Chapter 4 - Maintaining independence

Key Messages

• Major factors influencing an older persons ability to remain at home and to age positively are an adequate income, a safe and secure community, and access to health and support services.
• Promoting and maintaining the independence of older people is in the social and financial interests of all New Zealanders.
• key factor for most older people in maintaining independence is remaining in their own home.
• At the time of Census 2001, 98% of people aged 65-74 years, and 70% of those aged 85 years and over lived in private dwellings.

Introduction

In New Zealand, and across the world, people are living longer and the period beyond the age of 65 is increasingly characterised by ongoing independence, continued participation in activities outside work or home, and the uptake of new roles and challenges. There are a number of factors that influence an older persons capacity to maintain independence. These include personal health, income adequacy, safety and security, access to community-based support or social services, and mobility.

For many older people the key to maintaining independence is remaining in their own home.

Governments around the world are responding to their ageing populations by putting policies in place to encourage older people to live at home for as long as possible. Without such an approach, societies miss out on the experience and contributions of their older citizens and governments face higher costs associated with older people becoming dependent earlier and moving into residential settings prematurely.

While independence is an appropriate and laudable goal for older people, it needs to be recognised that not all older people will have the capacity to be fully independent.

This capacity can be influenced positively or negatively by a range of factors. These include personal health, wealth, mobility, access to communications technology, geographical location, previous life experience and engagement in activities outside of work.

Also important is a sense of community, proximity to kinship networks, education, involvement in the paid workforce and cultural, political and religious views of the world.

Maintaining their independence is very important to many older people, but on an individual level, being or not being independent is not the measure of a persons worth.

In New Zealand, the Positive Ageing Strategy, the Health of Older People Strategy, and specific policies, programmes and initiatives in transport, housing, social services, and health are all contributing to an environment that supports older people in maintaining independence.

As stated previously, a number of individual characteristics contribute to the ability of each older person to remain independent. There are also key environmental factors which more generally assist older people to remain living at home as long as possible.

These factors include adequate housing, transport and support services, access to the community, and safety and security. Another highly influential factor in people living in their homes late into old age is contact with family and support from friends and neighbours. The role of social service organisations in providing community and home-based support is also very important.

Housing

For older people to maintain independence, it is important that they have housing appropriate to their needs. This is reflected in Goal 3 of the Positive Ageing Strategy, which is affordable and appropriate housing options for older people.

The current cohort of older people has a high rate of home ownership. At the time of the 2001 Census, 76% of older people owned their own homes.[1] While home ownership among older people has decreased from 81% in the 1996 Census, home ownership is valued and most older people want to live in their own homes throughout their life. For many older people, their home is also their most significant asset and is a key source of personal and financial security while they are alive. A freehold house is also viewed by some older people as a cashable asset for their inheritors.

Home equity conversion schemes enable homeowners to utilise the equity in their homes as a source of retirement income, but this is not an option that is being taken up by many older homeowners. The range of home equity conversion products on the New Zealand market is limited, and the prevailing culture of retaining ownership is not consistent with the concept of home equity conversion.

Housing availability

For those older people who do not own their own homes, or who do not live with extended family, there are a range of rental accommodation options. These include Housing New Zealand Corporation, local authorities, social service and community organisations, and private landlords. In 1996, 10% of older people lived in rental accommodation. Among older people renting, more than a third (36%) were living in houses rented from Housing New Zealand or other central government agencies. A further 31% had a private landlord, while 29% were renting from local authorities, and the remainder from businesses, real estate agencies and other organisations.

Overall reductions in public housing stock over the last decade, lowering home ownership rates and an ageing population, mean that in the future more older people are likely to rent from the private sector. If affordable and suitable housing is not available to older people, this will impact on their ability to remain independent.

Changes in the availability and cost of accommodation in the private sector rental market are a product of the relationship between the supply of and demand for rental accommodation. In terms of providing public sector housing for older people, this is a matter in which both central and local governments are involved.

