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Offering end of life support as part of home care is important – but may face some challenges

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Earlier this month, the government announced <a href="https://theconversation.com/the-government-has-a-new-plan-for-residential-aged-care-heres-whats-changing-238765">major changes</a> to aged care in Australia, including a A$4.3 billion <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">investment in home care</a>.</p> <p>Alongside a shake up of home care packages, the Support at Home program will include an important addition – an <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">end of life pathway</a> for older Australians.</p> <p>This pathway will allow access to a <a href="https://www.health.gov.au/our-work/support-at-home/features">higher level</a> of in-home aged care services to help Australians stay at home as they come to the end of their life. Specifically, it will provide an extra A$25,000 for palliative support when a person has three months or less left to live.</p> <p>This is a positive change. But there may be some challenges to implementing it.</p> <h2>Why is this important?</h2> <p>Older people have made clear their preference to remain in their homes as they age. For <a href="https://journals.sagepub.com/doi/10.1177/0269216313487940">most people</a>, home is where they would like to be during their last months of life. The space is personal, familiar and comforting.</p> <p>However, data from the <a href="https://www.abs.gov.au/statistics/research/classifying-place-death-australian-mortality-statistics">Australian Bureau of Statistics</a> shows most people who die between the ages of 65 and 84 die in hospital, while most people aged 85 and older die in residential aged care.</p> <p>This apparent gap may reflect a lack of appropriate services. Both palliative care services and GPs have an important role in providing medical care to people living at home with a terminal illness. However, being able to <a href="https://grattan.edu.au/wp-content/uploads/2014/09/815-dying-well.pdf">die at home</a> relies on the availability of ongoing support including hands-on care and assistance with daily living.</p> <p>Family members and friends often provide this support, but this is not always possible. Even when it is, carers may <a href="https://pubmed.ncbi.nlm.nih.gov/38533612/">lack confidence and skills</a> to provide the necessary care, and may not have enough support for and respite from their carer role.</p> <p>The palliative care funding offered within Support at Home should help an older person to remain at home and die at home, if that is their preference.</p> <p>Unless someone dies suddenly, care needs are likely to increase at the end of a person’s life. Supports at home may involve help with showering and toileting, assessing and addressing symptoms, developing care plans, managing medications, wound dressing, domestic tasks, preparing meals, and communicating with the person’s family.</p> <p>Occupational therapists and physiotherapists can assist with equipment requirements and suggest home modifications.</p> <p>End of life supports may also involve clarifying goals of care, contacting services such as pharmacists for medications or equipment, liaising with organisations about financial matters, respite care or funeral planning, as well as acknowledging grief and offering spiritual care.</p> <p>But we don’t know yet exactly what services the $25,000 will go towards.</p> <h2>What do we know about the scheme so far?</h2> <p>The Support at Home program, including the end of life pathway, is scheduled to start from <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">July 1 2025</a>.</p> <p>We know the funding is linked to a prognosis of three months or less to live, which will be determined <a href="https://www.abc.net.au/news/2024-09-15/new-payment-aims-to-make-it-easier-for-people-to-die-at-home/104347984">by a doctor</a>.</p> <p>Further information has indicated that an older person can be referred to a <a href="https://www.health.gov.au/our-work/support-at-home/features">high-priority assessment</a> to access the end of life pathway. We don’t know yet what this means, however they don’t need to be an existing Support at Home participant to be eligible.</p> <p>The pathway will allow 16 weeks to use the funds, possibly to provide some leeway around the three-month timeline.</p> <p>Although more details are coming to light, there are still some things which remain unclear.</p> <p>Home care providers will be looking for details on what can be covered by this funding and how they will work alongside primary care providers and health-care services.</p> <p>Older people and their families will want to know the processes to apply for this funding and how long applications will take to be reviewed.</p> <p>Everyone will want to know what happens if the person doesn’t die within three months.</p> <h2>Some challenges</h2> <p>Ready availability of appropriate supports and services will be crucial for older people accessing this pathway. Home care providers will therefore need to assess how an end of life pathway fits into their operational activities and how they can build the necessary skills and capacity.</p> <p>Demand for nurses with palliative care skills and allied health professionals is likely to increase. Providing end of life care can be <a href="https://pubmed.ncbi.nlm.nih.gov/33096682/">especially taxing</a> so strategies will be needed to prevent staff burnout and encourage self-care.</p> <p>How pathways are implemented in rural and remote areas and in different cultural and community groups will need to be monitored to ensure all older people benefit.</p> <p>Effective coordination and communication between home care, primary care and specialist palliative providers care will be key. Digital health systems that connect the sectors could be helpful. Family engagement will also be very important.</p> <p>Escalation pathways and referral pathways should be established to enable appropriate responses to emergencies, unexpected deterioration, and family distress.</p> <p>Finally, <a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-023-01155-y">accurately determining</a> when someone will die can be difficult. Knowing when the last three months of life starts may not be easy, particularly where frailty, cognitive issues and multiple health concerns may be present.</p> <p>This might mean some people are not seen as being ready for this pathway. Others may not be willing to accept this prognosis. An older person may also be expected to live with a terminal illness for many months or years. Their palliative care needs would not be met under this pathway.</p> <p>Despite these challenges, the announcement of an end of life pathway within the home care program is timely and welcome. As a population we are living longer and dying older. More details will help us be better prepared to implement this scheme.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/239296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, Matthew Flinders Professor and Director of the Research Centre for Palliative Care, Death and Dying, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/offering-end-of-life-support-as-part-of-home-care-is-important-but-may-face-some-challenges-239296">original article</a>.</em></p> </div>

Retirement Life

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"We all come to an end": Beloved comedian's heartbreaking message from palliative care

<p>Scottish comedian Janey Godley has made an emotional announcement to her social media followers, sharing that she is now in palliative care. </p> <p>Godley was forced to cancel her tour after developing sepsis from her cancer treatments, and is now receiving end of life care after a years long battle with ovarian cancer. </p> <p>"So I'm now in palliative care and I am at end-of-life care now in the hospital," the 63-year-old said in a video posted to Instagram. </p> <p>"The chemo ran out of options, and I just couldn't take any more of it," she continued, adding that the "has spread, so it looks like this will be getting to near the end of it, and it's really difficult to speak about this and say it to people."</p> <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/reel/DAWJ3Qgt-Rx/?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/reel/DAWJ3Qgt-Rx/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Janey Godley (@janeygodley)</a></p> </div> </blockquote> <p>She went on to thank the hospital staff for their efforts, and family and friends for supporting her and husband Sean Storrie and their daughter Ashley through her illness. </p> <p>"It is devastating news to know that I'm facing the end of life but we all come to an end sometime," she continued. </p> <p>"I don't know how long I've got left before anybody asks. I'm not on TikTok so I just want you all to know that I appreciate all the love you've given me."</p> <p>She wished everyone a "lovely Christmas", adding, "I might be here, who knows? But I just want you to know I'm sending all my love to people living with a life-limiting disease."</p> <p>The news comes just weeks after Godley was forced to cancel her tour after developing sepsis while undergoing treatment. </p> <p>An official statement shared, "Janey has been living with stage four ovarian cancer for the past few years and the treatment from the wonderful Scottish NHS has kept the disease at bay, but sadly in the last few weeks the cancer has returned and there have been a few added complications."</p> <p><em>Image credits: Instagram</em></p>

