Part two: Issues and challenges for ageing in place
Most older people have enough to live on but some face difficulties
NZS supports an adequate standard of living for most older people
New Zealand has a universal superannuation system. It is unique in that it is neither income nor asset tested. The New Zealand state superannuation system is generally accepted as one of the most comprehensive state-funded pension systems in the world, and as recent research on the living standards of older New Zealanders shows, it supports an adequate standard of living for the majority of older people. 2 Some older people do, however, experience poverty, particularly those who do not own their own home or have not been able to save for their retirement.
New Zealand Superannuation (NZS) provides a basic income that enables the majority of older people to live adequately in New Zealand. The married couple rate of NZS is set at not less than 65% of the average ordinary time weekly wage, and is adjusted annually on 1 April to reflect increases in the Consumer Price Index. 3 The married couple rate is used as the threshold for the single living alone and single sharing rates of NZS, which are set at 65% and 60% respectively of the married couple rate.
Older people have lower incomes and lower levels of poverty
Older people have lower incomes than 15-64 year olds
Older people have varied sources of income
Around 7% of older people experience quite marked material hardship
Reflecting their lower levels of employment, older people have lower incomes, on average, than adults aged 15-64. In the year before the 2001 Census, the median annual income of people aged over 65 (from all sources and before tax) was $13,100, compared to $18,500 for all adult New Zealanders. One-quarter of older people had an annual income of $10,000 or less, while just 5% received income of more than $40,000.
The level of earnings among older people varies by gender and across ethnic groups. In the 12 months before the 2001 Census, older men's median income was $13,600, compared with $12,800 for older women. The income gap between men and women reduces with age, falling from $1,500 among 65–74 year olds to $600 among the population aged 85 years and over.
While most of the usually resident population aged 65 and over received NZS in 2001 (93%), more than half also received income from other sources. This includes income from interest, dividends and rent (40%) and income from other superannuation and annuities (15%). Men were more likely than women to receive income from other superannuation and annuities (20% and 11% respectively).
Six percent of older people reported that they had received income from wages and salaries in the 12 months before the 2001 Census, while 6% had received income from self-employment. The 65–69 age group was the most likely to receive income from wages and salaries (14%) and self-employment (12%).
While older people as a group have relatively lower levels of poverty than any other group in society, some people within the older population experience material hardship.
The Social Report 2005 4 showed that around 7% of the older population experience quite marked material hardship. The Living Standards of Older Zealanders report found that a further 5% to 10% have some difficulties. 5 Older people of Māori and Pacific ethnicity are more likely to experience difficulties than other older people. 6
Older people are living longer but need health support later in life
Access to health services is a concern for many older people, and is crucial to "ageing in place"
People are generally living longer and are in better health in older age. Despite this, many older people remain concerned about health issues, and current and future access to health services. Older people, particularly those in very old age, are relatively high users of health and disability support services.
The New Zealand Positive Ageing Strategy has a health goal of “equitable, timely, affordable and accessible health services for older people”. The Ministry of Health's policy framework for health sector action to 2010 is set out in the Health of Older People Strategy, which supports the health and independence goals of the New Zealand Positive Ageing Strategy. Together, these strategies provide the vision and policy framework for developing an environment where older people receive support services so they can age in place as long as possible, and have access to higher-level supportive care if and when it becomes needed.
As far as the public is concerned, these strategies are meaningless if they do not drive better outcomes and better services for older people. For example, access to appropriate health care is paramount if older people are to remain living in their own communities.
In 2001, government devolved responsibility for the funding of disability support services for older people from the Ministry of Health to district health boards (DHBs). Devolution of the disability support services for older people took place in October 2003. This was designed to provide greater integration of support services with other health services at the local level, and provides for a holistic focus on the total health needs of older people.
Under the Health of Older People Strategy, each DHB is required to outline in its annual plan the progress it has made towards the development of an integrated continuum of care for older people. The integrated continuum of care programme for older people is expected to be implemented nationwide by 2010.
Primary health care
PHOs have reduced the cost of primary healthcare for many older people
In 2002/2003, primary health organisations (PHOs) were established. A PHO is a local health provider that is a not-for-profit organisation, and is funded by the local DHB. The purpose of the PHO is to provide better access to primary health care to people of all ages, primarily through cheaper doctor visits and prescriptions. All people aged 65 and over belonging to a PHO now have a maximum prescription charge of $3.00. This has significantly reduced the costs for superannuitants who previously did not have access to a Community Services Card.
Secondary health care
More cataract operations and hip and knee replacements will be provided in coming years
Older people are extensive users of hospital services. Waiting lists are an area of major importance to many older people because delays in treatment make it more difficult to remain living independently, especially if the health condition affects mobility or vision.
Funding was provided in 2005 to increase the numbers of cataract operations and hip and knee replacements in recognition of the growing numbers of older people in the community requiring these treatments. In 2004, the Breast Screening Aotearoa programme was extended to women up to their 70th birthday.
