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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

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<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/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

Thinking of dabbling in investing? Expert’s 7 things to consider before investing a cent

Investing can be seen as both an art and a science, requiring a blend of patience, knowledge and strategy. It’s also crucial to understand the trade-off between risk and return, coupled with your time horizon. This means you do not invest in a vacuum, and each part of the investing world will impact another. Get your financial situation strong before you commit money to investing. This could be clearing consumer debt (credit cards, personal loans, buy-now-pay-later), funding your emergency fund or even setting up a spending plan so you know exactly how much you have free to invest. What else do you need to consider? <ol> <li>Your ‘why’</li> </ol> What is money to you? What do you believe about money? Why are you investing to start with? These questions must have an answer before you commit money to your investing account. If you’re unsure and want to build wealth with money you don’t need now, that’s also okay, but you need to have some conscious thought about your ‘why’ and your goals, as this is the basis of any strategy that you develop. <ol start="2"> <li>Your mindset</li> </ol> Do you have your own personal conviction about your investing, money and even life? Your mindset around investing and money needs to be rock solid, so when you hear someone tell you to do something because they do it, you don’t change a thing because your situation is set up correctly for you! This also helps if you’re part of online forums, listening to podcasts or reading investing books. Your mindset needs to be so firm that you can pick hype vs substance when it comes to investing and other opportunities. Just because everyone is doing it, does not mean it’s a good thing for you to do. <ol start="3"> <li>Setting your strategy</li> </ol> An effective investment strategy is personalised and aligned with your financial goals, risk tolerance and investment horizon. Whether you’re saving for retirement, a child’s education or building wealth, your strategy should dictate how you allocate your assets across different investment vehicles. It may be considered essential to have a balanced mix of shares (or ETFs), bonds (or fixed interest) and other assets to mitigate risk. Regularly reviewing and adjusting your portfolio to stay aligned with your goals is also a crucial part of your strategy. Your strategy will help you stay the course if things get rough out there and your emotions are tempted to take over! This goes hand-in-hand with having a sound mindset. <ol start="4"> <li>Ownership structure</li> </ol> Understanding the best ownership structure for your wealth building and investments can have significant implications for taxes, estate planning and asset protection. Options include individual or joint accounts, superannuation, investment bonds, trusts and companies. Each has its advantages and considerations, particularly concerning tax efficiency and control over the assets. Before you pull the trigger with significant wealth (for example, if you were to receive an inheritance), seek professional advice around the ownership of your investment vehicle. This will help you determine the most advantageous structure for your situation. <ol start="5"> <li>Broad-based index funds</li> </ol> Broad-based index funds are foundational to a well-rounded investment portfolio. These funds track the performance of a specific index, such as the ASX 200, S&P 500 or thematic indexes and provide investors with diversified exposure to a wide array of companies. The beauty of index funds lies in their simplicity and effectiveness. They offer a low-cost way to invest in the stock market, reducing the risk associated with picking individual companies. Over the long term, index funds have historically provided solid returns, making them an excellent choice for both novice and experienced investors. <ol start="6"> <li>Valuing and investing in individual companies</li> </ol> For those inclined to take a more hands-on approach with their investing or just to keep the interest alive, valuing single companies is a critical skill. This involves analysing a company's financial health, market position and growth prospects. Key metrics such as the price-to-earnings (P/E) ratio, earnings growth and dividend yield can provide valuable insights. However, it’s important to remember that ‘stock picking’ requires research, a deep understanding of market cycles and a higher tolerance for risk. Your goal may be to identify undervalued companies that have the potential for significant growth. A note to remember is to have your own guardrails in your life and make it part of your investment constitution that you will not have more than, say, 10 per cent of your portfolio allocated to individual companies. <ol start="7"> <li>Advanced concepts, trading and speculation</li> </ol> The key with advanced concepts, alternative/speculative asset classes, day trading and options trading is again to have solid guardrails in place. Be engaged and dialled in to your investing; however, you need to understand that the best thing you can do for your future wealth is buy and hold good, broad-based indexes for the long term. We love doing advanced strategies and some wild stuff, but we have strong guardrails because these strategies may flush you if you’re not careful, and you don’t want your whole portfolio allocated to such endeavours! Edited extract from The quick start guide to investing: Learn how to invest simpler, smarter & sooner by Glen James & Nick Bradley (Wiley $32.95), available at all leading retailers. Disclaimer: Any information here is general in nature and has been prepared without considering your personal goals, financial situation, or needs. Because of this, before acting on the general advice, you should consider its appropriateness, having regard to your unique situation. You should obtain and review the Product Disclosure Statement (PDS) and Target Market Determination (TMD) relevant to the product before making any financial product decisions. It's also strongly encouraged to seek the advice of a professional financial adviser. Image credits: Shutterstock

