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After living independently in a familiar home and community, the idea of moving into residential care can feel daunting. However, if your health or support needs change, it may be the best way to ensure you are safe, comfortable and well cared for.
Packing up and relocating does not need to be tackled all at once. With support from friends and whānau, good information and a plan broken into manageable steps, the transition can feel much less overwhelming.
What type of care do you need?
There are four main levels of full-time residential care in New Zealand. A Needs Assessment and Service Coordination service, known as NASC, will help determine which level is appropriate.
Rest home care is for older people who can manage some everyday tasks but need help with personal care and would find it difficult to live safely at home.
Hospital-level care provides 24-hour nursing for people with significant medical needs or disabilities. Residents may also need considerable support with mobility and daily activities.
Dementia care is provided in a secure environment for people living with dementia who require specialised support to remain safe. Having dementia does not automatically mean someone needs dementia-level care; this will depend on their individual needs.
Psychogeriatric care is specialist, secure care for people with complex behavioural or mental health needs who require a high level of nursing support.
Respite care offers a short stay in a care facility, giving both the person receiving care and their usual carer a break. Day programmes may also be available. Palliative care supports people with life-limiting conditions and may be provided at home, in a residential care facility, hospital or hospice.
Beginning the assessment process
A good first step is to talk to your GP or another health professional. If you are in hospital, staff can also begin the referral process. You or a family member may be able to contact your local NASC service directly.
A Needs Assessor will talk with you about your health, the daily tasks you find difficult, your preferences and the support available from friends and whānau. The assessment will consider whether additional services could help you remain safely at home or whether residential care is now the most suitable option.
You can invite a family member, friend or support person to attend the assessment. If residential care is recommended, the assessor will confirm the level of care you need and explain the next steps.
Choosing the right home
Once your level of care has been established, you can begin looking for a suitable residence. Location, availability, cost and the type of care offered will all influence your decision.
Aged Advisor allows you to search for aged-care facilities throughout New Zealand, compare options and read reviews from residents and their families. Reviews can provide useful insight, but it is still important to visit the facilities yourself wherever possible.
A home that offers day care or respite stays may give you the opportunity to become familiar with the surroundings, staff and residents before making a permanent move. If you are already living in a retirement village, ask whether it provides a continuum of care and what would be involved in moving to its care centre.
Make an appointment to visit each home on your shortlist so someone is available to show you around and answer your questions. Take a friend or family member with you, as they may notice different things and help you remember the information afterwards.
As you look around, consider the overall atmosphere. Do staff greet residents warmly? Do residents appear comfortable and engaged? Are the rooms and shared areas pleasant, and is there somewhere suitable for visitors?
Questions you might ask include:
• Who owns and manages the facility?
• How is the home staffed, including overnight and nursing cover?
• What is included in the standard fee, and what costs extra?
• Can you see a sample menu or stay for a meal?
• What activities, outdoor areas and shared facilities are available?
• Do services such as hairdressing, podiatry or physiotherapy visit?
• Is transport available for appointments and outings?
• How are cultural, spiritual and dietary needs supported?
• Can the home continue caring for you if your needs increase?
• Where can you read the facility’s latest audit report?
Understanding the costs
You may need to pay for all or part of your residential care, depending on your financial circumstances.
If you meet the criteria, you may be eligible for a Residential Care Subsidy. This is paid directly to the rest home or hospital and does not need to be repaid. A financial means assessment looks at factors including your income and assets.
If you do not qualify for the subsidy and own a property, you may be eligible for a Residential Care Loan. This is an interest-free loan paid directly to the care provider and secured against your home.
Care facilities may also charge for optional extras, such as a premium room, hairdressing or other services. Make sure you understand which services are included and which will incur an additional charge.
If you are moving from an independent retirement-village unit into a care suite, check whether you will need to sign a new Occupation Right Agreement. There may be transfer costs, an additional capital payment or another deferred management fee. Ask the village manager to explain the costs clearly and consider having the documents reviewed by a lawyer.
Check the Admission Agreement
Before moving in, the rest home or hospital must give you an Admission Agreement. This legal document explains the responsibilities of both you and the care provider, the services you will receive and any additional fees.
You are entitled to take the agreement away and read it before signing. Ask a trusted family member, friend or lawyer to go through it with you, especially if anything is unclear. Do not feel pressured to sign until your questions have been answered.
Making the move easier
Approach the move one task at a time. Familiar furniture, photographs, artwork and treasured belongings can help the new room feel more like home. Clearly label clothing and personal items, and make sure the facility has an up-to-date medication list, important health information and family contact details.
It can take time to adjust to new surroundings and routines. Regular visits and calls from friends and whānau can help maintain familiar connections while new relationships begin to form.
Residential care is not simply about receiving more help. The right home should support your independence, dignity, interests and relationships while providing reassurance that care is available whenever you need it.
Useful links
Aged Advisor — compare aged-care facilities and read reviews
Find your local NASC service
New Zealand Government — moving into residential care
Work and Income — help with residential-care costs
Seniorline — information for older people and their whānau
This article was first published in New Zealand’s Best Magazine 2024 edition.
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