Caring

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Red tape threatens to remove a man with Down's syndrome from his elderly mother

<p>An elderly mother and her disabled son are at risk of being separated over the woman's aged care home's red tape. </p> <p>Anne Deans, 81, moved into an aged care facility in July and hoped that she would be able to bring her son, Mark, who suffers from Down's syndrome with her. </p> <p>Mark, 56, has always lived with his mother, and despite his disability, has lived a full life and has dabbled in acting, appearing on Aussie TV hit <em>Blue Heelers</em>.</p> <p>But now, the mother and son have been left in limbo by a bureaucratic battle. </p> <p>Despite the family's history and Mark's disability, the government refuses to fund a place for Mark at Anne's aged care home, stating that aged care is "not an appropriate service for people aged under 65".</p> <p>"People with Down's syndrome have a life expectancy of 60 years. That's if we're lucky. So Mark is experiencing all of the age issues that my Mum is," Mark's sister Sharon said.</p> <p>Sharon and her sister Michelle have been lobbying on Mark's behalf, with Michelle saying, "I don't know why it's so hard. There's so much red tape."</p> <p>"There's so many hills to jump, just to have a mum and a son together. It doesn't make any sense."</p> <p>Anne is digging in and appealing to the Minister for Aged Care Anika Wells for help. </p> <p>"I brought him up all these years, and all of a sudden someone's going to walk in and take him out," Anne told <a href="https://9now.nine.com.au/a-current-affair/victoria-red-tape-threatens-to-tear-man-with-disability-from-his-mum/df4ef75b-6df1-4507-8a73-dfae0b258e08" target="_blank" rel="noopener"><em>A Current Affair</em></a>.</p> <p>"It is damn ridiculous. They should open up their eyes and see what it's doing. He's not going anywhere. I don't know how I'm going to stop it, but I will."</p> <p>In a statement, Ms Wells said, "While Aged Care is generally not suitable for people under the age of 65, we recognise there are exceptional circumstances where people may need to enter aged care before this age, including when there is no suitable accommodation for them."</p> <p>"The New Aged care Act includes exceptional circumstances for people to enter Aged Care before they turn 65, including when they would otherwise be at risk of homelessness."</p> <p>"There are processes in place to support people to explore their options and ensure they have safe and appropriate accommodation."</p> <p>"We encourage Mark to continue to work with Ability First Australia and the Aged Care Assessment Teams to explore all the options."</p> <p><em>Image credits: A Current Affair </em></p>

Family & Pets

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Is it worth selling my house if I’m going into aged care?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/colin-zhang-1234147">Colin Zhang</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>For senior Australians who cannot live independently at home, residential aged care can provide accommodation, personal care and general health care.</p> <p>People usually think this is expensive. And many assume they need to sell their home to pay for a lump-sum deposit.</p> <p>But that’s not necessarily the case. Here’s what you need to consider.</p> <h2>You may get some financial support</h2> <p>Fees for residential aged care are complex and can be confusing. Some are for your daily care, some are means-tested, some are for your accommodation and some pay for extras, such as cable TV.</p> <p>But it’s easier to think of these fees as falling into two categories:</p> <ul> <li> <p>an “entry deposit”, which is usually more than <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/eighth-report-on-the-funding-and-financing-of-the-aged-care-industry-july-2020-eighth-report-on-the-funding-and-financing-of-the-aged-care-industry-may-2020.pdf">$A300,000</a>, and is refunded when you leave aged care</p> </li> <li> <p>daily “<a href="https://www.myagedcare.gov.au/aged-care-home-costs-and-fees">ongoing fees</a>”, which are $52.71-$300 a day, or more. These cover the basic daily fee, which everyone pays, and the means-tested care fee.</p> </li> </ul> <p>To find out how much government support you’ll receive for both these categories, you will have a “<a href="https://www.myagedcare.gov.au/income-and-means-assessments/#aged-care-home">means test</a>” to assess your income and assets. This means test is similar (but different) to the means test for the aged pension.</p> <p>Generally speaking, the lower your aged-care means test amount, the more government support you’ll receive for aged care.</p> <p>With full support, you don’t need to pay an “entry deposit”. But you still need to pay the basic daily fee (currently, <a href="https://www.myagedcare.gov.au/aged-care-home-costs-and-fees">$52.71</a> a day), equivalent to 85% of your aged pension. If you get partial support, you pay less for your “entry deposit” and ongoing fees.</p> <h2>You don’t need a lump sum</h2> <p>You don’t have to pay for your “entry deposit” as a lump sum. You can choose to pay a rental-style daily cost instead.</p> <p>This is calculated as follows: you multiply the amount of the required “entry deposit” by the maximum permissible interest rate. This rate is set by government and is currently at <a href="https://www.health.gov.au/sites/default/files/documents/2021/03/schedule-of-fees-and-charges-for-residential-and-home-care-schedule-from-20-march-2021_0.pdf">4.01%</a> per year for new residents. Then you divide that sum by 365 to give a daily rate. This option is like borrowing money to pay for your “entry deposit” via an interest-only loan.</p> <p>You can also pay for your “entry deposit” with a combination of a lump sum and a daily rental cost.</p> <p>As it’s not compulsory to pay a lump sum for your “entry deposit”, you have different options for dealing with your family home.</p> <h2>Option 1: keep your house and rent it out</h2> <p>This allows you to use the rental-style daily cost to finance your “entry deposit”.</p> <p><strong>Pros</strong></p> <ul> <li> <p>you could have more income from rent. This can help pay for the rental-style daily cost and “ongoing fees” of aged care</p> </li> <li> <p>you might have a special sentimental attachment to your family house. So keeping it might be a less confronting option</p> </li> <li> <p>keeping an expensive family house will not heavily impact your residential aged care cost. That’s because any value of your family house above <a href="https://www.health.gov.au/sites/default/files/documents/2021/03/schedule-of-fees-and-charges-for-residential-and-home-care-schedule-from-20-march-2021_0.pdf">$173,075.20</a> will be excluded from your <a href="https://www.servicesaustralia.gov.au/organisations/health-professionals/services/aged-care-entry-requirements-providers/residential-care/residential-aged-care-means-assessment">means test</a></p> </li> <li> <p>you can still access the capital gains of your house, as house prices rise.</p> </li> </ul> <p><strong>Cons</strong></p> <ul> <li> <p>your rental income needs to be included in the means test for your aged pension. So you might get less aged pension</p> </li> <li> <p>you might need to pay income tax on the rental income</p> </li> <li> <p>compared to the lump sum payment, choosing the rental-style daily cost means you will end up <a href="https://www.smh.com.au/money/super-and-retirement/seek-help-when-weighing-up-how-to-pay-for-your-aged-care-20191202-p53g16.html">paying more</a></p> </li> <li> <p>you are subject to a changing rental market.</p> </li> </ul> <h2>Option 2: keep your house and rent it out, with a twist</h2> <p>If you have some savings, you can use a combination of a lump sum and daily rental cost to pay for your “entry deposit”.</p> <p><strong>Pros</strong></p> <ul> <li> <p>like option 1, you can keep your house and have a steady income</p> </li> <li> <p>the amount of lump sum deposit will not be counted as an asset in the pension means test.</p> </li> </ul> <p><strong>Cons</strong></p> <ul> <li> <p>like option 1, you could have less pension income, higher age-care costs and need to pay more income tax</p> </li> <li> <p>you have less liquid assets (assets you could quickly sell or access), which could be handy in an emergency.</p> </li> </ul> <h2>Option 3: sell your house</h2> <p>If you sell your house, you can use all or part of the proceeds to pay for your “entry deposit”.</p> <p><strong>Pros</strong></p> <ul> <li> <p>if you have any money left over after selling your house and paying for your “entry deposit”, you can invest the rest</p> </li> <li> <p>as your “entry deposit” is exempt from your aged pension means test, it means more pension income.</p> </li> </ul> <p><strong>Cons</strong></p> <ul> <li>if you have money left over after selling your house, this will be included in the aged-care means test. So you can end up with less financial support for aged care.</li> </ul> <h2>In a nutshell</h2> <p>Keeping your house and renting it out (option 1 or 2) can give you a better income stream, which you can use to cover other living costs. And if you’re not concerned about having access to liquid assets in an emergency, option 2 can be better for you than option 1.</p> <p>But selling your house (option 3) avoids you being exposed to a changing rental market, particularly if the economy is going into recession. It also gives you more capital, and you don’t need to pay a rental-style daily cost.</p> <hr /> <p><em>This article is general in nature, and should not be considered financial advice. For advice tailored to your individual situation and your personal finances, please see a qualified financial planner.</em></p> <p><em>Correction: this article previously stated the amount of lump sum deposit will not be counted as an asset in the aged-care means test, as a pro of option 2. In fact, the amount of lump sum deposit will not be counted as an asset in the pension means test.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/161674/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/colin-zhang-1234147"><em>Colin Zhang</em></a><em>, Lecturer, Department of Actuarial Studies and Business Analytics, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/is-it-worth-selling-my-house-if-im-going-into-aged-care-161674">original article</a>.</em></p> </div>

