Zealand and Japanese Institutional Care Models.

When it comes to developing different models for long-term institutional care for older people, New Zealand has some insights and expertise worthy of consideration. Case in point is a report developed by Rebecca Jarvis, Director of Operations at the Health Innovation Network (HIN), the Academic Health Science Network (AHSN) for South London.

As a firm believer of ‘pinching with pride’ and not reinventing the wheel, Rebecca Jarvis received a Winston Churchill Memorial Trust Fellowship in 2019 to research alternatives to institutional care for older people in Japan and New Zealand, and to bring back that learning to the United Kingdom. The two countries selected for investigation provided comparisons and contrasts with offerings in her home country. 

Her view is that that her country is lagging behind other countries in the development of alternative models of ‘housing with care’, with a shortage of privately developed specialist homes in the middle market.

Time was spent with staff and residents at The Ivan Ward Centre at Selwyn Village. Rebecca was particularly interested in:

• How the facilities are funded and how affordable are they?
• To what extent the facilities are truly alternatives to residential care, for example, are they able to meet the needs of people with dementia?

A further objective was to hear from residents and older people themselves about their experiences of how they decided to move to these facilities and their experiences of living there.

Important themes

During her number of themes emerged:

1. Social interaction – opportunities for residents to interact with others to avoid loneliness and isolation.
2. Connecting with the wider community – encouraging integration with the wider population by providing legitimate reasons for non-residents to visit and use the facilities.
3. Safety net – delivering the right level of support on a flexible basis, when people need it.
4. Scale – small-scale facilities which enabled person-centred care and maximised independence.
5. Planning ahead – making the move now to prepare for the future.

Two contrasting countries

Why Japan? Japan is a super-ageing society with 28% of the population aged over 65 in 2018, expected to rise to 35% by 2040. It is the country with the highest proportion of people aged over 100 in the world, according to United Nations estimates.17 In 2000 Japan introduced the Long Term Care Insurance (LTCI) system which is a compulsory initiative for adults aged 40 and over who pay insurance contributions which fund their long term care in older age. This has resulted in increased funding for the social care sector which has led to a number of innovations to support people to live in their communities.

Why New Zealand? New Zealand has a high proportion of people over 65 choosing to live in ‘housing with care’ (5.2%, compared to 0.7% in the UK). The term ‘retirement village’ is almost always used to describe any housing for later life in New Zealand and care services are provided in most of these schemes. The New Zealand Retirement Villages Act of 2003 is the strongest example of legislation specific to this sector in the world and incorporates a range of innovative elements that outline the requirements for operators and offer extensive consumer protection.

Read the full report here: Alternatives to Long Term Institutional Care for Older People