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Are older adults more vulnerable to scams? What psychologists have learned about who’s most susceptible, and when

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/natalie-c-ebner-1527554">Natalie C. Ebner</a>, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> and <a href="https://theconversation.com/profiles/didem-pehlivanoglu-1527551">Didem Pehlivanoglu</a>, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> About 1 in 6 Americans <a href="https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html">are age 65 or older</a>, and that percentage <a href="https://www.ncoa.org/article/get-the-facts-on-older-americans">is projected to grow</a>. Older adults often hold positions of power, have retirement savings accumulated over the course of their lifetimes, and make important financial and health-related decisions – all of which makes them attractive targets for financial exploitation. In 2021, there were more than 90,000 older victims of fraud, according to the FBI. These cases resulted in <a href="https://www.ic3.gov/Media/PDF/AnnualReport/2021_IC3ElderFraudReport.pdf">US$1.7 billion in losses</a>, a 74% increase compared with 2020. Even so, that may be a significant undercount, since embarrassment or lack of awareness <a href="https://assets.aarp.org/rgcenter/econ/fraud-victims-11.pdf">keeps some victims from reporting</a>. <a href="https://ncea.acl.gov/elder-abuse#gsc.tab=0">Financial exploitation</a> represents one of the most common forms of elder abuse. Perpetrators are often individuals in the victims’ inner social circles – family members, caregivers or friends – but can also be strangers. When older adults experience financial fraud, they typically <a href="https://public.tableau.com/app/profile/federal.trade.commission/viz/AgeandFraud/Infographic">lose more money</a> than younger victims. Those losses can have <a href="https://doi.org/10.1057/sj.2012.11">devastating consequences</a>, especially since older adults have limited time to recoup – dramatically reducing their independence, health and well-being. But older adults have been largely neglected in research on this burgeoning type of crime. We are <a href="https://ebnerlab.psych.ufl.edu/natalie-c-ebner-phd/">psychologists who study social cognition</a> and <a href="https://ebnerlab.psych.ufl.edu/didem-pehlivanoglu/">decision-making</a>, and <a href="https://ebnerlab.psych.ufl.edu/">our research lab</a> at the University of Florida is aimed at understanding the factors that shape vulnerability to deception in adulthood and aging. <h2>Defining vulnerability</h2> Financial exploitation involves a variety of exploitative tactics, such as coercion, manipulation, undue influence and, frequently, some sort of deception. The majority of current research focuses on <a href="https://doi.org/10.1002/acp.3052">people’s ability to distinguish between truth and lies</a> during interpersonal communication. However, deception occurs in many contexts – increasingly, over the internet. Our lab conducts laboratory experiments and real-world studies to measure susceptibility under various conditions: investment games, lie/truth scenarios, phishing emails, text messages, fake news and deepfakes – fabricated videos or images that are created by artificial intelligence technology. To study how people respond to deception, we use measures like surveys, brain imaging, behavior, eye movement and heart rate. We also collect health-related biomarkers, such as being a carrier of <a href="https://pubmed.ncbi.nlm.nih.gov/8346443/">gene variants</a> that increase risk for Alzheimer’s disease, to identify individuals with particular vulnerability. And <a href="https://doi.org/10.20900/agmr20230007">our work</a> shows that an older adult’s ability to detect deception is not just about their individual characteristics. It also depends on how they are being targeted. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.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/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=339&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=339&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=339&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=426&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=426&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=426&fit=crop&dpr=3 2262w" alt="A figure with two circles and an arrow between them. One circle shows icons that symbolize individual susceptibility to deception -- like a brain, and a walking cane -- while the other has icons of types of deception, like mail or a text message." /></a><figcaption>Vulnerability depends not only on the person, but also the type of fraud being used. Natalie Ebner and Didem Pehlivanoglu</figcaption></figure> <h2>Individual risk factors</h2> Better cognition, social and emotional capacities, and brain health are all associated with less susceptibility to deception. Cognitive functions, such as how quickly our brain processes information and how well we remember it, <a href="https://doi.org/10.1177/1745691619827511">decline with age</a> and impact decision-making. For example, among people around 70 years of age or older, declines in analytical thinking are associated with <a href="https://doi.org/10.1037/xap0000426">reduced ability to detect false news stories</a>. Additionally, low memory function in