Retirement Income

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

<div class="theconversation-article-body"> <p><em><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></em></p> <p>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.</p> <p>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.</p> <p>So what changes is the government making to home care packages? And what will these changes mean for ageing Australians?</p> <h2>Reducing waiting times</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Changes to services</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Some challenges</h2> <p>For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What about unpaid care at home?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p><em>More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/tracy-comans-696663"><em>Tracy Comans</em></a><em>, 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 &amp; Senior Principal Research Fellow, National Ageing Research Institute, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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>.</em></p> </div>

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Landmark aged care reforms set to benefit millions of Aussies

<p>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. </p> <p>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. </p> <p>"$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. </p> <p>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. </p> <p>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. </p> <p>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.</p> <p>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. </p> <p>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.</p> <p>New aged care quality standards will also be implemented to improve the sector and drive higher-quality care. </p> <p>The government also promised more resources to investigate and penalise bad behaviour by providers. </p> <p>Albanese said the reforms will be the "greatest improvement" to the aged care sector in 30 years. </p> <p>“This is about caring for the generation that cared for us,” he said. </p> <p>“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.”</p> <p>Aged Care Minister Anika Wells said the changes would lead to more services for older Australians.</p> <p>“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.</p> <p>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. </p> <p><em>Images: Shutterstock</em></p>

Caring

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Drunk couple forces emergency landing after mid-air meltdown

<p>A Ryanair flight to Ibiza had to be diverted after a drunk couple allegedly assaulted cabin crew and other passengers. </p> <p>The plane, carrying holiday-makers from Manchester to Ibiza had to make an emergency landing in Toulouse, where police hauled the intoxicated passengers off the plane. </p> <p>A British traveller on the flight, who asked to remain anonymous, recalled the man "swigging duty free vodka" on the first hour of the flight, before he started arguing with a male cabin crew member and punched him in the face. </p> <p>As they tried to restrain him, the intoxicated man assaulted another passenger and spat at a woman, hurling verbal abuse at her. </p> <p>“He was kicking off with everyone, he was out of control,” the witness said.</p> <p>Flight attendants reportedly warned him that the flight would have to be diverted if he didn't calm down, but he replied: “I don’t give a f***.” </p> <p>The altercation lasted for about 40 minutes until Flight FR2626 had to land in Toulouse, and 12 police officers took him away in custody. </p> <p>Video of the attack showed the man shouting and swearing at the police, before assaulting another traveller as he was being escorted off the flight. </p> <p>After he left the plane, his partner started harassing another traveller, hitting him and calling him a "paedo". </p> <p>In another video, police were filmed physically restraining the woman, before removing her from the plane. </p> <p>The flight spent just over an hour and a half on the tarmac at the Toulouse-Blagnac Airport before continuing its journey to Ibiza.</p> <p>Just last week Ryanair chief executive Michael O’Leary called for flyers to be limited to two drinks at airports to crack down on disorderly behaviour on flights. </p> <p>“We don’t want to begrudge people having a drink," he said. </p> <p>“But we don’t allow people to drink-drive, yet we keep putting them up in aircraft at 33,000ft.</p> <p>“In the old days, people who drank too much would eventually fall over or fall asleep. But now those passengers are also on tablets and powder.</p> <p>“It’s the mix. You get much more aggressive behaviour that becomes very difficult to manage.”</p> <p>The airline has started carrying out hand luggage checks to stop passengers on flights to Ibiza and the Greek islands from smuggling duty-free alcohol on-board. </p> <p>A Ryanair spokesperson has apologised for the incident saying:  “This flight from Manchester to Ibiza diverted to Toulouse after a small group of passengers became disruptive in-flight." </p> <p>“The crew called ahead for police assistance, who met the aircraft upon landing at Toulouse and offloaded two passengers before this flight continued to Ibiza.</p> <p>“We sincerely apologise to passengers for any inconvenience caused as a result of these unruly passengers’ behaviour, which was beyond Ryanair’s control. This is now a matter for local police.”</p> <p><em>Image: news.com.au</em></p>

Travel Trouble

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New details and pics emerge after baby scalded by stranger in Brisbane park