Housing New Zealand Corporation (HNZC) reduced the level of its housing stock from approximately 66,000 dwellings in 1992 to 59,000 in 1999. HNZC have since increased its stock and as at June 2002 had 60,532 properties available for rent. Many local authorities have sold or are planning to sell their pensioner housing units. Subsequent to the Auckland City Council announcement in April 2002 that it would sell its pensioner housing, the Local Government Bill has been amended to designate pensioner housing as a strategic asset. Local authorities are therefore required to undertake meaningful consultation with their local communities before any decision can be taken to sell pensioner housing stock.

Housing affordability

While most older people wish to remain in their own home, this can become problematic if the home is hard to maintain or becomes unaffordable. Increases in rates can be difficult to meet if an older person is on a low and/or fixed income.

Buying a new home with lower maintenance costs is not always a viable option, as the value of the older home may be less than a smaller, more modern dwelling.

Further, large homes and sections requiring ongoing maintenance can be a liability for older people who are not able to do the maintenance themselves and cannot afford to pay for someone else to undertake the work.

Older people may be eligible for financial assistance from the Ministry of Social Developments Work and Income Service in meeting the cost of insurance or major essential repairs. The Accommodation Supplement is also available for low income people who are renting in the private sector housing market or from a local authority, or who own their own home. Eligibility is subject to an income and asset test and an assessment of weekly accommodation costs. As at 30 June 2002, 3.6% (16,084) of the people in receipt of New Zealand Superannuation (NZS) were receiving an Accommodation Supplement.

Local authorities also offer rates rebates for older people whose rates are high relative to their income, with some providing a rates deferral scheme for older residents. While a number of private sector housing issues for older people can be mitigated through local government initiatives or the policies of central government agencies, others are a result of trends and changes in the private housing market.

On 1 December 2000, income related rents were introduced for HNZC tenants. Under the Housing Restructuring (Income-Related Rents) Act, HNZC rents are now based on the income of the signatories to the tenancy agreement and their partners. Those on low incomes, defined as those with a weekly income less than the rate of New Zealand Superannuation, pay no more than 25% of their income in rent for an HNZC house. Almost 90% of all HNZC tenancies qualify for income related rents.

Over 10,000 primary signatories to HNZC tenancy agreements are aged 65 years or more. In effect this means that at least 17% of all HNZC properties have an older person in residence, and likely more, as many are not the primary signatory to their tenancy agreement.

Older people have identified the cost of electricity as an important factor in remaining at home. In December 2000, the Government issued an electricity industry policy statement. Under the new policy, electricity retailers are now required to offer a low fixed charge tariff option to domestic consumers. The low fixed charge cannot be greater than 10% of the total bill for an average domestic customer[2], which in practice is likely to be approximately 30 cents per day.

This requirement aims to provide a fairer and more equitable pricing structure for small electricity consumers, many of whom are older people. Irrespective of this concession, there is a strong lobby group of older people who continually advocate for lower fixed electricity charges. The cost of electricity is an important factor for older people in remaining at home.

While a relatively small number of older people currently choose to live in a retirement village[3], for those who can afford such a living arrangement, it often represents a tailor-made mix of independent living within a very close community. The main attractions of retirement village living are often physical security, companionship, and assured access to support or care services. Many residents report great satisfaction with retirement village living, which indicates that villages represent a good structural model in terms of public sector housing design for older people.

Support services

Most older people do not need formal support in order to remain living in their own home. Some older people have pre-existing home based support needs that are disability, not age, related. Others receive support or practical assistance from family, friends and neighbours, which while not necessarily required, can be very important in terms of maintaining networks, saving costs, or having small support needs met before problems become overwhelming. In fact, there is growing evidence that low level support services, like housework, gardening, laundry, and home maintenance, enhance quality of life for older people and help them maintain their independence.[4]

The level of family support available to older people is affected by a range of factors. These include geographical mobility, among both the working age and older populations, smaller families which limit available support, and changing workforce patterns.

In effect, the old paradigm of several generations of the same family living in close proximity is the exception rather than the norm. In terms of the availability of immediate and extended family caregivers there are a number of demographic shifts and labour force changes which are having an impact.

In spite of their increased labour force participation, women continue to provide most of the support to older family members.[5] In general, women are also having fewer children and having them later than their mothers did. This affects intergenerational support patterns in that in each successive generation there are fewer family members available to provide care. Further, the second generation often needs to combine caring for older family members with parenting and with workforce participation.

