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Woman rescued after getting stuck in between two boulders

A NSW woman found herself stuck in between two boulders after trying to retrieve her phone from a rocky abyss in the Hunter Valley. Emergency services were called to the wine region after reports the woman slipped and got stuck between two boulders down a three-metre crevice. Her friends initially tried to rescue her for an hour before calling Triple Zero for help. Photos shared by NSW Ambulance on Facebook showed the woman's feet poking out as she was wedged inside the crevice. Paramedics had to remove the heavy rocks, including winching out a massive 500kg boulder to create a safe exit. The entire process took around seven hours as the woman had been stuck in a tight "S" bend which made it challenging for the rescue team. "In my 10 years as a rescue paramedic I had never encountered a job quite like this, it was challenging but incredibly rewarding," NSW Ambulance Specialist Rescue Paramedic Peter Watts said. "Every agency had a role, and we all worked incredibly well together to achieve a good outcome for the patient." NSW Ambulance confirmed that the woman was unable to get her phone back. Image: NSW Ambulance/ Facebook

Travel Trouble

Man decides to end his own life after waiting for at-home care

A terminally ill man has made the heartbreaking decision to end his life after waiting 10-month for end of life care. Cyril Tooze, an 86-year-old from South Australia's Fleurieu Peninsula, was approved for a Level 4 Home Care Package in January. The package - which is the highest available care for individuals with high-level needs under the federal government’s MyAgedCare scheme - would give Mr Tooze up to $59,594 annually for daily assistance with physical, medical and social tasks. But almost one year on from the approval, his funds and support have yet to be delivered. It’s understood his family, who live interstate, contacted the government to enquire about receiving an urgent reassessment, and were told he could be waiting another three to six months. Independent MP Rebekha Sharkie told reporters that his family were also told a reassessment “could delay it even longer”. While waiting for his vital funds, Mr Tooze - who suffers from terminal heart and lung conditions and regularly requires morphine for pain relief - has worsened and has been hospitalised after suffering a fall at home. Tired of waiting for help to arrive, Tooze has started the process of ending his life through South Australia’s voluntary assisted dying scheme. “There is no hope ... I don’t want to live my life laying in a bed waiting for something to happen,” he told <a href="https://7news.com.au/news/terminally-ill-mans-heartbreaking-decision-to-end-his-life-after-10-month-wait-for-home-care-in-australia-c-16471785" target="_blank" rel="noopener">7News</a>. “You can’t live like that, that’s unfair, we don’t deserve that in such a country as Australia.” Following the media coverage of his case, Tooze was contacted by the Aged Care Department, who said the package could temporarily be made available. Sharkie said Tooze’s situation was “shameful”, saying, “What devastates me is that Mr Tooze feels voluntary assisted dying is the only course available to him, and that is because we as a nation have failed him." “I would say, if Mr Tooze had that package in a timely manner, as he should have, he would probably be sitting at home now, making himself a cup of tea.” Anglicare Australia’s <a href="https://www.anglicare.asn.au/2024/09/20/life-on-the-wait-list-report-shows-older-australians-are-going-without-support/" target="_blank" rel="noopener" data-link-type="article-inline">Life on the Wait List report</a> revealed that as of May 2024, 68,109 Australians had been approved for a Home Care Package but were facing wait times of up to 15 months to access it. Image credits: 7News

Caring

"Police have done nothing": William Tyrrell's foster mother speaks out

William Tyrrell's foster mother has issued a rare statement, slamming the police investigation into the disappearance of the toddler. In her first public comments in two years, the woman - who cannot be identified - has been insistent on denying any involvement in William's disappearance despite being at the centre of a dedicated Strike Force team. She claimed police had “gone to great lengths to blacken my character in the media” as they built a case against her, since she was publicly outed as the current person of interest for Strike Force Rosann detectives in 2021. As <a href="https://www.news.com.au/national/crime/done-nothing-william-tyrrells-foster-mother-issues-statement/news-story/0503f8940a3bad2bb2648c38bc44e288" target="_blank" rel="noopener">news.com.au</a> continue their investigative podcast into William's disappearance and the subsequent investigation, the foster mother has slammed the authorities for the way they have handled the high-profile case. She said, “I believe that if the police had properly investigated this case, instead of persecuting me, they may well have found the person responsible for William’s disappearance.” She went on to reiterate she believes the three-year-old was taken from her mother’s yard in Kendall in September of 2014 and that she has “no idea who took William, or what happened to him”. “For the past five years, the police have done nothing to try to discover who took William, and what has happened to him," she said. “Instead, they have concentrated all their efforts on trying to build a case that I was in some way to blame for his death, and the disposal of his precious little body." “They have gone to great lengths to blacken my character in the media.” She went on to say she loved William “as much as any mother could love her child … if not more”. She said, “It did not matter one bit that he was not connected to us biologically. William made my life complete; I loved him fiercely. I just loved being his ‘mummy’.” “Never ever for a moment did I regret becoming a foster mother”, she said, adding the family was “and still are … connected as one”. “It’s challenging to have hope and build plans for the future when our hearts remain shattered and in pieces,” she said. “All I can hope for is that some person who knows something comes forward.” Image credits: NSW Police

Legal

Could a recent ruling change the game for scam victims? Here’s why the banks will be watching closely

