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More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member.</p> <p>Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%.</p> <p>Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed.</p> <h2>What are compassionate grounds?</h2> <p>Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds.</p> <p><a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are:</p> <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> <p>The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness.</p> <p>The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded.</p> <p>You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan.</p> <p>People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible.</p> <h2>Why are people using this scheme more?</h2> <p>The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures.</p> <p>But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues.</p> <p>There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system.</p> <p>Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system.</p> <p>While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated.</p> <h2>Lack of clarity</h2> <p>As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation.</p> <p>For example, the meaning of “mental disturbance” is not defined.</p> <p>You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early.</p> <p>People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues.</p> <p>Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications.</p> <p>In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment.</p> <h2>A closed-loop system</h2> <p>Conflict of interest is another major issue.</p> <p>There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment.</p> <p>Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments.</p> <p>This raises important questions about the independence of the process, as well as professional ethics.</p> <p>Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds.</p> <p>Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight.</p> <h2>What is needed?</h2> <p><strong>1. Mandatory financial counselling</strong></p> <p>The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications.</p> <p><strong>2. Tightening of the criteria</strong></p> <p>Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited.</p> <p><strong>3. Better oversight</strong></p> <p>Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest.</p> <p>Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<!-- 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/239588/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/neera-bhatia-15189"><em>Neera Bhatia</em></a><em>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin 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/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>.</em></p> </div>

Money & Banking

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Climate change threatens Australian tourism more than is widely believed. Here’s why

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Right now, Australia is one of the <a href="https://www.weforum.org/publications/travel-tourism-development-index-2024/">top five</a> tourist destinations in the world, a distinction the World Economic Forum says it shares with only the United States, France, Spain and Japan.</p> <p>So important is tourism to Australia’s economy that the best estimates are it employs <a href="https://www.tra.gov.au/en/economic-analysis/state-of-the-industry">655,000</a> people, 12 times as many as <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/jul-2024">Australia’s coal industry</a>.</p> <p>And most of them are employed in <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">regional locations</a>, where jobs are scarce.</p> <p>This month a report by the Zurich insurance group and the economic consultancy Mandala found <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">half</a> of Australia’s top 178 tourism assets were at risk from foreseeable climate change.</p> <p>There are reasons to believe its findings underplay what we are facing.</p> <h2>All major airports, all national parks at risk</h2> <p>The Zurich-Mandala report examines the impact of a 2⁰C increase in global temperatures on only eight so-called “climate perils”: wind, flood, heat, storm, drought, bushfire, hail and rain.</p> <p>It found that more than half of Australia’s top tourism assets faced a “significant risk from multiple perils” over the next 25 years, including all of Australia’s major airports.</p> <p>Scheduling disruptions and the closure of airports in extreme weather conditions were set to have major impacts on the transport of goods, the transport of tourists and accessibility for emergency services.</p> <p>All of Australia’s vineyards, national parks, scenic roads and railways were at risk.</p> <p>Queensland had the highest number of sites facing significant risk (79%) followed by Western Australia (69%) and the Northern Territory (63%).</p> <p>The report uses the impact of the 2019-20 <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianBushfires">black summer bushfires</a> to estimate that 176,000 jobs might be at risk nationwide from predictable climate change, most of them outside of Australia’s capital cities.</p> <h2>Multiple and interacting threats</h2> <p>Here is why I am fearful that the report underplays the threat Australia’s tourism industry is facing.</p> <p>There are many more threats to tourism from climate change than wind, flood, heat, storm, drought, bushfire, hail and rain.</p> <p>One is the threat to biodiversity. Iconic animals and habitats are an important part of Australia’s brand.</p> <p><a href="https://www.abc.net.au/news/2020-07-28/3-billion-animals-killed-displaced-in-fires-wwf-study/12497976">Three billion</a> animals were killed or displaced in the black summer bushfires.</p> <p>The deaths caused <a href="https://www.theguardian.com/australia-news/2023/apr/01/alexis-wright-black-summer-bushfires-vigil-sydney-speech-3-billion-animals-killed-are-our-relatives-they-deserve-to-be-mourned">loss and grief</a> that risk indexes are incapable of capturing, but that nonetheless might make tourism less attractive.</p> <p>And biodiversity helps in another way by <a href="https://www.australianwildlife.org/wp-content/uploads/2019/12/Hayward-Et-Al.-2016-Could-biodiversity-loss-have-increased-Australias-bushfire-threat.pdf">protecting against bushfires</a>, meaning that as species vanish, other risks to tourism climb in ways that aren’t captured in the assumptions used to evaluate risk.</p> <h2>Threats unexamined</h2> <p>What makes holiday locations unattractive is hard to measure, but is fed by extreme weather events.</p> <p>Although temporary, the smoke and heat from the 2019-20 bushfires made parts of Sydney, Melbourne and Canberra almost unlivable for a while, damaging the reputations of Australian capital cities in a way that is <a href="https://www.smh.com.au/national/nsw/not-a-good-look-bushfire-smoke-threatens-to-pollute-sydney-s-tourist-image-20191206-p53hpl.html">probably ongoing</a>.</p> <p>Another curious omission, especially curious given that the report was prepared by an insurance company, is the damage extreme weather events do to the insurability of tourism assets.</p> <p>The report is also silent on the effort to reduce carbon emissions on Australia’s desirability as an international destination.</p> <p>For many tourists, air travel is the only way to get to Australia and it is likely to become more expensive and also less attractive as tourists try to reduce their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0959652614011810">carbon footprints</a>.</p> <p>Australia might increasingly become an Australian rather than an international destination.</p> <p>Our biggest upcoming international promotion, the 2032 Brisbane Olympic Games, might lose a good deal of its shine, with Queensland tourism assets at the greatest risk from climate change, and those risks set to climb over time.</p> <h2>The higher the temperature the bigger the threats</h2> <p>Zurich and the Mandala consultancy are to be commended for identifying 178 top tourism assets and examining eight types of risk they face.</p> <p>Their finding that just over half of them face serious threats from those risks is likely to be an underestimate because it excludes other risks and fails to examine the way in which some risks can intensify others.</p> <p>And they will be an underestimate if global temperatures climb by more than 2⁰C.</p> <p>The report says if global temperatures climb to 3⁰C above pre-industrial levels, 80% of the Australian sites it examined will face serious threats.</p> <p>Australia could attempt to limit the increase in global temperatures by taking up the opportunity to co-host the <a href="https://theconversation.com/its-a-big-deal-if-australia-and-the-pacific-are-chosen-to-host-un-climate-talks-heres-why-238320">2026 UN climate talks</a> with Pacific nations.</p> <p>It would give us a shot at making a difference and drawing attention to our present status as one of the world’s top tourism destinations.<!-- 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/238768/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/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, Adjunct professor and adjunct senior lecturer in tourism management, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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/climate-change-threatens-australian-tourism-more-than-is-widely-believed-heres-why-238768">original article</a>.</em></p> </div>