Home support services for older people, funded through Vote: Health, focus on personal care and on providing household assistance, including meals and cleaning. Older people who are ill or frail often require additional practical services, such as transport, help with personal shopping, house maintenance and assistance with gardening.

For older people who can afford it, there is an increasing diversity of these kinds of services available from private providers. However, older people who cannot pay for these services have few options. A Disability Allowance, for people with an ongoing disability or health-related condition, is available to help meet the costs of a small range of services, such as gardening. Limited services are also provided by community organisations, which in many cases receive funding assistance from the Lottery Aged Distribution Committee.

Consideration of governments role in funding support services and in providing financial assistance to people on low incomes to purchase the services is an issue of increasing urgency in planning for New Zealands ageing population. The Positive Ageing goal relating to maintaining independence is Goal 5: Older people feel safe and secure and can age in place. The Ministry of Social Development and the Ministry of Health are committed to undertaking stocktakes of government policies that assist older people to live at home as long as possible, so that gaps or necessary improvements can by identified and policies developed to address them.

Older drivers

New Zealand society is very mobile, and private cars play an important role in recreation, friendships and access to services. In 1996, 95% of people aged 70 held a driving licence and this percentage decreased with age, with only 17% of people at age 90 retaining their licence.[6] The decision to stop driving is made for a variety of reasons, often related to ill health. Loss of a driving licence can have a significant impact on an older persons ability to access services, friends and family. New Zealands ageing population means that the number of older drivers on New Zealand roads will continue to increase.

Statistics from the Land Transport Safety Authority (LTSA) demonstrate that, while older people are numerically involved in fewer crashes than younger age groups, the accident rate per kilometres driven is higher for drivers aged 70 years and over than for drivers 25-69 years of age. The increased fragility of many older people also means that it is more likely that an older driver will be killed or injured in an accident than will a younger driver. New re-licensing provisions for older drivers[7] were introduced in 1999. Older people raised concerns about a number of aspects of the new regime, including:

• the costs of renewing their driver licences;
• that licence renewal fees for younger drivers were subsidised, while those for older drivers were not;
• negative attitudes of some driver licensing agents towards older people;
• and that while there were provisions for conditional licences for older people who fail the older driver test, no conditional licences had been issued.

An independent review of the costs and management of the new driver licensing regime was undertaken by PricewaterhouseCoopers in 2000. After considering the findings of the review, the Minister of Transport made several recommendations for policy changes that could be made to address some of the issues it raised, several of which will have positive effects for older drivers.

As a result of these recommendations, the fees subsidy was moved away from drivers in the general population to older drivers and rural school bus drivers, meaning significantly lower fees for these groups. On 31 December 2001 the licence fee for all drivers aged 75 years and over were decreased as shown in Table 1. The fee for the older driver test remained at $41.00, rather than increasing to reflect the true cost of the test, which is around $49.00.

Table 1: Changes in Full Drivers Licence Renewal Fees

Age	Pre 31/12/01	Post - 31/12/01
Under 75	$29.50	$44.30
75-79	$37.50	$18.30
80+	$36.00	$18.30

The LTSA began public consultation in June 2002 on proposed amendments to the Land Transport (Driver Licensing) Rule 1999. The changes proposed by the LTSA include several relating to older drivers:

• A new conditional licence for older people will be created, which will limit conditional licence holders to driving in areas where the speed limit is less than 80km/h.
• There will be a separate conditional licence test, and older people will be able to choose whether to sit that or the full older driver test.
• A telephone booking system will be put in place for booking driving tests, which will mean people in remote areas will no longer need to travel twice to the testing agent (once to book and once to sit the test).
• Older drivers will be able to renew their licences up to six months before the expiry date. as drivers. Alternatives to driving people want to travel. family and services.

Older peoples advocacy groups have consistently voiced concern at aspects of the older drivers licensing regime, which they perceive as imposing high thresholds for older people relative to the risks they pose as drivers.

Alternatives to driving

While public transport tends to be an important option for older people who do not drive, it is not universally available throughout the country, particularly in rural areas. Furthermore, public transport is only a practical alternative if there are services at the times, and to the destinations, older people want to travel.