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> In Australia, it’s scam victims who foot the bill for the overwhelming majority of the money lost to scams each year. A 2023 <a href="https://download.asic.gov.au/media/mbhoz0pc/rep761-published-20-april-2023.pdf">review</a> by the Australian Securities and Investments Commission (ASIC) found banks detected and stopped only a small proportion of scams. The total amount banks paid in compensation paled in comparison to total losses. So, it was a strong statement this week when it was revealed the Australian Financial Conduct Authority (AFCA) had <a href="https://my.afca.org.au/searchpublisheddecisions/kb-article/?id=f9f8941f-7379-ef11-ac20-000d3a6acbb4">ordered</a> a bank – HSBC – to compensate a customer who lost more than $47,000 through a sophisticated bank impersonation or “spoofing” scam. This decision was significant. An AFCA determination is binding on the relevant bank or other financial institution, which has <a href="https://www.afca.org.au/make-a-complaint#:%7E:text=Any%20determinations%20we%20make%20are,service%20is%20free%20to%20access">no direct right of appeal</a>. It could have implications for the way similar cases are treated in future. The ruling comes amid a broader push for sector-wide reforms to give banks more responsibility for <a href="https://www.fico.com/blogs/detection-prevention-tackling-scams-every-angle">detecting</a>, deterring and responding to scams, as opposed to simply telling customers to be “more careful”. Here’s what you should know about this landmark ruling, and what it might mean for consumers. <h2>A highly sophisticated ‘spoofing’ scam</h2> You might be familiar with “push payment” scams that trick the victim into paying money to a dummy account. These include the “<a href="https://www.acma.gov.au/articles/2024-01/scam-alert-re-emergence-hi-mum-scam">mum I’ve lost my phone</a>” scam and some <a href="https://www.scamwatch.gov.au/types-of-scams/online-dating-and-romance-scams">romance</a> scams. The <a href="https://www.smh.com.au/national/dragged-kicking-and-screaming-banking-giant-loses-battle-against-scam-victim-20241015-p5kide.html">recent case</a> concerned an equally noxious “bank impersonation” or “spoofing” scam. The complainant – referred to as “Mr T” – was tricked into giving the scammer access to his HSBC account, from which an unauthorised payment was made. The scammer sent Mr T a text message, purportedly asking him to investigate an attempted Amazon transaction. In an effort to respond to the (fake) unauthorised Amazon purchase, Mr T revealed security passcodes to the scammer, enabling them to transfer $47,178.54 from his account and disappear with it. The fact Mr T was dealing with scammers was far from obvious – scammers had information about him one might reasonably expect only a bank would know, such as his bank username. On top of this, the scam text message appeared in a thread of other legitimate text messages that had previously been sent by the real HSBC. <h2>AFCA’s ruling</h2> HSBC argued to AFCA that having to pay compensation should be ruled out under the <a href="https://download.asic.gov.au/media/lloeicwb/epayments-code-published-02-june-2022.pdf">ePayments Code</a>, a voluntary code of practice administered by ASIC. Under this code, a bank is not required to compensate a customer for an unauthorised payment if that customer has disclosed their passcode. The bank argued the complainant had voluntarily disclosed these codes to the scammer, meaning the bank didn’t need to pay. AFCA disagreed. It noted the very way the scam had worked was by creating a sense of urgency and crisis. AFCA considered that the complainant had been manipulated into disclosing the passcodes and had not acted voluntarily. AFCA awarded compensation covering the vast majority of the disputed transaction amount, lost interest charged to a home loan account, and $5,000 towards Mr T’s legal costs. It also ordered the bank to pay compensation of $1,000 for poor customer service in dealing with the matter, including communication delays. <h2>Other cases may be more complex</h2> In this case, the determination was relatively straightforward. It found Mr T had not voluntarily disclosed his account information, so was not excluded from being compensated under the ePayments Code. However, many payment scams fall outside the ePayments Code because they involve the customer directly sending money to the scammer (as opposed to the scammer accessing the customer’s account). That means there is no code to direct compensation. Still, AFCA’s jurisdiction is broader than merely applying a code. In considering compensation for scam losses, AFCA must consider what is “fair in all the circumstances”. This means taking into account: <ul> <li>legal principles</li> <li>applicable industry codes</li> <li>good industry practice</li> <li>previous AFCA decisions.</li> </ul> Relevant factors might well include whether the bank was proactive in responding to known scams, as well as the challenges for individual customers in identifying scams. <h2>Broader reforms are on the way</h2> At the heart of this determination by AFCA is a recognition that, increasingly, detecting sophisticated scams can be next to impossible for customers, which can mean they don’t act voluntarily in making payments to scammers. Similar reasoning has informed a range of recent reform initiatives that put more responsibility for detecting and responding to scams on the banks, rather than their customers. In 2023, Australia’s banking sector committed to a new “<a href="https://www.ausbanking.org.au/scam-safe-accord/">Scam-Safe Accord</a>”. This is a commitment to implement new measures to protect customers, including a confirmation of payee service, delays for new payments, and biometric identity checks for new accounts. Changes on the horizon could be more ambitious and significant. The proposed <a href="https://treasury.gov.au/consultation/c2024-573813">Scams Prevention Framework</a> legislation would require Australian banks, telcos and <a href="https://pursuit.unimelb.edu.au/articles/accc-vs-big-tech-round-10-and-counting">digital platforms</a> to take reasonable steps to prevent, detect, report, disrupt and respond to scams. It would also include a compulsory external dispute resolution process, like AFCA’s, for consumers seeking compensation for when any of these institutions fail to comply. Addressing scams is not just an Australian issue. In the United Kingdom, newly introduced <a href="https://www.bbc.com/news/articles/cy94vz4zd7zo">rules</a> make paying and receiving banks responsible for compensating customers, for scam losses up to £85,000 (A$165,136), unless the customer is grossly negligent.<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/241558/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, Senior lecturer, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-a-recent-ruling-change-the-game-for-scam-victims-heres-why-the-banks-will-be-watching-closely-241558">original article</a>. </div>

Money & Banking

"Unimaginable sorrow": Mother and two children drown during family outing

A mother and two children have died after struggling to swim in a Sydney waterway, with tributes and donations flowing in to support the grieving father. Hoai Nguyen, 32, and her two children, Mitchell, seven, and Hazel, five, were enjoying a day out at Shearer Park in south-west Sydney on Sunday, when they were spotted in distress in the waters of the Georges River. Hoai was pulled from the river, but despite the best efforts of bystanders and paramedics, she was unable to be revived. Police and volunteers from the State Emergency Service launched a large search and rescue operation for the two children, with divers locating their bodies in the water hours later, metres from a jetty. According to <a href="https://www.9news.com.au/national/sydney-news-georges-river-mother-hoai-nguyen-and-children-drown-lansvale/c8601ec9-47a1-4a79-8a12-67c3ff18f3ea" target="_blank" rel="noopener">9News</a>, the children's father and Hoai's husband had been at work during the incident and was only alerted to the tragedy when police showed up at his house. A <a href="https://www.gofundme.com/f/hoai-mitchell-and-hazel-nguyen" target="_blank" rel="noopener">GoFundMe</a> page has been set up by a family friend to support the children's father, Hoai's husband, and their one-year-old brother during the "time of unimaginable sorrow". "A beloved mother and her two young children tragically drowned... leaving behind a profound void in our hearts and a father and baby who is only 1 years old," the fundraiser reads. An investigation into how the mother and her children ended up in the water is ongoing, as NSW Police acting superintendent Luke Scott yesterday described the tragedy as "beyond words". Image credits: GoFundMe

