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New research proves travelling can slow down the ageing process

It turns out that going on holiday is good for you in more ways than one. According to new research conducted at Edith Cowan University in Western Australia, travelling can actually slow the ageing process both physically and mentally. The study, published in the <a title="Journal of Travel Research" href="https://journals.sagepub.com/doi/10.1177/00472875241269892#:~:text=The%20principle%20of%20entropy%20increase%20provides%20a%20dynamic%20perspective%20to,Silva%20%26%20Annamalai%2C%202008)." target="_blank" rel="noopener">Journal of Travel Research</a>, is believed to be the first-ever that applied the theory of entropy - the general trend of the universe towards death and disorder – to tourism. "Tourism isn't just about leisure and recreation. It could also contribute to people's physical and mental health," ECU PhD candidate Fangli Hu said. "Ageing, as a process, is irreversible. While it can't be stopped, it can be slowed down." According to the research, travelling, exploring new corners of the world and engaging in unique and relaxing activities can stimulate stress responses and elevate metabolic rates, positively influencing metabolic activities and the body's self-organising capabilities. "Leisurely travel activities might help alleviate chronic stress, dampen over-activation of the immune system, and encourage normal functioning of the self-defence system," Fangli added. While some people prefer relaxing holidays, others prefer to stay on their feet and keep active during their travels, enjoying the many well-known benefits of exercise. It can "enhance the body's immune function and self-defence capabilities, bolstering its hardiness to external risks". In response to their study, the experts suggested that "travel therapy could serve as a groundbreaking health intervention." Despite the positive results of the research, experts also warned that travelling can exposed to infectious diseases, accidents, injuries, violence, water and food safety issues, and concerns related to inappropriate tourism engagement, which in turn will have the opposite effect on our health. "Conversely, tourism can involve negative experiences that potentially lead to health problems, paralleling the process of promoting entropy increase," Fangli said. Image credits: Shutterstock

Travel Tips

Common drug shows potential in reversing ageing

A common medication has been found to have anti-ageing qualities, with scientists finding that the drug can de-age monkeys. Metformin, a cheap and common diabetes drug that has been used since the 1950s, could be an anti-ageing elixir, with scientists from the Chinese Academy of Sciences and Beijing Institute of Genomics using the pill to "markedly" slow down ageing in the animals. According to the experts, the medication reduced deterioration of the brain and boosted cognitive abilities in the primates while also slowing down bone loss and aiding in the "rejuvenation" of several tissues and organs. The most significant improvements were seen in the liver and frontal lobe, the part of the brain responsible for language, reasoning, problem solving, memory, movement and personality. Researchers said all of the findings led to the conclusion that "metformin can reduce biological age indicators" up to six years, with the medication paving the way for ageing reversal in humans. The drug was previously tested on mice, but since testing the medication on Cynomolgus monkeys - that are both physiologically and functionally similar to humans - the tests have shown more promise for potential human trials. The researchers said of the 40-month study, "Our research pioneers the systemic reduction of multi-dimensional biological age in primates through metformin, paving the way for advancing pharmaceutical strategies against human ageing." The scientists added, "[The study] represents an important advance in the quest to delay human ageing, with geriatric medicine research gradually shifting its focus from treating individual chronic diseases to systemic intervention against ageing." Image credits: Shutterstock

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What the government’s home care changes mean for ageing Australians

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The Albanese government has this week announced it will introduce one of the <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">largest reforms</a> to Australia’s aged-care sector to date. The package includes a A$4.3 billion investment in home care, now called “<a href="https://www.health.gov.au/our-work/support-at-home">Support at Home</a>”, to come into effect from July 2025. This reflects both the desire of many people to remain living at home as they age, and the government’s desire to reduce the costs of residential aged care. So what changes is the government making to home care packages? And what will these changes mean for ageing Australians? <h2>Reducing waiting times</h2> One of the major complaints about the current home care system is the long waiting times. Estimates suggest there’s a <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">6–to-12-month wait</a> for the higher level 3 and 4 home care packages. For people with the highest needs, this is far too long. As of March this year, around <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">45,000 people</a> were waiting for any level of home care. An additional 14,000 were already receiving a package, but on a lower level of home care than they were entitled to. With additional funding, the new system will <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">support more participants</a>. It aims to shorten wait times to <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">an average of three months</a> from July 2027. <h2>Changes to services</h2> The new system will replace the current four levels of home care packages with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">eight classifications</a> of funding for services. When participants are assessed, they will be assigned the most suitable category. There’s currently very limited information on what these classifications are, but the idea is they will provide more targeted services. A number of short-term supports will also be available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive program designed to build function after injury or illness – as well as palliative care support. The way different types of services are subsidised is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service. Under the new system, services are categorised into clinical care (for example, physiotherapy or wound care), independence (such as help with bathing or cooking) and everyday living (for example, gardening or home maintenance). The new reforms fully subsidise clinical services regardless of income, whereas independence and everyday living services will attract co-contributions based on means testing. For example, <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home.pdf">a self-funded retiree</a> would pay nothing out of pocket for physiotherapy, but would pay 50% for help with showering and 80% towards gardening costs. A full pensioner would also pay nothing for physiotherapy, but pay 5% for help with showering and 17.5% of the cost of gardening. This is a positive change. Our research has previously highlighted a tendency for people with home care packages to choose everyday living services <a href="https://onlinelibrary.wiley.com/doi/full/10.1155/2023/4157055">such as gardening</a> and cleaning and refuse clinical care such as allied health and nursing as these types of services were more expensive. These changes should make older people more likely to choose allied health and clinical care services, which will help them maintain their function and stay fitter for longer. <h2>Some challenges</h2> For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed. As people stay at home for longer, we also see that these <a href="https://academic.oup.com/ageing/article/52/5/afad058/7147101">people are frailer</a> and have more health conditions than in the past. This requires a different and more highly skilled home care workforce. The current <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">home care workforce</a> consists largely of personal care and domestic support workers alongside a much smaller skilled workforce of registered nurses and allied health professionals. But with the changing profile of people receiving care at home, there will need to be a greater focus on maintaining functional capacity. This might mean more allied health input will be required, such as from physiotherapists and occupational therapists. It’s difficult to source an appropriately skilled workforce across the sector, and almost impossible in <a href="https://www.ruralhealth.org.au/sites/default/files/publications/fact-sheet-allied-health.pdf">rural and remote areas</a>. Alternative models, such as training personal care workers to act as allied health assistants, and effectively using technology such as telehealth, will be necessary to meet demand without compromising on quality of care. One example of the need for upskilling in specific areas relates to caring for people with dementia. The majority of people who are living with dementia at home receive care from family carers, supported by home care workers. It’s vital that these care workers have adequate knowledge and skills specific to dementia. However, research has shown the home care workforce may <a href="https://pubmed.ncbi.nlm.nih.gov/31646701/">lack the knowledge and skills</a> to provide best-practice care for people living with dementia. Specialised <a href="https://onlinelibrary.wiley.com/doi/10.1002/gps.6140">dementia training</a> for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be rolled out across the sector. <h2>What about unpaid care at home?</h2> Unpaid carers, such as family members, provide <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy/goal-1-quality-care-and-support/support-for-informal-carers">significant amounts of care</a> for older people. The value of this unpaid care is estimated to be in the billions. As older people stay at home for longer, this is set to increase even further. However, carers with high care burdens are particularly vulnerable to <a href="https://www.sciencedirect.com/science/article/pii/S2352827316300283#s0025">poor physical and mental health</a>. Without adequate support, we may find extra caring pressures lead to a breakdown in caring relationships and an increase in other health-care costs for both the carer and care recipient. So we need to ensure carers have adequate financial, psychological and practical support. But the currently available detail on the reforms doesn’t indicate this has been adequately addressed. With careful implementation and ongoing evaluation, these reforms have the potential to significantly enhance the home care system. However, their success will depend on addressing workforce challenges, ensuring adequate support for unpaid carers, and maintaining a focus on the holistic needs of older Australians. More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238890/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, Executive Director, National Ageing Research Institute; Professor, Centre for Health Services Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, Director Clinical Gerontology & Senior Principal Research Fellow, National Ageing Research Institute, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">original article</a>. </div>