Older people who do not drive and cannot access public transport, largely depend on family, friends or community groups to take them to services and social activities. The introduction of more accessible buses in some centres has been of benefit to older people, as well as to younger people with disabilities and parents with young children. Also, some older people utilise the Total Mobility Scheme,[8] which enables people with a disability to travel in taxis for half price.

For older people who do not drive, lack of adequate public transport or other alternatives can have the effect of limiting their access to friends,family and services.

These limitations can in part be mitigated by communications technology, but the loss of actual human contact with family and friends cannot be Older peoples advocacy groups have voiced concern at the older driver licensing regime replaced. Nor can the sense of physical freedom enabled by ready access to transport. New technology in medical alarms can however mitigate the risk of limited transport mobility in a health or medical emergency.

Communication technology

The Internet, email, electronic banking, text messaging, cellular phones, video links, and now ordinary features of home telephones such as voice mail and dialler recall, represent a plethora of communications options that can assist people to maintain contact with friends and family. This allows them to readily access goods and services, and share or obtain knowledge and information.

The benefits and advantages of communication technology are the same for older people as they are for the general population. The exclusions that limited access to communications technology can create are also shared by both young and older people.

Most older people are able to enjoy the convenience and advantages of some communications technology. Very few older people do not have a telephone. In the Living Standards of Older New Zealanders research sample, 1.8% of single people and 0.3% of couples did not have a telephone. Almost half (0.8%) of the single people without a phone reported that they could not afford it. If this 0.8% was applied to the entire population of single people aged 65 and over, it would represent around 1,350 people.

At the time of the 2001 Census, 15% people aged 65 years and over lived in households with access to the Internet. There was gender variation, with 19% of men and 12% of women reporting access. While the Internet and email are very inexpensive, one must own or have access to a computer. Computers are becoming relatively less expensive but they are still a major cost item which many people cannot afford.

An increasing number of older people are recognising the opportunities for participation, communication, and learning that familiarity with computer technology affords. There are now 77 SeniorNet groups[9] throughout the country, which is an indication of older peoples interest in becoming computer literate.

Safety and security

Issues of safety and security both in and outside the home affect all people. People who are isolated, physically frail, or unable to tangibly improve the security of their immediate environment can feel, and be, particularly vulnerable. This again applies to all people. According to research, few older people had concerns about their security. This included a high proportion of those living in their own homes.[10] Concerns about safety and security can be a major factor in influencing older people to leave their homes and consider moving into a retirement village or other forms of age segregated housing.[11]

The main home safety issues for older people are prevention of crime, fire and accidents. In order to improve safety, the New Zealand Fire Service installs smoke alarms in homes free of charge.

The ACC has recently redeveloped its fall prevention educational resources for health professionals and older people, established a Fall Prevention in Older Adults Advisory Group, and implemented, in collaboration with the Fire Service, the Falls and Fires programme. The Falls and Fires programme provides installation of smoke alarms and in-home fall prevention education to isolated older people.

Fear of crime, which can for some older people be out of proportion to the risk, can be moderated by providing older people with practical information about how to reduce the possibility of crime and fire. Programmes that encourage confident living have shown that this type of initiative enhances older peoples independence by enabling them to live confidently within the community.

Endnotes

1. Statistics New Zealand. 2001 Census Snapshot 9: Older People.

2. The average domestic consumer is defined as one who uses around 8,000 electricity units per annum.

3. Around 4.65% of people aged 65 years and over live in a retirement village. This represents approximately 21,000 people.

4. Royal Commission on Long-Term Care Policy. With Respect to Older Age. March 1999.

5. Ibid.

6. Figures provided by Land Transport Safety Authority.

7. The age at which older drivers are first required to have a medical check increased from the previous requirement of 71 years, to 75 years of age. The first practical re-test now occurs when drivers turn 80 years of age, rather than 76 years as in the past. The frequency of medical checks for drivers aged 80 and over was reduced from the previous annual requirement to every second year, the same as for the practical tests.

8. This scheme is currently operated by most regional councils.

9. The SeniorNet programme is described in Chapter 9 of these papers.

10. Maire Dwyer, Alison Gray and Margery Renwick. Factors Affecting the Ability of Older People to Live Independently. Ministry of Social Policy 2000.

11. Ibid.