aging is associated with <a href="https://doi.org/10.1093/geronb/gby036">greater susceptibility to email phishing</a>. Further, according to recent <a href="https://osf.io/preprints/osf/6f2y9">research</a>, this correlation is specifically pronounced among older adults who carry a gene variant that is a genetic risk factor for developing Alzheimer’s disease later in life. Indeed, some research suggests that greater financial exploitability may serve as <a href="https://doi.org/10.1016/j.neubiorev.2022.104773">an early marker</a> of disease-related cognitive decline. Social and emotional influences are also crucial. Negative mood can enhance somebody’s ability to detect lies, while <a href="https://doi.org/10.1037/xap0000426">positive mood in very old</a> age can impair a person’s ability to detect fake news. Lack of support and loneliness exacerbate susceptibility to deception. Social isolation during the COVID-19 pandemic has led to <a href="https://doi.org/10.1093/gerona/glaa077">increased reliance on online platforms</a>, and older adults with lower digital literacy are <a href="https://doi.org/10.1093/geront/gnac188">more vulnerable to fraudulent emails and robocalls</a>. Finally, an individual’s brain and body responses play a critical role in susceptibility to deception. One important factor is <a href="https://doi.org/10.1016/j.tins.2020.10.007">interoceptive awareness</a>: the ability to accurately read our own body’s signals, like a “gut feeling.” This awareness is correlated with <a href="https://doi.org/10.1093/geroni/igad104.3714">better lie detection</a> in older adults. According to <a href="https://doi.org/10.1093/gerona/glx051">a first study</a>, financially exploited older adults had a significantly smaller size of insula – a brain region key to integrating bodily signals with environmental cues – than older adults who had been exposed to the same threat but avoided it. Reduced insula activity is also related to greater difficulty <a href="https://doi.org/10.1073/pnas.1218518109">picking up on cues</a> that make someone appear less trustworthy. <h2>Types of effective fraud</h2> Not all deception is equally effective on everyone. <a href="https://doi.org/10.1145/3336141">Our findings</a> show that email phishing that relies on reciprocation – people’s tendency to repay what another person has provided them – was more effective on older adults. Younger adults, on the other hand, were more likely to fall for phishing emails that employed scarcity: people’s tendency to perceive an opportunity as more valuable if they are told its availability is limited. For example, an email might alert you that a coin collection from the 1950s has become available for a special reduced price if purchased within the next 24 hours. There is also evidence that as we age, we have greater difficulty detecting the “wolf in sheep’s clothing”: someone who appears trustworthy, but is not acting in a trustworthy way. In <a href="https://doi.org/10.1038/s41598-023-50500-x">a card-based gambling game</a>, we found that compared with their younger counterparts, older adults are more likely to select decks presented with trustworthy-looking faces, even though those decks consistently resulted in negative payouts. Even after learning about untrustworthy behavior, older adults showed greater difficulty overcoming their initial impressions. <h2>Reducing vulnerability</h2> Identifying who is especially at risk for financial exploitation in aging is crucial for preventing victimization. We believe interventions should be tailored, instead of a one-size-fits-all approach. For example, perhaps machine learning algorithms could someday determine the most dangerous types of deceptive messages that certain groups encounter – such as in text messages, emails or social media platforms – and provide on-the-spot warnings. Black and Hispanic consumers are <a href="https://www.ftc.gov/system/files/documents/reports/combating-fraud-african-american-latino-communities-ftcs-comprehensive-strategic-plan-federal-trade/160615fraudreport.pdf">more likely to be victimized</a>, so there is also a dire need for interventions that resonate with their communities. Prevention efforts would benefit from taking a holistic approach to help older adults reduce their vulnerability to scams. Training in <a href="https://doi.org/10.1007/s40520-019-01259-7">financial, health</a> and <a href="https://www.nature.com/articles/s41598-022-08437-0.pdf">digital literacy</a> are important, but so are programs to <a href="https://doi.org/10.1186/s12889-021-10363-1">address loneliness</a>. People of all ages need to keep these lessons in mind when interacting with online content or strangers – but not only then. Unfortunately, financial exploitation often comes from individuals close to the victim.<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/227991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natalie-c-ebner-1527554">Natalie C. Ebner</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> and <a href="https://theconversation.com/profiles/didem-pehlivanoglu-1527551">Didem Pehlivanoglu</a>, Postdoctoral Researcher, Psychology, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</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-older-adults-more-vulnerable-to-scams-what-psychologists-have-learned-about-whos-most-susceptible-and-when-227991">original article</a>. </div>