Money & Banking

Is an electric bike right for you? Here’s what to consider before you buy

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/muhammad-rizwan-azhar-1472288">Muhammad Rizwan Azhar</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/waqas-uzair-1486684">Waqas Uzair</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> <a href="https://www.theguardian.com/australia-news/2023/oct/08/its-also-just-fun-why-a-growing-number-of-australia-families-are-ditching-cars-for-e-bikes">More Australians than ever</a> are riding electric bikes – a fact you may have noticed on the streets of our cities and towns. Electric bikes, or e-bikes, are typically equipped with an electric motor and a battery, providing power to help you pedal. Some allow you to boost and lower the amount of pedalling assistance you get. Globally, the transport sector produces <a href="https://www.un.org/sites/un2.un.org/files/media_gstc/FACT_SHEET_Climate_Change.pdf">about one-quarter</a> of greenhouse gas emissions. Finding cleaner ways to get around is vital to combating the climate crisis. E-bikes also offer solutions to the problems of traffic congestion, fuel costs and sedentary lifestyles. But is an electric bike right for you? Below, we discuss the pros and cons, to help you decide. <h2>The pros</h2> – Reduce carbon emissions In developed countries, transport can be one of the largest proportions of an individual’s carbon footprint. But you can <a href="https://sustainability.anu.edu.au/options-for-owning-an-e-bike">reduce your travel emissions</a> by 75% if you replace car use with an e-bike for short trips such as the work commute. <a href="https://www.creds.ac.uk/publications/e-bike-carbon-savings-how-much-and-where/">Research has found</a> e-bikes, if used to replace cars, could cut carbon dioxide (CO₂) emissions by up to 50% in England – or about 30 million tonnes a year. Other analysis showed the potential was <a href="https://www.sciencedirect.com/science/article/pii/S0967070X21003401">greatest</a> in rural areas. – Connect with your community The “car-rification” of our cities changed community dynamics. Retail became concentrated in <a href="https://www.sciencedirect.com/science/article/abs/pii/S0264837716312479">out-of-town shopping centres</a>, leading to a decline in smaller town centres. This provided fewer opportunities to meet our neighbours and has contributed to high rates of <a href="https://www.vox.com/features/23191527/urban-planning-friendship-houston-cars-loneliness">loneliness and social isolation</a>. Similar to <a href="https://www.researchgate.net/publication/308794595_From_Pedal_to_People_The_Social_Effects_of_Biking">regular cycling</a>, riding e-bikes helps create community bonds. It makes us more likely to engage with our surroundings and interact with people around us. You can even join an <a href="https://www.meetup.com/topics/electric-bicycles/au/">e-bike group</a> or community ride. – Save money E-bikes offer substantial long-term financial benefits to owners. In Australia, an e-bike costs from about A$1,000 to more than $5,000. An annual e-bike service will set you back <a href="https://www.choice.com.au/transport/bikes/electric/articles/how-to-maintain-your-electric-bike#:%7E:text=How%20much%20does%20an%20e,%24300%2C%20depending%20on%20what's%20included.">between $100 and $300</a>. And retailers <a href="https://crooze.com.au/blogs/news/the-costs-of-owning-an-ebike#:%7E:text=This%20means%20it%20costs%20roughly,electricity%20charges%20per%2030kms%20ridden.">currently</a> <a href="https://www.glowwormbicycles.com.au/blogs/electric-bikes/how-much-should-i-spend-on-an-e-bike">put the cost</a> of a full battery charge at 10–15 cents, translating to roughly $20 per year for an average commuter. Cars, of course, cost far more to run. For example, Victorian motoring body RACV <a href="https://www.racv.com.au/about-racv/newsroom/victorias-cheapest-cars-2023.html">last year found</a> the state’s cheapest car to own and operate was the MG3 Core light Hatch, with monthly costs of $734.84. Even taking into account charging costs and maintenance, you can see how quickly an e-bike would pay for itself. – Get active E-bikes are clearly better for your health than riding in a car. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790588/">2019 study investigated</a> e‐bike commuting for inactive, overweight people living in regional Australia. It found e-bike users increased their physical activity by an average 90 minutes a week. A <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/sms.14155">literature review in 2022</a> found e-biking was a moderately intense physical activity on measures such as energy expenditure, heart rate and oxygen consumption. The benefits were lower than conventional cycling, but generally greater than walking. Women, in particular, have reported benefits from e-bike use. A <a href="https://activetravelstudies.org/article/id/991/">New Zealand study</a> showed e-bikes provided less fit women with “more empowering physical activity experiences” and increased their cycling confidence. <h2>The cons</h2> – Safety challenges Like any form of mobility, e-bikes must be used safely. Concerns around e-bikes include <a href="https://www.abc.net.au/news/2023-09-13/fat-bike-boom-in-sydney-sparks-safety-fears/102823330">speeding</a>, <a href="https://www.nbcnews.com/nightly-news/video/concerns-grow-over-safety-of-e-bikes-amid-reports-of-accidents-192619077845">accidents</a> and people riding <a href="https://www.nbnnews.com.au/2024/03/20/e-bike-safety-concerns-spark-in-lennox-head/">without helmets</a>. In May this year, Sydney’s Northern Beaches Council <a href="https://www.northernbeaches.nsw.gov.au/e-bike-and-e-scooter-safety">launched a public awareness</a> campaign on e-bike safety. <a href="https://www.northernbeaches.nsw.gov.au/council/news/media-releases/northern-beaches-council-leads-pack-e-bike-safety-campaign">The advice includes</a>: <ul> <li>slow to walking pace when others are on the path</li> <li>ring your bell to signal your approach</li> <li>be ready for sudden changes.</li> </ul> Government regulation on e-bikes is also important for public safety. For example <a href="https://fit-ebike.com/en-en/about-us/blog/s-pedelecs/">in Germany</a>, high-speed e-bikes are classed as mopeds and cannot be ridden on bike paths. Separately, e-bikes usually contain lithium-ion batteries which can explode and start fires – particularly in e-bikes bought from overseas retailers that don’t meet Australian standards. Before buying, <a href="https://www.fire.nsw.gov.au/page.php?id=9406">check advice from fire authorities</a>. <figure><iframe src="https://www.youtube.com/embed/U58Pv7-7fnE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> – Lack of cycling and charging infrastructure Well-designed <a href="https://www.sciencedirect.com/science/article/pii/S2214140519301033">cycling infrastructure</a> encourages e-bike use. In Australia, governments are <a href="https://www.infrastructureaustralia.gov.au/sites/default/files/2019-06/Cycling_Infrastructure_Background_Paper_16Mar09_WEB.pdf">slowly accepting</a> the need for infrastructure such as dedicated bike lanes and <a href="https://www.transport.nsw.gov.au/get-nsw-active/emicro-smart-micro-mobility-infrastructure">charging stations</a>, but <a href="https://theconversation.com/why-do-so-few-people-cycle-for-transport-in-australia-6-ideas-on-how-to-reap-all-the-benefits-of-bikes-229811">more money</a> is needed. In the Netherlands, a surge in e-bike sales has <a href="https://www.government.nl/topics/bicycles">driven</a> investments in cycling paths, improvements in bicycle parking at train stations, and other efforts to promote cycling and e-bike use. – Higher upfront cost than a regular bike The cost of buying an e-bike can be a barrier for some. For example, <a href="https://activetravelstudies.org/article/id/991/">NZ-based research</a> found the purchase cost meant the benefits were less likely to be available to lower-income women. So how can the cost barrier be overcome? In Australia, some companies offer e-bike rentals, via a weekly <a href="https://lug-carrie.com">subscription service</a>. And overseas, <a href="https://www.pbsc.com/blog/2021/09/pbsc-e-bike-sharing-schemes-in-15-cities-around-the-world">share schemes</a> mean people can access e-bikes without having to buy one. In 2023, <a href="https://www.service.tas.gov.au/services/government-help-and-support/concessions-and-discounts/apply-for-an-electric-vehicle-or-e-mobility-rebate">Tasmania became the first Australian state</a> to offer a subsidy for e-bike purchases, and the uptake was rapid. However, the scheme has now closed. – Environmental impacts Almost everything we buy has an environmental impact, and electric bikes are no exception. However, they are obviously a better alternative to conventional cars – and also have less impact than electric vehicles. Over the total lifecycle of the product, including manufacturing, an e-bike emits <a href="https://ecf.com/resources/cycling-facts-and-figures/environmental">about 10%</a> of the CO₂ emissions associated with producing an electric car, according to the European Cyclists Federation. And e-bikes <a href="https://electrek.co/2023/05/04/you-cant-trust-electric-bike-companies-battery-range/">consume</a> about <a href="https://ebikes.ca/learn/solar.html#:%7E:text=6%20wh%2Fkm%20would%20be,heavy%20loads%20and%20riding%20fast.">15 watt-hours per kilometre</a>, compared to electric cars which <a href="https://www.drive.com.au/caradvice/what-is-a-good-energy-consumption-figure-for-electric-vehicles/">consume around</a> 150 to 200 watt-hours per kilometre. E-bike battery systems also typically require fewer raw materials and simpler design than an electric vehicle, which <a href="https://www.sciencedirect.com/science/article/pii/S0892687524000293">simplifies</a> the battery recycling process. <h2>Cleaner, cheaper, better</h2> Electric cars are crucial for replacing traditional vehicles on longer routes and for family travel. However, e-bikes offer a more affordable and lower-impact solution for commuting and short-distance travel – and if you buy a cargo e-bike, you can even take your family. Mass adoption of e-bikes in Australia requires better cycling infrastructure, new government regulation and price incentives. But in the meantime, thousands of Australians are already enjoying the benefits of e-bikes. Perhaps you could too? <a href="https://theconversation.com/profiles/muhammad-rizwan-azhar-1472288">Muhammad Rizwan Azhar</a>, Lecturer of Chemical Engineering, Sustainable Energy and Resources, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/waqas-uzair-1486684">Waqas Uzair</a>, Research Associate, Advanced Battery Systems and Safety, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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-an-electric-bike-right-for-you-heres-what-to-consider-before-you-buy-230024">original article</a>. </div>

Travel Trouble

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs. As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns. But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug. <h2>Potential benefits</h2> 1) It’s likely to help you lose weight The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity. The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight). In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg. Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication. 2) It may reduce your chronic disease risk factors When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases. In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels. In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels. 3) It might improve your quality of life, emotional wellbeing or sense of achievement The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health. Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image. <h2>What about the risks?</h2> 1) You may experience gastrointestinal symptoms In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%). In the UK study, nausea and diarrhoea were also commonly reported. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living. Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study. 2) You might feel fatigued Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants. 3) You might be among the minority who don’t tolerate the drug Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia. In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing. More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period. A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period. Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions. 4) It might be difficult to access Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024. To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication. 5) You might not always get clear information from vested interests Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>. Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications. <h2>Bottom line</h2> Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.<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/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images 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/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.

