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Services for Older People | Counties Manukau

Public Service, Older People's Health

Description

Services for Older People 

Care of the elderly is provided by a team of professionals including Doctors, Nurses, Physiotherapists, Occupational Therapists, Speech Therapists, Dietitians, Rehabilitation Assistants, Social Workers, Needs Assessors and Psychologists who specialise in conditions that affect older people. As people age they are more likely to have one or more medical illnesses and to have other difficulties as a result of these illnesses.  

Counties Manukau DHB Services for Older People are located at Middlemore Hospital, Manukau SuperClinic™, Botany SuperClinicPukekohe Hospital


The Team

Geriatricians are specialist doctors who are trained in the conditions that commonly affect older people as well as how the aging body’s needs change with respect to all illnesses.
 
Physiotherapists are experts in movement and function.  They review what you need to assist with walking and provide equipment if needed as well as exercises aimed to improve movement, pain, weakness or balance.
 
Occupational Therapists are experts in function.  They look at what you do during the day and what might help you to achieve things you are struggling with.  They often will see you in your home environment to look at how you manage.
 
Speech Therapists are experts in problems with speech and communication.  They are also experts in swallowing.

Rehabilitation Assistants work alongside therapy staff to carry out therapeutic interventions.
 
Dietitians are experts in nutrition and can give advice about diets to gain or lose weight as well as diets that help with certain illnesses.
 
Needs Assessors are experts in arranging support for you.  They organise funding for help in the home or going to a rest home.  They are able to advise you on what sort of help you may qualify for or benefit from.
 
Social Workers provide support for you and your family.  They are able to provide counselling to get through difficult times as well as advice about your rights as a patient.
Nurses in this team are specially trained in conditions affecting older people and may be involved in your follow up to provide practical advice at home and provide feedback to your specialist or GP.

Clinical Psychologists in Health of Older People are trained to understand the emotions, thoughts, and behaviours of people at all life stages and utilise this to help older patients and their family/whaanau or caregivers adjust optimally following illness or injury. The most likely issues that you would work on are cognitive deficits and emotional/coping difficulties due to dementia, memory problems, strokes, injuries, and illnesses that limit your adjustment, independence, or general welfare.

Psychologists include your opinions, culture, and lifestyle and try to work with your strengths towards your goals and values. They can provide you with information to educate you and your family/whaanau about what is happening psychologically, draw up a treatment plan with you, and start therapeutic interventions likely to help you cope better during hospitalisation and afterwards.

Psychologists can also help the rehabilitation team better understand a patient’s experiences.

Consultants

Referral Expectations

Services for Older People include Inpatient, Long Stay Residential and Outpatient services.  Different services are available at hospitals throughout the Counties Manukau region.

Inpatient Services

Inpatient services are available at:

You will be referred to hospital if your doctor thinks you would benefit from time in hospital to undergo assessment or treatment of your condition or for rehabilitation.  You may be referred from home by your GP or from another ward in the hospital if you need more time and therapy to regain the ability to go home.

 
What To Expect
Although there are doctors involved with your care they may only see you once or twice a week if you are medically stable, but can visit more often if needed. They are always happy to talk with you or your family. Your nurse can set up a time to suit.
The time you spend on the ward depends on the progress you make and whether or not you benefit from daily rehabilitation with the therapists.  The purpose of rehabilitation is to regain independence so you will be encouraged to do as much for yourself as possible as you recover.  Depending on your problems and abilities, you are encouraged to be as independent as possible during your time on the ward. 

Before going home you may have a home visit where the occupational therapist takes you home for about an hour to see how you manage with day to day things in your own home to assess what help or equipment might be needed. Before discharge you and your family may wish to have a meeting with staff if you want to discuss what has happened to you and what help you might need at home.

Long Stay Residential Services

Long Stay Residential Care is only available at:

You will be referred to this service following an assessment by a Geriatrician and NASC (Needs Assessment Service Coordinator) if it is felt that you or a relative requires long term hospital level care. In the future, long stay residential care will be phase out  at these hospitals and moved into community residential care.

What to Expect
You will need to visit the Unit first to make sure that there is a bed available or place your or your relative's name on the waiting list. You will be given a Welcome Pack which contains the information that you need to know prior to admission and an Admission Agreement which details the Ministry of Health contract which covers the services offered. It also details the cost or subsidies that are available for this service.