Money & Banking

Readers response: How do you handle changes in energy levels as you age?

As we get older, our levels of energy, ability and agility can slowly start to decrease, making us change our day-to-day lifestyles. We asked our readers how they handle these changes, and the response was overwhelming. Here's what they said. Margo Courtney - Eat clean and healthy and your body will reward you with heaps of energy and vitality. I have a very big green smoothie most days as one of my 2 meals, along with 2 litres of water a day, and I don't even need much sleep. Ron Stubbs - Up at 8am, can’t be late for my walk in the sun, and feeling great. Don’t need afternoon snooze then. I’m 77. Kristeen Bon - I don’t handle them. I flop on the couch most afternoons for a quick five minute interior eye check! Sylvia Brice - I have an autoimmune disease so my levels of energy are way down. I do what l can in small bursts and rest when l need to. Luckily l read and craft so can always do them. It's very hard to adapt but that's life and l am so much better for off than younger people with my disease. Think positive. Judie Fisher - Do chores in small stretches, and have regular breaks. Diane Green - Adjust. I do what I can, and what I can't just has to wait. Raymond Richards - As they told us at the heart clinic, if you have something you HAVE to do - do it first. Janis St George - Listen to your body - rest awhile when you need to. Kaylene Samuels - Have a SCAN..... Seniors Compulsory Afternoon Nap. Image credits: Shutterstock

Body

How do we save ageing Australians from the heat? Greening our cities is a good start

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/claudia-baldwin-248780">Claudia Baldwin</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/jason-byrne-6066">Jason Byrne</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/tony-matthews-234160">Tony Matthews</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Heatwaves have killed more Australians than <a href="https://ama.com.au/ausmed/heatwave-health-warning">road accidents</a>, fires, floods and <a href="https://www.sciencedirect.com/science/article/pii/S1462901114000999">all other natural disasters combined</a>. Although <a href="https://theconversation.com/forget-heatwaves-our-cold-houses-are-much-more-likely-to-kill-us-83030">recent research</a> shows extreme cold is a worry in some parts of Australia, <a href="https://theconversation.com/2018-19-was-australias-hottest-summer-on-record-with-a-warm-autumn-likely-too-112616">our hottest summer on record</a> points to more heat-related deaths to come. The <a href="https://theconversation.com/the-stubborn-high-pressure-system-behind-australias-record-heatwaves-110442">record heatwaves</a> have highlighted the damaging effects of heat stress. Understandably, it’s becoming a major <a href="https://ama.com.au/ausmed/heatwaves-nation%E2%80%99s-deadliest-natural-disaster-0">public health challenge</a>. The risk of extreme heat events and the adverse impacts on older people has been extensively <a href="https://jech.bmj.com/content/64/9/753.short">discussed in research</a>. Remarkably, very little attention has been paid to the role of urban greenery in reducing heat stress for seniors. Older people are particularly at risk of heat stress. Pre-existing medical conditions and limited mobility increase their vulnerability. <a href="http://www.cmaj.ca/content/182/10/1053.short">Deaths of older people increase</a> during extreme heat events. The physical features of urban areas shape the capacity of older adults to engage in many activities when it’s hot. These include vegetation volume and coverage, <a href="https://theconversation.com/building-cool-cities-for-a-hot-future-57489">thermal design</a>, and the extent of shading in public areas and walkways. Increasing urban greenery may offer a way to improve older people’s comfort and social experience. <h2>Ageing adds urgency to greening</h2> It is expected <a href="http://www.un.org/en/sections/issues-depth/ageing/">20% of the global population</a> will be older than 60 by 2050. The figure for Australia <a href="http://www.abs.gov.au/ausstats/abs@.nsf/mediareleasesbyTopic/2CA2134677EF9D03CA257C2E0017283B?OpenDocument">is even higher</a>, at 23%. This means that by 2050 around one in four Australians will be more vulnerable to extreme heat. <figure class="align-right zoomable"></figure> Climate change may make the problem worse by <a href="https://www.sciencedirect.com/science/article/pii/S0749379708006867">fuelling even more extreme heat</a> events. Planning our urban centres to meet the needs of a <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/demographics-of-older-australians">rapidly ageing population</a> is a matter of urgency. Urban greening to reduce their vulnerability to heat stress should be central to this agenda. It can also improve people’s quality of life, reduce <a href="https://www.sciencedirect.com/science/article/abs/pii/S1353829208001172">social isolation and loneliness</a>, and ease the burden on health systems. An important task is matching the design of communities with the needs of an ageing population. Where older adults live and the quality of their local areas strongly influence their lived experiences. Yet <a href="https://journals.sagepub.com/doi/abs/10.1177/0885412217704649">recent research</a> found the experiences of seniors were often not accounted for in research on neighbourhood design. <h2>What about aged care?</h2> People face choices about where they live as they age. The common choices are to “<a href="https://theconversation.com/for-australians-to-have-the-choice-of-growing-old-at-home-here-is-what-needs-to-change-91488">age in place</a>” or to move into aged care. Ageing in place includes living in one’s own home or <a href="https://theconversation.com/co-housing-works-well-for-older-people-once-they-get-past-the-image-problem-79907">co-habiting with relatives or friends</a>. Around 90% of Australian seniors <a href="https://www.pc.gov.au/research/completed/housing-decisions-older-australians/housing-decisions-older-australians.pdf">choose this option</a>, with the remainder opting for aged-care facilities. If one in ten Australian seniors live in aged-care facilities, it is clear these should be designed to minimise heat stress. This isn’t just good for residents; it may also benefit operators by lowering health-care and electricity costs. While these facilities are purpose-built for older people, many in Australia were built well over a decade ago, when heat stress was not such a large concern. Many more facilities are being built now and will be into the future. Yet it is uncertain whether they are being actively designed to reduce the impacts of heat. <h2>What has our research found?</h2> We recently conducted a focus group to investigate this issue. Participants were senior managers from four large corporate providers of aged care in Australia. We investigated if and how providers try to minimise heat stress through design. We also sought to understand the rationales used to support these design approaches. Several participants reported on refurbishments that they expect will have cooling effects. Cited design approaches included green roofs and walls, as well as sensory gardens. Other expected benefits included reducing anxiety and improving the mental health of residents. The fact that single design interventions could produce multiple benefits improved the potential for corporate buy-in. Participants expected that increasing green space and green cover would give their facilities a competitive advantage by attracting more clients and providing a better working environment for staff. Participants also reported on challenges of including greening in their projects. For example, the benefits of trees were weighed against concerns about roots disrupting footpaths and becoming trip hazards. Species selection was another concern, with fears that inappropriate plants could die and undermine support for greening programs. Our research suggests that more can be done to make cities hospitable for older people, especially during extreme heat. Urban greening is a start. Encouraging aged-care providers to adopt green infrastructure will have benefits. But we should also consider reforms to planning systems and urban design to better protect older people who choose to age in place.<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/112613/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/claudia-baldwin-248780">Claudia Baldwin</a>, Associate Professor, Urban Design and Town Planning, Sustainability Research Centre, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/jason-byrne-6066">Jason Byrne</a>, Professor of Human Geography and Planning, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/tony-matthews-234160">Tony Matthews</a>, Senior Lecturer in Urban and Environmental Planning, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-we-save-ageing-australians-from-the-heat-greening-our-cities-is-a-good-start-112613">original article</a>. </div>