Body

How do I handle it if my parent is refusing aged care? 4 things to consider

<a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s a shock when we realise our parents aren’t managing well at home. Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed. You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what? Here are four things to consider. <h2>1. Start with more help at home</h2> Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move. Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both. Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety. Call <a href="https://www.myagedcare.gov.au/">My Aged Care</a> to discuss your options. <h2>2. Be prepared for multiple conversations</h2> Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made. Ideally, the older person feels supported rather than attacked during these conversations. Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice. Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”. <h2>3. Understand the options when help at home isn’t enough</h2> If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be <a href="https://academic.oup.com/gerontologist/article/60/8/1504/5863160">considering a nursing home</a> (also known as residential aged care in Australia). Every person has a legal right to <a href="https://humanrights.gov.au/our-work/9-your-right-choose-where-you-live">choose where we live</a> (unless they have lost capacity to make that decision). This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”. It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational). Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else? Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space. Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826495/">Research</a> suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control. Mum and Dad should be involved in the decision-making process about where they live, and when they might move. Some families start looking “just in case” as it often takes some time to <a href="https://www.abc.net.au/everyday/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">find the right nursing home</a> and there can be a wait. After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule. We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions. For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”. Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead. <h2>4. Understand the options if a parent has lost capacity to make decisions</h2> If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests. If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity. Mum or Dad may have appointed an <a href="https://www.tag.nsw.gov.au/wills/appoint-enduring-guardian/what-enduring-guardian">enduring guardian</a> to make decisions about their health and lifestyle decisions when they are not able to. An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves. If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can <a href="https://www.tag.nsw.gov.au/guardianship/information-about-guardianship">appoint</a> that person a private guardian (usually a family member, close friend or unpaid carer). If no such person is available to act as private guardian, a public official may be appointed as public guardian. <h2>Deal with your own feelings</h2> Families often feel <a href="https://link.springer.com/article/10.1007/s12144-023-04538-9">guilt and grief</a> during the decision-making and transition process. Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.<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/221210/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images 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-i-handle-it-if-my-parent-is-refusing-aged-care-4-things-to-consider-221210">original article</a>.

Caring

An expert’s top 5 reasons why dogs can be considered exceptional animals

<a href="https://theconversation.com/profiles/melissa-starling-461103">Melissa Starling</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Dogs are important to a lot of humans, but what makes them so? Apart from being warm, soft and capable of inspiring our unconditional love, there are a number of unique characteristics that set dogs apart from other animals. As a dog researcher, animal behaviour consultant and canophile (which means I love dogs), let me share five traits that I think make dogs so special. <h2>Dogs are hypersocial</h2> We all know those golden retriever-type dogs that appear absurdly delighted to meet any new social being. It’s hard not to be taken in by their infectious friendliness. These furry, hypersocial creatures have some key genetic differences even to other domestic dogs. Most fascinatingly, these genetic differences are in the area of the genome <a href="https://www.insidescience.org/news/rare-human-syndrome-may-explain-why-dogs-are-so-friendly">associated</a> with hypersociability in people with a genetic condition called Williams-Beuren syndrome. Although people with this syndrome experience negative health effects, they also tend to be very open, engaging and sociable. Not all dogs fall into this hypersocial category – but even those that don’t are unusually accepting of unfamiliar people and dogs. Unlike other social wild canids such as wolves, domestic dogs can quite happily live in harmony with different species, as well as individuals of their own species that aren’t from their family. This is what makes it so easy to slot dogs into our lives. <h2>Dogs are wired to understand us</h2> Humans have selectively bred dogs for many generations. And in many cases, we’ve bred them to take direction to help us in a wide variety of jobs – including being companions to us. This has led to domestic dogs being born with an interest in humans. From an early age, <a href="https://www.sciencedirect.com/science/article/pii/S0960982221006023">puppies are attracted</a> to human faces. While dogs are as co-operative as wolves, they tend to be submissive towards humans and follow our directions – whereas wolves are bolder and more likely to lead when <a href="https://www.pnas.org/doi/10.1073/pnas.1709027114">co-operating with humans</a>. Dogs also learn to follow our gaze, and show a left-gaze bias when looking at human faces. This means they spend more time looking at the left side of our faces (which would be the right side from our perspective). This bias emerges in several species when they are processing emotional information, which shows that dogs are <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152393">reading our faces</a> to figure out how we’re feeling. For a while it was also thought dogs were particularly attentive to human gestures such as pointing – but recent research suggests many domestic species and some wild animal species can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555673/">follow pointing</a>. <h2>Dogs come in countless shapes and sizes</h2> No other species comes in such a huge variety of shapes and sizes as domestic dogs. Not even cats or horses display the same diversity. The largest dogs may be close to 25 times the size of the smallest! Beyond that, we have dogs with drop ears and prick ears and everything in between, tails and no tails, or bob tails, short legs and long legs, long noses and short noses – and a huge variety of coat colours, lengths and textures. For dogs, this huge variation might mean they have more to learn than other animals when it comes to understanding their own kind. For example, owners of herding breed dogs may find their dog a bit confused, or even defensive, when meeting a very different short-faced breed such as a bulldog. For us, it means we should appreciate how the size and shape of dogs can influence <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149403">their behaviour</a> and experiences. For instance, dogs with longer noses have sharper vision, while dogs with a lighter build tend to be more energetic and fearful. <h2>Dogs form deep emotional bonds</h2> Domestic dogs have been shown to form attachment bonds with human caregivers that are very similar to those formed between <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0065296">children and parents</a>. This may partly explain why they can read our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426098/">emotional signals</a>, why they become distressed (and try to help us) when <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231742">we are distressed</a>, and why MRI studies show dogs are happy when they smell <a href="https://www.sciencedirect.com/science/article/pii/S0376635714000473">their owners</a>. It may also be why they panic when separated from us. Dogs’ attachment to humans goes beyond being hypersocial. To them, we are a lot more than the food we provide and the balls we throw. We are an attachment figure akin to a parent. <h2>Dogs can help us be our best selves</h2> Most dog owners would agree their dog brings out the best in them. They can confide in their dog and love them unconditionally – sometimes more easily than they can another human. Dogs are playing important roles in animal-assisted therapy, where their nonjudgmental presence can be a calming influence and <a href="https://link.springer.com/article/10.1007/s40489-019-00188-5">facilitate social interactions</a>. They can even help children <a href="https://link.springer.com/article/10.1007/s10643-022-01392-5">learn to read</a> and <a href="https://www.mdpi.com/2077-0383/10/21/5171">alleviate anxiety</a>. Although assisting humans with their emotional problems can be a difficult task for such an emotionally sensitive species, research suggests the right dogs can rise to the task if their workload is <a href="https://www.sciencedirect.com/science/article/pii/S1558787818302193">managed carefully</a>. Horses are also used in animal-assisted therapy, as are some smaller furry animals. However, dogs are more portable and can remain at ease in stimulating environments such as courtrooms, schools and airports. They are uniquely placed to accompany us wherever we go. <h2>Paws for thought</h2> We might like to think dogs are special for some of the traits we value in humans, such as intelligence, selflessness or a loving nature. But really dogs are exceptional for simply being dogs. They are social acrobats that can find social harmony wherever they go. They have rich emotional lives in which they co-exist with different species and can even forge bonds <a href="https://www.youtube.com/watch?v=89dCR3VinMM&ab_channel=WCCO-CBSMinnesota">outside of their own species</a>. They are also generally tolerant of our primate ways – and good at receiving our love. And for me that’s enough.<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/211832/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/melissa-starling-461103">Melissa Starling</a>, Postdoctoral Researcher in Veterinary Science, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/an-experts-top-5-reasons-why-dogs-can-be-considered-exceptional-animals-211832">original article</a>.