Legal

Landmark aged care reforms set to benefit millions of Aussies

The federal government has reached a deal with the coalition for the long-awaited aged care reforms including $4.3 billion for in-home services. This means that senior citizens will be given more support and choice to live their golden years in dignity, as they intend to help them live at home for longer and improve conditions and protections for those in aged care facilities. "$4.3 billion will be invested in Support at Home, to come into effect on the first of July next year," Prime Minister Anthony Albanese announced at Parliament House on Thursday. The Support at Home package is expected to help 1.4 million Australians live independently at home with support, before going into aged care by 2035. It will provide support for nursing, occupational therapy and day-to-day tasks like cleaning, showering, dressing and shopping, with wait times for packages cut from 12 to three months. The government will also pay all of the cost of clinical care services, with a lifetime contribution cap of $130,000 for non-clinical care costs. Those using the Support at Home program could also get $25,000 in aid to spend their final three months at home, instead of the hospital. The $5.6 billion reform package is also set to affect the availability of funding for residential aged care, including a "no worse off" assurance that people currently in aged care won't be asked to pay more for their care. New aged care quality standards will also be implemented to improve the sector and drive higher-quality care. The government also promised more resources to investigate and penalise bad behaviour by providers. Albanese said the reforms will be the "greatest improvement" to the aged care sector in 30 years. “This is about caring for the generation that cared for us,” he said. “We will deliver historic aged care reforms to ensure the viability and quality of our aged care system and support the growing number of older Australians choosing to retain their independence and remain in their homes as they age.” Aged Care Minister Anika Wells said the changes would lead to more services for older Australians. “Our reforms will create better and safer care, help reduce the fear of a system that has been neglected for far too long,” she said. The reform has been welcomed as the number of Australians over the age of 65 is expected to double and those older than 85 are predicted to triple in the next four decades. Images: Shutterstock

Caring

Five signs in your senior pet you shouldn’t ignore

Just like humans, pets can become susceptible to health complications as they age. Cats are considered senior at around 11 years, and many dogs are considered senior from about seven years old, depending on their breed. As your furry friends get older, it's important to look out for these five changes in your pet, because if caught early, addressing them promptly may significantly improve their well-being, lifespan and quality of life. Dramatic weight changes If your pet either loses or gains weight dramatically, it’s time to book an appointment at the vets. Significant weight changes can signal issues such as heart disease, diabetes, liver disease, or alterations in metabolism and muscle tone, which are sometimes associated with ageing. Increased thirst An increase in thirst, and in turn an increase in urination, could be the sign of several health conditions such as kidney disease or diabetes. Addressing these symptoms early can help manage the condition and drastically improve your pet's quality of life. Changes in appetite Several health problems in pets can manifest in a change of appetite, whether it's a decrease or increase in hunger. Changes in appetite might be due to dental issues, gastrointestinal problems, diabetes or more severe conditions like cancer. Signs of chronic pain Chronic pain can present in pets in many different ways, such as Repeated chewing, biting, or scratching at a specific area, altered activity levels, reluctance to move or jump, or poor response to medications. If your furry friend looks like they are struggling to move, or are slower when getting up and down, it's time to schedule a trip to the vet. Changes in demeanour As pets age, they can experience similar symptoms to humans, such as changes in vision, hearing and general confusion. Some pets can even experience dementia, with symptoms including anxiety, aimless wandering, decreased appetite, and notable shifts in behaviour. Although there is no cure, management is possible through medication, dietary adjustments, and lifestyle changes and available under veterinary guidance. Image credits: Shutterstock