Domestic Travel

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How you can get the official Australian portraits of The King and Queen

<p>Royal fans nationwide can now request a special keepsake online for free. </p> <p>All Australians are entitled to their very own free portrait of King Charles and Queen Camilla. The way one can obtain the monarchy keepsake is through sending an email to their local federal MP requesting one. </p> <p>The initiative comes under the constituents' request program, which allows registered Australian voters to receive their own printed portrait of the royals. </p> <p>Official portraits of the King and Queen were provided to the Australian Government by Buckingham Palace in July and are available for public access. </p> <p>Photos available include a photo of the royal couple standing together, and seperate ones of the monarch and her majesty posing alone. </p> <p>In the photos the King and Queen both donned royal blue outfits and their Commonwealth Insignia, with the King wearing The Sovereign's Badge of the Order of Australia and the Queen wearing the Wattle Brooch.</p> <p>The portraits were taken by royal photographer Millie Pilkington in Buckingham Palace's White Drawing Room in June.</p> <p>The digital images can be downloaded for free from the Department of the Prime Minister and Cabinet <a href="https://www.pmc.gov.au/government/official-australian-portraits-king-and-queen" target="_blank" rel="noopener">website</a> for private use. Those who want a physical copy can request printed versions through  their Federal Member of the House of Representatives or Senator in their state or territory via email.</p> <p>The government-funded program, introduced in the Parliamentary Entitles Act 1990, is available for Australian citizens only.</p> <p><em>Image: <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Department of the Prime Minister and Cabinet/ </span>Millie Pilkington</em></p>

Art

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How cutting edge AI technology is helping doctors reduce waitlists

<div> <p>Artificial intelligence is now being used by Australian specialist doctors to reduce patient wait times and experts say it could be a game changer for the health sector, where some patients are waiting months or even years for an appointment.</p> </div> <div> <p>Leading Australian tech company <a title="https://www.medowhealth.ai/" href="https://www.medowhealth.ai/" data-outlook-id="ad0ccae0-1f97-484e-ba83-d8d566a7608a">Medow Health</a> has developed an AI “co-pilot” technology which automates medical reports for specialist doctors while operating in the background during patient consultations, saving clinicians hours  which allows them to see more patients each day. </p> </div> <div> <p>“This technology transforms the way medical reports are formulated and processed, helping specialists reduce their paperwork and freeing up valuable time and resources which can be better spent on patient care,” said Joel Freiberg who co-founded Medow Health with his brother after his own experience with a chronic illness coupled with watching their father who is a respiratory specialist dictate reports until 10pm from the dinner table, prompting them to come up with a more efficient way for clinicians to work.</p> </div> <div> <p>“The idea was to improve what really is an archaic reporting system, which saw specialists taking notes with their back to the patient during consultations or having to speak into a dictaphone to be transcribed later, instead of solely focusing on the patient in front of them,” Mr Freiberg said.</p> </div> <div> <p>The uptake from specialists utilising the new technology has been swift, with doctors reporting the technology is giving them back two to three hours a day, reducing burnout and allowing them to see multiple more patients in that time if they choose.</p> </div> <div> <p>“Instead of your doctor staring into the computer typing notes, they can really concentrate on your needs and wellbeing while the technology does the note taking in the background and creates an almost instant report that the doctor just has to review rather than formulate from scratch,” Mr Freiberg said.</p> </div> <div> <p>Data from the Australian Medical Association on “hidden waitlists” for a specialist outpatient appointment shows some people are languishing for years for an initial consultation - up to 800 days for an initial appointment for an Ear, Nose and Throat Surgeon, up to 898 days for an urgent appointment with a  neurosurgeon, while waitlists for a gastroenterologist or ophthalmologist can be as long as five years and up to 36 months to see a paediatrician.</p> </div> <div> <p>Mr Freiberg said the new cutting edge technology could supercharge a reduction in waitlists and speed up the appointment process.</p> </div> <div> <p>“We’re not trying to replace doctors, we’re trying to help them. Manually producing medical reports is a time-consuming and complex process that requires extensive paperwork and hours of labour-intensive work,” he said.</p> </div> <div> <p>“By using cutting edge AI specific to each medical specialty to examine patient interactions, formulate reports, and provide valuable insights we can enable doctors to do what they do best - focus on patient care,” Mr Freiberg said.</p> </div> <div> <p>Chris O’Brien Life House Chief Executive and medical oncologist Professor Michael Boyer who is on the Medow Health Clinical Advisory Council agreed the technology will improve patient care and help reduce waiting lists.</p> </div> <div> <p>"Any piece of technology that allows doctors to focus on the patient, helps deliver better care,” Prof Boyer said.</p> </div> <div> <p>"This technology helps the health professional to really turn their attention to the patient and what matters, instead of worrying about what notes they need and what letters they need to write. It allows them to focus on what is important.</p> </div> <div> <p>"There's no doubt this technology saves time and while it might only allow a single doctor to see an extra one of two patients a day, if you multiply that across the health system then it makes a big difference,” Prof Boyer said.</p> </div> <div> <p>Engagement with Medow Health is taking off in Australia, with the company reporting growth of more than 50 percent month on month across 15 different specialties including Cardiology, Gastroenterology, ENT, Geriatric, Orthopaedic Surgery, Paediatric, Neurology, General Surgery and Breast Surgeons, with some of Australia’s leading specialist doctors among the investors and Medtech Entrepreneurs to invest in its recent Seed round.</p> </div> <div> <p><strong>About Medow Health AI</strong></p> </div> <div> <p><em>Medow Health AI is a pioneering Australian based healthcare technology company dedicated to revolutionising the medical industry through the power of artificial intelligence to streamline processes, improve patient care, and enhance overall efficiency in healthcare settings.</em></p> </div> <div> <p><em> The company was founded by Joel Freiberg and soon after his brother Josh and former CTO and colleague Andrew joined as co-founders using their combined 30 years experience in technology and software to help build the business into the leading Specialist AI platform it is today.</em></p> </div> <div> <p><em>Joel lives with Crohn’s disease and has experienced long waits to see a specialist. The pair recognised there was a need for change growing up as they watched their father, a respiratory physician spend endless hours doing admin after work. </em></p> </div> <div> <p><em>The company has just completed a $1M funding round in the first half of 2024, grown the team to 10 full time employees and signed a partnership with Magentus the owner of leading specialist electronic medical record systems Genie &amp; Gentu (who Medow Health integrates with).</em></p> <p><em>Image credits: Shutterstock</em></p> </div>

Caring

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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>

Legal

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The hidden epidemic: How ageism affects Australians over 60

