title: Restructuring long-term care and the geography of ageing: a view from rural New Zealand.
abstract: This paper examines the major points of contact between the restructuring of long-term care and the evolving geography of the elderly in the Waikato, one of New Zealand's agricultural heartlands. The time frame of the study is 1981-91, a decade in which new Zealand embarked on a sweeping program of service restructuring and privatization. Comparative analysis of data on the evolving distribution of the elderly and on the shifting supply of long-term care beds reveals that restructuring has sharpened contrasts between urban and rural contexts for ageing. Almost all the urban centres in the Waikato benefited from an expansion of long-term care driven by private-sector initiatives, while rural communities suffered a broad-based depletion of services. However, the data indicate that, contrary to the trend in long-term care, more older elderly people (defined as those aged 80 or older) are "staying on' in rural communities. The paper concludes with a consideration of emergent policy issues; we speculate that it through the aggregate outcomes of decisions to "stay on' that the personal troubles of the elderly residents of service-depleted communities may yet become an important policy issue in rural New Zealand.
authors.affiliation: Department of Geography, University of Guelph, Ontario, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Joseph
authors.forename: A I
authors.initials: AI
authors.lastname: Chalmers
mesh_terms: D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D006287:Health Planning Guidelines; D006291:Health Policy / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011156:Population Density; D011158:Population Growth; D011332:Privatization / Q000639:trends; D012424:Rural Population / Q000706:statistics & numerical data*