Family & Pets

Rolf Harris' widow dies at age 93

The wife of disgraced paedophile TV star Rolf Harris has passed away at the age of 93, just one year after the death of her husband. Alwen Hughes stood by Harris when he was jailed in 2014 for 12 indecent assaults on four underage girls between 1968 and 1986. Hughes passed away due to a “stroke, frailty of old age, vascular dementia”, according to her death certificate. Harris died in May 2023 from neck cancer, after the couple were married for 65 years. According to reports by The Sun, Hughes has been pictured in a wheelchair and was reportedly suffering from Alzheimer’s disease in the years before her death. Alwen stood by her husband through the court proceedings and his. subsequent jail term, attending every day of Harris’ initial trial alongside their daughter Bindi. Speaking shortly after Harris’ conviction in 2014, singer Vince Hill said, “Alwen is very poorly. We’re all very worried about her." “I don’t know if she will survive his prison term. She’s quite fragile. She suffers from arthritis and she’s had hip replacements and God knows what.” Image credits: BER/CLS/Shutterstock Editorial

Caring

Hollywood legend dies at age 93

Hollywood acting legend James Earl Jones has died at the age of 93. <a href="https://deadline.com/2024/09/james-earl-jones-dead-1236082801/" target="_blank" rel="noopener">Deadline</a> revealed that the actor passed away at his home in Dutchess County, New York, although no cause of death has yet been given. Jones was responsible for some of the most memorable roles in modern cinema history, lending his voice to iconic characters including Star Wars’ Darth Vader and The Lion King’s Mufasa. After making his big screen debut in the 1964 film Dr Strangelove, he went on to rack up hundreds of roles and didn't stop working until 2021, with his latest project being in the Eddie Murphy sequel, Coming 2 America. Jones' most notable roles came in films such as the original Coming To America, Field of Dreams and The Hunt for Red October, making him a household name in the movie industry. Throughout his career, Earl Jones won three Tony Awards, two Emmy Awards, a Grammy Award, and was also inducted into the American Theatre Hall of Fame in 1985. He went on to receive an honorary Academy Award in 2011, as well as a special Tony for lifetime achievement in 2017. Image credits: Joanne Davidson/Shutterstock Editorial

Caring

Olympian killed at just 33 years of age

Ugandan Olympic athlete Rebecca Cheptegei, 33, has tragically passed away at Moi Teaching and Referral Hospital in Eldoret, Kenya, where she had been receiving treatment for severe burns sustained in an attack by her former boyfriend. A hospital spokesperson, Owen Menach, confirmed that Cheptegei succumbed to her injuries after suffering multiple organ failures. Cheptegei, who competed in the women’s marathon at the Paris Olympics just weeks ago, sustained burns to 80% of her body after her ex-partner, Dickson Ndiema, allegedly doused her in petrol and set her on fire during a domestic dispute. Trans Nzoia County Police Commander Jeremiah ole Kosiom revealed that Ndiema also suffered burns in the incident to 30% of his body, and that he remains in intensive care but is in a stable condition. Cheptegei's parents stated that she had recently bought land in Kenya’s Trans Nzoia County to be near athletic training centres in the region. A report from the local chief indicated that Cheptegei and her former boyfriend were involved in a heated argument over the property before the attack occurred. The Uganda Athletics Federation and the Uganda Olympic Committee have expressed their grief over the loss of Cheptegei. In a statement shared on the social media platform X, the Athletics Federation wrote, "We are deeply saddened to announce the passing of our athlete, Rebecca Cheptegei early this morning who tragically fell victim to domestic violence." They further condemned the attack, calling for justice. Uganda Olympic Committee president Donald Rukare added, “May her gentle soul rest in peace and we strongly condemn violence against women. This was a cowardly and senseless act that has led to the loss of a great athlete. Her legacy will continue to endure.” Image: Narnabi / Wikimedia Commons

Caring

Hollywood legend dies at age 94

The Notebook star Gena Rowlands has passed await the age of 94 after a lengthy battle with Alzheimer's. Her death was confirmed today by representatives for her son, filmmaker Nick Cassavetes, who told TMZ that Rowlands died on Wednesday afternoon at her home in Indian Wells, California, surrounded by family including her husband Robert and daughter Alexandra Cassavetes. While no official cause of death has been announced, Rowlands had been suffering from Alzheimer's for five years. In June, director of The Notebook and Rowland's son Nick Cassavetes was discussing the film's 20th anniversary when he shared <a href="https://oversixty.com.au/health/caring/hollywood-star-s-heartbreaking-health-update" target="_blank" rel="noopener">details</a> of his mother's diagnosis and how it was reminiscent of her character in the movie. “I got my mum to play older Allie, and we spent a lot of time talking about Alzheimer’s and wanting to be authentic with it, and now, for the last five years, she’s had Alzheimer’s,” Cassavetes told <a href="https://ew.com/the-notebook-star-gena-rowlands-has-alzheimers-8668642">Entertainment Weekly</a> of Rowlands’ character, who also had dementia. “She’s in full dementia. And it’s so crazy — we lived it, she acted it, and now it’s on us.” Gena’s mother, fellow actress Lady Rowlands, had also suffered from the same disease. While The Notebook was Rowlands’ most notable 21st century role, the acting veteran broke into the industry in the 1950s and earned two Academy Award nominations and multiple Golden Globe and Emmy Award wins throughout her career. She was known for her frequent collaborations with actor-director husband John Cassavetes in ten films, including 1974’s A Woman Under the Influence and 1980s Gloria. Image credits: New Line Cinema/Demmie Todd/Warner Bros/Spring Creek/Kobal/Shutterstock Editorial <div class="more-coverage-v2" style="box-sizing: inherit; margin-bottom: 0px; border-top-width: 1px; border-top-style: solid; border-top-color: #e0e1e2; float: right; margin-left: 16px; max-width: 40%; padding: 16px 0px;"> </div>