You will be cared for by a General Practitioner, Registered Nurses, Health Care Assistants and Allied Health Staff. You will be encouraged to remain as independent as possible but assisted with tasks that are difficult.

There is a mix of shared rooms and a few single rooms.

Palliative Care Services

Palliative care services are only available at:

You will be referred to this service by Middlemore Hospital, Franklin Hospice or your General Practitioner. This support is also available for symptom control and management.

What to Expect
You will be cared for by a General Practitioner and Registered Nurses. There are single room facilities for these services.  

Outpatient Services

Outpatient Clinics are held at the following locations:

Your GP will refer you to this service if they think you would benefit from seeing a team of people to assist with any difficulties related to illnesses affecting you in old age or if they feel you would benefit from a specialist doctor’s advice regarding your medical condition.

Clinics

The waiting times for clinics range from 1 to 12 weeks depending on the urgency of the condition described in your GP’s referral letter. 

You will see a Geriatrician, a Registrar (a doctor training to become a specialist) with supervision, Specialist Nurse or Allied Health Professional (PhysiotherapistDietitian, or Psychologist).
Before seeing the doctor, you may be seen by a nurse who will ask you some questions and take some recordings such as blood pressure and weight. The average length of a clinic appointment is 1 hour with tests following afterwards often taking another 30 mins. During the clinic appointment you will be asked about any symptoms you have as well as your past medical history. Please bring all your medications with you.  It is very common in this clinic to be asked a series of questions to test your memory. You will have a physical examination and are likely to have blood tests, an ECG (tracing of your heart) and a Chest X-Ray, depending on what problems you have.

Home Visits

Your GP may request a home (or rest home or private hospital) visit by one of our doctors or nurses.  This occurs if you are unable to come into hospital or would be best assessed in your own home.  You will be phoned the day before and asked if it is OK for us to visit.  The waiting times for home visits are usually 1-2 weeks. 

Assessment For Going Into A Rest Home or Long Stay Hospital

Before going into a rest home or private hospital, government agencies require an assessment.  This has two parts to it.  The first is an assessment by a specialist doctor to look at any health issues that could be affecting your ability to live independently.  It is often a good chance to have a general review of your medications.  At the clinic your medical history will be reviewed and you will have a physical examination.  Depending on your wishes you may see other members of the team to look at what could be done to help keep you in your own home.  The second part of the assessment is done by the needs assessment coordinators.  They look at what options you have with respect to home assistance and the financial implications of going into a rest home.  This assessment usually takes place after the clinic appointment.

Fees and Charges Description

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the eligibility specified criteria set by the Ministry of Health.  If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website.

For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.

Common Conditions

Osteoporosis

Osteoporosis is a disease that weakens your bones. Osteoporosis is not painful but it makes your bones more prone to breaking (fracture). Women are more likely than men to suffer from osteoporosis and as you get older you are more likely to have it. Tests Osteoporosis can be diagnosed by measuring bone mineral density (BMD). This test involves taking x-rays or a computer tomography (CT) scan of the bones in your spine, wrist, arm or leg. You may be asked to have a blood test to look for reasons why you might have osteoporosis. Treatment There is no cure for osteoporosis, but there are treatments that can improve bone strength and reduce your chances of breaking a bone. If you are diagnosed with osteoporosis you may be prescribed several medications to improve your bone strength. You will have follow-up either with your GP or specialist to make sure that the medication suits you. You will be given some more detailed reading about things you can do to help manage your osteoporosis and about the type of medication you are on.

Osteoporosis is a disease that weakens your bones. Osteoporosis is not painful but it makes your bones more prone to breaking (fracture). Women are more likely than men to suffer from osteoporosis and as you get older you are more likely to have it.

Tests

Osteoporosis can be diagnosed by measuring bone mineral density (BMD). This test involves taking x-rays or a computer tomography (CT) scan of the bones in your spine, wrist, arm or leg. You may be asked to have a blood test to look for reasons why you might have osteoporosis.

Treatment

There is no cure for osteoporosis, but there are treatments that can improve bone strength and reduce your chances of breaking a bone. If you are diagnosed with osteoporosis you may be prescribed several medications to improve your bone strength. You will have follow-up either with your GP or specialist to make sure that the medication suits you. You will be given some more detailed reading about things you can do to help manage your osteoporosis and about the type of medication you are on.

