Community-based Alzheimer’s specialists are “running on the smell of an oily rag” and services for the elderly and people with dementia have been “grossly underfunded for decades”.

That’s the view of Alzheimer’s New Zealand chief executive Catherine Hall following the “tragic” case of a man who murdered his wife, who had the condition, by strangling her with a necktie in a Mount Maunganui retirement village.

John Alfred Salter, 80, pleaded guilty in the High Court at Tauranga to murdering his wife, Jean Ann Salter, 78, in their Bayswater Metlifecare Retirement Village apartment in Mount Maunganui on October 8.

Court documents released to the Bay of Plenty Times this week revealed Salter had become distressed after it was suggested his wife, who had mild Alzheimer’s, should move to a specialist facility.

Salter claimed to have made a suicide pact with his wife, who would nod in agreement at times before forgetting the arrangement, because he “could not live without her” and planned to kill himself to be with her.

The deceased had cried out, ‘‘Oh John”, several times as her husband strangled her, then tried to take his own life, before he called the police.

He will be sentenced in February.

Nigel Matthews, the chief executive of the Retirement Village Residents Association of New Zealand.

Retirement Village Residents Association of New Zealand chief executive Nigel Matthews said this was a “tragic event” that was " bigger’” than just retirement villages.

In his opinion: “Maybe there does need to be a bit of a review by retirement villages around the difference between independent living residents and those transitioning to specialist care or needing to do so.

“But unfortunately, I think this tragic situation is systemic of a bigger or wider community issue. While it occurred in a retirement village, it could have happened anywhere. I think it is important that we have a better look at resourcing mental health services in the wider community across all ages and communities.”

Matthews believed more people needed to have “those conversations” with their whānau, friends and colleagues and reach out to help agencies to ensure patients and carers were well-supported and safe.

Hall, from Alzheimer’s New Zealand, said the issue was how much dementia care was available.

Dementia, the umbrella term to describe symptoms that affect how the brain works, can affect anyone, with the risk increasing with age.

She said the progressive condition was incurable, “difficult” to live with and had “significant” stigma and discrimination.

“That is all made worse because there is not enough of the right type of services, and makes it even tougher on the person, their primary carer and their family.”

Broadly, there was primary care, home support, specialist community-based dementia support for the person and carer, respite and residential care, and hospital care for the acutely unwell - however “there isn’t enough of any of that”.

She said some people had struggled to see a GP and getting access to home support which helped with showers and dressing, and rest homes had been closing beds.

Hall also said community-based specialists were “running on the smell of an oily rag”, and healthcare in general, and in particular services for the elderly and those with dementia, had been “grossly underfunded for decades”.

Almost 70,000 people were living with dementia in New Zealand, and that number was expected to reach about 170,000 by 2050, according to the Dementia Economic Impact Report 2020 - and this was “the tip of the iceberg” as family and friends were also impacted.

She said Alzheimer’s NZ, the NZ Dementia Foundation, the Mate Wareware Advisory Rōpū and Dementia NZ put together the Dementia Mate Wareware Action Plan, which was a blueprint for the Government to take action.

It was endorsed by the Government two years ago but no decision had been made to implement it, Hall said.

Alzheimer’s Tauranga/Western Bay of Plenty’s general manager, Glenn Bradley, said the organisation had supported more than 600 whānau affected by Dementia Mate Wareware in the past 12 months and received more than 260 new referrals to help in the 2023 year to October 31.

“We are seeing consistent growth in demand for our services.’'

Families being supported had risen from 538 in June 2021 to 632 in June 2023. Referrals predominantly made by GPs, Bradley said.

“Our services include introductory education sessions about dementia and caring for a partner/loved one, an assigned family navigator to provide ongoing information and support, regular support groups and Cognitive Stimulation Therapy programmes”.

Dementia NZ chief executive Catherine Cooney.

Dementia NZ chief executive Catherine Cooney said the situation was “an absolute tragedy for the couple, their loved ones and everyone who knew them”.

She said being a family carer “can be exhausting” and data showed people caring for someone with a cognitive disorder experienced extra stress.

“The most important step to take is to reach out for help if you become concerned about a family member or a friend’s health, this includes when you notice changes in their memory or other cognitive function.”

In response to questions about John Salter, a Department of Corrections spokeswoman said the department did not comment on the placement and management of individual prisoners because of “operational safety and security reasons” and Privacy Act obligations.

Department acting deputy chief executive - health Emma Gardner said the “number-one priority” was the safety of the public, staff and those serving prison sentences.

There were 626 people aged 60 and over in prison, as of October 31.

“We have a responsibility to support the wellness and wellbeing of all older people in prison acknowledging the varying needs of the diverse prison population.

“Although the older population (65-plus) in prison is low in comparison to other age groups, the trajectory of people in our prisons shows that over the next 20 to 30 years this age group will increase significantly,” Gardner said.

Prisoners’ health was assessed when they entered prison and specialist staff supported them if they were assessed as being at risk of suicide or self-harm.

Bayswater Metlifecare Retirement Village declined to comment.