<p>New photos and details have emerged of the nine-month-old baby who was scalded by a stranger in a park in Brisbane.</p> <p>Police have alleged that a man, between 30 and 40 years old, tipped hot coffee over a baby in Hanlon Park on Wednesday before <a href="https://oversixty.com.au/finance/legal/manhunt-after-stranger-pours-scalding-hot-coffee-on-baby-in-public-park" target="_blank" rel="noopener">fleeing the scene</a>. </p> <p>On Thursday morning, police released new images of a man they wish to speak to in relation to the alleged assault.</p> <p>Police said the man was of an average build and with tanned skin and was wearing a black hat, glasses, a checkered button-up shirt and shorts at the time of the attack. </p> <p>The plea from police comes after an image of the baby in hospital was released, with the nine-month-old completely wrapped in bandages. </p> <p>After the incident, the baby was rushed to Queensland Children's Hospital and has since undergone surgery for burns to his face and chest, reportedly suffering serious burns to 60 per cent of his body including his face, neck, chest and arms.</p> <p>A friend of the baby's mother, Zara Mazza, shared an update with <em>The Project</em> on Wednesday night, recalling how she was sitting down with her own son and looked up to see a man standing above her friend’s nine-month-old baby. </p> <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/C_Nruwavg67/?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/C_Nruwavg67/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Project (@theprojecttv)</a></p> </div> </blockquote> <p>“This man was standing above him, behind him, and poured a Thermos of hot coffee over him. He just started screaming,” she told the program.</p> <p>Ms Mazza said she tried to chase the man but he was “very fast”, and she tripped while attempting to keep up.</p> <p>“Essentially all I could hear was his mum screaming that it’s hot. ‘It’s hot, it’s hot coffee’, so I ran back and as I ran back picked up my water bottle and dumped it over him,” she said.</p> <p>“I removed him from his mum and we laid him down on the picnic rug and we peeled his clothes away, which revealed the peeling of his skin, his skin had started to blister.”</p> <p>Bystanders reportedly came over with filled water bottles to pour over the baby, before a nurse in training offered up a shower at her nearby apartment so water could constantly be running on him.</p> <p>“Very grateful. The ambulance came really quickly, I think it was within five minutes. Police, too,” Ms Mazza said.</p> <p>“It was chaotic. It happened really quickly.”</p> <p>The baby’s mother is reportedly “really traumatised” after the incident, as Ms Mazza said, “She’s got a lot of anxiety right now. She’s not been able to sleep very well, if at all. So definitely struggling.”</p> <p>“Bub is in a stable condition … they say that he’ll need regular dressing changes under anaesthetic over the next weeks. They don’t know how long, but, yeah. It’s gonna take a while.”</p> <p><em>Image credits: 7News / Queensland Police</em></p>

Caring

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"Pure terror" after Jetstar passenger climbs out onto wing

<p>A passenger onboard a Jetstar flight from Sydney to Melbourne has recalled the "commotion" when a man opened the emergency door just seconds after the plane landed. </p> <p>Audrey Varghese was on the flight that landed at Tullamarine airport on Thursday morning, and said the trouble began when the man became very agitated as soon as the plane touched down. </p> <p>“It’s assumed common knowledge that you stay in your seats until the seatbelt sign is turned off, but he got up as the plane was still moving," the 2GB producer told <em><a href="https://7news.com.au/news/jetstar-passenger-reveals-commotion-as-man-climbs-through-emergency-door-onto-wing-c-15792138" target="_blank" rel="noopener">7News</a></em>. </p> <p>“The cabin crew were sort of shocked at the fact that he would even do that.”</p> <p>When the plane eventually came to a stop, Varghese said the man charged to the emergency exit rows and forced passengers out of their seats to get to the emergency door. </p> <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/reel/C-9OACGPBco/?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/reel/C-9OACGPBco/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by 7NEWS Sydney (@7newssyd)</a></p> </div> </blockquote> <p>The man then managed to open the emergency exit door and climbed out onto the wing of the plane, causing terror among the rest of the passengers.</p> <p>“There was a bit of a commotion. It was hectic, everyone was screaming,” Varghese said.</p> <p>“It was just pure terror. People were so terrified of what could possibly have gone wrong.”</p> <p>Video capture of the incident shows the man standing on the wing before sliding down the emergency slide, only to be met with police as he reached the ground. </p> <p>The AFP said officers arrested a man for “alleged aggressive behaviour and breaching aircraft safety protocols” and charges were likely to be laid.</p> <p>The remaining passengers safely disembarked the aircraft but had to wait about 45 minutes for their luggage, as the emergency slide had blocked the cargo door.</p> <p>Varghese added that Jetstar were "really good" about the luggage delays, and said the cabin crew did a “great job” handling the situation.</p> <p><em>Image credits: 7News</em></p>

Travel Trouble

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Chilling videos emerge from mum accused of murdering schoolgirl

<p><em><strong>Warning: This article contains distressing content that some readers may find upsetting. </strong></em></p> <p>Chilling videos have emerged from the mother accused of killing her 10-year-old daughter, Sophie Wang. </p> <p>Yingying Xu, who was named in court on Wednesday, posted a series of videos to TikTok before she allegedly murdered her daughter. </p> <p>“I want to let everyone know that the situation you see is fake. Fake god, the antichrist is a fake god,” Xu, 46, said while speaking in Mandarin.</p> <p>“I have felt the devil Satan saying to me how he has been influencing me, disturbing my soul.</p> <p>“Eventually possessing me 100 per cent. Possessing my soul to do evil things.”</p> <p>The videos were posted earlier in the day on Tuesday, and the little girl's body was found by her father, Yun Wang, later that evening.</p> <p>Sophie is alleged to have suffered several<a href="https://www.oversixty.com.au/finance/legal/schoolgirl-identified-after-allegedly-being-murdered-by-mother" target="_blank" rel="noopener"> injuries</a>, and was  allegedly killed by having her throat slashed in her Carrara home.</p> <p>Her father, who is an associate professor at Griffith University, could reportedly be heard screaming by neighbours after discovering her body. </p> <p>Paramedics attempted to revive the girl, but she was declared dead at the “incredibly confronting” scene.</p> <p>Xu was arrested in a nearby street hours later and charged with murder.</p> <p>“This is absolutely sickening, gut-wrenching, awful,” Queensland Premier Steven Miles said.</p> <p>“I just can’t imagine how that father felt and hearing the reports of him screaming - nobody would ever wish that on him.”</p> <p>Her mother was formally remanded in custody until she appears in court again on November 29. </p> <p>The family's home remains a crime scene, but flowers have been left outside the home, as the local community try to come to terms with the horrific news. </p> <p>Police are continuing to investigate the motive of the alleged murder, and are taking into account Xu's social media activity. </p> <p>“Police are continuing to investigate the motive of the alleged homicide, including social media activity of the accused,” police told <em>7News</em>.</p> <p>Sophie has been remembered as a caring, kind and high-achieving Year 5 student, with the local community honouring her memory in an hour-long vigil on Friday at The Boulevard in Emerald Lakes.</p> <p>Sophie’s school, Emmanuel College, is also offering counselling to students, staff and parents.</p> <p>“Our prayers are with the family, friends, first responders and all affected by the loss of this beloved child in her home,” the school said in a statement.</p> <p><em>Images: Emmanuel College /TikTok</em></p>

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WHO declares new global health emergency

