The Wellington Coroner says more high-dependency units are needed to ensure that people in rest homes aren't bullied by more aggressive residents.
Garry Evans has released his findings on the death of a 98-year-old resident at a home in Upper Hutt last year.
He says Florence Coombes died in hospital from a head injury after a fall.
Although no specific injuries suggested an assault, twice when she fell other residents were found standing over her in suspicious circumstances.
Mr Evans says that Mrs Coombes was gentle and loving, and it is most unsatisfactory that she should have been the subject of bullying.
Patients with aggressive tendencies should not be in a unit with others, he says, calling for careful assessment of patients with dementia to ensure that they get the right accommodation.
Union seeks minimum staff levels
Two days ago, the Nurses Organisation union said it wanted compulsory minimum staffing levels set for rest homes. That would go some way, it said, towards addressing the concerns about rest-home standards raised by a damning Auditor-General report.
Spokesperson David Wait says there is currently no requirement to have a certain number of staff working a shift. The union gets frequent reports, he says, of staff not being able to meet patients' needs because of short-staffing.
These workers look after some of the community's most vulnerable members, Mr Wait says, but that is not reflected in their hourly rate of $14.
Sector reaction
A major provider of aged residential care says there is a lack of high-level beds for dementia patients nationwide.
Dwayne Crombie, the head of resthome provider Bupa Care Services (the former Guardian Healthcare), says funding inadequacies are at the root of the lack of beds.
Dr Crombie says New Zealand should follow the example of Australia and the United Kingdom and develop a plan for dementia.
He also says a suggestion (from the police investigation into the death) that closed-circuit television could be installed in resthomes poses problems.
However, Oceania Group, the company that ran the now-closed home where Mrs Coombes died, supports CCTV.
Chief executive Geoff Hipkins says it is a good idea.
Listen to Geoff Hipkins
Review started
District health boards say providing enough high-dependency beds is challenging, and a major review underway will provide much-needed answers in aged care.
The DHBs' spokesperson on aged care, South Canterbury DHB chief executive Chris Fleming, says they began a review in October with the Ministry of Health and the Aged Care Association into funding and wider issues.
Association chief executive Martin Taylor says the Coroner's sweeping statements in calling for improvements to aged care are premature; with the work underway to assess the need for separate facilities.