Family & Pets

Lump sum, daily payments or a combination? What to consider when paying for nursing home accommodation

<a href="https://theconversation.com/profiles/anam-bilgrami-1179543">Anam Bilgrami</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Moving yourself or a loved one to a nursing home can be <a href="https://theconversation.com/should-we-move-our-loved-one-with-dementia-into-a-nursing-home-6-things-to-consider-when-making-this-tough-decision-189770">emotional and difficult</a>. While some have their nursing home accommodation costs fully covered by the government (based on a <a href="https://www.myagedcare.gov.au/how-much-will-i-pay">means test</a>), most will have to pay their own way. The average lump sum room value is <a href="https://www.health.gov.au/sites/default/files/documents/2021/08/ninth-report-on-the-funding-and-financing-of-the-aged-care-industry-july-2021.pdf">A$334,000</a>. Choosing how to pay can make this time even more challenging, particularly for those with <a href="https://theconversation.com/would-you-pass-this-financial-literacy-quiz-many-wont-and-its-affecting-expensive-aged-care-decisions-175063">low financial literacy</a>. This is an important and complex decision. It can affect your income, wealth, means-tested aged care fee, and bequests. Here are some things to consider before you decide. <h2>3 ways to pay</h2> You can <a href="https://www.myagedcare.gov.au/understanding-aged-care-home-accommodation-costs">pay</a> for a nursing home room in three ways. You can pay the entire room price as a one-off, refundable lump sum (a “refundable accommodation deposit”, sometimes shortened to RAD). This lump sum is refunded to the resident or their estate when the person leaves the nursing home (if they move or pass away). The refund is <a href="https://www.myagedcare.gov.au/aged-care-home-accommodation-refunds">guaranteed by the government</a>, even if a provider goes bankrupt. People who don’t want to pay a lump sum can instead choose rent-style, “daily accommodation payments” (sometimes shortened to DAP). These are fixed, daily interest-only payments calculated on the total room price. The rate at which they are calculated is known as the “maximum permissible interest rate” or MPIR. The maximum permissible interest rate is set by the government and is currently <a href="https://www.health.gov.au/sites/default/files/2023-06/base-interest-rate-bir-and-maximum-permissible-interest-rate-mpir-for-residential-aged-care_0.pdf">7.9%</a> per annum. The <a href="https://www.health.gov.au/our-work/residential-aged-care/managing-residential-aged-care-services/managing-accommodation-payments-and-contributions-for-residential-aged-care#accommodation-payment">formula</a> for a daily accommodation payment is (RAD × MPIR) ÷ 365. Unlike lump sums, daily accommodation payments are not refunded. The third option is a <a href="https://www.health.gov.au/our-work/residential-aged-care/managing-residential-aged-care-services/managing-accommodation-payments-and-contributions-for-residential-aged-care#accommodation-payment">combination payment</a>. This means paying part of the room price as a lump sum, with daily payments calculated on the remaining room amount. On leaving the home, the part lump sum is refunded to the resident or their estate. With a combination payment, the consumer can choose to pay whatever amount they like for the lump sum. The table below shows three different ways someone could pay for a room priced at $400,000. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&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/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=432&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=432&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=432&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=542&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=542&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540310/original/file-20230731-130241-shaphm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=542&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> So which is best? It’s impossible to say. It depends on a person’s circumstances, family situation, finances, preferences and expected length of stay. <h2>Why do some people choose a lump sum?</h2> One downside of a lump sum (or part lump sum) is that choosing this option means this money is not invested elsewhere. By handing over the lump sum, for example, you forgo returns you could have made by investing this same money into property or stocks over the period of your nursing home stay. On the other hand, paying lump sum means you get to avoid the daily interest payments (the 7.9% in the table above). So you could potentially be better off paying a lump sum if you think there’s no way you could make investment returns on that money that are substantially higher than the interest you’d be charged through daily payments. One advantage of choosing a lump sum is it’s considered an <a href="https://www.dva.gov.au/get-support/health-support/care-home-or-aged-care/help-pay-home-or-aged-care/residential-aged-0">exempt asset</a> for pension purposes; some people may get more <a href="https://www.afr.com/wealth/personal-finance/five-things-you-need-to-know-about-aged-care-deposits-20200302-p54606">pension</a> if they pay the lump sum. The lump sum, however, does count as an asset in determining the <a href="https://www.health.gov.au/our-work/residential-aged-care/charging-for-residential-aged-care-services/residential-aged-care-fee-scenarios-for-people-entering-care-from-1-july-2014">means-tested care fee</a>. And if you sell your house, remember any money leftover after you pay the lump sum will be counted as assets when you’re means-tested for the pension and means-tested care fee. <h2>Why might some people prefer daily payments?</h2> Not everyone can can afford a lump sum. Some may not want to <a href="https://theconversation.com/is-it-worth-selling-my-house-if-im-going-into-aged-care-161674">sell their home</a> to pay one. Some may want to hold onto their house if they think property prices may increase in the future. Daily payments have recently overtaken lump sums as the most <a href="https://www.health.gov.au/sites/default/files/documents/2021/08/ninth-report-on-the-funding-and-financing-of-the-aged-care-industry-july-2021.pdf">popular payment option</a>, with 43% of people paying this way. However, recent <a href="https://amp-smh-com-au.cdn.ampproject.org/c/s/amp.smh.com.au/money/super-and-retirement/aged-care-interest-rate-increase-sees-daily-payments-almost-double-20230324-p5cuz2.html">interest rate rises</a> may slow or reverse this trend. And if a spouse or “<a href="https://www.dva.gov.au/get-support/health-support/care-home-or-aged-care/residential-aged-care/aged-care-costs">protected person</a>” – such as a dependant or relative that meets certain criteria – is still living in the house, it’s also exempt from assets tests for the pension and other aged care fees. If the home is vacated by a protected person, its value is still excluded from the pension means test for <a href="https://www.dva.gov.au/get-support/health-support/care-home-or-aged-care/help-pay-home-or-aged-care/residential-aged-0">two years</a> (although rental income is still assessed). If you do not anticipate a lengthy nursing home stay, daily payments may potentially be the easiest option. But it’s best to consult a financial adviser. <h2>What does the research say?</h2> My <a href="https://www.mq.edu.au/__data/assets/pdf_file/0007/1190086/What-drives-end-of-life-financial-decisions.pdf">research</a> with colleagues found many people choose the lump sum option simply because they can afford to. Those <a href="https://ahes.org.au/portfolio-items/entering-aged-care/">owning residential property</a> are more likely to pay a lump sum, mostly because they can sell a house to get the money. People who consult financial advisers are also more likely to choose lump sums. This may be due to <a href="https://www.afr.com/wealth/aged-care-costs-most-opt-for-pay-as-you-go-20181023-h170g4">financial advice</a> suggesting it’s tough to earn investment returns higher than what you’d save by avoiding the interest charged in the daily payment option. Some aged care providers <a href="https://www.mq.edu.au/__data/assets/pdf_file/0003/1164243/the-role-of-refundable-accommodation-deposits-FINAL.pdf">prefer</a> lump sum payment since they <a href="https://www.agedcarequality.gov.au/providers/prudential-standards/permitted-use-refundable-deposits">use</a> these to renovate or refurbish their facilities. But providers are not allowed to influence or control your decision on how to pay. The recent Royal Commission into Aged Care recommended <a href="https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-recommendations.pdf">phasing out</a> lump sums as a payment option, leaving only daily payments. While that would reduce the complexity of the payment decision and remove the incentive for providers to sway decisions, it would also reduce consumer choice. <h2>Is there anything else I should know?</h2> Some 60% of people we <a href="https://www.mq.edu.au/__data/assets/pdf_file/0007/1190086/What-drives-end-of-life-financial-decisions.pdf">surveyed</a> found the decision complex, while 54% said it was stressful. It is best to seek professional <a href="https://www.myagedcare.gov.au/understanding-aged-care-home-accommodation-costs#financial-advice">financial advice</a> before you decide. Services Australia also runs a free <a href="https://www.servicesaustralia.gov.au/what-financial-information-service?context=21836">Financial Information Service</a> that can help you better understand your finances and the payment decision. But it does not give <a href="https://www.servicesaustralia.gov.au/financial-information-service-officers?context=21836#a2">financial advice or prepare plans</a>. You have <a href="https://www.health.gov.au/our-work/residential-aged-care/managing-residential-aged-care-services/managing-accommodation-payments-and-contributions-for-residential-aged-care">28 days to choose a payment method</a> after admission, and six months to pay if you <a href="https://www.health.gov.au/our-work/residential-aged-care/managing-residential-aged-care-services/managing-accommodation-payments-and-contributions-for-residential-aged-care">choose a lump-sum payment</a>. In the interim, you will be charged daily interest payments on the room price.<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/207405/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anam-bilgrami-1179543">Anam Bilgrami</a>, Research Fellow, Macquarie University Centre for the Health Economy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Getty Images 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/lump-sum-daily-payments-or-a-combination-what-to-consider-when-paying-for-nursing-home-accommodation-207405">original article</a>.