<p>The World Health Organisation (WHO) has declared the spread of mpox a global public health emergency, after sounding the alarm following the dramatic rise of cases in Africa. </p> <p>Concerned about the increase in infections in the Democratic Republic of Congo, which has subsequently spread to at least 10 neighbouring countries, the WHO quickly convened a meeting of experts to study the outbreak.</p> <p>“Today, the emergency committee met and advised me that in its view, the situation constitutes a public health emergency of international concern. I have accepted that advice,” WHO chief Tedros Adhanom Ghebreyesus told a <a href="https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern" target="_self">press conference</a> on Wednesday. </p> <p>A PHEIC is the highest level of alarm under the International Health Regulations, which are legally binding in 196 countries.</p> <p>“The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” said Dr Tedros.</p> <p>“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives. This is something that should concern us all.”</p> <p>Since January 2022, 38,465 cases and 1456 deaths have been reported in Africa due to mpox, with cases surging 160 per cent and deaths 19 per cent in recent months compared to 2023. </p> <p>Dr Tedros said the more than 14,000 cases and 524 deaths reported so far this year in DR Congo had already exceeded last year’s total.</p> <p>“The emergence last year and rapid spread of clade 1b in DRC, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring DRC is especially concerning,” he said, citing Burundi, Kenya, Rwanda and Uganda.</p> <p>Maria Van Kerkhove, the WHO’s epidemic and pandemic preparedness and prevention director, insisted, “We can stop transmission of mpox with a concerted effort.”</p> <p>However, she said experts needed a “much better understanding of the epidemiology” and the transmission patterns of the virus, which would help make sure the limited number of vaccines could be deployed to best effect.</p> <p>Two vaccines for mpox are recommended by WHO immunisation experts.</p> <p>Formerly called monkeypox, the virus was first discovered in humans in 1970 in what is now the DRC.</p> <p>Mpox is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.</p> <p>The disease causes fever, muscular aches and large boil-like skin lesions.</p> <p>A PHEIC has only been declared seven times previously since 2009, over H1N1 swine flu, poliovirus, Ebola, Zika virus, Ebola again, Covid-19 and mpox.</p> <p><em>Image credits: Manuel Romano/NurPhoto/Shutterstock Editorial </em></p>

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Tragic new details emerge after three-time mayor found dead at just 45

<p>Three-time Maribyrnong mayor Sarah Carter was found dead at her home on Tuesday, </p> <p>Now, her devastated mother Gaynor Morris has broken her silence and revealed that Carter was due to fly to Europe with her partner, Nikki Roy, but never made it to the airport. </p> <p>“She hadn’t made it to the airport to meet him for their holiday together,” Morris told the <em>Herald Sun</em>.</p> <p>“He (Roy) went and checked on her and he literally found her dead.</p> <p>“No-one knows anything different unfortunately.”</p> <p>She was treated by emergency services at her home in Maribyrnong, Victoria at 3:45pm on Tuesday but unfortunately could not be saved.</p> <p>Her cause of death is not yet known but Victoria police has confirmed that her death is not being treated as suspicious. </p> <p>Carter's mother said that Roy was  “absolutely heartbroken”.</p> <p>“I think she sets a great example for everybody and there’s a lot of people that will miss her. I am very proud,” she added.</p> <p>Carter was a councillor on Maribyrnong Council, in Melbourne’s west, which covers suburbs including Footscray, Yarraville and Tottenham as well as Maribyrnong. </p> <p>She was first elected to office in 2008 and was the first woman who served as mayor of Maribyrnong three times. </p> <p>Many believed that her political career could go beyond council boundaries. </p> <p>“Children’s champion, community leader, Labor through and through. The best of us,” Former Labor leader and current minister Bill Shorten said in a tribute to Carter. </p> <p>“My thoughts are with her family and loved ones in this difficult time.”</p> <p>Labor MP Tim Watts added that her  “energy was limitless”.</p> <p>“She had an impact on so many people’s lives.</p> <p>“She gave so much of herself and wanted to give so much more. She’s been taken from us far too soon.</p> <p>“It’s a terrible loss to our community and our country”.</p> <p><em>Images: Instagram</em></p>

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Cruise worker shares what you should always take into a lifeboat

<p dir="ltr">A cruise ship worker has shared the six essentials you should always take if you ever need to get into the lifeboat on a cruise. </p> <p dir="ltr">Lucy Southerton, who has worked on cruise ships for nine years, regularly shares cruising advice on social media to help travellers get the most out of their voyage. </p> <p dir="ltr">In her most recent video, Lucy shared invaluable advice on what items you should take on a lifeboat in the event of an emergency. </p> <p dir="ltr">While many people would instinctively leave all their belongings behind in an emergency, Lucy said there are six things you should always take. </p> <p dir="ltr">The first thing to bring in the event of an emergency is your documentation, such as a form of ID, such as a passport, driving licence or even a visa.</p> <p dir="ltr">The second thing may surprise some people, as Southerton recommends always having lip balm in case of emergencies. </p> <p dir="ltr">The cruise worker said, “[In a life-threatening situation] the body prioritises the distribution of water to essential organs such as the liver and the brain.” </p> <p dir="ltr">“Because of this, the lips receive no water so they are going to dehydrate faster, meaning they could crack. If you are in a lifeboat for a long period of time, your lips are going to be one of the first things that suffer so you should protect them at all costs.”</p> <p dir="ltr">Thirdly, Lucy recommends you should always have sunscreen, as you never know how long you will be exposed to the elements for. </p> <p dir="ltr">She said, “If you are sitting directly under the hatch or where they take the roof off to let the breeze in, you're going to want a hat or sun cream to protect yourself from the beating sun.”</p> <p dir="ltr">“This is not as much of a priority as lip balm, but if you can get hold of some sun cream before entering a lifeboat then you should.”</p> <p dir="ltr">Next up, the veteran cruise-ship worker said you should always take layers of clothes that you can easily take on and off in changing weather.</p> <p dir="ltr">Lucy's penultimate item that passengers should always take on a lifeboat might seem obvious but she warned that it is essential for those who take medication on a regular basis to bring it with them. </p> <p dir="ltr">However, she added, “What they don't tell you to take is stuff like paracetamol, ibuprofen, aspirin, Sudocrem and ointments.” </p> <p dir="ltr">“'While you may not need these types of medication, somebody else on your lifeboat might - it's better to have it and not need it than the reverse scenario. Just shove them in your pocket just in case.”</p> <p dir="ltr">Last but not least, Lucy said you should - as obvious and essential as it may seem - never forget to take water on board a lifeboat. </p> <p dir="ltr">She stressed that “there is only so much water you can fit in a lifeboat, so the water is going to be rationed out”. </p> <p dir="ltr">Lucy continued, “If you can take extra water on board with you, do it, even if it's just in the form of an extra water bottle. [Humans] cannot last long without water so make sure you grab some if you are able to.”</p> <p dir="ltr">Finishing up the video, Lucy reassured passengers that “getting into a lifeboat is the absolute last resort”, adding that it is more likely that anyone on board the ship is taken to an assembly station while emergency services on board attempt to fix any issues that could arise. </p> <p dir="ltr"><em>Image credits: Instagram / Shutterstock </em></p> <p></p>

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

<div class="theconversation-article-body"> <p><em><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></em></p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Good nutrition is essential for healthy ageing</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Understanding more about who is malnourished in aged care can help providers better address this problem.</p> <h2>Malnutrition is an ongoing problem in aged care</h2> <p>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.</p> <p>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.</p> <p>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%.</p> <p>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.</p> <p>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.</p> <h2>What can we do about it?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>As such, our teams at Monash and Griffith universities are focusing on strategies that minimise the burden on staff and providers.</p> <p>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.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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>.</em></p> </div>

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Wild conspiracy theory emerges over leaked horse cruelty video