Caring

Desperate search after Aussie man swept out to sea while saving swimmer

A desperate search is underway for an Australian man who got swept out to sea while saving a tourist from drowning on a Bali beach. Craig Laidley, 56, was walking along Balian Beach about 4.15pm on Wednesday when he heard 29-year-old Micro Stalla calling out for help. The Perth man rushed into the water to save the German tourist, but unfortunately Laidley never made it back to shore after being swept out to sea by an "extreme" wave. Laidley, who reportedly lives in Bali, was last seen “drifting back out to the ocean”. He was reported missing to police about three hours later, and they immediately launched a search, with with Denpasar Search and Rescue Office head Nyoman Sidakarya confirming the search is still ongoing. “[On Wednesday] night our team tried to search for victims using land searches and today the Denpasar Search and Rescue Office dispatched 10 people with land and sea SRU divisions,” Sidakarya said. “Information from the team at the location is that the wave conditions are extreme," he added. Rescue teams used rubber boats to search for Laidley within a 10km radius of where he was last seen and also scoured the coastline on foot. Police have also conducted interviews with witnesses as part of their ongoing search. One witness said that there were no warning signs around the beach, despite the dangers. “Incidents like this happen often here,” he told the ABC. “About four months ago, a foreigner went missing. He was found dead 4 hours later. In the last five years, there have been five incidents like this.” Laidley's family have appealed to the public to help find him. “Hello, our family is seeking assistance from the public in Bali,” Craig’s nephew posted on Facebook. “Craig was last seen helping a male that was reportedly drowning in the ocean between Tebing Balian rocks near Balian Beach. “He was then seen drifting back out to the ocean after saving this man’s life.” The search is set to continue on Friday morning. The Department of Foreign Affairs and Trade (DFAT) said it is providing consular assistance to the family of an Australian reported missing in Indonesia. Editors Update: Craig Laidley’s body has been found on the beach on Friday morning by searchers. His two brothers, Bruce and Glenn, arrived in Bali overnight to join the search. His family are still coming to terms with the loss, but have told 7News that they are proud of his heroic rescue and glad that his brothers were there to bring him home. Images: Denpasar Search and Rescue Agency/ Facebook

Caring

"We let you down": Karl Stefanovic speaks out on Nine report

Karl Stefanovic has spoken out about the report into toxic workplace culture at the Nine Network, calling out the “perpetrators” of bad behaviour. On Thursday, a <a href="https://www.oversixty.com.au/finance/legal/damning-report-exposes-toxic-workplace-culture-at-channel-nine" target="_blank" rel="noopener">report</a> conducted by independent investigators revealed that Nine has “has a systemic issue with abuse of power and authority; bullying, discrimination and harassment; and sexual harassment”, with several employees sharing their own horror stories of working for the network. During Friday's episode of the Today Show, Karl took a moment to discuss the findings of the report, saying "many people are hurting" over the shocking allegations. Echoing the concerns of Nine stars including Deb Knight and Dimity Clancey who raised concerns at a meeting on Thursday, the Today show host said he understood concerns that the report didn’t “name names.” “They feel like what was the point of speaking out if perpetrators are not called out? I asked the same question yesterday and it’s my understanding several investigations are now underway and we have to be patient for the process of all that,’’ he said. “It’s essential and it’s critical. I want to say it’s not about us, but there are good men who do work here at Nine who find what happened absolutely intolerable, who struggle to understand how we didn’t know more and do something, how it grieved you." “I feel like we have all in a way, let you down. I love my work colleagues here. Women I have the honour to present with women on the floor of this great show." “Women behind the scenes who make us all better. I’m grateful women are this company and they are the way forward. They will show the way. We just have to listen and act.” "I genuinely, genuinely feel for the women who have given testimony, I can't imagine how hard that was and the courage that it took," Karl said. <div> <div id="adspot-mobile-mobile-3-above"></div> </div> "It's going to be up to all of us now to do better, to say enough - this stops now." Image credits: The Today Show

Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results. We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise. To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes. The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits. All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated. Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile. It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results. <h2>Exercise genes</h2> Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight. While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>. More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates. Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training. When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics. We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified. For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene. Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise. <h2>Piece of the puzzle</h2> Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight. While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan). It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern. On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<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/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/trying-to-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>. </div>