Domestic Travel

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

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

Eight simple changes to our neighbourhoods can help us age well

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Where we live can play a big part in ageing well, largely because of the links between physical activity and wellbeing. <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0012/2181/AHURI_Final_Report_No214_Downsizing-amongst-older-Australians.pdf">Research shows</a> that two-thirds of Australians prefer to age in place. That is, we want to live independently in our homes for as long as we can. Our neighbourhoods and their design can then improve or hinder our ability to get out of the house and be physically active. The rapid ageing of Australia’s population only adds to the importance of neighbourhood design. In 2016, 15% of Australians were aged 65 or older. That proportion is <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/overview">projected to double</a> by 2056. These trends present several <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/reports">social and economic challenges</a>, particularly for the health sector. Designing neighbourhoods in ways that promote physical activity can help overcome these challenges. <h2>Eight simple steps</h2> The following is a short list of <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0471-5">evidence-based steps</a> local and state governments can take to assist older people to be physically active. These involve minor but effective changes to neighbourhood design. Improve footpaths: Research indicates that older people have a <a href="https://theconversation.com/why-older-people-get-osteoporosis-and-have-falls-68145">higher risk of falls</a>. Ensuring footpaths are level and crack-free, and free from obstructions, will encourage walking among older people – especially those with a disability. Connected pedestrian networks: Introducing footpaths at the end of no-through-roads and across long street blocks reduces walking distances to destinations. This makes walking a more viable option. Slowing traffic in high-pedestrian areas: Slowing traffic <a href="https://www.heartfoundation.org.au/images/uploads/publications/Safe-Speed-Evidence-Report.pdf">improves safety</a> by reducing the risk of a collision. It also reduces the risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/28557669">death and serious injury</a> in the event of a collision. Age-friendly street crossings: Installing longer pedestrian crossing light sequences gives older pedestrians <a href="https://academic.oup.com/ageing/article/41/5/690/47318/Most-older-pedestrians-are-unable-to-cross-the">more time to cross</a>, and installing refuge islands means those who walk more slowly can cross the street in two stages. Disabled access at public transport: Although a form of motorised transport, public transport users undertake more incidental physical activity compared with car users. This is because they walk between transit stops and their origins and destinations. Improving disabled access helps make public transport a viable option for more older people. Places to rest: <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1054">Providing rest spots</a> such as benches enables older people to break up their walk and rest when needed. Planting trees: Planting trees <a href="http://www.sciencedirect.com/science/article/pii/S0277953614004109?via%3Dihub">creates more pleasant scenery</a> to enjoy on a walk. It also provides shade on hot days. Improving safety: Ensuring that streets are well-lit and reducing graffiti and signs of decay are likely to <a href="https://www.ncbi.nlm.nih.gov/pubmed/24552845">improve perceptions of safety</a> among older people. <h2>Why physical activity matters</h2> Physical function – the ability to undertake everyday activities such as walking, bathing and climbing stairs – often declines as people age. The reason for this is that ageing is often accompanied by a reduction in muscle strength, flexibility and cardiorespiratory reserves. Regular physical activity can <a href="https://www.ncbi.nlm.nih.gov/pubmed/14552936">prevent or slow the decline</a> in physical function, even among those with existing health conditions. Middle-to-older aged adults can reduce their risk of physical function decline <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-7-38">by 30%</a> with regular physical activity (at least 150 minutes per week). This includes recreational physical activity, like walking the dog, or incidental physical activity, such as walking to the shops or to visit friends. By making minor changes as outlined above, the health and longevity of our elderly population can be extended. Such changes will help our elderly age well in place. <a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, Research Fellow in Social Epidemiology, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, Professorial Fellow, Institute for Health and Ageing, Australian Catholic University, and Emeritus Professor, Department of Family Medicine and Public Health, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, PhD Candidate, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic 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/eight-simple-changes-to-our-neighbourhoods-can-help-us-age-well-83962">original article</a>. </div>