Most older people want to live in their own homes
Home ownership is high among older people, though rates are likely to decline
One-third of older people (three-quarters of them women) live on their own
"Home is a familiar place and a treasure chest of memories. It can be an expression of one's personality, hobbies and skills. Home provides a sense of identity and a face to the community".
( Creating communities for all ages 40+ Project and Age Concern, 2000 )
Access to affordable and appropriate housing options for older people is essential to ageing in place.
Table 2.1 65+ housing tenure by percentage of total population, 2001
| Age group | Owned with a mortgage | Owned without a mortgage | Owned unspecified | Rented | Rent free | Not specified | Total |
|---|---|---|---|---|---|---|---|
| 65–74 | 9 | 68 | 1 | 12 | 4 | 6 | 100 |
| 75–84 | 5 | 69 | 2 | 13 | 4 | 7 | 100 |
| 85 plus | 5 | 64 | 3 | 15 | 5 | 9 | 100 |
| Total population | 39 | 25 | 1 | 29 | 3 | 4 | 100 |
Source: From Birth to Death database 2001, cited in Accommodation options for older people in Aotearoa/New Zealand – New Zealand Institute for Research on Ageing (NZiRA) Report for the Centre for Housing Research, Aotearoa New Zealand (CHRANZ), 2004.
Home ownership is high among older New Zealanders. In 2001, three-quarters of all older people, and more than half of people aged 85 and over, owned or part-owned their homes (Table 2.1). In part, this reflects past government policies that fostered home ownership through low-interest loans and the capitalisation of family benefit. The proportion of older people who own their own home has declined since the last census, from 81% in 2001 to 75% in 2004.
There is likely to be more diversity in housing tenure among older people in the future, including larger numbers living in retirement villages in owned, rented or leased units, or in houses owned by family trusts. Possibly fewer older people will be mortgage-free home owners.
In 2001, one-third of older people were living on their own, with almost three-quarters of these being women. Around 14,500 women aged 85 and over (68%) were living in a single-person household. While most older people live independently in their own homes, around 50,000 respondents to the 2001 Census aged 65 or over (13%) said they usually lived with their children.
Older people receiving residential care
In 2001, 7% of the older population were living in non‑private dwellings. Of these, 81% were living in a retirement home, while 9% were living in a hospital. The likelihood of living in non-private dwellings increases with age, rising from 2% of 65–74 year olds to 30% of people aged 85 and over.
Older women are more likely to live in non-private dwellings than older men. At the time of the 2001 Census, 8% of women and 4% of men were living in a non-private dwelling such as a retirement village, a home for older people, or a hospital. Women made up 55% of the 65–74 age group, and 80% of the group aged 85 and over, living in a long-stay residential care facility.
Older New Zealanders are less likely to live in rural areas
Older Māori are more likely than older non-Māori to live in rural areas – affecting access to services and amenities
Older people are slightly less likely than the rest of the population as a whole to live in rural areas (11%, compared to 14%). In 2001, more than two-thirds of older people lived in major urban areas, around a fifth in secondary or minor urban areas, and just over a tenth lived in rural areas (Table 2.2). The likelihood of living in a rural area was greater among people aged 65–74 than among those aged 75 and over. This may reflect the fact that the very old are more likely to require access to the services and amenities available in urban areas.
Older Māori are more likely than older non-Māori to live in rural areas. In 2001, one-quarter of Māori aged 65 and over lived in rural areas, compared with a tenth of non-Māori of that age. Therefore access to health and other services is likely to be more difficult for Māori.
Table 2.2 Urban and rural distribution of older people, 2001
| Number | Percentage | |
|---|---|---|
| Main urban areas (more than 30,000) | 310,116 | 69 |
| Secondary urban areas (10,000–29,999) | 38,442 | 9 |
| Minor urban areas (1,000–9,999) | 52,281 | 12 |
| Rural centres and rural other (0–999) | 49,524 | 11 |
| Total | 450,420 | 100 |
Source: Statistics New Zealand, 2001 Census Regional Summary, Table 2 and Table 2a.
Older people make valuable contributions to their communities
Older people are a significant proportion of the voluntary workforce, bringing great benefits to themselves and others
"Working for the community keeps me connected. I continually make new friends and we help each other just by doing things that need to be done."
(Roma Cook, Positive Ageing Ambassador for the Office for Senior Citizens)
The value of older people to their communities cannot be underestimated. Many older people are involved in unpaid activities, either inside or outside of the home, and older people comprise a significant proportion of the volunteer workforce. Around 15% of all unpaid work is done by older people. 7 In the four weeks before the 2001 Census, 17% of people aged 65 and over had been involved in voluntary work, such as for an organisation, group or marae. This proportion was highest (21%) among 65–74 year olds. 8
Older people volunteer in many different ways. They are volunteers in community groups and are business advisors and mentors. They volunteer on boards, in schools, on the marae and in köhanga reo, in health and support services, as sports coaches and for their churches.
Older people report that volunteering can be emotionally and spiritually satisfying. It contributes to their physical and mental wellbeing, and it provides opportunities to learn new skills and to continue to actively contribute to their communities. People of all ages benefit from the talents and knowledge that older people share through their voluntary work. 9
