Supporting staff who care for elderly relatives Ngaire Kerse, School of Population Health

NZ population projection Statistics New Zealand

Māori and Non-Māori Statistics New Zealand

Caring Older, young disabled, mental health Common Women Impact on health Reciprocal benefit Some data-LiLACS NZ Transitions Some simple recommendations Questions

Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu - LiLACS NZ Ngaire Kerse, FRNZCGP, PhD, MBChB School of Population Health

Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu-LiLACS NZ Longitudinal cohort Bay of Plenty and Lakes DHBs Recruited 421 out 766 Māori 80- 90 years (56%) Non Māori 516 out of 870 aged 85 yrs (59%) Visit every year until death Measures – Core and Full Functional transitions, care Falls, fractures Cognition – 3MS, MMSE Contributions, caring Health Multimorbidity Medications – STOPP, START Quality of life – SF-12 NHI match Hospitalisation, mortality Wave 3 – carer engagement and interviews Kerse, cohort profile Int J Epi, 2015, 1–10

Health conditions CVD 66-68% Māori have more heart failure (30 vs 20%) and Atrial Fibrillation (30 vs 20%), diabetes (30 vs 16%), lung disease (35 vs 25%) Less arthritis (35 vs 44%), eye disease (49 vs 66%). Men have more Coronary disease (40%) and peripheral vascular disease (20%) 52% Māori bilingual Teh RO, NZMJ 2014, Vol 127 No 1397;

Informal care Closely associated with level of function More women, more Māori received informal care

Informal care and HRQOL Women Men

Receiving support services

Services by level of function Māori Non- Māori

Change in HRQOL over time

Formal and informal care and HRQOL

Stayed the same or improved Women did better than men, Māori did better than non-Māori No impact on HRQOL

Function changes in both directions, not associated with HRQOL (at this age) More women received support services Maori receipt of services – lower function Services maintained HRQOL Informal care increased over time Those receiving support services and informal care maintained physical HRQOL, suggesting that the combination of care types is important.

Carers Wave 4, 438 remained 162 Māori (62% women), 276 non-Māori (54% women). 74% (319) consented to carer, 286 Kaiāwhina interviews were completed. 261 informal carers (91% of the interviewees) and 25 formal carers (9%) were interviewed.

Where carers live Māori Non- Māori

Hours of care/ week given to:

Type of care

HRQOL of carers

Positive > negative

Average yearly cost

Carers knowledge of services (unprompted) Relatively low knowledge of service availability amongst carers when asked without prompting

Where got info about services (unprompted)

Contributions of older people to family and whanau, communities and society

Volunteering - Māori Non-Māori

Mokopuna grandchildren Māori – 16 moko, 13 mokopuna, Non-Māori – 7 children, 3 grdchdn

Giving Care and assistance regularly Māori Non-Māori

Type of care or assistance

Older people are part of the social workforce Contribute to whanau and family Wider society Giving care or assistance was associated with higher physical but not mental HRQOL

Conclusions Large amount of care Impact on health of carer Caring has perceived positive impact Costly

Funders

Transitions Able to disable to enable Loss Denial Maintenance of productive engagement Independent To care Level of care Residential care Palliative care

For the older person - simple things Senses Hearing deficit – 60% of 75+ Visual deficit – 30% causes impairment Teeth – 60% dentures – this will change Dentist infrequent GP relationship Medications Access all supports possible Positive productive activities Participation and engagement

For the carer Exercise Health Information Moral support Family Work

Questions… ?

n.kerse@auckland.ac.nz make a donation at https://www.fmhs.auckland.ac.nz/en/faculty/lilacs.html make a donation at https://www.givingtoauckland.org.nz/en/FundPages/lilacs.html