Body

How to choose a legal decision-maker as you get older – 3 things to consider

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/joseph-ibrahim-252671">Joseph Ibrahim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/amelia-grossi-1280226">Amelia Grossi</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> “It’s my life and I’ll do what I want,” <a href="https://www.youtube.com/watch?v=HNzmrEgz_GI">sang</a> Eric Burdon of The Animals to the baby boomer generation. Unfortunately, that’s not always the case. As we get older, sometimes we are no longer capable of making our own decisions. Diseases that affect the brain such as dementia, stroke and head injury can impair cognition and thinking. Some people may choose to appoint a <a href="https://www.legislation.vic.gov.au/in-force/acts/medical-treatment-planning-and-decisions-act-2016/008">medical treatment decision-maker</a> or an <a href="https://www.legislation.vic.gov.au/in-force/acts/powers-attorney-act-2014/007">enduring power of attorney</a> to make certain decisions on their behalf. Alternatively, a legal tribunal or court may appoint <a href="https://www.legislation.vic.gov.au/in-force/acts/guardianship-and-administration-act-2019/005">a guardian or trustee</a> to help guide decisions about health care, finances, accommodation and lifestyle. Who is the right person to take on this important role? Is it the family member or partner who knows you best? Or someone with time and energy? Perhaps someone who understands the services you need – like a nurse, accountant or real estate agent? The role of a decision-making representative has <a href="https://www.alrc.gov.au/publication/equality-capacity-and-disability-in-commonwealth-laws-alrc-report-124/3-national-decision-making-principles-2/will-preferences-and-rights-2/#:%7E:text=The%20'best%20interests'%20principle%20is,an%20equal%20basis%20with%20others">changed significantly</a> in recent years, shifting from a paternalistic approach to a more person-centred focus. Our <a href="https://pubmed.ncbi.nlm.nih.gov/35157838/">research</a> looks at the differences between these approaches and how subconscious bias can influence decision-making. <h2>Taking care</h2> These days, guardianship has <a href="https://www.legislation.vic.gov.au/in-force/acts/guardianship-and-administration-act-2019/005">moved</a> from deciding what’s deemed to be in the individual’s “best interests” to what best reflects their “will and preferences”. While <a href="https://www.legislation.vic.gov.au/repealed-revoked/acts/guardianship-and-administration-act-1986/089">previously</a>, decisions were made for the person by their guardian or representative, new laws require representatives to enact the person’s “will and preferences”. That is, to make decisions with them. This is an important difference. The newer model gives the represented person more autonomy over personal, financial and other decisions. It recognises that even though a person may struggle with aspects of decision-making, they should not be excluded from decisions about how they live their life. This fundamental shift was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313688/">earlier adopted</a> by the United Nations in the <a href="https://www.ohchr.org/en/hrbodies/crpd/pages/conventionrightspersonswithdisabilities.aspx">Convention on the Rights of Persons with Disability</a>, to which Australia is a signatory. <h2>Challenging in real world situations</h2> The will and preferences <a href="https://supporteddecisionmaking.com.au/wp-content/uploads/sites/4/2021/08/Realising-will-preferences-and-rights-reconciling-differences-on-best-practice-support-for-decision-making.pdf">framework</a> may sound simple, but it can be <a href="https://www.tandfonline.com/doi/full/10.1080/09687599.2021.1941781">challenging in practice</a>, when concepts of empowerment are tricky to define and the will of someone with cognitive difficulties is hard to discern. Representatives <a href="https://supporteddecisionmaking.com.au/wp-content/uploads/sites/4/2021/08/Realising-will-preferences-and-rights-reconciling-differences-on-best-practice-support-for-decision-making.pdf">bring their own biases, perceptions and lived experience</a> to the role of supporting another person to make decisions. This subjectivity is a natural and an inherent part of decision-making. The representative faces the challenge of setting aside their own opinion and, instead, stepping into the shoes of the represented person to give effect to what they want. A mismatch between the age, gender, ethnicity, religion or socioeconomic status of the representative and the represented person can exacerbate this challenge. An older able-bodied female, who is deeply religious and from a middle-to-high income background might find it difficult to represent a young man with a disability who is an atheist and from a working-class background. Now, imagine a scenario where the young man expresses a desire to go bungee-jumping or parachuting, despite previously showing a fear of heights. What’s his representative to do? Older people and women generally <a href="https://www.tandfonline.com/doi/abs/10.1080/1366987032000105315?journalCode=rjrr20">have a lower appetite for risk</a>, as do those who have a faith and with a high socioeconomic status. A heightened perception of danger or a feeling the activity as frivolous, may lead to the representative reframing the situation with their subconscious bias. They may fail to respect the younger person’s will and preferences. Understanding what might shape a representative’s approach to decision-making is essential. Especially when decisions involve <a href="https://theconversation.com/do-you-want-to-be-resuscitated-this-is-what-you-should-think-about-before-deciding-105506">health</a> or <a href="https://theconversation.com/theres-no-need-to-lock-older-people-into-nursing-homes-for-their-own-safety-73954">living arrangements</a>. <h2>3 things to look for when selecting a legal decision-making representative</h2> 1. Deep understanding An intimate understanding of your situation is crucial. An ideal representative is someone who actively listens and has a holistic view of your circumstances. This may come from discussions with you and your loved ones. The representative must be careful your views are not outweighed by those of family or friends who are often more vocal. They should have a deep sense of who you are as an individual. 2. Self-awareness The person you choose should be able to describe their personal views and values and understand how their perspective may influence their decisions. This is vital to mitigate the effects of pre-existing bias. They should be able to reflect on their own lived experiences, to understand how their history shapes their approach to decision-making. They should be able to assess whether what you would do is the same as what they think you should do, and why. 3. Effective documentation A record of conversations between the representative and represented person often helps to illuminate a person’s will and preferences. Writing or recording compels us to commit to an idea and explain what we mean. It helps to clarify what is intended far better than a one-time conversation that may be remembered differently by participants. Further research is needed to better match representatives with represented persons. Improved tools are needed to identify the role of bias in decision-making and evaluate whether the represented person’s wills and preferences are being respected.<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/177631/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joseph-ibrahim-252671">Joseph Ibrahim</a>, Professor, Health Law and Ageing Research Unit, Department of Forensic Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/amelia-grossi-1280226">Amelia Grossi</a>, , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-choose-a-legal-decision-maker-as-you-get-older-3-things-to-consider-177631">original article</a>. </div>

