JUDE BARBACK gets a chance to snoop around a residential aged care facility in Tauranga.
Althorp Private Hospital is nestled in a cosy, quiet corner of Tauranga, yet close enough to the busy Tauranga Hospital, alongside which Althorp works closely. I’m met by general manager Ginni Cashell, who having managed Althorp Private Hospital for the past four years, is undeniably proud of Althorp.“I don’t like to boast, but …”, she says on a few occasions. During my tour of the hospital, I am struck by the positive and nurturing ambience exuding from every part, and I think Cashell is entitled to boast. It appears to be a good ship she is running here.
A busy ship, though. Once beyond the serene reception area and into the business end of the hospital, I become aware of the hustle and bustle of running this popular 90-bed operation. The 90 beds include 36 hospital-level, 36 psychogeriatric, 10 dementia care, four palliative care, three funded respite care, and two transitional orthopaedic.
I notice a slant towards the complex end of care, with the dementia unit and the psychogeriatric beds comprising just over half their bed count, and Cashell, who comes from a psychiatric nursing background herself, confirms this is what sets Althorp apart from other aged care facilities. Apparently, Althorp is the only provider in the Bay of Plenty with a contract to provide psychogeriatric care, and as a result, there is huge demand for these beds.
“At this very moment, there are five psychogeriatric clients at Tauranga Hospital waiting for beds,” says Cashell.
We’ve touched on a significant issue for Althorp, and I suspect, for many hospitals around the country in a similar situation. While there is potentially a long-term plan to extend the facility to create room for more beds, in the short-term, Althorp is faced with the pressure of trying to find space in their existing facility. Occasionally, a reassessment of a client in one of the highly sought-after psychogeriatric or dementia beds will result in their transfer to a hospital-level bed. However, Cashell says this rarely happens and is generally unpopular with the families of their clients, who don’t like to see them moved about or their level of care diminished.
It is the same old chestnut. With the ageing population and consequently the number of dementia patients on the rise, Cashell shares the mantra of the NZACA that there need to be more beds. In spite of this, she thinks it unlikely the DHB will extend the contract to another provider because of the resulting cost. The funding Althorp receives for the daily rate of care is not sufficient to cover the capital development and building costs to extend their facility, and Cashell confirms that people these days expect single rooms with ensuite bathrooms, which are not cheap to build. So the problem remains.
Interestingly, it transpires that Althorp Private Hospital’s origins stem from a need to meet demand. When Cambrae Private Hospital could no longer meet the demands of a modern aged care facility, Thomas Scott and Matthew and Yvonne Best – the directors of Althorp – shifted the operation to Althorp Private Hospital. The hospital, and later, the adjacent Althorp Retirement Village, was built on land owned by the Munro and Church families, who had previously used the land to grow kiwifruit. The hospital’s history begins to take on more significance as I walk around; the four homes housing the residents are named Scott, Best, Munro, and Church.
As I enter Church Home, which caters for the hospital-level beds, I tentatively pull out my camera and ask if it would be ok to snap a few pics of staff and residents. Cashell informs me that a professional photographer will also be visiting the hospital that morning and they are all looking forward to having their photo taken.
Both staff and residents are certainly very obliging. Debbie, a registered nurse, and Maria, an enrolled nurse pose for a quick photo with Colleen, a resident more fondly known as “Nana” I am told.
Cashell is full of praise for her staff and says they have a very high ratio of registered nurses, including specialist gerontology nurses. I also encounter Althorp’s physiotherapist, Diane, with a resident in the hydrotherapy pool, which is apparently the only pool in an aged care facility in the Bay of Plenty. Diane has worked for Althorp for 10 years and has specialised in geriatric physiotherapy and manual handling. In fact, Diane’s expertise is often sought after by people outside of the hospital, and she provides training and education beyond Althorp.
Cashell says their annual in-service training touches on issues that arise during the year. In addition to their own comprehensive orientation programme, staff members are also encouraged to work towards their level 2 certificate in foundation skills, and those working with dementia patients must complete their level 4 dementia unit standards. Althorp has two on-site assessors.
While scrupulously clean, the main hospital shows a few signs of wear and tear and looks a little dated in places, perhaps unsurprising given it opened 12 years ago. However, the design still bears relevance, with each home containing a roomy lounge area and approximately 15 beds. Each bed in its own room has an ensuite bathroom.
The dementia unit is particularly homely. Although the unit is, by definition, ‘secure’, the sunny bedrooms and lounge all open out onto the garden area, giving a feeling of openness rather than of being ‘locked in’. The ‘men’s shed’, complete with mailbox and flowers, is a lovely touch. Cashell tells me it helps to familiarise residents with everyday objects and rituals and also puts them at ease.
The development of the men’s shed was driven by the diversional therapy team, led by Fay. The results of their efforts are starting to show. Tania, one of Althorp’s diversional therapists and the hospital’s ‘Spark of Life’ champion (an approach renowned for visibly rekindling the spark of life in dementia patients), tells me about one of their residents who had suffered a stroke and used to sit with her eyes closed, but now opens her eyes and looks around taking in her surroundings and what is going on around her. Tania puts such good results down to the positivity, time spent with them by the therapists, and interaction with the other residents.
These attributes could certainly be extended to the whole of Althorp. It comes as no surprise to me that one of the attractions of living at the Althorp Retirement Village next door is to gain access to the superior care offered in Althorp Private Hospital. Otherwise, it’s a case of forming an orderly queue – such is the demand to get into Althorp.