Patients receive a MAPLe (Method for Assigning Priority Levels) score. If their score is four or five, aged residential care should be considered and 24-hour care support likely needed. In 2021\/22, Europeans were far, far more likely to enter a residential care facility within 12 months of receiving a four or five MAPLe score than any other ethnicity.<\/p>\n
Helena\u2019s grandpa, with his dementia diagnosis and comorbidities, would likely be recommended residential care, if not now then very soon. He would qualify for near full government subsidies given the family\u2019s financial situation, which would mean his care fees being paid by his NZ Super and topped up by the government, as much as $1,200 a week (the average government spend on a subsidised rest home resident in 2023 was $65,000 per year, compared to $7,400 for at-home care services).\u00a0<\/p>\n
Health NZ\u2019s 2024 report, prepared by Sapere, noted that \u201cgiven M\u0101ori, Pacific and Asian populations do not utilise [aged residential care] at the same rate as NZ Europeans, a case could be made that a more equitable funding arrangement would involve a significant increase in [home care] expenditure\u201d.<\/p>\n
By caring for her grandpa full time at home, Helena is both freeing up a bed in a facility for someone else, and saving the government money. The supported living payment, if her application is approved, would pay $424.60 a week.\u00a0<\/p>\n
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Rose* was about 40 when she became the sole caregiver for her widowed Samoan mum in Wellington. Rose\u2019s dad died years earlier, but her sister\u2019s family also lived at home so the care responsibility was shared. When they moved out 17 years ago, Rose, now 57, became the primary carer. \u201cIt was never a discussion with the family,\u201d she remembers. \u201cIt\u2019s just something that happened because I happened to be staying with her, and I think if she was staying with somebody else, then it might have just fallen on that person.\u201d<\/p>\n
Until recently, Rose\u2019s mum was largely independent. She was a prolific cook, had lots of visitors and, although she couldn\u2019t drive, liked to use her Gold Card to catch the bus and train around Wellington. Rose worked five minutes from home, \u201cand Mum knew it too\u201d, so could always pop home for small errands like firing up YouTube on the computer or grabbing something from the dairy.<\/p>\n
Now, however, Rose\u2019s mum is 90 and rapidly slowing down. The medical appointments have become more frequent and she can\u2019t leave the house on her own. After being made redundant at her long-held job last year, Rose was able to find new work, but it\u2019s 45 minutes away. \u201cIt does become a worry sometimes when I know that she isn\u2019t feeling that great,\u201d Rose says. \u201cSo sometimes I call just to make sure that she\u2019s going to answer the phone.\u201d<\/p>\n
The income is good, but Rose will soon be leaving the job as, among other reasons, \u201cthe distance that I\u2019m away from home is a bit of a concern\u2026 and the hours I\u2019m putting in are just a bit too long.\u201d<\/p>\n
For both Helena and Rose, having their loved one cared for out of home is not an option for cultural and social reasons. Helena\u2019s grandpa always spoke Tongan, Samoan and English (in that order), and despite speaking English to his granddaughters for decades, he now speaks only in Samoan. Helena suspects as his dementia progresses, he\u2019ll eventually speak exclusively Tongan, his first language. \u201cSo that\u2019s why I\u2019m now trying to learn Tongan.\u201d<\/p>\n
Moving him into a new environment, where only English is spoken and strangers are caring for him, would be \u201cunnecessary stress\u201d, she thinks. \u201cFor some people it does work, but I think for Pacific Islanders especially, they thrive off being surrounded by others in their culture.\u201d<\/p>\n
Rose\u2019s mum can speak some English but communicates mostly in Samoan, and has lived in her own, same home for decades. \u201cShe just wouldn\u2019t be happy [in a village or rest home],\u201d says Rose. \u201cI reckon she\u2019d just shut down if we put her in there. So after everything that she\u2019s done, the least we can do is look after her.\u201d<\/p>\n
<\/p>\n
Caring for family elders is an ingrained cultural expectation for many New Zealanders, and begins well before medical care is required. While increased government funding of $79m for 2026\/27 was welcomed by aged care facilities, wh\u0101nau who want their elders to age well in place have been working on their own solutions.<\/p>\n