Travel Tips

George Negus dies at age 82

George Negus has died at the age of 82 after a lengthy battle with Alzheimer's. The news of the veteran broadcaster's death was announced by his family in an emotional statement, as they shared that Negus "passed away peacefully surrounded by loved ones" and thanked Australian healthcare workers for supporting him "in the best possible way" during his final moments. "Despite the challenges diseases like Alzheimer's inflict on families, we still shared beautiful times, laughter and happiness together in recent times." "We also learnt a lot." Negus began his journalistic career writing for The Australian and The Australian Financial Review. Throughout his stellar media career, he also worked as attorney-general Lionel Murphy's press secretary during the Whitlam government-era, and presented Nine's 60 Minutes from 1979 until 1986. He also hosted the first episode of Foreign Correspondent on ABC in 1992, and went on to became a Member of the Order of Australia in 2015, recognised for his significant service to the media, conservation and the environment. He is survived by his wife Kirsty and sons Ned and Serge. Image credits: Getty Images

Caring

Mother and son reunited after rigid aged care rules divided them

An elderly woman and her disabled son are celebrating after they successfully beat a bureaucratic blockage that threatened to <a href="https://oversixty.com.au/lifestyle/family-pets/red-tape-threatens-to-remove-a-man-with-down-s-syndrome-from-his-elderly-mother" target="_blank" rel="noopener">split</a> them up for good. Anne Deans, 81, and her 56-year-old son, Mark, who suffers from Down's syndrome, were hoping to live together in Anne's aged care facility, but the pair were met with countless hurdles when trying to get Mark a room of his own. Now, Mark's sister Sharon shared the happy news that the mother and son are to be reunited. "We're very happy today. We've got a great result," Sharon told <a href="https://9now.nine.com.au/a-current-affair/melbourne-mum-and-son-living-with-downs-syndrome-reunited-in-aged-care-facility/ff023844-be2d-4ab8-be95-75bf91f17b4a" target="_blank" rel="noopener">A Current Affair</a>. "I'm so grateful that people understood and they listened. That's all I ever wanted through this whole thing, was someone to listen." The problems began when authorities originally refused Mark's request to move into Anne's aged care facility, with federal government policy saying that aged care is "not appropriate for people under 65". But Mark's relatives argued that given the life expectancy of people living with Down's syndrome is 60 years, an exception should be made. A new assessment was done and Mark has been granted a place at the same nursing home as his mother, as Mark's other sister Michelle said, "We got what we wanted. Everything worked out perfectly, the way it's supposed to." After Anne received the exciting news, she said, "I'm feeling great. He's staying with Mum!" Sharon and Michelle hope that their experience will assist other families with unique circumstances. "My advice is to keep pushing," Sharon said. "Only you know your family and you have to be their voice. "There's a lot of difference out there and a lot of people who are individuals [and] they need to be looked at individually." Image credits: A Current Affair