Caring

How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> A growing number of complaints against older doctors has prompted the Medical Board of Australia to <a href="https://www.medicalboard.gov.au/News/2024-08-07-Medical-Board-consults-on-new-approach-to-keep-late-career-doctors-in-safe-practice.aspx">announce</a> today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table. The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine. The second would require only general health checks for doctors over 70. A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their <a href="https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx">professional code of conduct</a>, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo. <h2>Haven’t we moved on from set retirement ages?</h2> It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “<a href="https://law.unimelb.edu.au/__data/assets/pdf_file/0019/2061019/02-Blackham.pdf">still valid in a modern society</a>”. However, unlike judges, doctors are already <a href="https://www.medicalboard.gov.au/Registration/Registration-Renewal.aspx">required to renew their registration</a> annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct <a href="https://www.ahpra.gov.au/Notifications/Further-information/Guides-and-fact-sheets/Performance-assessments.aspx">performance assessments</a> if and when they are needed. <h2>What has prompted these proposals?</h2> This latest <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD24%2f33840&dbid=AP&chksum=vCEdxXaBs0%2bMeMZFxSb7SQ%3d%3d&_gl=1*3ol06k*_ga*MzU1NjAzMTc1LjE3MjMwMDA1Nzc.*_ga_F1G6LRCHZB*MTcyMzAwMDU3Ny4xLjEuMTcyMzAwMDU4My4wLjAuMA..">proposal</a> identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years. Studies of medical competence in ageing doctors show <a href="https://qualitysafety.bmj.com/content/29/2/113">variable results</a>. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour. The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors. In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70. In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015. While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate. It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients. <h2>So what distinguishes the two new proposed options?</h2> The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80. Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions. Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia. The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia. In practice, both of these proposals appear to allow doctors to manage their own general health confidentially. <h2>The law tends to prioritise patient safety</h2> All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/act/consol_act/hprnl428/s3a.html">That provision</a> basically says patient safety is paramount and trumps all other considerations. <figure class="align-center zoomable"><figcaption></figcaption></figure> As with legal <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2010-104a#sec.3">regimes regulating childcare</a>, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional. Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3383892">punished</a>” for errors in practice. All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care. <h2>Could these proposals amount to age discrimination?</h2> It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws. For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/ada2004174/s22.html?context=1;query=inherent;mask_path=au/legis/cth/consol_act/ada2004174">who are</a> “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”. In broader terms, a licence to practise medicine is often compared to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797044/">licence to drive</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236877/">pilot an aircraft</a>. Despite <a href="https://www.smh.com.au/national/nsw/mandatory-test-older-drivers-facing-discrimination-says-pensioner-group-20170607-gwm45u.html">claims of discrimination</a>, New South Wales law requires older drivers to undergo a medical assessment <a href="https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/older-drivers-and-riders/assessments">every year</a>; and similar requirements affect older <a href="https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.casa.gov.au/guidelines-medical-assessment-aviation&ved=2ahUKEwil-9GXlOKHAxUdslYBHdN_EboQFnoECBkQAQ&usg=AOvVaw0SgpoCCKjNriMN20fs16rq">pilots and air traffic controllers</a>. <h2>Where to from here?</h2> When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different. How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, <a href="https://www1.racgp.org.au/newsgp/professional/ahpra-eyes-mandatory-health-checks-for-older-gps">others have suggested</a> this would only exacerbate shortages in the health-care workforce. The proposals are open for <a href="https://www.medicalboard.gov.au/News/Current-Consultations.aspx">public comment</a> until October 4.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236305/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-olds-too-old-to-be-a-doctor-why-gps-and-surgeons-over-70-may-need-a-health-check-to-practise-236305">original article</a>. </div>

Body

Readers response: What are you starting to like more as you get older?

As we age, we start to have a whole new appreciation for things we previously overlooked in our younger years. We asked our reader what of life's simple pleasures they are starting to enjoy more as they get older, and the response was overwhelming. Here's what you said. Wendy Turner - The beauty and companionship of dogs, the wildness of a garden, the treasured times between physical pain, and the love of family and treasured friends. SE Rosenberg - Being on my own away from people but hanging out with my cats. Lynette Miller - Taking time to enjoy sunrise and sunsets, smelling the roses and just little things that sometimes pass you by because you're too busy to enjoy them. Antoinette Devlin - Peace and quiet. Robert Edward Fleming - Not having to work for the man anymore. Janine Sarai George - Putting my feet up, a good book and my wildlife. Maureen Brown Montgomery - Finally starting not to mind living a solo life and enjoying my own company without drama. Liz Lewis - Not having to set the alarm but being able to wake up naturally and usually not having to be anywhere in a hurry. Roselyn Reincastle - Appreciating life more now that I have had the experience. Frances Bradshaw - Peace and hearing the birds sing. Margie Buckingham - Serenity, that my opinions matter, travelling, spare time & being a grandparent. Rob Anderson - Time with the grandchildren, and reflection. Wendy Hope - Travel and wonder at the diversity of people. Maya Richardson - Staying as far away from people as possible. Christine Tully - Not having to commit to anything if I don’t want to. Margaret Inglis - Doing what I want to do, although my 4 legged mate still wants to get me out of the house each morning. Image credits: Shutterstock

