Through the looking glass: toward a brighter future for long-term care in a greying New Zealand.

In the USA, a recent report produced to inform the work of the National Commission for Quality Long-Term Care--Out of the Shadows: Envisioning a Brighter Future for Long-Term Care in America--should be of interest not only to US observers, but to policymakers, providers, and users of long-term care within New Zealand. Despite differences in financing and organisation, both the US and New Zealand face similar challenges in meeting the long-term care needs of an ageing population. Information technology systems in long-term care need to be adopted to better enable improvements in quality and efficiency; increased attention needs to be given to recruiting and retaining a well-trained, stable workforce; and continued development of home- and community-based alternatives to residential care must be pursued. The quickly developing culture change movement, which aims to improve the way chronically frail and disabled people live and are treated, must also be encouraged and supported. New Zealand has many advantages over the USA in its policy context for long-term care. It is critical that New Zealand build upon these advantages in the short term to ensure that the longer term implications of the ageing population can be met.