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

Hollywood legend Kris Kristofferson dies at age 88

Music and movie legend Kris Kristofferson has died at the age of 88. The acclaimed country singer and actor who appeared in A Star is Born alongside Barbara Streisand passed away "peacefully” at his home in Hawaii on September 28th surrounded by family, according to <a href="https://people.com/kris-kristofferson-dead-at-88-7496435">People.</a> No cause of death has yet been announced. The statement from his family read, “It is with a heavy heart that we share the news our husband/father/grandfather, Kris Kristofferson, passed away peacefully on Saturday, September 28 at home. We’re all so blessed for our time with him. Thank you for loving him all these many years, and when you see a rainbow, know he’s smiling down at us all.” Throughout his career as a musician, Kristofferson won multiple Grammy's and was inducted into the Country Music Hall of Fame in 2004. He was also known for his acting accolades, including a Golden Globe award for Best Actor in a musical for A Star Is Born and starring in the popular Blade franchise. Kristofferson’s death comes three and a half years after he announced his retirement, following what was to be his final concert in Florida in February 2020. Kristofferson was a father to eight children and is survived by his third wife, Lisa Meyers, who he married in 1983. Image credits: Joanne Davidson/Shutterstock Editorial

Caring

Iconic Days of Our Lives star dies aged 70

Drake Hogestyn has passed away aged 70. The Days of Our Lives actor, known for his long-running role as John Black passed away on Saturday after a battle with pancreatic cancer, according to a statement shared by his family on Instagram. “It’s with heavy hearts that we announce the passing of Drake Hogestyn,” the statement began. “He was thrown the curve ball of his life when he was diagnosed with pancreatic cancer, but he faced the challenge with incredible strength and determination.” “After putting up an unbelievable fight, he passed peacefully surrounded by loved ones. He was the most amazing husband, father, papa and actor. He loved performing for the ‘Days’ audience and sharing the stage with the greatest cast, crew, and production team in the business. We love him and we will miss him all the Days of our Lives.” Hogestyn first appeared on the iconic US soap opera in 1986, and played John Black for 38 years. In a statement to Soap Opera Digest, Days Of Our Lives executive producer Ken Corday remembered the actor, who appeared in more than 4,200 episodes of the show. “This is a very difficult one for all of us,” he said. “Hogey was the ultimate team player and there are not sufficient words to express how deeply he will be missed. His impact on our show, personally and professionally, was profound and will forever remain unmatched.” His co-stars and colleagues have also paid their respects on social media. “I’m so saddened by this news,” tweeted Kassie DePaiva, who played Eve on the soap. “One of the kindest people I have ever worked with. What an amazing life he lived. He will be missed. He made the world a better place.” Fellow veteran soap star Nancy Lee Grahn, who plays Alexis on General Hospital tweeted: “My deepest condolences to Drake Hogestyn’s family, friends and fans. What a lovely, lovely gracious man.” Image: SplashNews.com/ Shutterstock Editorial

Caring

"Absolutely heartbroken": Son of AFL legend tragically dies at age 24

Warning: This article contains discussions about suicide that some readers may find distressing. The son of a premiership-winning AFL has tragically taken his own life, with his grieving family paying tribute to the "affectionate and cheeky" young man. Kye Hart, son of former West Coast Eagles player David Hart, died on Saturday at the age of 24. “On 21st September our family lost Kye who is a son, brother, uncle, nephew and grandchild. We are absolutely heartbroken and devastated,” a family member has written on a <a href="https://www.gofundme.com/f/kye-david-hart" target="_blank" rel="noopener">GoFundMe</a> fundraiser that has been established to help Mr Hart’s family with funeral expenses. “There aren’t enough words to describe how much we love Kye and how much we will miss him,” the fundraiser reads. “Kye’s love and affection was contagious, his cheeky beautiful smile would light up any room. Kye had the biggest heart and only wanted to give and help others." “In this incredibly difficult time we are reaching out for your support to navigate through the challenging times ahead. The funds raised will go towards covering immediate expenses and funeral costs." “We are grateful for your kindness, prayers and support through this tragedy.” Other friends and family paid tribute to Kye on social media, with one family friend writing, “His name was Kye Hart. Just 24 freaking years old for god’s sake. Enough! When are we going to sort mental health out in this world!” Another added, “Sorry for your loss and his family too. A life cut too short.” <p style="box-sizing: inherit; border: 0px; font-stretch: inherit; line-height: inherit; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 24px; padding: 0px; vertical-align: baseline;">Kye leaves behind his parents Linda and David Hart, who represented the West Coast Eagles in the 1980s and 1990s, helping them claim their victory in the premierships. Need to talk to someone? Don't go it alone. Call Lifeline on 13 11 14 or visit lifeline.org.au Beyond Blue: 1300 224 636 SANE: 1800 187 263; saneforums.org Mensline Australia: 1300 78 99 78 Image credits: GoFundMe <div class="media image" style="box-sizing: inherit; margin-bottom: 24px; align-items: center; display: flex; flex-direction: column; width: 705.202209px; max-width: 100%;"> </div>