<p>Ageism, the stereotyping and discrimination against individuals or groups based on their age, is a pervasive issue that significantly impacts the daily lives of Australians over 60. While often overlooked, this form of prejudice can have far-reaching consequences on various aspects of life for older Australians. </p> <p><strong>Employment discrimination: barriers to work</strong></p> <p>One of the most prominent ways ageism impacts older Australians is through employment discrimination. Approximately 35% of individuals aged 55-64 report experiencing age-related discrimination in the workplace. This often manifests as difficulty in finding new jobs or securing additional work hours. Many qualified and experienced seniors find themselves overlooked for positions or passed over for promotions simply due to their age, despite their wealth of knowledge and skills.</p> <p><strong>Financial insecurity: a growing concern</strong></p> <p>The repercussions of employment discrimination often lead to financial insecurity among older Australians. Alarmingly, about 80% of Australians aged 65 and over rely at least partially on the Age Pension for their income. Even more concerning is that more than one in four older Australians live in poverty. This financial strain can severely impact quality of life, limiting access to healthcare, social activities, and basic necessities.</p> <p><strong>Negative stereotypes: the invisible senior</strong></p> <p>Society often views older people as frail onlookers rather than active participants. This perception can lead to patronising treatment and exclusion from various aspects of public life. Seniors may find themselves ignored in conversations, their opinions dismissed, or their capabilities underestimated. Such treatment can erode self-esteem and lead to a sense of worthlessness among older Australians.</p> <p><strong>Mental health: the psychological toll</strong></p> <p>The constant barrage of ageist attitudes and behaviours takes a significant toll on the mental health of older adults. Research has shown that ageism is associated with increased stress, anxiety and depression among seniors. It can also lead to lower life satisfaction, impacting overall well-being and quality of life. The psychological impact of feeling devalued or irrelevant in society should not be underestimated.</p> <p><strong>Healthcare discrimination: unequal access to treatment</strong></p> <p>Perhaps one of the most alarming manifestations of ageism is in healthcare. Some older Australians report being denied health services or treatment because of their age. This discrimination is particularly pronounced among those 90 and over, with 20% having experienced such treatment. This not only violates the principle of equal access to healthcare but can also have severe consequences for the health and well-being of older Australians.</p> <p><strong>Loss of independence: unwanted assistance</strong></p> <p>Many older Australians find their independence undermined by well-meaning but misguided attempts to help. About 21% of those over 50 report people insisting on doing things for them that they are capable of doing themselves. This can lead to a loss of confidence and a sense of helplessness, even when seniors are fully capable of managing their own affairs.</p> <p><strong>Social isolation: going it alone</strong></p> <p>Ageism can lead to social isolation, with 28% of those over 50 saying they have been ignored or made to feel invisible due to their age. This invisibility can occur in social settings, public spaces or even within families. Social isolation not only impacts mental health but can also lead to physical health issues and a decreased quality of life.</p> <p><strong>Technological exclusion: the digital divide</strong></p> <p>In our increasingly digital world, ageism manifests in assumptions about older adults' ability to use technology. About 36% of those over 50 say people have assumed they cannot understand or learn new technology. This stereotype can lead to exclusion from digital services, information and social connections, further isolating older Australians in a tech-driven society.</p> <p><strong>Workplace issues: feeling out of place</strong></p> <p>Even for those who remain in the workforce, ageism can create a hostile environment. A quarter of Australians in their 50s and 60s report feeling too old for their work. This sentiment can lead to decreased job satisfaction, lower productivity, and even early retirement, depriving workplaces of valuable experience and knowledge.</p> <p><strong>What to do about it</strong></p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">To combat ageism in Australia, a multi-faceted approach is necessary. This includes launching education and awareness campaigns to challenge stereotypes, implementing intergenerational programs to foster positive interactions between age groups, and introducing workplace initiatives to promote age-inclusive practices. </span></p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Policy and legislative changes are crucial to strengthen anti-discrimination laws, while improved media representation can help shift societal perceptions. </span></p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Empowering older adults through self-advocacy and promoting active ageing can showcase the valuable contributions of seniors. In healthcare, training professionals to avoid ageist practices is essential. </span></p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Ongoing research and data collection will inform evidence-based interventions, and promoting positive self-perceptions of ageing can help individuals challenge their own ageist beliefs. </span></p> <p>Addressing these issues requires a societal shift in attitudes towards ageing, policy changes to protect older Australians, and increased awareness of the valuable contributions seniors make to our communities. By implementing these strategies across various sectors, Australia can work towards creating a more age-inclusive society that values and respects individuals of all ages.</p> <p>Only by combatting ageism can we ensure that all Australians, regardless of age, can live with dignity, respect and full participation in society.</p> <p><em>Image: Shutterstock</em></p>

Retirement Life

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"So Australian": Local trust praised for response to illegal tree cutting

<p>A resident's decision to cut down a tree for a better view of Sydney Harbour has backfired after a sign was erected where the tree once stood, to condemn tree vandalism. </p> <p>Following multiple reports of resident carrying out tree vandalism along affluent streets, the Sydney Harbour Federation Trust has called out the behaviour by setting up the sign in the Sydney lower North Shore suburb of Woolwich. </p> <p>"Tree vandalism has occurred in this area," the sign read. </p> <p>"The Sydney Harbour Federation Trust protects and manages this land for the enjoyment of the public.</p> <p>"Acts of vandalism like this deprive all of us of the natural environment."</p> <p>The sign also warned that offenders could be subject to fines and/or prosecution as punishment, and urged those who notice any suspicious activity to contact 8969 2100. </p> <p>After an image of the sign was shared to a Sydney group on social media, the local trust's actions have been praised, with many saying they "loved how petty this is" and one even declaring the response  "so Australian". </p> <p>"I hope they keep this sign, as a reminder to anyone contemplating doing something similar," one commented.</p> <p>"We're petty but we have a right to be. You don't f**n poison or cut down trees. F**n unacceptable behaviour," another added. </p> <p>Others accused the person who cut down the tree of being "entitled". </p> <p>In last November alone, over 300 native trees and shrubs vanished in front of multi-million dollar homes along the Sydney Harbour waterfront strip.</p> <p>Lane Cove Council believe that hand tools were used to silently cut down the trees, which impacts plants, and local wildlife including wallabies, possums and dozens of other species. </p> <p>On Monday, the council put out a statement saying its "pursuit of justice" is now ramping up, referring to the incident as "the largest tree vandalism case in Lane Cove’s recent history".</p> <p>They are trying to obtain permission to put up a sign to block "the harbour view of the property which would most benefit from the mass clearing of the trees." </p> <p>"As the area is classified as a Threatened Ecological Community and contains some items of Aboriginal Heritage, it was important the appropriate approvals were in place before installing the signage," the council added.</p> <p>"The legal case and banner installation are important steps in our commitment to seeking the strongest possible recourse response to send a message that we stand tall against tree vandalism."</p> <p><em>Images: Reddit</em></p>

Legal

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11-year-old Australian girl identified as London stabbing victim