Legal

NRL legend calls for help to get newborn baby home

NRL legend Jesse Ramien and his partner Shell are pleading for help to get their newborn baby home after Shell's traumatic birth experience in Bali. The Cronulla Sharks player and his wife travelled to Bali for a friend's wedding while Shell was 33 weeks pregnant, who was cleared by her doctor before their trip. However, after just three days into their holiday, Shell went into early labour which quickly led to an emergency C-section, with mum under anaesthetic and baby boy Teo needing five minutes of resuscitation. Baby Teo was rushed into a neonatal intensive care unit, with his parents not able to meet him until the day after he was born. The family has been torn apart since with the parents still yet to hold Teo, who remains in an incubator, and older son Tallen returning home after Shell’s mother rushed to Bali to help. It is not known when the family can return to Australia, as Teo's condition is still unstable. “There’s just so much uncertainty here. We’ve been told by doctors it could be four weeks before our baby is okay to travel, but that could quickly change to five, six, or seven weeks, who knows,” Ramien told <a href="https://www.dailytelegraph.com.au/sport/nrl/sharks-star-jesse-ramiens-impassioned-plea-for-help-from-the-australian-government-to-source-flight-to-bring-baby-back-to-australia/news-story/1208830641c06ecb8c2450b95eeabece" target="_blank" rel="noopener" data-link-type="article-inline">News Corp</a>. “We’re doing everything to contact the Australian embassy to see how we can get home both as quickly as possible, so that our boy can get the medical attention he needs.” A family friend has set up a <a href="https://www.gofundme.com/f/need-your-help-to-fly-our-boy-teo-home" target="_blank" rel="noopener">GoFundMe</a> page to help the couple get home with their baby on an emergency flight, with $45,000 of their $100,000 goal already raised. “I’ll play for nothing just to get our baby boy home safely,” Ramien said. Shell, who received clearance from her obstetrician and the airline before travelling, ensured her pregnancy was covered by a top travel insurance package, however baby Teo’s medical costs — tallying more than $20,000 so far — are not included, while the total costs to get Baby Teo home could exceed $130,000. Ramien has been sharing updates on Instagram, posting a picture of his new son with the caption, “Home soon my boy,” while Shell added, “Won’t be long my boy, we'll be home soon.” Image credits: Instagram / GoFundMe

Caring

One Direction star passes away aged 31

Former One Direction star Liam Payne has reportedly been found dead outside a hotel in Buenos Aires, in Argentina, according to local newspaper La Nacion. The 31-year-old is believed to have fallen from the third floor of a hotel at around 5pm local time the newspaper said, citing emergency services. According to La Nacion the local police station was called by the hotel manager who reported "an aggressive man who could be under the influence of drugs or alcohol". It is reported that Payne fell from around 13 or 14 metres and suffered "very serious injuries incompatible with life." Alberto Crescenti, head of the state emergency medical system SAME (El Sistema de Atención Médica de Emergencias), told local TV that Payne had fallen into a courtyard of the Casa Sur Hotel in the Palermo neighbourhood. “At 17.11, a SAME team arrived and confirmed the man’s death. We later learned that he was a singer in a musical group. “Unfortunately, he had injuries incompatible with life as a result of his fall, so we had to confirm his death. There was no possibility of resuscitation.” Payne was one of the founding members of One Direction, one of the most loved boy bands of the past decade. He auditioned first as a solo act for the UK reality series The X Factor in 2008, before being eliminated. In 2010 he auditioned again and was grouped with Harry Styles, Niall Horan, Louis Tomlinson and Zayn Malik by the judges to form One Direction. Image: SplashNews.com/ Shutterstock Editorial

Caring

"So precious!" Kochie celebrates arrival of his 9th grandchild

David Koch has shared the happy news that his tribe of grandchildren has grown by one, posting a photo of his 9th grandchild. Kochie announced the safe arrival of baby girl Heidi, who is the first child of his daughter Georgie and her husband Alex. The former Sunrise host posted a photo of the moment his wife Libby met the new arrival for the first time in London, as his friends and colleagues shared their congratulations. “When Libby meets Heidi… grandchild #9… in London for the first time. First child for Georgie and Alex,” he wrote alongside the image. Former colleague Melissa Doyle commented, "Just gorgeous 😍", while Seven sports reporter Mark Beretta added, "Congratulations and what a beautiful moment!!👏". Fans also shared their congratulations to Kochie, celebrating the happy news of his latest grandchild’s arrival. “Congratulations to you all,” one wrote, while another said, “Gorgeous photo. So precious!” Kochie first shared the news of his growing family when Georgie was halfway through her pregnancy with Heidi, telling The Morning Show hosts Larry Emdur and Kylie Gillies that he and Libby were planning a trip to London to partake in a family tradition. "We have a family tradition, we buy the first pram for each of the families. (We're) very excited. It's number nine for us," he said in April. Heidi is David's ninth grandchild, as his three eldest children have eight kids between them. His son AJ welcomed his first child - a daughter called Catalina May - with his wife Carolina in 2021. The little one was born weeks after Samantha welcomed a daughter called Florence May with her partner Toby. They also share three other children - Lila, Oscar, and Matilda. David's other daughter Brianna, who lives in Perth, also has three children - Jax, Teddy and Ella - with her partner CJ Jayasinghe. Image credits: Instagram / Sunrise

Family & Pets

Radio legend calls it quits

Gus Worland has announced his departure from Triple M after 16 years with the network. The radio legend shared the news during The Rush Hour show he co-hosts with Jude Bolton each weekday afternoon on 104.9 in Sydney. "After 16 years, starting back in 2009, I'm leaving Triple M," he said on the show. He revealed that he would be focusing on his foundation Gotcha4Life, dedicated to teaching Aussies how to manage their mental health, with their Mental Fitness Gym program being rolled out in schools around the country. "I've decided to focus 100 per cent on Gotcha4Life which, of course, you blokes have been a part of and the station has been very supportive of me being away and doing that work. "I just feel it's right. It's at the stage now where it really needs critical leadership and critical energy ... just the passion, so forth, that goes behind Gotcha4Life." In an interview with 9Honey, he revealed that moving on from the show will be difficult. "Especially when you've done it for more than a few years, you know what I mean? I feel like we've been through the trenches a bit together," he said. He also spoke about how his gig on Triple M has helped him cope with the intensity of the work he is doing for his foundation. "To give me the balance of fun and being able to come in here after horrific stories, and then to see everyone and have a laugh and have a cuddle and eat too much sugar," he said. "I've needed that. I don't know how well I'll go without it, to be honest with you." But despite the uncertainty, Worland said he felt it was "the right call." "It's going to take me probably, you know, a few months or maybe a year to work out whether or not I can just do that job without the balance of media, but I'll still do my Wide World of Sports on Channel 9 and I'll do my Weekend Today on Channel 9," he said. While he has been getting offers from other media organisations, he said that the majority of his energy will be focused on his foundation. "I've got to be strong in my convictions," he said. "Gotcha needs me every day, fully focused." He hopes that one day mental fitness will be a subject in schools. "We've just started a primary schools program and I want to really focus in on the little ones and making sure that they're learning that it's okay to show their emotions at a young age when a lot of us have our emotions turned off," he said. "And I will continue to speak to every pollie [politician] and tell me what's a more important subject than mental fitness." Worland will stay on the show until the end of the year, ahead of his replacement being announced. Images: Triple M/ The Rush Hour/ Instagram