<p>The equestrian world continues to reel after <a href="https://www.oversixty.com.au/finance/legal/leaked-footage-shows-olympic-star-s-horrific-animal-abuse" target="_blank" rel="noopener">a controversial video surfaced</a> showing British dressage star Charlotte Dujardin whipping a horse 24 times, described by critics as "like a circus elephant".</p> <p>However, the timing of the video's release, just days before the Olympics, has led to allegations of sabotage from within the British dressage community.</p> <p>In a statement to members, British Dressage Chief Jason Brautigam condemned Dujardin's actions as "completely unacceptable" but expressed skepticism about the motives behind the leak. "I do find claims that this was done to 'save dressage' somewhat disingenuous, given that it was timed to cause maximum damage to our sport," Brautigam wrote. He urged members to be kind to Dujardin, acknowledging the human element in the controversy.</p> <p>Madeline Hall, a former dressage correspondent for <em>Horse & Hound</em> magazine, echoed Brautigam's sentiments. Speaking to <em>The Daily Mail</em>, Hall remarked, "The timing of this video days before the Olympics smells of sabotage. To me, it is suspect."</p> <p>The video's release has led to significant fallout for Dujardin, including the loss of sponsorships and a tarnished reputation, jeopardising her chance to become Britain's most decorated female Olympian.</p> <p>The identity of the individual who leaked the video remains unknown, though the complainant's lawyer, Stephan Wensing from the Netherlands, has refused to comment on the matter. Wensing's involvement has fuelled speculation, given the historic rivalry between the British and Dutch equestrian teams.</p> <p>The Dutch team, which Dujardin defeated at the Tokyo Olympics in 2021, have quickly distanced themselves from the incident. A spokesperson for the Netherlands team stated, "We regret the expulsion of our fellow athlete but also condemn the training method used by Dujardin in the video. This has no place in our equestrian sports, where the welfare of the horse comes first."</p> <p>As the dressage community grapples with the scandal, Brautigam reminded people of the need for a compassionate response. "Charlotte Dujardin has done the right thing by <a href="https://www.oversixty.com.au/travel/travel-trouble/no-excuse-olympic-legend-quits-days-before-paris-games-commence" target="_blank" rel="noopener">accepting responsibility and expressing remorse</a>," he said. "While we do not condone her behaviour, we must remember that there is also a human element to this – and, regardless of what has happened, she still deserves our understanding."</p> <p>Dujardin, who was a favourite for a Damehood if she secured a medal in Paris, now faces an uncertain future in her sport. The dressage community continues to debate the ethical and competitive implications of the video, with calls for increased focus on the welfare of horses and the integrity of the sport.</p> <p><em>Images: Instagram / Good Morning Britain</em></p>

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Wild reason why woman divorced her husband

<p>A woman has asked for advice online after she explained the wild reason why she is divorcing her husband. </p> <p>Taking to Reddit's popular "Am I The A**hole?" thread, the mother explained that after her husband sat in the car for too long, she decided to end her two-year marriage. </p> <p>As she began to recall the situation, she prefaced the story by saying that for many years, her partner always liked to stay in the car five to 10 minutes after he got home.</p> <div> <div id="sda-INARTICLE"></div> </div> <p>“I don’t know why he does it, but he talked about a past traumatic experience he had when he came home and caught his ex cheating on him,” the Redditor wrote. “Because of that he’d just spend few minutes in his car before he enters his home as response to his trauma.”</p> <p>While the woman is understanding of her husband's unusual car quirk, she said he does not take into account how it negatively impacts her and their family. </p> <p>According to the Reddit writer, his prolonged period in the car makes her “uneasy” and has caused several arguments, especially when he’s sat in the driveway when guests are inside, or "when dinner is waiting on him and he’d take 10 minutes silently sitting in the car.”</p> <p>She went on to share that her biggest concern was finding her husband sitting in the car during a crisis, which was realised when a family emergency unfolded at home. </p> <p>The woman explained that her eight-year-old son fell and tripped when walking down the stairs, breaking his ankle as a result and needed to be taken to hospital.</p> <p> She then called her husband and asked if he could leave work to take him to the emergency room, saying, “Then I called and called and then I was stunned when I looked out the window and I saw him sitting outside the house in his car. I was both shocked and angry.”</p> <p>According to her husband, he had been sitting in the car for eight minutes and said that he wouldn’t come inside to help until his 10 minutes lapsed because he didn’t feel “comfortable.”</p> <p>The original poster noted, “He told me to get my son ready to take him to the hospital, but I started screaming at him nonstop telling him this was a family emergency and that he was out of his mind to behave like that.”</p> <p>The mother took her son to the hospital with the help of a neighbour and refused to answer her husband's calls when he finally emerged from the car. </p> <p>Later, she decided his response was so uncalled for that she took herself and her son to her mother's place and said she wanted a divorce from her husband of two years. </p> <p>“He tried to rationalize and justify what he’s done saying he could not help it and that he was nervous and wanted to help my son but felt stuck,” the Redditor said.</p> <p>She continued, “I refused to reply to his messages and days later his family literally harassed me saying I was making my husband’s trauma more severe and that I disrespected his boundaries.”</p> <p>After time had passed from the situation, the woman wondered if she had been too rash in her decision, and asked those online for their advice. </p> <p>Her post was met with hundreds of comments, with many saying they believe her husband is suffering from obsessive-compulsive disorder (OCD). </p> <p>“It sounds like some form of OCD to me,” one person commented, while another agreed: “It sounds like he is stuck in a compulsive behavior.”</p> <p>The original writer confessed she had asked him to seek professional help for his behaviours, but he wasn’t up for it, saying, "He had refused professional help and his family sided with him.”</p> <p>To this, one reader added, “The fact that he has refused to seek help for it. Peak selfishness. Leaving is warranted. Best luck to you and your boy.”</p> <p>“If he refused professional help then you have your answer. You need to be able to rely on your husband in case of an emergency and he proved to you that you can’t. You’re definitely NTA (not the a**hole,” another argued.</p> <p><em>Image credits: Shutterstock </em></p>

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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"><em><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></em></p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Australians are ageing</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Why don’t enough people want to work in aged care?</h2> <p>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.</p> <p>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%.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;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&amp;q=45&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=337&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=423&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">The manufacturing workforce has declined, while health, aged care and social assistance has risen.</span> <span class="attribution"><span class="source">ABS 6291.0.55.001 Labour Force, Australia.</span></span></figcaption></figure> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What are the consequences?</h2> <p>An understaffed and under-trained aged care workforce reduces access to services and the quality of care and support.</p> <p>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.</p> <p>Staff shortages are already having an impact on residential care occupancy rates falling, with some regional areas now down to only 50% occupancy.</p> <p>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.</p> <p>Inevitably, lack of aged care workers puts pressure on hospital services when older people have nowhere else to go.</p> <h2>What needs to be done?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Registration, qualifications and training for direct care work have to become mandatory to make sure care standards are met.</p> <p>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.</p> <p>“Learn and earn” incentives, including scholarships and traineeships for aged care, are needed to attract the future workforce.</p> <p>At the same time, a much broader investment in upskilling the entire workforce through continuing professional development and good quality supervision is necessary.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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>.</em></p> </div>

Caring

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Doctor shares her holy grail tips for overcoming eye sensitivity