<p>The Department of Foreign Affairs and Trade (DFAT) has confirmed that the 11-year-old girl stabbed in Leicester Square in London on Monday is Australian.</p> <p>“Owing to our privacy obligations we cannot provide further comment,” a DFAT spokesperson said.</p> <p>The girl's mother, 34, was initially believed to have also been hurt, but UK police have confirmed that blood from her daughter's injuries had been mistaken for injuries of her own. </p> <p>The young girl was taken to hospital with serious but not life threatening injuries to the face, shoulder, wrist and neck area, and will require plastic surgery for the injuries she sustained. </p> <p>The DFAT are providing consular assistance to the pair reportedly from NSW, according to the <em>ABC</em>. </p> <p>A 32-year-old man, Ioan Pintaru, was arrested and appeared in court on Tuesday charged with the attempted murder. </p> <p>The girl and her mother were visiting the busy tourist area at the time of the random attack. </p> <p>Pintaru is a Romanian citizen with no fixed address, and spoke through a translator during the court hearing. </p> <p>Prosecutor David Burns told the court: "the defendant has approached the 11-year-old girl, placed her into a headlock and he has then stabbed her eight times to the body." </p> <p>Pintaru was detained by members of the public and allegedly found with a steak knife. </p> <p>Abdullah, a security who was working nearby during the random attack said he “heard a scream” before tackling the alleged offender to the ground.</p> <p>“I just saw a kid getting stabbed and I just tried to save her. It’s my duty to just save them,” he told the <em>Press Association</em>.</p> <p>“I jumped on him, held the hand in which he was [carrying] a knife, and just put him down on the floor and just held him and took the knife away from him.”</p> <p>He performed CPR on the child before emergency services arrived at the scene. </p> <p>Police have said that Pintaru did not know the girl or her mother and do not believe the stabbing was terror-related. </p> <p>Pintaru was remanded in custody and is due to appear in court again on September 10. </p> <p><em>Images: 9News</em></p>

Caring

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Your legacy. Their future. Will you be the difference in an uncertain world?

<p>Connection. Safety. Friendship. Family. When you <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">leave a gift in your Will for Australian Red Cross</a>, there’s no end to the difference you can make.</p> <p>Just ask Elsie. At 95 years old, Elsie has been transformed by weekly visits from Fiona, her Red Cross volunteer. For Fiona, her visits to see 95-year-old nursing home resident Elsie quickly turned into a family affair. </p> <p>"My children, Tom and Meg, have become very attached to her and vice versa. They're like, 'Are you going to see Elsie, can we come too?' They see how lovely it is to be kind to someone like Elsie," says Fiona. "Elsie tells me, 'You're my special family.'"</p> <p>Fiona's dog, Mia, is even a regular visitor at the Tasmanian nursing home. "Mia's like a celebrity. All the residents love her."</p> <p>The family marks all the big milestones with Elsie, like Christmas Day when they brought her home for a special morning tea. "When she turned 95 in December, we took her to a café. She said that was the best birthday she'd had for a long time."</p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_01.jpg" alt="" width="1280" height="720" /></p> <p><em>Elsie celebrating her birthday with Fiona's children, Tom and Meg. </em></p> <p>It is very much a two-way friendship, says Fiona. "I wasn't expecting it to be like that. I thought it was going to be more me doing lots of things for Elsie. But she gives back a lot."</p> <p>Like when Fiona's daughter, Meg, didn't pass her driver's license test. "Meg was quite upset. Elsie goes to her, 'That's why they invented pencils with rubbers at the end. They are there for you to rub out your mistakes, and then you can have another go.' </p> <p>"She's wise. She gives them little bits of advice and words of wisdom, and they listen to what she says … I can't believe she's 95 years old. Her mind is so unbelievably sharp."</p> <p>Fiona says that, lately, Elsie has not been as mobile as she was, and so they often spend their time together at the nursing home. "We find a nice spot and have a cuppa … She likes telling stories about her life. She talks a lot about her husband, her upbringing, people she's met.</p> <p>"Often, I'll bring her some magazines, or she will have asked me to get some stamps. And my kids have been great with her with technology, how to do this and how to do that. </p> <p>"We chat with other residents as well. Even though Elsie's our person, there are other people we've got to know. She introduces us as 'This is my family.'" </p> <p>Fiona says the first time they met, she and Elsie discovered they had much in common. They both grew up in the same country town and had travelled around Australia managing hotels.</p> <p>They care a lot about each other, she says. "I think it's given her more of a will to live. That sounds pretty deep, but I know how much she looks forward to seeing us; it's giving her more purpose in life.</p> <p>"Elsie always says, 'You make me feel so happy. I love seeing you, it's such a highlight.' I say it back to her because it's the same for me, 'I get so much joy out of seeing you.'"</p> <p>Fiona says she hopes her story inspires other people to volunteer, too.</p> <p>Your generosity, captured in your Will, can help fund programs like our Aged Care Volunteer Visitors Scheme and foster social connections like Elsie and Fiona’s. The program supports more than 1000 participants across the country with the majority between the ages of 78 and 89.</p> <p>Everybody deserves the warmth of kindness and friendship, and your Will can help Australian Red Cross share that with people for generations to come.</p> <p><a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener"><img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_02_wQRCode.jpg" alt="" width="1280" height="638" /></a></p> <p>If you would like a free <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">Will Planning Checklist</a>, or more information, our <a href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">Gifts in Wills Specialist</a> would love to help.</p> <p>You <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">get in touch here</a><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> or call 1800 733 276.</span></p> <p><em>All images: Supplied.</em></p> <p><em>This is a sponsored article produced in partnership with Australian Red Cross.</em></p>

Caring

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Pet cat lost in the outback ends in purr-fect reunion months later

<p>A beloved pet cat who went missing in the South Australian outback while on a road trip with his owner has been miraculously returned to his family months later.</p> <p>In June, Murry Rantall was travelling from Warnambook Victoria to Darwin in a caravan when he made a pit stop on the Stuart Hwy so his Burmese cat Raj could use the litter box. </p> <p>Rantall went for a walk and came back assuming that his 14-year-old feline friend was still inside so he drove off. </p> <p>It wasn't until 200km later, when he went to check on Raj, that he realised the cat was missing. </p> <p>“I was just about bawling … I knew he was in trouble,” Rantall said.</p> <p>Rantall who had recently lost his wife said that Raj was the only loved one he had left at home. </p> <p>“We were sort of looking after each other more or less,” Rantall said.</p> <p>He turned back to search for Raj, and even had his daughter, Katrina drive from Victoria to South Australia to help find the cat, but they had no luck. </p> <p>The feline was lost but not fur-gotten as Rantall's children put up Facebook posts about Raj missing in the South Australian outback. </p> <p>Two months later, the outback cat-astrophe ended with the purr-fect homecoming when Raj was found in Port Augusta, about 50km from where he ran away. </p> <p>Raj was found in Milla Dey’s backyard on Thursday, August 8.</p> <p>“I just saw that he was there and covered in prickles. We got him some food and water and he spent probably 15 to 20 minutes just eating,” Dey said.</p> <p>He was taken to a local vet to scan his microchip, but the details were outdated. </p> <p>Locals managed to track down Rantall's family on social media after seeing the Facebook posts about Raj, and they were reunited over the weekend. </p> <p>Rantall said Raj had lost a lot of weight but was content to be back in his arms.</p> <p>“We’ll feed him up, he’ll be all right,” Rantall said.</p> <p>Port Augusta City Council animal control officer Kylie McKerlie said the reunion was thanks to the care and dedication of the local community.</p> <p>“It’s just a really good town and a really good feeling for everyone,” she said.</p> <p>Rantall also thanked everyone who helped saying, “it’s unbelievable, the help I’ve had.” </p> <p><em>Images: 7News</em></p>