Retirement Life

Extreme Hollywood body transformations have become standard preparations for film actors – but we need to consider the consequences

<a href="https://theconversation.com/profiles/gemma-sharp-314703">Gemma Sharp</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/bronwyn-dwyer-1453560">Bronwyn Dwyer</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> “…when you’re shooting a film like Magic Mike, and you’re doing dance routines for two weeks at a time, you have to peak every day. So that became kind of crazy. We had a gym in the parking lot, and we’d all be lifting weights on set all day,” <a href="https://wegotthiscovered.com/movies/interview-channing-tatum-joe-manganiello-magic-mike/">explained actor Joe Manganiello</a>, about performing in the film Magic Mike. It is not unusual for actors to undergo drastic changes in preparation for a role, including gaining muscle and losing body fat for that shredded look. In fact, this is becoming the norm in Hollywood. <a href="https://www.menshealth.com/fitness/a43945188/jake-gyllenhaals-road-house-transformation/">Jake Gyllenhaal</a> in Road House, <a href="https://www.insider.com/michelle-rodriguez-rege-jean-page-workout-dungeons-and-dragons-sdcc-2022-7">Michelle Rodriguez</a> in Dungeons & Dragons, and <a href="https://www.menshealth.com/entertainment/a42532547/paul-rudd-marvel-ant-man-interview/">Paul Rudd</a> in Ant-Man and the Wasp: Quantumania, have all undertaken body modifications for roles this year. As the audience, we readily accept these body modifications to be part of the preparation for the role without necessarily considering the potentially long-term physical and mental health consequences. <h2>So how do they do it?</h2> From what Hollywood shares with the general public about these body modifications, which is generally very limited, it appears these transformations occur through excessive exercise and highly restrictive diets. Nevertheless, these Hollywood workouts are highly popular with ordinary people, with Dwayne “The Rock” Johnson and Chris Hemsworth’s workouts <a href="https://sustainhealth.fit/lifestyle/most-searched-hollywood-actor-workouts/">particularly sought after</a>. These regimens resemble those of competitive bodybuilders, <a href="https://journals.lww.com/hrpjournal/Abstract/2019/07000/Competitive_Bodybuilding__Fitness,_Pathology,_or.3.aspx">whose success also relies on appearance</a>. The <a href="https://link.springer.com/article/10.2165/00007256-200434050-00004">typical process for bodybuilders</a> involves two phases: a “bulking” phase, during which the goal is to have enough energy for muscle growth, and a “cutting” phase, when the aim is to lose weight but not muscle. The end result of such a process is usually highly applauded, even though drastic measures have been taken to achieve such a look. Actors of all genders are undergoing these body transformations for <a href="https://www.sportskeeda.com/comics/10-marvel-actors-whose-body-transformation-shocked-world">various roles</a> such as superheroes, athletes, or the portrayal of real-life people. <h2>What are the consequences?</h2> “I’ve become a little bit more boring now, because I’m older and I feel like if I keep doing what I’ve done in the past I’m going to die. So, I’d prefer not to die,” <a href="https://www.menshealth.com/uk/fitness/lifestyle/a29725245/christian-bale-no-more-body-transformation-roles/">said Christian Bale</a>, who has undertaken multiple extreme transformations for roles. To achieve what is needed for a particular role, extreme measures are often taken. However, the consequences of these measures, such as use of substances, exercise dependence, and an increased risk of developing muscle dysmorphia and/or an eating disorder, is seemingly not common knowledge. A concern for the bodybuilding community is the widespread use of drugs, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026349/">often multiple drugs at a time not obtained through prescription</a>. Androgenic-anabolic steroids are commonly used which can have extensive negative effects on the human body, including on the cardiovascular system, hormones, metabolism and even psychiatric wellbeing. Exercise dependence can also occur when an individual engages in an extreme amount of exercise, to the point at which <a href="https://link.springer.com/article/10.1007/s11936-018-0674-3">physical, psychological or emotional harm</a> can occur. We are not sure exactly why exercise dependence happens, but it could potentially be a form of <a href="https://www.tandfonline.com/doi/full/10.1080/19585969.2023.2164841">behavioural addiction</a>. Another risk is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977020/">muscle dysmorphia</a>, a subtype of body dysmorphic disorder characterised by the individual being preoccupied with the idea their physique is not muscular enough, even if they have a high degree of muscle. <h2>What about the dieting impacts?</h2> There are many similarities between the requirements of bodybuilding and eating disorders. Both are characterised by restrictive diets, high levels of exercise, potential social isolation, and adherence to a <a href="https://journals.lww.com/hrpjournal/Abstract/2019/07000/Competitive_Bodybuilding__Fitness,_Pathology,_or.3.aspx">rigid schedule</a>. The seminal <a href="https://www.sciencedirect.com/science/article/pii/S002231662210249X?via%3Dihub">Minnesota Starvation Experiment</a> fundamentally shaped our understanding of the changes a person can experience when they are consuming less than their daily nutrition energy needs, such as during the “cutting” phase for bodybuilders. This research showed that people who are experiencing starvation for a period of time will experience devastating impacts in the physical, psychological, behavioural and social aspects of their lives. Some of the many documented changes included reductions in heart muscle mass, heart rate and blood pressure, dizziness, fatigue, increased feelings of depression and anxiety, obsessive thoughts about food, and withdrawal from social activities and relationships. Concerningly, even once a person is renourished, the psychological issues around body size and food <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23095">can persist</a>. Therefore, even after an actor has returned to their pre-modification weight and size, it does not mean they have recovered from the consequences that came with that body modification. <h2>What are the impacts on the general public?</h2> Rapid changes in physical appearance are not realistically achievable for most people. So seeing actors doing this seemingly easily with the assistance of their professional teams sets an <a href="https://link.springer.com/article/10.1007/s40894-022-00179-4">unrealistic standard</a>. For people without the same income or access to resources to achieve these body modifications in a safe way, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872588/">more extreme means</a> would be undertaken and consequent damage to mental and physical wellbeing can ensue. These body modifications are definitely a case of “do not try this at home”. There are many risks when undertaking dramatic body modifications, most of which are not talked about in public. Actors are just as vulnerable to these risks, despite us rarely seeing what exactly they go through to achieve these dramatic transformations. Hollywood is a highly competitive environment, and being honest about body modification and its consequences could stop an actor landing their next gig. We don’t recommend body modifications in any way, but if someone does want to make a change to their lifestyle, we strongly recommend consulting with a team of health professionals to ensure physical and psychological safety during the process and beyond. –– If this article has raised issues for you, or if you’re concerned about someone you know, do not hesitate to reach out for support. For concerns around eating, exercise, or body image visit the <a href="https://butterfly.org.au/">Butterfly Foundation</a> or call the national helpline on 1800 33 4673. For concerns around drug use visit <a href="https://www.health.gov.au/our-work/drug-help">Drug Help</a> or call the National Alcohol and Other Drug Hotline on 1800 250 015.<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/207722/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gemma-sharp-314703">Gemma Sharp</a>, Associate Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/bronwyn-dwyer-1453560">Bronwyn Dwyer</a>, , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: 20th Century Fox 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/extreme-hollywood-body-transformations-have-become-standard-preparations-for-film-actors-but-we-need-to-consider-the-consequences-207722">original article</a>.