Caring

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/colin-zhang-1234147">Colin Zhang</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> For senior Australians who cannot live independently at home, residential aged care can provide accommodation, personal care and general health care. People usually think this is expensive. And many assume they need to sell their home to pay for a lump-sum deposit. But that’s not necessarily the case. Here’s what you need to consider. <h2>You may get some financial support</h2> Fees for residential aged care are complex and can be confusing. Some are for your daily care, some are means-tested, some are for your accommodation and some pay for extras, such as cable TV. But it’s easier to think of these fees as falling into two categories: <ul> <li> an “entry deposit”, which is usually more than <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/eighth-report-on-the-funding-and-financing-of-the-aged-care-industry-july-2020-eighth-report-on-the-funding-and-financing-of-the-aged-care-industry-may-2020.pdf">$A300,000</a>, and is refunded when you leave aged care </li> <li> daily “<a href="https://www.myagedcare.gov.au/aged-care-home-costs-and-fees">ongoing fees</a>”, which are $52.71-$300 a day, or more. These cover the basic daily fee, which everyone pays, and the means-tested care fee. </li> </ul> To find out how much government support you’ll receive for both these categories, you will have a “<a href="https://www.myagedcare.gov.au/income-and-means-assessments/#aged-care-home">means test</a>” to assess your income and assets. This means test is similar (but different) to the means test for the aged pension. Generally speaking, the lower your aged-care means test amount, the more government support you’ll receive for aged care. With full support, you don’t need to pay an “entry deposit”. But you still need to pay the basic daily fee (currently, <a href="https://www.myagedcare.gov.au/aged-care-home-costs-and-fees">$52.71</a> a day), equivalent to 85% of your aged pension. If you get partial support, you pay less for your “entry deposit” and ongoing fees. <h2>You don’t need a lump sum</h2> You don’t have to pay for your “entry deposit” as a lump sum. You can choose to pay a rental-style daily cost instead. This is calculated as follows: you multiply the amount of the required “entry deposit” by the maximum permissible interest rate. This rate is set by government and is currently at <a href="https://www.health.gov.au/sites/default/files/documents/2021/03/schedule-of-fees-and-charges-for-residential-and-home-care-schedule-from-20-march-2021_0.pdf">4.01%</a> per year for new residents. Then you divide that sum by 365 to give a daily rate. This option is like borrowing money to pay for your “entry deposit” via an interest-only loan. You can also pay for your “entry deposit” with a combination of a lump sum and a daily rental cost. As it’s not compulsory to pay a lump sum for your “entry deposit”, you have different options for dealing with your family home. <h2>Option 1: keep your house and rent it out</h2> This allows you to use the rental-style daily cost to finance your “entry deposit”. Pros <ul> <li> you could have more income from rent. This can help pay for the rental-style daily cost and “ongoing fees” of aged care </li> <li> you might have a special sentimental attachment to your family house. So keeping it might be a less confronting option </li> <li> keeping an expensive family house will not heavily impact your residential aged care cost. That’s because any value of your family house above <a href="https://www.health.gov.au/sites/default/files/documents/2021/03/schedule-of-fees-and-charges-for-residential-and-home-care-schedule-from-20-march-2021_0.pdf">$173,075.20</a> will be excluded from your <a href="https://www.servicesaustralia.gov.au/organisations/health-professionals/services/aged-care-entry-requirements-providers/residential-care/residential-aged-care-means-assessment">means test</a> </li> <li> you can still access the capital gains of your house, as house prices rise. </li> </ul> Cons <ul> <li> your rental income needs to be included in the means test for your aged pension. So you might get less aged pension </li> <li> you might need to pay income tax on the rental income </li> <li> compared to the lump sum payment, choosing the rental-style daily cost means you will end up <a href="https://www.smh.com.au/money/super-and-retirement/seek-help-when-weighing-up-how-to-pay-for-your-aged-care-20191202-p53g16.html">paying more</a> </li> <li> you are subject to a changing rental market. </li> </ul> <h2>Option 2: keep your house and rent it out, with a twist</h2> If you have some savings, you can use a combination of a lump sum and daily rental cost to pay for your “entry deposit”. Pros <ul> <li> like option 1, you can keep your house and have a steady income </li> <li> the amount of lump sum deposit will not be counted as an asset in the pension means test. </li> </ul> Cons <ul> <li> like option 1, you could have less pension income, higher age-care costs and need to pay more income tax </li> <li> you have less liquid assets (assets you could quickly sell or access), which could be handy in an emergency. </li> </ul> <h2>Option 3: sell your house</h2> If you sell your house, you can use all or part of the proceeds to pay for your “entry deposit”. Pros <ul> <li> if you have any money left over after selling your house and paying for your “entry deposit”, you can invest the rest </li> <li> as your “entry deposit” is exempt from your aged pension means test, it means more pension income. </li> </ul> Cons <ul> <li>if you have money left over after selling your house, this will be included in the aged-care means test. So you can end up with less financial support for aged care.</li> </ul> <h2>In a nutshell</h2> Keeping your house and renting it out (option 1 or 2) can give you a better income stream, which you can use to cover other living costs. And if you’re not concerned about having access to liquid assets in an emergency, option 2 can be better for you than option 1. But selling your house (option 3) avoids you being exposed to a changing rental market, particularly if the economy is going into recession. It also gives you more capital, and you don’t need to pay a rental-style daily cost. <hr /> This article is general in nature, and should not be considered financial advice. For advice tailored to your individual situation and your personal finances, please see a qualified financial planner. Correction: this article previously stated the amount of lump sum deposit will not be counted as an asset in the aged-care means test, as a pro of option 2. In fact, the amount of lump sum deposit will not be counted as an asset in the pension means test.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/161674/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/colin-zhang-1234147">Colin Zhang</a>, Lecturer, Department of Actuarial Studies and Business Analytics, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/is-it-worth-selling-my-house-if-im-going-into-aged-care-161674">original article</a>. </div>