Retirement Life

65-year-old woman transforms life after divorce

Harrah Brown was left “alone, devastated and scared for the first time in my life” at age 60, and had spend her days crying and wishing that her ex would come back. It took her one nasty fall while walking her dog to turn her life around. "I heard a tiny voice tell me to ‘get your life together and stop wasting away’” she said on social media. The now 65-year-old fitness fanatic said that she feels better than ever after she began weight training in her sixties, in the midst of the heartbreak. “Once I accepted I was on my own at age 60, I picked myself up and rebuilt my life from the inside out,” she said in one video. The mother-of-four began her fitness journey in 2019. “In August 2019, I borrowed 5k to move into my one bedroom apartment. I had nothing more than my clothes, my Great Dane, and a few personal belongings,” she wrote on Instagram. “I had my bed, a borrowed chair and desk and ate at my desk for well over a year. “It was the hardest time of my life. I honestly wasn’t sure how or if I would survive.” After her nasty fall, she began her transformation journey and started "listening to great motivational speakers on mindset and I read inspiring books on transformation, and I journaled." “Day by day, my mindset became stronger. The will to turn my setback into my comeback became a powerful force within me. “In September 2020 at age 61 I started lifting weights in my apartment gym, where I still workout today.” And the rest is history. Brown has amassed over 192k followers on Instagram and TikTok, sharing an array of positive messages and clips of her working doing workouts that others her age may consider almost impossible, including heavy barbell squats and pull ups. “Lifting weights renewed my strength, my spirit, and my confidence,” she said in one video. Her followers have praised her for being an inspiration. “You go girl!!! The 60s are a great place to be,” one said. “You make me excited to age!! You’re radiant and so inspiring, keep shining babe,” shared another. “Weight training made me feel like a badass, it’s amazing for mood boosting too," a third added. Since embarking on her new lifestyle, Brown has become an "empowerment coach", where she helps others “be healthy, fit and beautiful at any age”. Images: Instagram

Beauty & Style

Last Australian 'Rat of Tobruk' dies age 102

Thomas Pritchard, Australia's last "Rat of Tobruk" has passed away at the age of 102. Pritchard was part of the famous garrison who held the eponymous Libyan port against a furious Nazi siege in World War II. The Rats of Tobruk Association announced Pritchard's death on Saturday, honouring his service to his country. "Tommy was a stalwart member of our association and a most humble veteran, having served with the 2/5th field ambulance throughout the Middle East and the South West Pacific," the association wrote in a post. "We as an Association are extremely grateful to have had Tommy for so long yet we mourn his loss and the last direct linkage with some 14,000 Australian servicemen who served in Tobruk." The post added that Pritchard would be farewelled in a private family funeral, as was Tommy's wishes. However, they added that a public memorial for all Rats of Tobruk will take place in Melbourne, with the date yet to be confirmed. The Rats of Tobruk were an Allied garrison of about 26,000 soldiers, including 14,000 Australians, commanded by Australian Lieutenant-General Leslie Morehead. They were besieged by the Nazi Afrika Korps, comprised of German and Italian troops, from April 10th to November 27th 1941. The Africa Korps, under the leadership of Nazi general Erwin Rommel, had never known defeat, until he faced the Rats for 231 days, who denied Rommel a port on the Libyan coast as the Nazis were unable to take control of Tobruk. The nickname came from American-born Nazi propagandist William Joyce, who, when he heard the Allied soldiers were taking cover in the pre-existing below-ground defences of the city, derided them as living like "rats". However, Aussies took the nickname with pride as they celebrated their victory. Image credits: Rats of Tobruk Association

Caring

Our research shows 4 in 10 Australians in aged care are malnourished. What can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In the next 40 years <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150-fs.pdf">in Australia</a>, it’s predicted the number of Australians aged 65 and over will more than double, while the number of people aged 85 and over will more than triple. If you’re not really interested in aged care, you should be. Given these figures, you will almost certainly be engaging with aged care services at some stage – either for yourself, or supporting family members or friends seeking aged care. One service you are likely to encounter is residential aged care homes. In the past few years this sector has been under more scrutiny than ever before. Changes to legislation, workforce and funding are in motion. But the question remains as to whether these changes can happen fast enough to meet our ageing population’s needs. One area of need not being adequately met at present is nutrition. In a <a href="https://www.mdpi.com/2227-9032/12/13/1296">new study</a>, we’ve found four in ten older Australians living in residential aged care are not receiving enough of the right types of nutrients, resulting in loss of weight and muscle. This is known as malnutrition. <h2>Good nutrition is essential for healthy ageing</h2> Malnutrition in older people is <a href="https://www.agedcarequality.gov.au/providers/food-nutrition-dining/why-meals-matter">associated with</a> poorer overall health, such as increased risk of falls and infections. This can accelerate loss of independence for older people, including the need for extra assistance with basic activities such as bathing and dressing. Older people are at increased risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02612-5/abstract">malnutrition</a> for a range of reasons. These can include decreased appetite, difficulties with chewing and swallowing, and the presence of other chronic diseases such as Parkinson’s disease or dementia. Importantly, ensuring adequate nutrition is about more than just offering healthy foods. We eat not only to meet nutritional requirements, but for enjoyment and socialisation. We each have different preferences around what we want to eat, when and with whom. Food provision poses a challenge for residential aged care providers who must navigate the range of residents’ preferences together with dietary restrictions and texture modifications. This must also be balanced against the practicalities of having the right number of appropriately trained kitchen and mealtime assistance staff, and working within funding constraints. Understanding more about who is malnourished in aged care can help providers better address this problem. <h2>Malnutrition is an ongoing problem in aged care</h2> We looked at more than 700 aged care residents in New South Wales, Queensland and South Australia. We assessed participants for malnutrition using a screening tool that collects data on medical history and dietary intake, and includes a physical examination of muscle and fat. We found 40% were malnourished, including 6% who were severely malnourished. This likely underestimates the true rate of malnutrition, as residents with dementia were excluded. International <a href="https://www.mdpi.com/2072-6643/15/13/2927">studies</a> have shown an average of 80% of aged care residents with dementia are malnourished or at risk of developing malnutrition. Our findings are broadly in line with a synthesis of <a href="https://www.sciencedirect.com/science/article/pii/S0378512219301148">38 international studies</a>, which reported an average malnutrition rate in residential aged care of 52%. In Australia, malnutrition was highlighted as <a href="https://www.royalcommission.gov.au/aged-care">a priority</a> for immediate attention in the 2021 Royal Commission into Aged Care Quality and Safety. Its report cited <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dairy-food-supplementation-may-reduce-malnutrition-risk-in-institutionalised-elderly/52E93ADD586C634A3913A2AFE9D07847">an Australian study</a> of 215 residents, published in 2017, which found 68% were malnourished or at risk of malnutrition. It’s difficult to directly compare malnutrition rates between studies due to differences in diagnostic measurements. But it’s clear malnutrition is an ongoing challenge in aged care. <h2>What can we do about it?</h2> Since the royal commission, we’ve seen the strengthening of the <a href="https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards">quality standards</a> to be included in the new Aged Care Act, anticipated to be introduced to parliament in 2025. The strengthened quality standards provide an important framework to guide action by aged care providers on malnutrition. Key requirements include partnering with residents to design food options, regular assessment and reassessment of resident nutrition requirements, developing systems to monitor and improve satisfaction with food, designing pleasant dining environments, and providing staff with the training they need to achieve all of the above. However, achieving these standards will require investment of money and time. At the moment, <a href="https://kpmg.com/au/en/home/insights/2023/09/australian-aged-care-sector-analysis.html">64% of residential aged care providers</a> in Australia are operating at a financial loss. While we know carers and facility managers want to provide the best care possible, it’s difficult to achieve this when contending with underlying financial problems. As such, our teams at Monash and Griffith universities are focusing on strategies that minimise the burden on staff and providers. We are working on automating malnutrition screening. Current tools take 10–15 minutes and should be used when a new resident moves into an aged care home and regularly during their stay. But anecdotal evidence suggests providers lack the staff and funding needed to routinely carry out this screening. Instead, we aim to use existing data from aged care providers, including quarterly reports from the <a href="https://www.health.gov.au/our-work/qi-program">National Aged Care Mandatory Quality Indicator Program</a>, to detect malnutrition automatically. This will allow staff to focus more on care. Given the complexity of malnutrition, it’s likely that addressing the issue at a national scale will take some time. In the short term, for those with loved ones in aged care homes, we encourage you to be actively involved in their care, including noticing and speaking up if you think more can be done to optimise their nutrition.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235507/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, Lecturer, Physiotherapy, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, Senior Lecturer, School of Health Sciences and Social Work, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/our-research-shows-4-in-10-australians-in-aged-care-are-malnourished-what-can-we-do-about-it-235507">original article</a>. </div>