Body

5 reasons why you should consider fostering a pet

Becoming an animal foster carer is one of the most selfless and rewarding things you can do in life. Usually through no fault of their own, some pets find themselves in dire need of a home, and if you have room in your house (and in your heart), here are five reasons why you should help them out. 1. You’re saving a life and offering a second chance Part of the reason why shelters rely on foster care so much is that they simply don’t have the space to provide a temporary home for the pet themselves. By taking in downtrodden four-legged friends, you’re easing the strain on local rescues, saving a life and giving animals a second chance. 2. You’re helping prepare the pet for its new home Many shelter animals have had rough lives and potentially spent time living on the streets. You have the opportunity to help them adapt to life at home, where they’ll be fed, exercised, socialised and loved. 3. There’s no commitment If you like the idea of having a pet but can’t commit to owning one long-term, fostering is a great way to still have them in your life. It’s also a fantastic first option for people who have never owned a pet but always wanted to. After all, you need to make sure you can handle it before you jump right in! There’s also a lot less of a financial commitment. Generally, the rescue group will cover vet costs and all you need to provide is food and lots of love. 4. It’s good for your health Countless studies have proven that pet ownership (particularly dogs) can significantly improve both your physical and mental health. Knowing they’re relying on you to maintain their own health is the best motivation to look after your own. 5. It’s good for your social life Want to make new friends? Foster a dog! Not only will you gain a four-legged friend, but any dog owner will attest to the fact that people love stopping to gush over your canine pal. You can also attend meet-ups with other pet owners or make new friends at dog-friendly beaches and parks. Image credits: Getty Images

Family & Pets

The unusual new words and phrases being considered by the Macquarie Dictionary

Macquarie Dictionary has unveiled their words of the month, with each of them going into the running to be 2023 Word of the Year and possibly included in their next edition. The words and phrases have largely been submitted by the public, with five unique phrases being crowned the words of the month. The words of the month include the phrases gendy nooch, cozzie livs, tiger toast, password child and murder noodle. According to the dictionary, the term “gendy nooch” is a shortening of gender-neutral, which means something not relating or specific to a particular gender. <blockquote class="twitter-tweet"> An online shortening of gender-neutral to become 'gendy nooch' is gaining traction. Find more new words here. <a href="https://t.co/rO6OF4QuRK">https://t.co/rO6OF4QuRK</a> <a href="https://t.co/3QkYLiNLEA">pic.twitter.com/3QkYLiNLEA</a> — Macquarie Dictionary (@MacqDictionary) <a href="https://twitter.com/MacqDictionary/status/1648861592421801987?ref_src=twsrc%5Etfw">April 20, 2023</a></blockquote> “Cozzie livs” has quickly become slang for the ongoing cost of living crisis, which has been affecting most Australians in 2023. The phrase has become a classic Aussie way of downplaying a quite serious matter. <blockquote class="twitter-tweet"> The words on everybody's lips these days, the 'cost of living'. But have you ever called it the cozzie livs (crisis)? More new words at the link. <a href="https://t.co/rO6OF4QuRK">https://t.co/rO6OF4QuRK</a> <a href="https://t.co/ZXdOhwNdkv">pic.twitter.com/ZXdOhwNdkv</a> — Macquarie Dictionary (@MacqDictionary) <a href="https://twitter.com/MacqDictionary/status/1646302360254177282?ref_src=twsrc%5Etfw">April 13, 2023</a></blockquote> Another phrase that Aussies have been adopting more is the patriotic concept of “tiger toast”, which refers to "toast with a topping of Vegemite and strips of cheese" according to the dictionary. “Password child” is another new phrase recognised by the dictionary, meaning "a child favoured over their siblings, as shown by the use of their name in the parent's online passwords". The final top pick for April words of the month is “murder noodle”, which refers to "a snake, especially one that is venomous". Each of these phrases has now gone in the running to be crowned the 2023 Word of the Year, which the Macquarie Dictionary awards each year to a phrase that has seamlessly been integrated into the Aussie vocabulary. The 2022 Word of the Year was Teal, defined by the dictionary as "a political candidate who holds generally ideologically moderate views, but who supports strong action regarding environmental and climate action policies, and the prioritising of integrity in politics (so called as many of the candidates use the colour teal in their electoral material)”. Image credits: Getty Images

Books

The legal matters you need to consider as you get older

Barbara Binland is the pen name of a senior, Julie Grenness, in Melbourne, Victoria, Australia. She is a poet, writer, and part-time English and Maths tutor, with over 40 years of experience. Her many books are available on Amazon and Kindle. As we are ageing, it is essential at some stage to be realistic and sort our legal affairs. This incorporates writing your last will and testament. It is an individual’s choice whether to use a will kit, or to engage a solicitor. We must decide on an executor of the will, to ensure any assets are disposed of, in accordance with our intentions. Secondly, it is an excellent idea to appoint a medical power of attorney to a trusted person, to factor in a case scenario if you are on life support. Someone needs a medical power of attorney to make tough decisions on your behalf. Thirdly, when writing your will, you need to list your beneficiaries. Moreover, you need to compile a file of your assets and investments. Furthermore, it is also a good intention to prepare any wishes for your funeral, burial or cremation. Do you wish to be an organ donor? Ultimately, if any doubts occur, it is always possible and feasible to seek advice from any legal professionals. Right, having done all that, it’s easy to think, “all sorted!” But remember, any golden oldie’s status can be affected by any change in circumstance, such as either health conditions, or by marriage, or divorce, or the death of a spouse. Then we may need to revise our will and testament. But, in the interim, put morbid thoughts to one side, that is all ‘worst case scenario’. Now we can plan for our happy and leisurely retirement, enjoying being ‘golden oldies’, anyway we choose! Here are the stats: 10/10 people are going to die, so appreciate being alive! Rise and smile! Image credit: Shutterstock