Retirement Life

William Tyrrell's biological grandmother speaks out

William Tyrrell's biological grandmother has spoken out about the child's first disappearance, two years before he disappeared without a trace in 2014, and how she was the "mastermind" behind the plan. Natalie Collins, whose three-year-old grandson was last seen alive on 12th September 2014, said she orchestrated for William to be hidden away when a court ordered William to be taken from his parent's custody. “So I hid them,” Ms Collins told the second episode of <a href="https://www.news.com.au/national/crime/i-hid-him-william-tyrrells-biological-grandmother-speaks/news-story/49b7f2998daf1d13035a794622e9a463" target="_blank" rel="noopener">news.com.au</a>’s investigative podcast into William's disappearance. “I hid them for three months after I knew (state government officials) were going to take William … I arranged it all.” When asked if that made her the mastermind of William’s first disappearance, which caused police to set up a dedicated strike force to find him, Ms Collins said “Yeah, that’s right”. “I should have taken him myself … Then no one would have been able to take him off me. That’s what I should have done,” she said. The court order for William to be removed from his biological parents' care came in 2012, when he was jut seven months old. The NSW government Department of Family and Community Services (FaCS) had raised concerns about domestic violence and substance abuse between William's parents Brendan Collins and Karlie Tyrrell, the court heard. The court ordered for William to be taken by officials and placed into government care, but when the officers arrived to take William, he was gone. A police strike force, codenamed Duncraig, was set up to find William, with officers making repeated visits to various addresses over the coming weeks, without success. In 2012, William was ultimately found in the custody of Ms Collins and taken by authorities, who placed him with foster parents. Ms Collins said the government made the wrong decision to re-home William in 2012, and their actions directly led to William's 2014 disappearance. “These (FaCS) people didn’t do their job,” she said. “They failed to do their job properly." “Because this shouldn’t happen these days with foster care children. What it’s done to my family from day one has stuffed all of us up,” she continued. “I’ve got one son in rehab, I’ve got one in jail and my family has been stuffed up. I lost my son and I lost myself on the way.” The podcast also spoke to one of the officials who was present when William was first taken from his biological family, as the man claimed he constantly wonders if he made the right decision about William's care. “We take kids off … families all the time,” the man said, breaking down in tears. “You do it. It is part of the job. “The thing I get upset about is … we took William off Karlie to protect him. I can still see myself walking into that bloody unit … And there was William, on the floor." “And I just think … did we do the right thing? Would he still be alive? Maybe.” Image credits: NSW Police

Legal

Charlise Mutten's grieving mother speaks out about her daughter's killer

The heartbroken mother of Charlise Mutten has spoken out about her "amazing little girl", and how she will never forgive herself for starting a relationship with the man who would go on to kill the nine-year-old. In her first TV interview, Kallista Mutten revealed what the final days were like between her, Charlise and Justin Stein - Kallista's partner - who was jailed for life in August after being found <a href="https://oversixty.com.au/finance/legal/unspeakably-vicious-judge-hands-down-verdict-to-justin-stein" target="_blank" rel="noopener">guilty</a> of Charlise's murder. In the days before the young girl's death in January 2022, the trio were celebrating Christmas in the Blue Mountains. Kallista revealed that during their holiday, Stein had asked Charlise to call him "daddy", saying he was “always going to be a father figure”. “That was a very touching moment for both of us because she’s always longed for a dad,” she told 60 Minutes. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/DBDz4pqhG4e/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/DBDz4pqhG4e/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by 60 Minutes Australia (@60minutes9)</a> </div> </blockquote> Kallista and Justin met in 2018 in prison and formed their relationship on wanting to build a better life together, but Kallista now says she will always hate herself for trusting him. “I am forced to live with the fact that I trusted someone with my daughter and that because of my trust in someone, I put my daughter in harm’s way,” She said. "I hate myself for it. I really do. It’s taken this for me to wake up and realise that I already had someone that loved me … He’s a monster, pure evil.” The grieving mum opened up about the nature of her relationship, admitting that her time with Stein had been erratic, in no small part due to their drug use, but she never believed he was capable of what happened. “The thought of what she had gone, would’ve gone through, that’s … that’s what breaks me,” Ms Mutten said. “There is just not enough justice that will make it better for me and my family.” Ms Mutten said she understands why she was judged by those who blamed her for her daughter's death and now knows “Charlise deserved more”. “I do take accountability of the things that I have done,” she said. “I wish I had been there more for her and, like, I see that now and I’ve got to live with that.” While Kallista continues to mourn the loss of her daughter, she hopes Charlise is remembered as a bundle of joy with a kind soul. “We just had this amazing connection and that she just absolutely, she was my number one fan,” she said. “She just was just the most incredible amazing little girl.” Image credits: 60 Minutes / NSW Police / Facebook