Body

We have too few aged care workers to care for older Australians. Why? And what can we do about it?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> In a country like Australia, we all expect that when we get old, we’ll be able to rely on a robust aged care system. But aged care providers can’t find staff and a crisis is brewing. If the problem isn’t fixed, there are serious risks to quality and access to services for older people who need support. There are also broader social, economic and political consequences for undervaluing the rapidly expanding health and social assistance workforce. Aged care <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">employs</a> around 420,000 people. Around 80% of those are front line staff providing care and demand for them is increasing rapidly. <h2>Australians are ageing</h2> The number of people aged 80 and over is <a href="https://treasury.gov.au/sites/default/files/2019-03/IGR_2010_Overview.pdf">projected to double</a> by 2050. At the same time, informal family care is becoming less available. In the next 25 years, <a href="https://www.australianageingagenda.com.au/executive/shortfall-of-400000-aged-care-workers-predicted-by-2050/">twice as many</a> aged care staff will be needed. Currently, about 1.4 million older people <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/aged-care">receive</a> aged care services, including basic and more intensive home care and residential care. Health care and social support job vacancies and ads are the highest of any industry. Between 30,000 and 35,000 additional direct aged care workers a year are already needed. By 2030 the <a href="https://cedakenticomedia.blob.core.windows.net/cedamediacontainer/kentico/media/attachments/ceda-duty-of-care-3.pdf">shortfall</a> is likely to be 110,000 full time equivalent workers. <h2>Why don’t enough people want to work in aged care?</h2> Despite recent <a href="https://www.health.gov.au/topics/aged-care-workforce/what-were-doing/better-and-fairer-wages">pay increases</a>, it is difficult to attract and retain aged care workers because the work is under-valued. The Australian workforce is undergoing profound change. A generation ago, manufacturing made up 17% of the workforce. Today it has fallen to 6%. By contrast, the health care and social assistance workforce has doubled from 8% to 16%. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The manufacturing workforce has declined, while health, aged care and social assistance has risen. ABS 6291.0.55.001 Labour Force, Australia.</figcaption></figure> Manufacturing jobs were <a href="https://australiainstitute.org.au/wp-content/uploads/2020/12/Manufacturing-Briefing-Paper-FINAL.pdf">mainly</a> secure, full-time, reasonably paid jobs dominated by male workers. By contrast, jobs in aged care are often insecure, part-time and poorly paid, dominated by women, with many workers coming from non-English speaking backgrounds. Since moving to take over aged care in the 1980s, the federal government has over-emphasised <a href="https://arena.org.au/a-genealogy-of-aged-care/">cost constraint</a> through service privatisation, activity-based funding and competition, often under the cover of consumer choice. The result is a highly fragmented and poorly coordinated aged care sector with almost 3,200, often small and under-resourced providers centrally funded and regulated from Canberra. This has <a href="https://www.health.gov.au/sites/default/files/a-matter-of-care-australia-s-aged-care-workforce-strategy.pdf">led to</a> high levels of casualisation, low investment in training and professional development, and inadequate supervision, particularly in the home care sector. Aged care is facing a perfect storm. Demand for care and support staff is increasing dramatically. The sector is poorly coordinated and difficult to navigate. Pay and conditions remain poor and the workforce is relatively untrained. There are no minimum standards or registration requirements for many front-line aged care staff. <h2>What are the consequences?</h2> An understaffed and under-trained aged care workforce reduces access to services and the quality of care and support. Aged care providers <a href="https://www.agedhealth.com.au/content/compliance-and-governance/news/troubled-outlook-for-aged-care-reforms-1224428737#:%7E:text=Its%20report%20found%20that%2053.8,was%20%22impossible%20to%20achieve%22.">routinely report</a> it is difficult to attract staff and they can’t meet the growing demand for services from older people. Staff shortages are already having an impact on residential care occupancy rates falling, with some regional areas now down to only 50% occupancy. That means older people either don’t get care or they are at increased risk of neglect, malnutrition, avoidable hospital admissions and a poorer quality of life. Inevitably, lack of aged care workers puts pressure on hospital services when older people have nowhere else to go. <h2>What needs to be done?</h2> Addressing these challenges requires a multifaceted approach. Australia will need a massive increase in the number of aged care workers and the quality of the care they provide. Wages have to be competitive to attract and retain staff. But better pay and conditions is only part of the story. Unless aged care becomes a career the community recognises, values and supports, it will continue to be difficult to train, attract and retain staff. The recent <a href="https://www.royalcommission.gov.au/aged-care">Royal Commission on Aged Care Quality and Safety</a> highlighted the need for a more skilled workforce, emphasising the importance of ongoing professional development for all staff. To date the federal government’s aged care workforce initiatives have been underwhelming. They are a limited and piecemeal rather than a coherent workforce strategy. In the short term, skilled migration may be part of the solution. But progress to bring in skilled aged care workers has been glacial. Currently only about 1% of providers <a href="https://theconversation.com/overseas-recruitment-wont-solve-australias-aged-care-worker-crisis-189126">have agreements</a> to bring in staff from overseas. At best, overseas migration will meet only 10% of the workforce shortfall. Registration, qualifications and training for direct care work have to become mandatory to make sure care standards are met. Much more significant and systematic incentives and support for training will be needed. Supervision, career progression and staff development will also have to be dramatically improved if we are to attract and retain the workforce that is needed. “Learn and earn” incentives, including scholarships and traineeships for aged care, are needed to attract the future workforce. At the same time, a much broader investment in upskilling the entire workforce through continuing professional development and good quality supervision is necessary. Like manufacturing a generation ago, aged care needs to become valued, skilled, secure and well-paid employment if it is going to attract the staff that are needed to avoid a looming crisis.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232707/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor of Public Health, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-have-too-few-aged-care-workers-to-care-for-older-australians-why-and-what-can-we-do-about-it-232707">original article</a>. </div>