Legal

5 key things you need to consider before downsizing

Retirement is a time of change, and it can be a change of address too. Many pre-retirees consider making a sea change or a tree change and make the decision to move into a property that better meets their changing lifestyle needs. Often the move is out of a larger family home into a smaller house, an apartment, or a retirement village. Of course it doesn’t need to be a change of suburb, it might be something smaller in the same area. Like all decisions, your own goals about moving homes should be front and centre. There is a financial planning opportunity associated with a decision like this and it’s one that many Australians are making. It’s called the downsizing contribution strategy and it allows you to use superannuation to help you fund your retirement lifestyle using proceeds from the property sale. The good news is that you don’t have to use all of the proceeds from the sale of the family home into a superannuation downsizer contribution. You get to choose how much you’d like to contribute, up to $300,000 for singles and $300,000 each for couples. There are 5 key things you should consider before you make a decision to use the downsizing contribution strategy. 1. What type of property and which suburb will you downsize to? Many people approaching retirement don’t want to be rattling around in a larger family home. So if you do look for something smaller, what type of property and which suburb will you move to? Some key considerations may include: · Proximity to family and friends · The distance to essential services you use, shopping and medical services · Availability of public transport · Accessibility of lifestyle activities such as golf, tennis courts, swimming · The type of property itself, perhaps single level with no stairs Many city dwellers who choose the sea or tree change often take what they have for granted so if you’re moving to a region, make sure you do your homework to ensure you will have everything you need. 2. Check your eligibility to ensure this strategy is open to you In addition to finding your next home, you should also make sure you understand and follow the rules the government has set out about using the downsizer contribution strategy. There are always rules! Check the eligibility requirements to make sure it’s available to you, including completing the right paperwork at the right time. Originally this was only open to those aged 60 or over from 1 July 2022, however the government has now lowered the accessibility age to those aged 55 and over from 1 January 2023. Other conditions apply too so ensure you meet them to ensure you’re eligible for this financial planning strategy. 3. Make the most of your contribution options. The downsizer contribution allows an individual to make a $300,000 contribution to your super. And if you’re a couple, you each can make a $300,000 contribution. With the focus on getting money into your super to fund your retirement life, remember that you may also make a non-concessional contribution of up to $330,000 (total super balance permitting). This way you can maximise the base from which a tax free income stream may be commenced or equalise the value of accounts if one member is over the transfer balance cap. Remember that you can also make a downsizer contribution if you have reached your transfer balance cap of $1.7 million. 4. Ensure the strategy is considered with Centrelink. For many Australians, Centrelink provides an important source of income for their retirement and it makes sense to consider this strategy in the context of your eligibility for that income. The money you receive from the sale of your family home will be considered when determining your entitlements. Your new home however, the one you downsize to, becomes exempt once you have purchased it. This is because it becomes your primary residence. 5. Don’t forget about the other ways you can contribute to super. The downsizing contribution strategy is just one way you can contribute to super. There are other ways you can contribute too. An example is making a personal deductible contribution to super. Through this type of contribution, you make your contribution, and you claim a tax deduction when you get your tax return completed. Downsizer super contributions don’t allow you to claim a tax deduction. Make sure you consider all of your options when making super contributions and assess the pros and cons of each. There is a lot to consider when making the decision to downsize your family home and it’s not just about where you want to live next. The downsizer contribution strategy is a great way to get extra money from the sale of your family home to fund your retirement lifestyle. Make sure you understand your financial planning options though, before making a decision, to be more confident that you will achieve the outcomes that you’re seeking. No one likes surprises around unexpected outcomes, so do your homework and seek advice from a licensed financial planner if you need help. Luke Smith is a licensed Australian financial planner and author of the new book, Smart Money Strategy – Your Ultimate Guide to Financial Planning (Wiley, $34.95), published by Wiley. Luke is also the host of the popular podcast ‘The Strategy Stacker – Luke Talks Money’ and appears every Friday afternoon on Canberra’s 2CC. Found out more at <a href="http://www.thestrategystacker.com.au">www.thestrategystacker.com.au</a> Image credit: Getty

Downsizing

So, you want to live tiny? Here’s what to consider when choosing a house, van or caravan

The reasons for choosing to go tiny range from reducing debt, inability to afford a conventional home, the search for sustainability, a life crisis, or even <a href="https://theconversation.com/architecture-of-doom-diy-planning-for-global-catastrophe-31836">preparing for an uncertain future</a> in the face of climate change by going off-grid. Or perhaps a combination of these. An important first step is to decide what type of tiny house you want. To many, the phrase “tiny house” brings to mind an archetypal tiny house on wheels, a miniature cottage on a trailer, often made of wood, with a pitched roof and dormer windows. Indeed, most tiny housers prefer some degree of mobility, whether a ready-made or DIY tiny house, converted caravan or bus/van. A survey by the <a href="https://australiantinyhouseassociation.org.au/">Australian Tiny House Association </a>found most (78% of 109 respondents) lived in tiny houses on wheels, but a small but growing proportion live in converted caravans, vans or buses. <h2>Why do you want to go tiny?</h2> First you need to evaluate your motives, which may differ according to your situation or stage of life. The most important question here is, how often do you want to move? Do you want to be ultra-mobile, and live like a digital nomad, perhaps in a “stealth van” in the city, changing parking spaces every night? Or do you want to travel around Australia like a “grey nomad”, staying in caravan parks or roadside camps for a week or so before moving on? Alternatively, do you want to be more settled, perhaps moving occasionally, to be closer to work, medical facilities or schools for children? (Yes, some tiny housers have children). Or do you want to travel between the houses of adult children or do petsitting, staying from weeks to months? Many off-the-shelf caravans are extremely well designed and are accepted everywhere, at caravan parks or roadside parking areas. On the other hand, a tiny house on wheels is less mobile, and not suited to frequent moving (they are also extremely heavy, not aerodynamic and large tow vehicles are costly). They’re also less accepted in caravan parks, and <a href="https://www.tandfonline.com/doi/full/10.1080/07293682.2019.1632358">most local councils consider them caravans</a>, with restricted periods of occupancy and often onerous conditions. Vans and buses are the most flexible (in the “stealth van” or vanlife movement, people live rent-free by parking, mostly illegally, often in industrial estates, and using public or work/gym bathrooms). They are, however, extremely small and while it may seem glamorous to live in a van like celebrity rock climber <a href="https://www.ft.com/content/d1ac7b02-34f8-11e9-bd3a-8b2a211d90d5">Alex Honnold</a>, the reality may not be practical. <h2>What can you afford?</h2> Cost will likely be the next factor to consider. <a href="https://tinyrealestate.com.au/what-does-a-tiny-house-cost/">Ready-built tiny houses range from around A$50,000 - $120,000</a>; DIY are cheaper, especially if self-built, with some costing under $2,000. The higher end, architect-designed ones are more expensive. Converted caravans can be affordable, even under $10,000, but prices vary markedly, with some ultra-luxurious five-wheelers costing more than a typical suburban house (>$600,000). Converting old buses and vans is much cheaper, with the cost of the vehicle tending to be under $20,000. Of note, unless you are living <a href="https://www.tandfonline.com/doi/full/10.1080/07293682.2019.1636837">under the radar</a> or free camping, you are going to have to factor in the ongoing cost of renting someone’s backyard or caravan park space. <div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/B6y6fT6nEOE","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"> </div> <h2>How sustainable is your choice?</h2> Sustainability is a more nuanced aspect of tiny house living; living small means less energy needed for heating and less room for superfluous stuff, encouraging or enforcing a minimalist lifestyle. Most tiny houses on wheels are off-grid to some extent, relying on <a href="https://www.tandfonline.com/doi/full/10.1080/07293682.2019.1634111">solar power, rainwater and composting toilets</a>. They are often built entirely out of sustainable or reclaimed materials. On the other hand, most caravans and vans are not particularly sustainable — they’re often built out of mass-produced material and may produce outgassing from carpets and paints. Vans and busses are generally no more or less sustainable than any similar vehicle. <h2>What kind of life do you want?</h2> Tiny houses, whatever the type, are just that: tiny. Space is at a premium and living tiny requires reducing stuff, such as clothes, sporting and hobby equipment. Tiny houses on wheels, where parked more permanently, allow for decks and even sheds, but caravans and vans are self contained, unless in a permanent caravan park. If you are used to living in a very large space, it may take time to adapt to the practicalities of tiny living; people often complain about cooking smells and composting toilets. Despite the popularity of tiny houses however, very few people actually live in them. Nonetheless, the vast majority of people who live or have lived tiny, <a href="https://theconversation.com/life-in-a-tiny-house-whats-it-like-and-how-can-it-be-made-better-110495">view their experience positively</a>, and feel it has greatly enriched their lives, and helped them <a href="https://theconversation.com/when-people-downsize-to-tiny-houses-they-adopt-more-environmentally-friendly-lifestyles-112485">re-evaluate their life choices, especially consumerism</a> even after moving to more conventional dwellings. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/so-you-want-to-live-tiny-heres-what-to-consider-when-choosing-a-house-van-or-caravan-129790" target="_blank" rel="noopener">The Conversation</a>.

