Carers describe themselves "sitting in their cars and crying at the end of the day." The drivers of burnout in this sector are structural. The response needs to be too.
The evidence
1,000+
aged care beds closed permanently and 1,200 closed temporarily in 2023, primarily due to acute registered nurse shortages.
NZ Aged Care Association, 2023
~$20,000
gap between aged care nurse pay and Te Whatu Ora nurse pay. The sector lost around 1,000 nurses to Te Whatu Ora, roughly 20% of the nursing workforce.
NZ Aged Care Association, 2023
$18,661
estimated cumulative pay loss per care and support worker since the 2017 pay equity settlement expired in June 2022. Around 65,000 mainly female workers affected.
Public Service Association, March 2025
What it looks like
In aged care and disability support, burnout has a particular shape: carers skipping their own breaks so residents aren't left waiting, nurses covering work meant for three, care managers absorbing the load when staff can't make it in. Dementia, palliative and complex disability support carry an emotional weight the public conversation rarely names, on top of pay that hasn't kept pace with the hospital next door.
The workforce is mission-driven, largely female, immigration-dependent, and structurally underpaid against comparable Crown roles. The work is meaningful; it's the system around it that produces the burnout. The most-cited data, the 2019 E tū / NZNO survey of 1,200 caregivers, found 83% said basic care was delayed or missed on most shifts, and the structural drivers haven't improved since.
The drivers
Aged care nurses earn up to $20,000 less than nurses doing comparable work inside Te Whatu Ora. The sector has lost around 1,000 nurses, roughly 20% of the nursing workforce, primarily to the Crown employer. The structural arithmetic is simple: a sector can't keep training a workforce it can't afford to retain.
The sector is heavily reliant on internationally qualified nurses and carers. Border policy, visa settings and global competition for the same workforce create persistent volatility in supply. When supply tightens, residents wait, ratios slip, and the workforce that remains absorbs the deficit.
Dementia, end-of-life and high-acuity disability care carry sustained emotional weight. Combined with shift patterns and chronic understaffing, basic recovery time is the first thing to go. The 2019 E tū / NZNO data showed 83% of carers said basic care was delayed or missed on most shifts. The pattern persists.
How we help
3 Big Things works with aged residential care providers, retirement village operators, home and community support providers, and disability support organisations across Aotearoa. We understand the funding realities of contracted care delivery, the pay equity context, and the particular psychological load of dementia, end-of-life and disability support work.
Identify the structural drivers in your workforce with psychosocial hazard assessment aligned to ISO 45003 and WorkSafe NZ guidance, designed for the realities of a care workforce: shift patterns, ratio pressure, language and cultural diversity, and the emotional weight that engagement surveys typically don't capture.
Equip your leaders for the realities of leading a care workforce with coaching and people leader development for chief executives, facility managers, clinical leads and team leaders, with explicit attention to leading immigrant workforces, navigating pay disparity conversations, and supporting kaimahi through cumulative emotional load.
Provide registered-psychologist support for kaimahi carrying the load with confidential clinical support delivered by psychologists experienced with care workforces. Trauma-informed, culturally aware, and designed for shift-based staff who may have limited access during business hours.
We understand the financial reality of operating in this sector under contracted funding models. We work with you to find a delivery model that is genuinely viable.
Talk to us