<p>As the chill of winter sets in, many people find that their eyes become more sensitive and prone to dryness. This can be particularly challenging for those who already suffer from dry eye syndrome. </p> <p>Dr. Jacqueline Beltz is a leading Australian Ophthalmologist and the founder of <a href="https://www.okkiyo.com" target="_blank" rel="noopener">OKKIYO</a>, a beauty brand that makes PRIORITEYES mascara for people with sensitive eyes.</p> <p>Dr Beltz has shared her insights into dry eye syndrome and how winter can exacerbate symptoms, also sharing her top tips for managing eye sensitivity during the colder months.</p> <p><strong>Understanding Dry Eye Syndrome</strong></p> <p>The surface of the eye is covered by a delicate layer of tears, essential for comfort, vision, protection, and nutrition. The tear film comprises two main layers: an outer lipid (oily) layer and an inner aqueous (watery) layer. The lipid layer, produced by oil glands in the eyelids, prevents tears from evaporating too quickly, while the aqueous layer, consisting of water, electrolytes, and proteins, spreads tears evenly across the eye and helps them adhere to the surface.</p> <p>When the balance of tear production, evaporation, absorption, and drainage is disrupted, it can lead to dry eye syndrome. Symptoms may include redness, irritation, a gritty sensation, tired eyes, itching, excessive watering, and fluctuating vision. In severe cases, dry eye can be painful and significantly impact daily life.</p> <p><strong>How common is dry eye syndrome?</strong></p> <p>Dry eye syndrome is a widespread issue, particularly among older adults. According to the Blue Mountains Eye Study, 57% of adults over the age of 50 experience some degree of dry eye. This condition is notably more prevalent in women, with higher rates observed compared to their male counterparts. The increased prevalence in women is often attributed to hormonal changes, particularly during and after menopause. </p> <p>A more recent study, Optometry Australia’s 2022 Vision index found that over 85% of Australians are estimated to have experienced dry eyes at some point in their lives.  Of those affected, 55% say they only developed the condition following the beginning of the pandemic in 2020.  They reported that almost 1 in 5 (18%) of people experience dry eye symptoms frequently.  </p> <p>These statistics highlight the importance of understanding and managing dry eye, especially as we age.</p> <p><strong>DEWS II Study and Treatment Approaches</strong></p> <p>The DEWS II (Dry Eye Workshop II) study provides a comprehensive framework for understanding and treating dry eye syndrome. According to the study, dry eye is a multifactorial disease characterised by a loss of homeostasis (or balance) in the tear film, accompanied by eye symptoms. Factors such as tear film instability, hyperosmolarity (increased saltiness), inflammation, and neurosensory (altered feelings or sensations) abnormalities play significant roles.</p> <p>There are two primary types of dry eye: aqueous deficient and evaporative. Most individuals have a combination of both. Aqueous deficient dry eye occurs when there is insufficient production of the watery layer of tears, often due to aging, hormonal changes, or certain medications. Evaporative dry eye is typically caused by environmental factors or conditions affecting the lipid layer, such as meibomian gland dysfunction (MGD).</p> <p><strong>Winter's Impact on Dry Eyes</strong></p> <p>Winter poses unique challenges for dry eye sufferers. Cold, dry air, indoor heating, and wind can all exacerbate symptoms. Here's how to combat these winter-specific issues:</p> <p><em><strong>1. Humidify Your Environment</strong></em></p> <p>Indoor heating reduces humidity levels, leading to increased tear evaporation. Consider using a humidifier to maintain moisture in the air, especially in bedrooms and living spaces. This helps keep your eyes hydrated.</p> <p><em><strong>2. Protect Your Eyes Outdoors</strong></em></p> <p>Cold winds can strip away the tear film. When outside, wear wraparound sunglasses to shield your eyes from the elements. This not only protects your eyes from the wind but also from UV rays, which can be strong even in winter.</p> <p><em><strong>3. Stay Hydrated</strong></em></p> <p>Dehydration can worsen dry eye symptoms. Drink plenty of water throughout the day to maintain overall hydration, which supports healthy tear production.</p> <p><em><strong>4. Optimise Your Diet</strong></em></p> <p>Certain foods can promote eye health. Omega-3 fatty acids, found in fish like salmon and flaxseeds, have anti-inflammatory properties that can help manage dry eye symptoms. Incorporate these into your diet for added benefits.</p> <p><em><strong>5. Use a Warm Compress</strong></em></p> <p>A warm compress can help improve the function of the meibomian glands, which produce the oily layer of the tear film. This is particularly helpful for those with meibomian gland dysfunction, or MGD. Gently apply a warm, damp cloth to your closed eyelids for 10-15 minutes, followed by a gentle massage of the eyelids to encourage oil secretion. It is important to avoid rubbing or compressing the eyeballs.</p> <p><em><strong>6. Use Over-the-Counter Lubricant Eye Drops</strong></em></p> <p>Artificial tears can provide temporary relief by supplementing the natural tear film. Choose preservative-free options to avoid further irritation, and use them frequently.</p> <p><em><strong>7.  Remember to have regular eye checks</strong></em></p> <p>In Australia, Optometrists provide our primary eye health check ups. Dr Beltz recommends adults over the age of 40 see their optometrist once a year, but if you’re struggling with symptoms of dry eye in winter, an extra check up might help and your optometrist will be able to help you to come up with an individualised treatment plan.</p> <p><em><strong>8. Invest in Quality Eye Products</strong></em></p> <p>For those who wear makeup, using products designed for sensitive eyes is crucial. <a href="https://www.okkiyo.com/products/protect-and-preserve-mascara" target="_blank" rel="noopener">PRIORITEYES</a> mascara by OKKIYO has been specifically formulated to be gentle on sensitive eyes, avoiding common irritants while providing excellent performance.</p> <p><strong>Managing Dry Eye in Winter: A Recap</strong></p> <p>Winter can be tough on our eyes, but with the right strategies, you can manage dry eye symptoms effectively. Maintain a humid environment, protect your eyes from cold winds, stay hydrated, and incorporate eye-healthy foods into your diet. Regularly use warm compresses and opt for gentle, high-quality eye products like PRIORITEYES mascara.  </p> <p>Dry eye syndrome may be a common condition, but it doesn't have to dominate your life, especially during the harsh winter months. With these tips, you can keep your eyes comfortable and healthy all season long. For personalised advice and treatment, always consult with your eye care professional.</p> <p>Stay warm, stay hydrated and take care of your eyes this winter!</p> <p><em>Image credits: Shutterstock </em></p>

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Rare footage captures secluded tribe emerging from the Amazon

