Alzheimer's Care in New Zealand

I have visited 5 practices in the last 2 days and had 13,000 steps on my Fitbit by 1PM today. It helps that I walked the wrong way 3 out of 3 times while trying to follow my Google Maps directions. Sometimes I think I should have a compass around my neck and a paper map in my hand.

Seriously, the Google Maps ap is great and it helps me know when to “tag out” with my Snapper card and hop off the bus (see picture below). The bus rides are very interesting and I try to observe at least one new thing on each bus ride. Today I happened into a Korean neighbor and enjoyed waiting for the bus with a few Korean elders. Most people (young and old) say “Thank you Driver” as they get off the bus – what a nice custom.

I am making progress with scheduling interviews – 3 are lined up and I’m hoping for many more. When a practice manager said “We are keen to help” it was Kiwi music to my ears!

My wellness activities for the last two days have been – a great 3000 meter swim with my pal Cynthia and 6:30 AM yoga in the most beautiful yoga studio I have ever been in. ONWARD!

An invitation to an interprofessional discussion, with a visiting geriatrician at a GP office, gave me my first BIG idea of the trip.  What if… telehealth consultation by dementia experts was available to all Vermont primary care practices  on a rotating basis regarding diagnosis and management of people with dementia and their families?  That might help!  Thank you to the nurse manager to invited me to the interprofessional conference with their new district geriatrician.  This nurse manager finds interprofessional brainstorming VERY helpful; always a good sign. 

Today’s wellness activity: a long walk on the beach at Seatoun after visiting my 3^rdprimary care practice today.  The wind in Wellington is very strong and a firm hat and substantial jacket make beach walking very fun. Here is a picture from the Seatoun Beach and the Oruaiti Reserve. Unfortunately, no blue penguins were around but, I had already met them at the zoo.

I got to meet my second Kiwi octogenarian; what a wonderful man Don is.  He told me a little story to illustrate how well he thinks elders are cared for in New Zealand.  His brother is 94 years old and received home health services because he lived alone until recently.  Don explained that one person would come in the AM and put his bedding into the wash, the next person would come and hang his sheets out to dry, and third person would come later that day to take down the sheets and make his bed. Don felt that it was all seamlessly coordinated.  What a great idea to spread care throughout the day and give more opportunities for conversation.  I have included a picture of Don and his daughter, a healthy and active family for sure. 
So far, I have visited 3 primary care practices and have about 20 on my list.  I have also learned that the “navigators” referred to in the NZ Framework for Dementia Care are social workers who are district based.  I hope to meet some soon.  The primary care  or “GP” offices seemed to be in each neighborhood in Wellington.  Staff are friendly and the waiting rooms are full of health information. Although New Zealand has a universal healthcare system, there are fees associated with each visit.  Nurse visits have been available in all the offices that I have visited so far.  Can’t wait to learn more about that.  I did note on one practice’s website that the nurse’s bio included “smear collector.”  I’ll let you ponder that one.   

For the last two days we have been settling into our AirB&B in Wellington.  Dr. Reese and I have gotten our bus passes and started to learn the different routes around town.  I have been contacting the primary care offices that I identified and corresponded with over the last few months. I have also discovered more primary care offices to add to my list using the “snowball method”.    Today’s wellness activity: a visit to the Wellington Zoo. 

What a way to see the North Island!  The train ride was comfy and the scenery was stunning. Here is link to the route of the train which gives a good description of each region that I traveled through https://www.greatjourneysofnz.co.nz/northern-explorer/.  There is a series of 5 viaducts over which the train goes very slowly and you can stand outside in the observation car for some great pictures.  Headphones are provided for a description of what you are seeing along the way.  It was a great introduction to how the geography of this beautiful land has shaped it’s people and commerce. Lastly come the views of the Cook Strait and glimpses of the Southern Island.  No WIFI, so bring a good book or download your work before booking.  

2/17 Auckland is surrounded by some beautiful islands and volcanic preserves that are easily accessible by ferry. So we headed out early for a full day of exploring Waiheke Island.  The island is filled with rolling hills topped by beautiful ancient trees.  The bus can take you all over the island and the drivers are friendly and helpful.  First we stopped at the beach at Oneroa Bay which gave us a good initial stretch of our legs and plenty of shells to examine.  We were able to get some good hikes in between the 3 wineries that we visited – Kennedy Point Vineyard, Goldie Wines, and Stonyridge Vineyard.  All had long driveways to inviting outdoor tasting areas with beautiful visas of vineyards and the ocean.  Lindsay and I walked about 9 miles and were happy not be to delivered place to place by van, taxi or helicopter.  A great introduction to lovely New Zealand wine and landscape.  On the bus back to the ferry, I had my first interview with an New Zealand octogenarian.  He felt very supported by the NZ health care system.  His only complaint was sometimes a wait for non- urgent surgeries, but he reported that he was quickly seen for a cardiac event with extensive workup and treatment.  He noted a physician shortage in his rural area but feel well taken care of by the nurses that were involved in all of his primary care visits.  Our 2 days in Auckland acclimating to New Zealand were delightful and now we are ready to move on and set up the homebase for the research project in Wellington.