Family & Pets

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Retirement tips for Australians without a full superannuation safety net

<p>Most people who commenced paid work before the 1992 launch of compulsory employer contributions won’t have enjoyed money going into their retirement fund for the full duration of their working lives.</p> <p>Others have spent most or all of their adult lives as caregivers – stay-home parents, carers for elderly parents or relatives living with disability. Unquestionably valuable work, yet sadly unpaid – meaning no superannuation.</p> <p>Then there other factors impacting retirement savings – the gender pay gap, periods of unpaid leave, unemployment, working abroad, being a low income earner and more.</p> <p>So don’t think you are alone if you don’t have enough in superannuation for a comfortable retirement. </p> <p>Consider the following options to fall back on instead of, or as well as, your super:</p> <p><strong>Age pension</strong></p> <p>This is the most obvious alternative. What fewer realise, though, is that you may still be eligible for a part-pension, even if your assets exceed the eligibility threshold for the full amount.</p> <p>Claiming a part-pension will stretch what super you do have further. Plus, the related concession card entitles you to a range of discounts, reducing your living costs.</p> <p>Don’t overestimate the value of your assets under the pension means test – potentially denying yourself a legitimate source of income.</p> <p><strong>Semi-retirement</strong></p> <p>Consider transitioning to part-time work instead of retiring outright, allowing you to reduce your workload while still generating both income and employer contributions into your super.</p> <p>This could include self-employment – many retirees begin building a business out of their hobby or do paid consulting work within their industry (often a much higher hourly rate than as a permanent employee).</p> <p><strong>Your home</strong></p> <p>If you own your home, chances are you are sitting on a pile of equity. </p> <p>Yes, you would need to sell and move in order to unlock those funds. But it’s tax-free money. And it can be as much of a lifestyle opportunity as a financial one: downsize to a home with less maintenance needs; relocate nearer to grandkids; enjoy a seachange or treechange. </p> <p>Downsizer provisions also allow you to contribute a chunk of the proceeds into your superannuation over-and-above voluntary contribution caps.</p> <p><strong>Investments</strong></p> <p>Certain investments can deliver a lucrative passive income stream, which you can use in lieu of – or alongside – income from super. Think investment property rents, share dividends, even renting out your car/caravan/boat when you’re not using it.</p> <p>Or you could sell investments you own and use the proceeds to top up your super, which is typically more tax effective than holding as cash.</p> <p><strong>Family business/trust</strong></p> <p>If you have a family business or family trust, you may be able to draw down a regular income from it if structured correctly.</p> <p>Doing so over time from operating profits/investment returns, rather than as a lump sum, means a trust can continue as normal without being forced to sell assets or be wound up, while a business can continue trading under family ownership without the remaining directors having to find the cash to buy out your share (though this may be another option to explore with them).</p> <p><strong>Living costs</strong></p> <p>Your living costs are quite different in full-time retirement compared to full-time work. </p> <p>Goodbye to many commuting, clothing, personal grooming, professional development, registration/certification, lunches and coffees, and work-from-home expenses.</p> <p>Hello to greater energy bills (more time at home and no more remote working tax deductions), travel and lifestyle spending.</p> <p>Don’t overlook the power of updating your household spending and investments plan to reflect this new reality, cancel work-related outgoings and cut unnecessary spending.</p> <p><strong>Timing</strong></p> <p>Perhaps the most far-reaching, yet most commonly overlooked, aspect around retirement is timing. For instance:</p> <ul> <li>the later in the financial year you retire, the more employment income you have accrued – potentially pushing you into a higher tax bracket and ballooning your tax bill.</li> <li>the proceeds from investments differ depending on when in the market cycle you sell them.</li> <li>retiring early may reduce employment bonuses, leave payouts, share option entitlements etc.</li> <li>both spouses/partners retiring simultaneously may reduce overall employment earnings, while conversely unlocking greater opportunities to do things together (like travel, shared hobbies, visiting family).</li> </ul> <p>A qualified financial adviser can help you work through your various options and alternatives, allowing you the peace of mind to enjoy your golden years comfortably – whether that is with or without superannuation.</p> <p><em><strong>Helen Baker is a licensed Australian financial adviser and author of On Your Own Two Feet: The Essential Guide to Financial Independence for all Women. Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au/">www.onyourowntwofeet.com.au</a></strong></em></p> <p><em><strong>Disclaimer: The information in this article is of a general nature only and does not constitute personal financial or product advice. Any opinions or views expressed are those of the authors and do not represent those of people, institutions or organisations the owner may be associated with in a professional or personal capacity unless explicitly stated. Helen Baker is an authorised representative of BPW Partners Pty Ltd AFSL 548754.</strong></em></p> <p><em><strong>Image credits: Shutterstock </strong></em></p> <p><strong><em> </em></strong></p>