Legal

Are you over 75? Here’s what you need to know about vitamin D

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even <a href="https://pubmed.ncbi.nlm.nih.gov/38337682/">more crucial</a> as we age. New guidelines from the international Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommend</a> people aged 75 and over should consider taking vitamin D supplements. But why is vitamin D so important for older adults? And how much should they take? <h2>Young people get most vitamin D from the sun</h2> In Australia, it is possible for most people under 75 to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun for a few minutes on most days. The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommends</a> people get 800 IU (international units) of vitamin D a day from food or supplements. <h2>Why you need more as you age</h2> This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D. Overall, older adults also tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/">less exposure</a> to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors. As we age, our skin also becomes <a href="https://pubmed.ncbi.nlm.nih.gov/18290718/">less efficient</a> at synthesising vitamin D from sunlight. The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889852913000145">harder for the body to maintain</a> adequate levels of the vitamin. All of this combined means older adults need more vitamin D. <h2>Deficiency is common in older adults</h2> Despite their higher needs for vitamin D, people over 75 may not get enough of it. Studies <a href="https://www.abs.gov.au/articles/vitamin-d">have shown</a> one in five older adults in Australia have vitamin D deficiency. In higher-latitude parts of the world, such as the United Kingdom, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627050/">almost half</a> don’t reach sufficient levels. This increased risk of deficiency is partly due to <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">lifestyle factors</a>, such as spending less time outdoors and insufficient dietary intakes of vitamin D. It’s difficult to get enough vitamin D from food alone. <a href="https://dietitiansaustralia.org.au/health-advice/vitamin-d">Oily fish, eggs and some mushrooms</a> are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference. In some countries such as the <a href="https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/">United States</a>, most of the dietary vitamin D comes from fortified products. However, in <a href="https://pubmed.ncbi.nlm.nih.gov/35253289">Australia</a>, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it. <h2>Why vitamin D is so important as we age</h2> Vitamin D <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/">helps the body absorb calcium</a>, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis. Keeping bones healthy is crucial. Studies <a href="https://pubmed.ncbi.nlm.nih.gov/28726112/">have shown</a> older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured. Vitamin D may also help <a href="https://pubmed.ncbi.nlm.nih.gov/28202713/">lower the risk</a> of respiratory infections, which can be more serious in this age group. There is also emerging evidence for other potential benefits, including <a href="https://pubmed.ncbi.nlm.nih.gov/29233204/">better brain health</a>. However, this requires more research. According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">moderate evidence</a> to suggest vitamin D supplementation can lower the risk of premature death. The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all. <h2>Should we get our vitamin D levels tested?</h2> The Endocrine Society’s guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">suggest</a> routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75. There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders. Routine <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498906">testing</a> can also be expensive and inconvenient. In most cases, the <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommended approach</a> to over-75s is to consider a daily supplement, without the need for testing. You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation. Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.<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/231820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, PhD Candidate - Nutrition and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-you-over-75-heres-what-you-need-to-know-about-vitamin-d-231820">original article</a>. </div>

Body

Getting antivirals for COVID too often depends on where you live and how wealthy you are

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Medical experts <a href="https://www.health.gov.au/health-alerts/covid-19/treatments/eligibility">recommend</a> antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID. But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable. <h2>Who missed out?</h2> We <a href="https://grattan.edu.au/wp-content/uploads/2024/10/How-we-analysed-COVID-antiviral-uptake-Grattan-Institute.pdf">analysed</a> COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds. Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities. <h2>How stark are the differences?</h2> Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script. People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=329&fit=crop&dpr=1 600w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=329&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=329&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=413&fit=crop&dpr=1 754w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=413&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=413&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Dispensing rates by group. Grattan Institute</figcaption></figure> Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west. Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west. <h2>Why are people missing out?</h2> COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often <a href="https://link.springer.com/article/10.1007/s40121-024-01003-3">don’t realise</a> they would benefit from the medication. They <a href="https://www.phrp.com.au/?p=43363">wait</a> until symptoms get worse and it is too late. Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral. Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell. Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% <a href="https://hwd.health.gov.au/resources/data/gp-primarycare.html">fewer</a> GPs, see their GP about half as often, and are 30% more likely to <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release">report</a> waiting too long for an appointment. Just like for <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">vaccination</a>, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds. <h2>Care should go those who need it</h2> Since the period we looked at, evidence has emerged that raises <a href="https://url.au.m.mimecastprotect.com/s/FmjFC91ZVBSmBpXpZSEh9CqMtQx?domain=nejm.org">doubts</a> about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals. But all Australians who are eligible for antivirals should have the same chance of getting them. These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than <a href="http://medicarestatistics.humanservices.gov.au/statistics/do.jsp?_PROGRAM=%2Fstatistics%2Fpbs_item_standard_report&itemlst=%2712910L%27%2C%2712996B%27&ITEMCNT=2&LIST=12910L%2C12996B&VAR=SERVICES&RPT_FMT=6&start_dt=202201&end_dt=202408">30,000</a> packs of COVID antivirals were dispensed in August, costing about $35 million. Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most. People born overseas have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-country-of-birth">40% more likely</a> to die from COVID than those born here. Indigenous Australians have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#covid-19-mortality-among-aboriginal-and-torres-strait-islander-people">60% more likely</a> to die from COVID than non-Indigenous people. And the most disadvantaged people have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-socio-economic-status-seifa-">2.8 times</a> more likely to die from COVID than those in the wealthiest areas. All those at-risk groups have been more likely to miss out on antivirals. It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID <a>vaccination</a>, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as <a href="https://www.aihw.gov.au/getmedia/54a38a6a-9e3c-4f58-b2f6-cdef977a7d60/aihw-can-155_15sept.pdf?v=20230915162104&inline=true">cancer</a> <a href="https://www.aihw.gov.au/getmedia/27f32443-5206-4189-8775-0c1f55a26bc4/aihw-can-160.pdf?v=20240617095924&inline=true">screening</a>. <h2>A 3-step plan to meet patients’ needs</h2> The federal government should do three things to close these gaps in preventive care. First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out. Second, the government should extend its <a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be <a href="https://grattan.edu.au/report/a-new-medicare-strengthening-general-practice/">expanded</a> to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick. Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also <a href="https://theconversation.com/pharmacists-should-be-able-to-work-with-gps-to-prescribe-medicines-for-long-term-conditions-212359">work</a> for medications for chronic diseases, such as cardiovascular disease. COVID antivirals, unlike vaccines, have been <a href="https://theconversation.com/covid-wave-whats-the-latest-on-antiviral-drugs-and-who-is-eligible-in-australia-218423">keeping up</a> with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast. In the meantime, fairer access to care will help close the big and persistent <a href="https://www.aihw.gov.au/getmedia/0cbc6c45-b97a-44f7-ad1f-2517a1f0378c/hiamhbrfhsu.pdf?v=20230605184558&inline=true">gaps</a> in health between different groups of Australians. <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/getting-antivirals-for-covid-too-often-depends-on-where-you-live-and-how-wealthy-you-are-239497">original article</a>. </div>

