In 20 years time 1-4 New Zealanders will be over 85

That is the estimation. So just how are these people going to be accommodated?

Social isolation is going to be a much bigger problem in 20 years time if it is not addressed not. People who cannot get out and mix with people through illness, disability or depression are causing concern now so just imagine what it will be like in 2031!

Nutrition is also a major problem. How are people going to be nutritionally balanced? This is what helps their survival, motivation and ward off disease and illness.

Anyone who has lived on their own will know there is not quite so much joy in cooking for yourself as there is in sharing a meal with another person.

Many older people are under nourished not so much from lack of food, though it is a contributer, it is the lack of company. Dr Carol Wham from Massey University has just completed a study on the effects of nutrition on the elderly. It was conducted on 1000 people living at home. It was discovered that sharing a meal has a bigger impact on whether a person eats there meal or not.

Meals on Wheels does a great job, but it is empty if you have no one to share it with. What people enjoy most is the visit from the person who delivers the meal.

Not everyone gets involved in the community or in organisations. While when you are young and busy this is not a problem but when you live on your own, the skills to mix with people have not been developed. This leads to a person being more at risk of social isolation and are more likely to suffer from depression and disease and undernutrtion is also a contributer.

This is why when people enter a residential facility their depression abates, their weight increases and their nutritional status improves. Don't have to be a rocket scientist to understand this.

In 1987 when home care was first introduced with the aim of keeping people at home and out of the then Stage 1 rest homes, I predicted that the biggest disease we will see is social isolation. It has come true.

Social isolation costs the health care system far more than residential care does. The number of people who have repeated public hospital stays, increased homecare to keep them at home costs much more than residential care.

While I agree people have the right to stay home with support if they choose. I do not believe that ALL of the people who are receiving home care are there by choice. They are encouraged to stay home, even if they do not want to and know they need to have people around them. It is considered fiscally beneficial to keep them at home.

Wrong. It cost more when you take into consideration of all the different services that are involved in keeping them at home -home care, meals on wheels, public hospital care.

I am going to be one of the 1-4 over 85 in 20 years time. While I pray that I will remain active and able and have family around who are willing to support me, I am also prepared for the fact that I may need some help or residential care.

This means I have 20 years to ensure the caregivers who are going to help me live at home or in residential care know how to care for me as an individual and understand any medical conditions I have. Hence my mission to get on-line training throughout the country so consistent individualized care is the norm and everyone gets the care they want and what they deserve.