Retirement Income

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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>A growing number of complaints against older doctors has prompted the Medical Board of Australia to <a href="https://www.medicalboard.gov.au/News/2024-08-07-Medical-Board-consults-on-new-approach-to-keep-late-career-doctors-in-safe-practice.aspx">announce</a> today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.</p> <p>The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.</p> <p>The second would require only general health checks for doctors over 70.</p> <p>A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their <a href="https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx">professional code of conduct</a>, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.</p> <h2>Haven’t we moved on from set retirement ages?</h2> <p>It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “<a href="https://law.unimelb.edu.au/__data/assets/pdf_file/0019/2061019/02-Blackham.pdf">still valid in a modern society</a>”.</p> <p>However, unlike judges, doctors are already <a href="https://www.medicalboard.gov.au/Registration/Registration-Renewal.aspx">required to renew their registration</a> annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct <a href="https://www.ahpra.gov.au/Notifications/Further-information/Guides-and-fact-sheets/Performance-assessments.aspx">performance assessments</a> if and when they are needed.</p> <h2>What has prompted these proposals?</h2> <p>This latest <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD24%2f33840&amp;dbid=AP&amp;chksum=vCEdxXaBs0%2bMeMZFxSb7SQ%3d%3d&amp;_gl=1*3ol06k*_ga*MzU1NjAzMTc1LjE3MjMwMDA1Nzc.*_ga_F1G6LRCHZB*MTcyMzAwMDU3Ny4xLjEuMTcyMzAwMDU4My4wLjAuMA..">proposal</a> identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.</p> <p>Studies of medical competence in ageing doctors show <a href="https://qualitysafety.bmj.com/content/29/2/113">variable results</a>. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.</p> <p>The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.</p> <p>In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.</p> <p>In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.</p> <p>While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.</p> <p>It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.</p> <h2>So what distinguishes the two new proposed options?</h2> <p>The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.</p> <p>Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.</p> <p>Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.</p> <p>The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.</p> <p>In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.</p> <h2>The law tends to prioritise patient safety</h2> <p>All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/act/consol_act/hprnl428/s3a.html">That provision</a> basically says patient safety is paramount and trumps all other considerations.</p> <figure class="align-center zoomable"><figcaption></figcaption></figure> <p>As with legal <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2010-104a#sec.3">regimes regulating childcare</a>, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.</p> <p>Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3383892">punished</a>” for errors in practice.</p> <p>All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.</p> <h2>Could these proposals amount to age discrimination?</h2> <p>It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.</p> <p>For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/ada2004174/s22.html?context=1;query=inherent;mask_path=au/legis/cth/consol_act/ada2004174">who are</a> “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.</p> <p>In broader terms, a licence to practise medicine is often compared to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797044/">licence to drive</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236877/">pilot an aircraft</a>. Despite <a href="https://www.smh.com.au/national/nsw/mandatory-test-older-drivers-facing-discrimination-says-pensioner-group-20170607-gwm45u.html">claims of discrimination</a>, New South Wales law requires older drivers to undergo a medical assessment <a href="https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/older-drivers-and-riders/assessments">every year</a>; and similar requirements affect older <a href="https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;opi=89978449&amp;url=https://www.casa.gov.au/guidelines-medical-assessment-aviation&amp;ved=2ahUKEwil-9GXlOKHAxUdslYBHdN_EboQFnoECBkQAQ&amp;usg=AOvVaw0SgpoCCKjNriMN20fs16rq">pilots and air traffic controllers</a>.</p> <h2>Where to from here?</h2> <p>When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.</p> <p>How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, <a href="https://www1.racgp.org.au/newsgp/professional/ahpra-eyes-mandatory-health-checks-for-older-gps">others have suggested</a> this would only exacerbate shortages in the health-care workforce.</p> <p>The proposals are open for <a href="https://www.medicalboard.gov.au/News/Current-Consultations.aspx">public comment</a> until October 4.<!-- 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/236305/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/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</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/how-olds-too-old-to-be-a-doctor-why-gps-and-surgeons-over-70-may-need-a-health-check-to-practise-236305">original article</a>.</em></p> </div>

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Antarctic heat, wild Australian winter: what’s happening to the weather and what it means for the rest of the year

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/martin-jucker-379172">Martin Jucker</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Australia’s south and east have seen <a href="https://theconversation.com/southern-australia-is-freezing-how-can-it-be-so-cold-in-a-warming-climate-233977">freezing temperatures</a> and <a href="https://www.theguardian.com/australia-news/article/2024/jul/29/australia-winter-weather-forecast-east-coast-colder-records">wild weather</a> this winter. At the same time, the continent as a whole – and the globe – have <a href="https://www.abc.net.au/news/2024-08-03/australia-suffers-cold-winter-weather-despite-mild-forecast/104176284">continued to warm</a>.</p> <p>What’s going on? As ever, it’s hard to pinpoint a single cause for weather events. But a key player is likely an event unfolding high above Antarctica, which itself may have been triggered by a heatwave at surface level on the frozen continent.</p> <p>Here’s what’s happening – and what it might mean for the rest of this year’s weather.</p> <h2>When the stratosphere heats up</h2> <p>Out story begins in the cold air over Antarctica. July temperatures in the stratosphere, the layer of air stretching between altitudes of around 10 and 50 kilometres, are typically around –80°C.</p> <p>The winds are also very strong, averaging about 300 kilometres per hour in winter. These cold, fast winds loop around above the pole in what is called the <a href="https://sites.krieger.jhu.edu/waugh/research/polarvortex">stratospheric polar vortex</a>.</p> <p>Occasionally, persistent high air pressure in the lower atmosphere can influence large-scale waves that extend around the globe and up into the stratosphere. There they cause the strong winds to slow down, and the air high above the pole to become much warmer than normal.</p> <p>In extreme situations the stratospheric winds can completely break down, in what is called a “sudden stratospheric warming” event. These events occur every few years in the northern hemisphere, but only one has ever been observed in the south, in 2002 (though another <a href="https://theconversation.com/the-air-above-antarctica-is-suddenly-getting-warmer-heres-what-it-means-for-australia-123080">almost happened in 2019</a>).</p> <h2>Pushing polar weather our way</h2> <p>Once the polar vortex is disturbed, it can in turn influence the weather at the surface by steering weather systems from the Southern Ocean towards the Equator. However, this is a slow process.</p> <p>The impact at the surface may not be felt until <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">a few weeks or even months</a> after the initial weakening of the stratospheric polar vortex. Once it begins, the stratospheric influence can prevail for more weeks or months, and helps meteorologists make <a href="https://doi.org/10.5194/acp-22-2601-2022">long-range weather forecasts</a>.</p> <p>In climate science terms, the weak stratospheric winds put an atmospheric system called the <a href="http://www.bom.gov.au/climate/sam/">Southern Annular Mode</a> into a negative phase. The main effect of this on surface weather is to bring westerly winds further north.</p> <p>In winter, this means polar air outbreaks can reach places like Sydney more easily. As a result, we see more <a href="https://doi.org/10.1175/JCLI4134.1">rain over much of southern Australia</a>, and snowfall in alpine regions. In spring and summer it means westerly winds blow over the continent before reaching the east coast, bringing warm and dry air to southeastern Australia.</p> <p>The exact impact of a weaker polar vortex depends on how much and for how long the weather systems are being pushed further northward. It will also depend on other weather influencers such as El Niño and the Indian Ocean Dipole.</p> <h1>This winter’s weirdness</h1> <p>Unpicking exactly why any weather event occurs is tricky at the moment, because global weather has been absolutely crazy over the past 12 months or so. Global temperatures are <a href="https://theconversation.com/we-just-blew-past-1-5-degrees-game-over-on-climate-not-yet-213364">much higher than usual</a>, which is making unusual weather very common.</p> <p>But there are indications that the stratosphere is having some influence on our weather this winter.</p> <p>The stratospheric polar vortex started to warm in mid-July, and is about 20°C warmer than the long-term average. At the time of writing, the winds slowed down to about 230 kilometres per hour, 70 kilometres per hour slower than average.</p> <p>These numbers mean that, technically, the event does not qualify as a sudden stratospheric warming. However, further warming may still occur.</p> <p>If we look at how southern hemisphere winds have evolved in the past few weeks, we see a pattern which looks like what we would expect from a sudden stratospheric warming.</p> <p>First, we see warming in the stratosphere which is <a href="https://doi.org/10.1029/2021GL095270">at first accompanied by a poleward shift of weather systems</a>.</p> <p>The stratosphere’s influence then propagates downward and seems to <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">induce many weeks</a> of weather systems shifted towards the equator.</p> <p>This coincides with the period of cold and rainy weather along Australia’s east coast in late July and the beginning of August. Forecasts suggest the Southern Annular Mode will be a long way from normal conditions in the first half of August – four standard deviations below average, which is extremely rare.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.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/611211/original/file-20240804-19-sp862a.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/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=3 2262w" alt="Diagram showing atmospheric warming and winds" /></a><figcaption><span class="caption">How initial warming high in the stratosphere ends up changing winds near the surface and pushing polar weather further north.</span> <span class="attribution"><a class="source" href="https://stratobserve.com">Z.D. Lawrence / StratObserve / Annotated by Martin Jucker</a></span></figcaption></figure> <h1>A surface disturbance</h1> <p>The main reason for the polar vortex to slow down is disturbances from the surface. Weather over the Amundsen Sea near Antarctica in the South Pacific is <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">an important source</a> of these disturbances.</p> <p>This year, we have seen disturbances of this sort. There have been <a href="https://www.theguardian.com/world/article/2024/aug/01/antarctic-temperatures-rise-10c-above-average-in-near-record-heatwave">near-record surface temperatures around Antarctica</a>.</p> <p>These disturbances may be due to the globally high ocean temperatures, or even lingering effects of the <a href="https://doi.org/10.1175/JCLI-D-23-0437.1">eruption of the Hunga Tonga volcano in 2022</a>. But more research will be required to confirm the causes.</p> <h1>What should we expect for the rest of the year?</h1> <p>There are two pathways until the end of the year. One is that the stratospheric winds and temperatures recover to their usual values and no longer influence surface weather. This is what the forecasts from <a href="https://ozonewatch.gsfc.nasa.gov">Ozone Watch</a> seem to suggest.</p> <p>Another is that the stratosphere keeps warming and the winds keep being slower all the way into summer. In this scenario, we would expect a persistent negative Southern Annular Mode, which would mean a spring and potentially even summer with warmer and drier than usual weather over southeastern Australia, and a small ozone hole.</p> <p>The seasonal forecasting models from the European Centre for Medium Range Weather Forecasts <a href="https://x.com/drahbutler/status/1819142206348759170?s=46&amp;t=sayfGwpo3_s310BwYpcdcQ">seem to favour this second scenario</a>.<!-- 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/martin-jucker-379172">Martin Jucker</a>, Senior Lecturer in Atmospheric Science, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</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/antarctic-heat-wild-australian-winter-whats-happening-to-the-weather-and-what-it-means-for-the-rest-of-the-year-236067">original article</a>.</em></p> </div>