Caring

‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

<a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Our <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">ageing population</a> brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss). Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are <a href="https://www.senseswa.com.au/wp-content/uploads/2016/01/a-clear-view---senses-australia.pdf">living with dual sensory impairment</a>. Combined vision and hearing loss <a href="https://doi.org/10.1177/0264619613490519">describes</a> any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is <a href="https://doi.org/10.1016/j.annepidem.2012.02.004">increasingly common</a> as people get older. The experience can make older people feel isolated and unable to participate in important conversations, including about their health. <h2>Causes and conditions</h2> Conditions related to hearing and vision impairment often <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">increase as we age</a> – but many of these changes are subtle. Hearing loss can start <a href="https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/highlighting-priorities-for-ear-and-hearing-care">as early as our 50s</a> and often accompany other age-related visual changes, such as <a href="https://www.mdfoundation.com.au/">age-related macular degeneration</a>. Other age-related conditions are frequently prioritised by patients, doctors or carers, such as <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview">diabetes or heart disease</a>. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our <a href="https://hdl.handle.net/2123/29262">research</a> told us <blockquote> I don’t see too good or hear too well. It’s just part of old age. </blockquote> <h2>An invisible disability</h2> Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts <a href="https://doi.org/10.1080/09638280210129162">social activities and communication</a>, making it difficult for older adults to manage. It is underdiagnosed, underrecognised and sometimes misattributed (for example, to <a href="https://doi.org/10.1093/geronb/gbz043">cognitive impairment or decline</a>). However, there is also growing evidence of links between <a href="https://doi.org/10.1002/dad2.12054">dementia and dual sensory loss</a>. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, <a href="https://doi.org/10.1002/dad2.12054">feel happy and be safe</a>. A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us: <blockquote> There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else. </blockquote> <h2>Isolated yet more dependent on others</h2> Global trends show a worrying conundrum. Older people with dual sensory impairment become <a href="https://doi.org/10.1002/dad2.12054">more socially isolated</a>, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing. One aspect of this is how effectively they can <a href="https://doi.org/10.1001/jamanetworkopen.2020.25522">comprehend and communicate in a health-care setting</a>. Recent research shows <a href="http://dx.doi.org/10.3390/healthcare12080852">doctors and nurses in hospitals</a> aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, <a href="https://www.mdpi.com/2227-9032/12/8/852">researchers note</a>. It facilitates: <ul> <li>shorter hospital stays</li> <li>fewer re-admissions</li> <li>reduced emergency room visits</li> <li>better treatment adherence and medical follow up</li> <li>less unnecessary diagnostic testing</li> <li>improved health-care outcomes.</li> </ul> <h2>‘Too hard’</h2> Globally, there is a better understanding of how important it is to <a href="https://www.who.int/publications/i/item/9789240030749">maintain active social lives</a> as people age. But this is difficult for older adults with dual sensory loss. One person told us <blockquote> I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people. </blockquote> Again, these experiences increase reliance on family. But caring in this context is tough and largely <a href="https://doi.org/10.3389/feduc.2020.572201">hidden</a>. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring <a href="https://doi.org/10.1159/000507856">frustration, social isolation and depression</a> for carers too. One spouse told us: <blockquote> He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair. </blockquote> So, what can we do? Dual sensory impairment is a growing problem with potentially devastating impacts. It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers. We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to <a href="https://www.tandfonline.com/doi/full/10.1080/09649069.2019.1627088">navigate health care</a>. Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, Lived Experience Research Fellow, Centre for Disability Research and Policy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, Postdoctoral research fellow, Department of Linguistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-keep-away-from-people-combined-vision-and-hearing-loss-is-isolating-more-and-more-older-australians-232142">original article</a>.