Retirement Income

Readers response: What do you regret not appreciating more when you were younger?

When it comes to ageing, we often learn to appreciate things that we often dismissed when we were younger. We asked our readers what they have only truly started to appreciate with age, and the response was overwhelming. Here's what they said. Ross Forbes - Being brought up on a farm in a family environment where I was taught excellent work ethics and the value of community. Alice McMurdo - The beauty of the scenery in Scotland and not taking the opportunity to see more of the beautiful countryside when I had the chance. Pat Isaacs - My health and energy. Esther Miller - Not having to pay bills. I now understand why my daddy was always telling us cut off the light, shut the door, stop wasting food, do not pour more milk than you are going to drink. I remember him saying "wait till you have to pay for it yourselves". Lesson learned. Marie Chong - My parents. Rosalie Jones - Movement without pain. Michelle Nightingale - My family. Sally O'Neill - Being happy and free, not having any responsibilities to worry about. Chris Gray - My mum. If only I had known what I now know. Margie Buckingham - My ability to always be employed and buy my first house at 21. Also, my upbringing and great start my parents gave me by ensuring I went to a good school and studied hard. Kerri Anderson - Being younger. Linda Kauffman - My mother. Image credits: Shutterstock

Family & Pets

Beloved MasterChef star dies aged 64

Tributes have poured in for well-known Australian chef Greg Malouf, who has passed away at the age of 64. The Melbourne cook, who has been dubbed Australia’s godfather of Middle Eastern cuisine, appeared on MasterChef Australia throughout his career. His tragic death was announced on Saturday and the news has rocked the culinary industry, with friends, family and chefs alike taking to social media to pay tribute. Former MasterChef Australia judge George Calombaris shared a heartbreaking post to Instagram, saying the world has lost a “beautiful man”. “Along with so many today is a sad day for us all,” Mr Calombaris captioned a picture of the star. “We lost a giant of a human @gregmaloufchef. A beautiful man. Yes an amazing chef. I send love to his family and strength." “I will miss the banter of all things Greek v Lebanese food. RIP great man. See you on the other side. Gc xxx.” Many of Greg's celebrity friends quickly took to the comment section to share their sadness at his passing. "One of the giants," wrote fellow celebrity chef Miguel Maestre, while The Great Australian Bake Off star Matt Moran posted a crying emoji. Greg was well-known to lovers of Australian food for his frequent guest appearances on reality TV, including stints of MasterChef Australia and Food Safari. Image credits: Instagram

Caring

New research proves travelling can slow down the ageing process

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

Travel Tips

Common drug shows potential in reversing ageing

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

Body

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

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

Legal

Landmark aged care reforms set to benefit millions of Aussies

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

Caring

Five signs in your senior pet you shouldn’t ignore

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

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

Landmark aged care reforms set to benefit millions of Aussies

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