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Last Australian 'Rat of Tobruk' dies age 102

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

Caring

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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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Mysterious leg pain that’s quietly killing older Australians

<p>Peripheral Artery Disease (PAD) has long been overshadowed by its more widely recognised counterparts, such as heart attacks and strokes. Often referred to as the “poor cousin” or “Cinderella” of cardiovascular diseases, PAD affects one in five older Australians, yet it remains largely under-diagnosed and misunderstood. However, a wave of optimism is sweeping through the medical community with the launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a>, an Australian-first facility dedicated to pioneering research and improving patient outcomes.</p> <p>Spearheaded by the Heart Research Institute, the Centre for Peripheral Artery Disease, marks a significant step forward in addressing the challenges posed by PAD. The centre aims to fill critical gaps in our understanding of the disease, which is responsible for a limb amputation in Australia every two hours. This initiative promises to enhance diagnosis, transform patient care, and raise awareness about PAD.</p> <p>Associate Professor Mary Kavurma, the Centre Lead, is at the forefront of this ground-breaking effort. “We’re supercharging research into PAD because there are still many unknowns about the disease’s biology that could unlock new methods for early detection and better management,” she explains. This research is particularly urgent given the prevalence of PAD among women and First Nations Australians, groups that remain disproportionately affected by this condition.</p> <p>The centre’s mission is to develop a simple blood test for early diagnosis and explore novel therapies that could reduce the need for limb amputations and significantly improve patients’ quality of life. Unlike current treatments that primarily focus on symptom management, this new approach seeks to prevent the disease from progressing.</p> <p>One of the most inspiring aspects of the centre is its commitment to involving patients and their families in the research process. At the inaugural consumer meeting, nearly 20 patients and their carers shared their personal experiences with PAD. </p> <p>Take the story of Simon Josephson, a renowned advertising guru – who famously designed the Solo logo. PAD almost cost him his life after taking more than five years to diagnose.</p> <p>He woke up one morning with a sore leg, thinking he’d overdone it exercising but the 73-year-old – who was otherwise healthy and active – unknowingly had Peripheral Artery Disease, caused by a build-up of plaque in his arteries causing them to narrow and stiffen.</p> <p>It wasn’t until a trip to the hospital emergency department years later that doctors would discover his aorta had expanded to more than twice the usual size and was at risk of rupturing. He immediately underwent open heart surgery and has faced a lengthy recovery.</p> <p>The launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a> heralds a new era of hope and progress in the fight against PAD. Through world-leading research, community engagement, and a commitment to patient-centred care, the CPAD is poised to make a profound impact on the lives of many Australians. As Assoc Prof Kavurma aptly put it, “By understanding more about this debilitating condition, we are paving the way for better health outcomes and a brighter future for all those affected by PAD.”</p> <p><em>Images: CPAD</em></p>

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Aussie flag bearers for Paris Olympics announced

<p>The Australian flag bearers have been announced for the upcoming opening ceremony of the Paris Olympics. </p> <p>Chef de mission Anna Meares officially confirmed the flag bearers for the event on the River Seine to massive applause at a function in Paris on Wednesday, announcing Jess Fox and Eddie Ockenden as the two champions who will carry the flag. </p> <p>Meares admitted that she told Fox, an award-winning canoeist, about the special honour two months ago so she could break the news in person.</p> <p>“Even though I’ve known a little while, it’s really hit me today ... all the emotions came up,” Fox said.</p> <p>“It is probably the greatest moment of my career ... just visualise us, leading our team down the Seine.”</p> <p>History-making Kookaburra Eddie Ockenden, who will become the first Australian hockey player to play five Games, will join Fox in carrying the flag.</p> <p>He also carried the flag at the opening ceremony of the Commonwealth Games in Birmingham two years ago.</p> <p>“This really means a lot to me ... if I get emotional, it’s because of gratitude, so thank you,” Ockenden said.</p> <p>“I feel special, to represent Tasmania. It’s something that I’ve always felt a real connection to and if I could even say to kids in Tassie - dream big and chase your dreams, sport or otherwise.</p> <p>“It doesn’t feel real yet ... it’s a huge honour. I never thought this was something that could be a possibility.”</p> <p>The opening ceremony of the Paris Games will be like none other in history with boats taking athletes from each county down the Seine River. </p> <p><em>Image credits: Pete Dovgan/Speed Media/Shutterstock Editorial </em></p>