Body

Country singer dies aged 79

Country singer Kinky Friedman has passed away aged 79. A post shared on his social media account confirmed the news that he was surrounded by family and friends before his death. “Kinky Friedman stepped on a rainbow at his beloved Echo Hill surrounded by family and friends,” the post read. “Kinkster endured tremendous pain and unthinkable loss in recent years but he never lost his fighting spirit and quick wit. Kinky will live on as his books are read and his songs are sung.” The musician, whose real name is Richard Samet Friedman, developed a cult following for his unique and quirky approach to country and Western music. His first album Sold American was released in 1973, and he also toured with Bob Dylan on his Rolling Thunder Revue. Outside of his music career, Friedman was also a writer, penning detective novels and a working as a columnist for Texas Monthly. He published his first book Elvis, Jesus and Coca-Cola: A Novel in 1994 and ten years later published his second one, Kinky Friedman’s Guide to Texas Etiquette: Or How to Get to Heaven or Hell Without Going Through Dallas-Fort Worth. In 2006 he dabbled in politics, running for the Governor of Texas and received 12.6 per cent of the votes among six candidates. He also helped run the Echo Hill Gold Star Camp for children, with his sister Marcie. Kent Perkins, a longtime friend of Friedman, paid tribute to the musician on social media. “Somewhere in heaven,” he wrote, “I’m sure there’s a quiet corner with a big easy chair, a bright floor lamp, a big stack of biographical books, and a few old dogs wagging their tails to the faint smell of cigar smoke.” Image: Rick Diamond/ Shutterstock Editorial

Caring

First lady of Australian television dies aged 92

Renowned Australian children’s presenter Dawn Kenyon has died aged 92. Kenyon, originally Dorothy Dingwell, was born in Toowoomba in 1932 and made her TV debut in 1956, the same year that it was introduced in Australia. She became the country's first female host of children's show, with her appearance on Captain Fortune, and was later referred to as the “first lady of Australian television”. Known affectionately as Miss Dawn, she hosted several early Australian children's shows and became a household name with her role on Channel Seven’s Romper Room in the late 1950s, almost a decade before ABC’s Play School made its debut in 1966. In addition to her on screen roles, she also made significant contributions behind the scenes as a producer and screenwriter. A year after she made her TV debut, she married Fred Kenyon, a British TV engineer, and they share three children, Steven, Peter and Anne. After her marriage she chose to step away from her presenting career and relocated to England when her husband accepted a job there. Her legacy endured, with her friends in the media industry paying tribute to her as news broke of her death. “Dawn was always a shining light,” Australian journalist Anita Jacoby said. “She was so often the first to greet us, introduce us to new families, and lead us deeper into that magic of the Merry Makers,” 60 Minutes’ Jeff McMullen said. Image: National Archives of Australia/ news.com.au

Caring

Hollywood legend Donald Sutherland dies at age 88

Legendary Hollywood actor Donald Sutherland has died at the age of 88 after a battle with an ongoing illness. The actor, known for his roles in M*A*S*H, Klute and The Hunger Games, passed away on Thursday in Miami, his agency confirmed. Donald's actor son Kiefer announced his father's death in an emotional post on Instagram, reflecting on his illustrious career. “With a heavy heart, I tell you that my father, Donald Sutherland, has passed away,” he began. “I personally think one of the most important actors in the history of film. Never daunted by a role, good, bad or ugly." “He loved what he did and did what he loved, and one can never ask for more than that. A life well lived.” <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C8cgckJJ548/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C8cgckJJ548/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Kiefer Sutherland (@kiefersutherland)</a> </div> </blockquote> Tributes from past colleagues have flooded social media, as director Ron Howard reflected on working with the iconic actor. "I was blessed to direct him in Backdraft. One of the most intelligent, interesting & engrossing film actors of all time," he wrote on X (formerly Twitter). "Incredible range, creative courage & dedication to serving the story & the audience with supreme excellence." Helen Mirren, who co-starred with Sutherland in 2017's The Leisure Seekers, also paid tribute to her late friend, saying in a statement, "Donald Sutherland was one of the smartest actors I ever worked with. He had a wonderful enquiring brain, and a great knowledge on a wide variety of subjects." "He combined this great intelligence with a deep sensitivity, and with a seriousness about his profession as an actor. This all made him into the legend of film that he became." Sutherland’s career spanned more than 50 years and 140 film credits and earned an Emmy for his role as a Soviet official in the fact-based HBO movie Citizen X, as well as a pair of Golden Globes. Sutherland’s big break came when he was cast as one of The Dirty Dozen in the star-studded 1967 film, before landing a role in the movie version of M*A*S*H, and also playing alongside Jane Fonda in her Oscar-winning portrayal of a high-class “call girl” in the crime mystery Klute. Image credits: Ace Pictures/Shutterstock Editorial

Caring

"Terrifies me": Tracy Grimshaw reveals her biggest fears around ageing

Tracy Grimshaw has headed back to TV alongside alongside Dr Nick Coatsworth in a new medical series Do You Want To Live Forever? In an interview with 9Entertainment, the journalist explained why she chose to return to TV, after standing down from A Current Affair in 2022 following 17 years on the show. She explained that what pulled her to the medical series was "the extreme end of longevity." "People who shake the tree always fascinate me, particularly if they're putting their bodies on the line," she said. "It's so new, some of this stuff... that's probably what brought me in, but we're not just going to be at that end of the whole longevity discussion. "We're talking to people on how they can improve their quality of life and address issues that might lead to a premature death." In the interview she also revealed her own fears on ageing, especially what she finds most terrifying about it. "I'm not too scared about the passage of time," she began. "The only thing that scares me about getting older is becoming feeble." "Alzheimer's terrifies me. My brain has always been I think the best part of me, and it would be really sad to lose that." The show itself follows four pairs of everyday Aussies, including sisters from The Block, Eliza and Liberty, husband and wife, Enver and Eliana, partners Luke and Taylor, and father and son duo Duncan and Tom, as they undergo medically supervised trials and health interventions that may provide clues to help us live longer. Image: Channel 9

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