<p>Remarkable new footage has captured one of the world's most secluded tribes, who have been known for firing arrows at outsiders who get too close, as they emerged from the Amazon rainforest in Peru. </p> <p>The tribe were spotted near several controversial logging sites that have been making clearings throughout the forest, decimating their home lands.</p> <p>According to the Indigenous rights advocacy group Survival International, members of the Mashco Piro tribe, believed to be the biggest group of indigenous people living with no outside contact, were spotted near the Las Piedras River a few kilometres from tree-cutting projects in Southeastern section of the country.</p> <p>“This is irrefutable evidence that many Mashco Piro live in this area, which the government has not only failed to protect, but actually sold off to logging companies,” local Indigenous organisation Fenamad’s President Alfredo Vargas Pio said.</p> <p>Near the remote villages of Monte Salvado and Puerto Nuevo, the tribe emerged in search of food, with President Pio voicing concerns that violent fights could break out between loggers and the Indigenous people.</p> <p>He also added that the outside loggers could potentially bring new diseases to the area, which could wipe out the tribe.</p> <p>According to Survival International, Indigenous advocates have urged authorities to pull the certifications from the logging companies to protect the tribes. </p> <p>Logging company Canales Tahuamanu has been granted permission to log on the jungle land since 2002 with its invasive activity now sprawled out over 193 square miles, <em><a href="https://www.washingtonpost.com/world/2024/07/17/mashco-piro-tribe-photos-peru/" target="_blank" rel="noopener">The Washington Post</a></em> reported.</p> <p>The publication also reported that the firm also has a history of clashing with local tribes, although in the past, the firm said its workers have never reported seeing any Mashco Piro people and has complied with laws in Peru, where it is illegal to contact the tribe.</p> <p>Despite the Mashco Piro tribe’s seclusion, they have had limited contact with outsiders, with most of their rare contact resulting in violence, as they have been known for fire arrows at tourists boats and park rangers as warnings not to approach the area. </p> <p><em>Image credits: Survival International </em></p> <p> </p> <div class="media image side-by-side" style="caret-color: #000000; color: #000000; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none; box-sizing: inherit; margin-bottom: 24px; align-items: center; display: flex; flex-direction: column; width: 705.202209px; max-width: 100%;"> </div>

International Travel

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Planning a country escape these school holidays? 4 ways to avoid clogging up the emergency department

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/katherine-riley-1499452">Katherine Riley</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/rebekkah-middleton-314433">Rebekkah Middleton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>Winter school holidays are either here or coming up, depending on where in Australia you live. Maybe you’re planning a <a href="https://www.tra.gov.au/en/domestic/domestic-tourism-results">rural escape</a>.</p> <p>Rural tourism is crucial for job growth and sustainability of small rural towns. However, for rural emergency departments, <a href="https://www.abc.net.au/listen/programs/am/holiday-medico-shortages-in-rural-and-remote-australia/103266540">school holidays</a> are often the busiest times.</p> <p>No-one plans a trip to the emergency department on holidays. But if you need health care, there are often other ways of accessing it than turning up at a rural hospital.</p> <p>Here’s why it’s so important to leave rural emergency departments for life-threatening illness or injuries, and some other options for seeking care.</p> <h2>We’re short of doctors and nurses</h2> <p>The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health">reports</a> a significant shortfall of nurses and specialist doctors in rural towns compared with staffing levels in big cities.</p> <p>This means many small rural emergency departments only have nurses on staff, with doctors on call or consulted remotely from a larger hospital.</p> <p>In a <a href="https://www.sciencedirect.com/science/article/pii/S1755599X2300143X">study</a> published earlier this year, my colleagues and I discovered this dynamic was especially challenging for rural emergency nurses when critically ill patients presented.</p> <p>One nurse told us: "We need more staff. I mean, I look at these emergency TV shows, and you see them in Kings Cross at the big hospitals there or overseas, they get a phone call […] there’s a resus coming in. Everyone’s standing around the bed with all their signs on, the airway/circulation/team leader […] and here, we have two people. It’s just so different. It’s just a false sense of reality. It’s ridiculous."</p> <p>So emergency departments should be used for <a href="https://www.health.nsw.gov.au/Hospitals/Going_To_hospital/Publications/keep-ed-emergencies.pdf">emergencies only</a>. These include:</p> <ul> <li>sudden collapse</li> <li>chest pain or pressure lasting more than ten minutes</li> <li>breathing difficulty</li> <li>serious mental health condition</li> <li>uncontrollable bleeding.</li> </ul> <p>When emergency departments are used responsibly, this can reduce the pressure on staff. It ensures the most seriously ill receive the care they need promptly.</p> <h2>What are my alternatives?</h2> <p>Here are four ways you and your family can be better prepared for your rural holiday and avoid an unnecessary visit to the emergency department.</p> <p><strong>1. Pack your scripts and medical history summary</strong></p> <p>Bring essential scripts and medications with you. This reduces the need to visit the local emergency department and ensures you have what you need during your stay.</p> <p>Do you have a chronic condition or have had a recent illness or surgery? Make sure you speak to your GP before you go. They can provide a medical health summary that includes your recent treatments and medications. Alternatively, if you have access to <a href="https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record">My Health Record</a>, ask your GP to prepare a shared health summary and upload it to your record. If you need medical care, this summary will assist in a timely assessment.</p> <p><strong>2. Call Healthdirect, NURSE-ON-CALL or 13HEALTH depending on where you are</strong></p> <p><a href="https://www.healthdirect.gov.au/how-healthdirect-can-help-you">Healthdirect</a> is a 24-hour telephone health advice line (known as NURSE-ON-CALL in Victoria or 13HEALTH in Queensland). By calling the relevant number, you will be connected to a registered nurse who will ask a series of questions and provide evidence-based advice and guidance. The Healthdirect website also offers an interactive <a href="https://www.healthdirect.gov.au/symptom-checker">symptom checker</a> to advise whether you should see a GP, go to an emergency department, or manage your symptoms at home (or in this case, on holidays):</p> <ul> <li> <p><a href="https://www.healthdirect.gov.au">Healthdirect</a> - 1800 022 222</p> </li> <li> <p><a href="https://www.healthdirect.gov.au/nurse-on-call">NURSE-ON-CALL</a> (Vic) - 1300 60 60 24</p> </li> <li> <p><a href="https://www.qld.gov.au/health/contacts/advice/13health">13HEALTH</a> (Qld) - 13 43 25 84.</p> </li> </ul> <p><strong>3. Need a GP? How about GP telehealth services?</strong></p> <p>For minor health concerns or non-urgent issues, <a href="https://www.smh.com.au/national/nsw/how-emily-took-advantage-of-one-of-the-few-good-things-to-come-out-of-covid-20240507-p5fpg3.html">GP telehealth services</a> are a remote-access option that can be used when away from home. Before you go away, check with your GP to see if they offer a <a href="https://www.health.gov.au/topics/health-technologies-and-digital-health/about/telehealth">telehealth service</a>.</p> <p><strong>4. Go to an Urgent Care Clinic</strong></p> <p>The Australian government has funded the opening of <a href="https://www.health.gov.au/find-a-medicare-ucc/about">Urgent Care Clinics</a> across the country. These clinics provide medical assessment and care for urgent illnesses or injuries. They have been created as a solution to divert people away from busy emergency departments. But these Urgent Care Clinics are not suitable for people experiencing emergency or life-threatening conditions.</p> <p>Urgent Care Clinics are ideal for illnesses and injuries that would require urgent treatment such as gastroenteritis, minor infections, lacerations and back pain. Check <a href="https://www.health.gov.au/find-a-medicare-ucc">here</a> to find your closest clinic.</p> <hr /> <p><em>Please keep the emergency department for life-threatening illnesses or injuries, and if needed, call 000 for an ambulance immediately.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/232262/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/katherine-riley-1499452">Katherine Riley</a>, Lecturer, School of Nursing, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/rebekkah-middleton-314433">Rebekkah Middleton</a>, Associate Professor, School of Nursing, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/planning-a-country-escape-these-school-holidays-4-ways-to-avoid-clogging-up-the-emergency-department-232262">original article</a>.</em></p> </div>

Domestic Travel

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