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You don’t need a doctor to get more physically active – here are 10 simple steps you can take by yourself

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p>We all know physical activity has many <a href="https://www.nhs.uk/live-well/exercise/exercise-health-benefits/">health benefits</a>, including for mental health. It helps <a href="https://theconversation.com/exercise-can-reduce-stress-and-improve-sleep-particularly-for-women-with-breast-cancer-186144">manage stress</a>, ease joint or back pain, and boost energy levels.</p> <p>Exercise can also improve <a href="https://theconversation.com/exercise-and-the-brain-three-ways-physical-activity-changes-its-very-structure-150203">brain function</a> and <a href="https://theconversation.com/exercise-really-can-help-you-sleep-better-at-night-heres-why-that-may-be-192427">sleep</a>, and lift mood. In contrast, inactivity or spending too much time <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308180/">sedentary</a> is a leading factor in developing a range of diseases.</p> <p>The <a href="https://www.who.int/publications/i/item/9789240015128">World Health Organization</a> recommends we should do a weekly minimum of 150-300 minutes of moderate intensity physical activity, such as walking, or 75 minutes of vigorous physical activity, such as swimming, jogging or an exercise class – as well as <a href="https://theconversation.com/strength-training-could-be-the-answer-to-one-of-the-worlds-worst-killers-228665">regular strength training</a>.</p> <p>However, many people <a href="https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022">fail to meet these guidelines</a>. So what to do about this <a href="https://www.weforum.org/agenda/2022/12/lack-exercise-inactivity-preventable-diseases/">health crisis</a>?</p> <p>There is already <a href="https://www.bmj.com/content/376/bmj-2021-068465">evidence</a> that when GPs give patients guidance and continued support to increase physical activity, this encourages them to be more physically active – at least in the short term. However, we don’t yet know the best way for doctors to communicate with patients to help them sustain these increased activity levels so the current guidance and support on offer to patients isn’t as effective as it could be.</p> <figure><iframe src="https://www.youtube.com/embed/vCCD1xHKpZc?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For example, my <a href="https://www.bmj.com/content/386/bmj-2023-078713">latest research</a> examines the <a href="https://www.bmj.com/content/340/bmj.c1900">“motivational interviewing” (MI)</a> method GPs currently use to encourage patients to change their lifestyle. MI is a patient-centred, non-confrontational communication style that helps patients address any problem behaviour by exploring their ambivalence towards changing it. MI has been shown to help patients with a host of health problems, including <a href="https://pubmed.ncbi.nlm.nih.gov/25577724/">addiction issues</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/23001832/">eating disorders</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/25726920/">smokers</a> and those with <a href="https://pubmed.ncbi.nlm.nih.gov/33637368/">diabetes</a> to change their behaviour.</p> <p>However, I found that while MI programmes can help patients increase their total amount of physical activity – the benefits are only short term.</p> <h2>Ten simple ways to be more physically active</h2> <p>If you want more physical activity in your life, then, there are many self-directed things you can do to help yourself, without joining a programme or seeing your GP.</p> <p>Here are ten simple and effective ways to help you become – and stay – more physically active:</p> <p><strong>1) Don’t sit, stand</strong></p> <p>We <a href="https://theconversation.com/sitting-is-bad-for-your-health-and-exercise-doesnt-seem-to-offset-the-harmful-effects-225056">sit a lot</a>. In fact, it’s likely you’re sitting right now – and you needn’t be. Sitting for long periods has been <a href="https://doi.org/10.1016/j.amepre.2010.05.024">linked</a> with many adverse health outcomes, so try to stand more.</p> <figure><iframe src="https://www.youtube.com/embed/wUEl8KrMz14?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p><strong>2) Take the stairs</strong></p> <p>Being physically active needn’t mean expensive gym memberships. Try building physical activity into your daily routine. One easy way to do this is by swapping the lift or escalator for the stairs.</p> <p><strong>3) Make it fun</strong></p> <p>If you like doing something, you’re <a href="https://theconversation.com/why-you-shouldnt-let-guilt-motivate-you-to-exercise-220342">more likely</a> to continue doing it. Why not try an activity you liked doing as a child, or even something new? Who knows, you might enjoy it.</p> <p><strong>4) Phone a friend</strong></p> <p>Exercising <a href="https://theconversation.com/exercise-can-be-punishing-but-heres-how-to-stop-thinking-of-it-as-a-punishment-76167">with a friend</a> or loved one is a great way to stay motivated, and it can make physical activity more fun too.</p> <p><strong>5) Do less, more often</strong></p> <p><a href="https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-023-01272-8">“Snacktivity”</a> – a term for breaking up your activity into shorter <a href="https://theconversation.com/forget-the-gym-in-january-exercise-snacking-is-the-way-forward-69702">activity “snacks”</a> – can help you increase activity in convenient, manageable bursts while reaping the health benefits.</p> <p><strong>6) Track your progress</strong></p> <p>Activity trackers aren’t a fad. There is <a href="https://doi.org/10.1016/S2589-7500(22)00111-X">evidence</a> that just using an activity tracker such as a pedometer to count steps or a smart watch that logs activity can help increase your activity levels, reduce body fat and increase muscle mass – and increase your overall physical fitness.</p> <p><strong>7) Get into a habit</strong></p> <p>We know it takes about ten weeks to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/">form a habit</a>. Repetition is key – so stick with it and keep going. Once you’ve formed a physical activity habit, it will be <a href="https://www.psychologytoday.com/gb/basics/habit-formation#:%7E:text=Building%20healthy%20habits%20can%20involve,listening%20to%20music%20while%20exercising">hard to shake it off</a>.).</p> <p><strong>8) Hold still</strong></p> <p>Try to incorporate <a href="https://en.wikipedia.org/wiki/Isometric_exercise">isometric exercises</a> like the plank or wall squats into your routine. These exercises, which need no equipment, require you to tighten muscles and hold still – and have been shown to <a href="https://bjsm.bmj.com/content/57/20/1317">lower your blood pressure</a>.</p> <p><strong>9) Set a goal</strong></p> <p>Give yourself an achievable target to work towards – it will <a href="https://theconversation.com/three-tips-to-help-you-stay-motivated-to-keep-exercising-all-year-long-175868">motivate you</a> to reach your goal.</p> <p><strong>10) Reward yourself</strong></p> <p>And don’t forget to reward yourself when you meet that goal. You can also build in rewards to mark your progress along the way. After all, who doesn’t like to treat themselves when they’ve done well?<!-- 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/231991/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/nerys-m-astbury-410114">Nerys M Astbury</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</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/you-dont-need-a-doctor-to-get-more-physically-active-here-are-10-simple-steps-you-can-take-by-yourself-231991">original article</a>.</em></p> </div>

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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>

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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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