Caring

Clint Eastwood celebrates arrival of new granddaughter

Clint Eastwood's youngest daughter, Morgan Eastwood, has welcomed her first child with husband Tanner Koopmans. The 27-year-old revealed that she'd given birth to a daughter named Cleo two weeks ago in an Instagram post shared over the weekend. "Two weeks with our Cleo," she captioned the post with a series of photos, giving fans their first look at her adorable baby girl. In the first photo, baby Cleo was swaddled in a blanket with a small smile on her face as she slept in the hospital crib. Another photo showed the new parents smiling down at their beautiful bub as they enjoyed a seaside stroll as a family. She included a few other shots of baby Cleo at home with her, Tanner and their beloved bulldog. Family and fans were quick to congratulate the couple. "She’s for real and our lives are already better! So happy for you! So happy for all of us! ❤️❤️❤️" Morgan's mum and Clint's ex-wife Dina commented. "I have looked at slide three 8,742 times" the first-time grandma gushed in another comment. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/DAucKTAPZeM/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DAucKTAPZeM/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Morgan Eastwood (@morganeastwood)</a> </div> </blockquote> "She is the definition of Bundle of Joy 😍 Congratulations beautiful family!" wrote one fan. "Congratulations Morgan she is beautiful!!! What a blessing," another added. The birth of baby Cleo makes the Hollywood legend a grandfather of six. Morgan, who has stayed out of the spotlight and works as a freelance writer, announced her pregnancy back in May with a photo of her baby bump and the caption "Our baby". A month later she tied the knot with Tanner, with her father walking her down the aisle during her intimate ceremony at Mission ranch in Carmel, California. The ceremony was attended by 130 guests, according to the Daily Mail, including Morgan's mum, as well as her seven siblings. Morgan is Clint's only child with Dina before the couple separated in 2012. Prior to his relationship with Dina, Clint had an "open marriage" with Maggie Johnson that lasted from 1953-1984, where they welcomed daughter Allison, 52, and son Kyle, 56. In total the actor has welcomed eight children with six different women. Images: Instagram

Family & Pets

Nat Barr slammed for “out of touch” comments about the housing crisis

Nat Barr has been widely slammed online for her comments on the housing crisis, with many claiming she is “stirring the pot”. On Wednesday’s Sunrise show, Barr was just joined by two experts to discuss Labor’s Help To Buy Bill, which would allow Australians earning under $90,000 to buy a home with just a 2 per cent deposit. While discussing the legislation, Barr said she’s worried her two sons — aged 19 and 22 — won’t be able to purchase a home after finance spokesperson Jane Hume claimed “Australians have already rejected this policy right around the country”. “I’m in the lucky position that I got to buy mine when they were cheaper years ago but I don’t know how my kids are going to buy one,” Barr said. Barr, who has hosted Sunrise since 2020, has never spoken publicly about her salary, but it has long been speculated that she earns more than $1 million per year. Viewers were quick to slam her comments on Facebook, claiming Barr will “set her kids up”. “She is the last person who should speak. she’s wealthy and will set her kids up,” one person commented, while another added, “So many young people are buying houses every day without the help of mum and dad. Nat’s just stirring the pot.” Another commenter added, “She makes enough money to buy a house for each of her sons. They’ll be just fine. Check your privilege, Nat.” Image credits: Instagram / Sunrise

An unbroken night’s sleep is a myth. Here’s what good sleep looks like

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> What do you imagine a good night’s sleep to be? Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep. Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">the same belief</a>. In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like. <h2>Sleep cycles are a roller-coaster</h2> As an adult, our sleep moves through <a href="https://www.sleepfoundation.org/stages-of-sleep">different cycles</a> and brief awakenings during the night. Sleep cycles last roughly 90 minutes each. We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming. If sleeping well, we get most of our deep sleep in the first half of the night, with <a href="https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep#:%7E:text=During%20REM%20sleep%2C%20your%20eyes,from%20acting%20out%20your%20dreams">REM sleep</a> more common in the second half of the night. Adults usually move through five or six sleep cycles in a night, and it is entirely <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">normal</a> to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief. <h2>What does getting a ‘good’ sleep actually mean?</h2> You’ll often hear that adults <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need#:%7E:text=Sleep%20requirements%20stabilise%20in%20early,their%20best%20the%20next%20day">need between seven and nine hours</a> of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality. For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day. You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb). But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons. <h2>Common issues</h2> Sleep disorders are common. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/35478719/">25% of adults</a> have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like. Rates of common sleep disorders such as insomnia and <a href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631">sleep apnoea</a> – where your breathing can partially or completely stop many times during the night – also increase with age, affecting <a href="https://pubmed.ncbi.nlm.nih.gov/32280974/">20% of early adults</a> and 40% of people in <a href="https://pubmed.ncbi.nlm.nih.gov/35082023/">middle age</a>. There are effective treatments, so asking for help is important. Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0012369218311139">pain</a> – and by <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13075">certain medications</a>. There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “<a href="https://www.tandfonline.com/doi/full/10.1080/07420528.2021.2003375">forced awakenings</a>” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause. A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help. We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own <a href="https://www.sleephealthfoundation.org.au/sleep-categories/circadian-rhythm-disorders#:%7E:text=The%20circadian%20rhythms%20throughout%20the,regulation%20of%20our%20sleeping%20patterns">internal clock</a>, which can influence the time your body prefers to sleep. If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern. <h2>Can my smart watch help?</h2> It is important to remember sleep-tracking devices can <a href="https://www.nature.com/articles/s41746-024-01016-9">vary in accuracy</a> for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure. In-laboratory <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a>, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep. Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time. <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8356">Understanding your sleep patterns</a> may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment. And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.<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/238069/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, Associate Professor in Clinical Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, Research Associate, Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, Postdoctoral Research Fellow, Clinical Psychologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, Research Fellow in Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/an-unbroken-nights-sleep-is-a-myth-heres-what-good-sleep-looks-like-238069">original article</a>. </div>

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