Memory Problems

There are several types of memory problems people can have. If you are referred because of memory concerns it is very helpful to bring along a family member. It is also very important to bring all of your medications with you as these can often affect memory. A full medical examination will be done and you will be asked some questions to test your memory and concentration as well as mood. You are likely to have blood tests looking for some causes of memory loss and depending on your history you may be referred for a CT scan of your brain. This is a computerised X-ray, which involves you lying down for about 15 minutes while a machine passes over you.

There are several types of memory problems people can have.   If you are referred because of memory concerns it is very helpful to bring along a family member.  It is also very important to bring all of your medications with you as these can often affect memory.  A full medical examination will be done and you will be asked some questions to test your memory and concentration as well as mood.  You are likely to have blood tests looking for some causes of memory loss and depending on your history you may be referred for a CT scan of your brain.  This is a computerised X-ray, which involves you lying down for about 15 minutes while a machine passes over you. 
Dementia

This is a condition of gradual loss of memory and other functions of awareness or thinking such as concentration over time. There are several types of dementia including Alzheimer’s disease and vascular dementia, which is due to the same sort of illnesses that cause stroke.

This is a condition of gradual loss of memory and other functions of awareness or thinking such as concentration over time.  There are several types of dementia including Alzheimer’s disease and vascular dementia, which is due to the same sort of illnesses that cause stroke.
Falls

These are not a natural part of aging. There are many reasons why people fall over and a review of your medical problems and medications may well reveal some reasons for falling that can be fixed. If you have lots of falls, seeing a specialist as well as the physiotherapist and occupational therapist can reduce your chances of falling again. You will be asked about the circumstances surrounding your falls and it is helpful if family or friends who witnessed your falls come into the clinic with you. You will have an examination looking at your general health as well as strength, balance, vision and memory. An occupational therapist may come to your home to look into any changes that can be made to improve safety. For more information on falls prevention click here for the ACC website.

These are not a natural part of aging.  There are many reasons why people fall over and a review of your medical problems and medications may well reveal some reasons for falling that can be fixed.  If you have lots of falls, seeing a specialist as well as the physiotherapist and occupational therapist can reduce your chances of falling again.  You will be asked about the circumstances surrounding your falls and it is helpful if family or friends who witnessed your falls come into the clinic with you.  You will have an examination looking at your general health as well as strength, balance, vision and memory.  An occupational therapist may come to your home to look into any changes that can be made to improve safety.  For more information on falls prevention click here for the ACC website.
Strokes

A stroke is where the blood supply to an area of the brain is interrupted causing damage to brain cells. This happens either with a clot in the blood vessel or the blood vessel bursting. The effects of a stroke depend on where in the brain, and how big, the interruption to blood flow is. Most people who have had a stroke are admitted to hospital. If the stroke has had significant physical effects you may be admitted to our rehabilitation unit aimed at increasing your independence, preventing complications from stroke and preventing further strokes. For more information on stroke a very useful website is the New Zealand Stroke Foundation site www.stroke.org.nz

A stroke is where the blood supply to an area of the brain is interrupted causing damage to brain cells.  This happens either with a clot in the blood vessel or the blood vessel bursting.  The effects of a stroke depend on where in the brain, and how big, the interruption to blood flow is.  Most people who have had a stroke are admitted to hospital.  If the stroke has had significant physical effects you may be admitted to our rehabilitation unit aimed at increasing your independence, preventing complications from stroke and preventing further strokes.  For more information on stroke a very useful website is the New Zealand Stroke Foundation site www.stroke.org.nz

Urinary Incontinence

Urinary incontinence or a loss of bladder control is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

Urinary incontinence or a loss of bladder control is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

Visiting Hours

Middlemore Hospital
Visiting hours are between 2pm and 8pm. Visitors are restricted to two at a time. Children are welcome, but must be supervised by an adult

Pukekohe Hospital and Franklin Memorial Hospital
Usual visiting hours daily between 10am and 8pm. Outside of these hours in consultation with the Charge Nurse.

Contact Details

This page was last updated at 3:36PM on May 23, 2023. This information is reviewed and edited by Services for Older People | Counties Manukau.