Home & Garden

Should we move our loved one with dementia into a nursing home? 6 things to consider when making this tough decision

Almost <a href="https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/summary">400,000</a> Australians are living with dementia. A million or more family members and friends care for and support them. About two-thirds of people with dementia live in the community. Deciding to move a loved one into a nursing home is an incredibly difficult one. I found it difficult and stressful considering this move for my own loved one, even with 20 years of experience in dementia and aged care. Sometimes the decision has to be made quickly, such as when the person is in hospital. Sometimes the decision takes much longer and is made over months, or even years. There are some important things you should consider when trying to decide the best option for you and your loved one. I’ve outlined six here. <h2>1. Your loved ones’ views around going into care</h2> We don’t want to force our loved one to do something against their wishes. It’s unusual for someone to want to go into a nursing home. It may take many conversations and a decent amount of time before your loved one accepts they might need more care and that a nursing home is the right place to get that care. <h2>2. Your loved one’s current quality of life</h2> If you think your loved one has an overall good quality of life, and that their quality of life may decrease when they go into a nursing home, this could be a sign you should keep trying to support the person to live at home. However, if their quality of life is currently poor, particularly if this is due to not having enough day-to-day physical care, health care or emotional support, then moving into a nursing home might help meet their daily needs. Spend some time observing to figure out <a href="https://theconversation.com/home-for-the-holidays-and-worried-about-an-older-relative-make-observations-not-assumptions-173782">how your loved one is doing at home</a>. You could perhaps make a list of the things they need to lead a good life (company, three square meals, help taking medicines, going out into the community) and see if these are currently being met. <h2>3. Risks if your loved one stays at home</h2> People often <a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-7-13">go into a nursing home</a> because we think they are no longer safe living at home. It might be possible to reduce some of the risks of them being at home through <a href="https://www.enablingenvironments.com.au/home.html">modifying the home</a> and <a href="https://www.alzheimerswa.org.au/about-dementia/living-well-dementia/assistive-technology-help-sheets/">using technology</a>(personal emergency alarms, GPS trackers, stove timers) or services (meals on wheels, community care, physiotherapy for mobility). <h2>4. Capacity of your loved one’s family and friends to keep supporting them</h2> The availability and capacity of family carers is probably the most crucial part in supporting someone with dementia to keep living well at home. Carers often have other responsibilities such as work and children, which means they can’t support their loved one as much as they would like. Being a carer is physically and emotionally demanding, and over time caring can take its toll. Carers should seek help and support from other family and friends, learn more about <a href="https://forwardwithdementia.au/">dementia</a>, use services including <a href="https://theconversation.com/respite-care-can-give-carers-a-much-needed-break-but-many-find-accessing-it-difficult-183976">respite care</a> and <a href="https://www.dementia.org.au/support">Dementia Australia</a>. Carers often face a difficult choice between their own health and wellbeing, and supporting their loved one to remain at home. If carers are caring as much as their time, energy and physical and mental wellbeing will allow, and that care is not enough for their loved one’s needs, then more help is needed – and residential care is one way of getting that help. <h2>5. Alternatives to nursing home care</h2> Community care services are government-subsidised services to support older people to keep living at home. You can get up to 14 hours of care a week depending on need, though there is an assessment process and often a waiting time for services. You can pay for community care privately as well, although this can be very expensive. An <a href="https://www.cota.org.au/information/aged-care-navigators/who-can-use-aged-care-navigator-services/">Aged Care Navigator</a> (or from 2023 an “aged care finder”) can help you search for suitable available home care services. Some families choose to move in with the person with dementia, or have them move in with family. This may be an option if there is suitable accommodation, and they are able to live together comfortably. <h2>6. Availability of quality nursing home care</h2> It’s emotionally easier to place a loved one in a nursing home if carers are confident the home will provide suitable care. Often, family want a nursing home that is geographically close so they can visit, has a suitable room (such as a single room with an ensuite), sufficient and kind staff with training in supporting people with dementia, a pleasant environment, nutritious appealing food, and quality clinical care. It takes time to visit and pick a <a href="https://theconversation.com/when-choosing-a-nursing-home-check-the-clothing-and-laundry-100727">suitable nursing home</a>, check it’s appropriately <a href="https://theconversation.com/how-to-check-if-your-mum-or-dads-nursing-home-is-up-to-scratch-123449">accredited</a>, and understand how much it will <a href="https://theconversation.com/so-youre-thinking-of-going-into-a-nursing-home-heres-what-youll-have-to-pay-for-114295">cost</a>. You might have to wait for a bed in a quality home. You can often trial the nursing home by having your loved one stay for two weeks of respite care. When your loved one enters nursing home care, you’ll still be caring for them. You want to ensure you can continue to support your loved one emotionally and practically in partnership with the nursing home. <h2>Getting help</h2> Usually there is no “right” or “wrong” decision. You might struggle and there might be family conflict around what the “right” decision is. Speaking to a counsellor at <a href="https://www.dementia.org.au/support/counselling">Dementia Australia</a> might help work through the options and your feelings, you can talk to them as an individual or attend as a family. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/should-we-move-our-loved-one-with-dementia-into-a-nursing-home-6-things-to-consider-when-making-this-tough-decision-189770" target="_blank" rel="noopener">The Conversation</a>.

Caring

3 things to consider when travelling with hearing loss

Hearing loss is a challenge, but with some preparation your holiday can go off without a hitch. Here are five ways to manage hearing loss while travelling. 1. While you’re at the airport If you think you’re going to require assistance boarding the plane or during your flight, it’s a good idea to inform your airline at least 48 hours before boarding. It’s also a good idea to ask staff to inform you personally when the plane is ready to board, or stand near the boarding desk as it might be difficult to hear announcements over the loudspeaker. 2. While you’re on the plane Cabin crew are generally well trained to cater for travellers with hearing loss, but it’s a good idea to explain your difficulties as you’re boarding. That way they can keep you informed of any important messages on your trip regarding delays or even emergencies. Some airlines will even board you first, and provide you with an individual safety briefing. 3. When you arrive at your destination There’s a few things to consider when you reach your destination, but it’s generally a good idea to make sure you have enough batteries for your trip with a few spare ones thrown in. It’s generally a good idea to bring a decent supply (better to take too many than too few) and spread them out over too bags in case one of them is lost in transit. Also, if you’re travelling anywhere that’s humid or tropical it might also be an idea to pack a dehumidifier pack to minimise the change of corrosion of the device. Image credits: Getty Images

Travel Tips

“Never say never”: Nat Barr considers cosmetic enhancements

Natalie Barr has confessed that she is open to getting plastic surgery despite being scared of going under the knife. The Sunrise co-host claims her good looks are thanks to regular facials and intense pulsed light therapy (IPL). But now the 54-year-old is saying “never say never” if she chooses to go ahead with a little nip and tuck. “I think never say never. I haven’t had anything yet. I’ve been a bit scared, to be honest. But as I get older, I’m open to ideas,” she told The Daily Telegraph. When asked about the ugliest part of her body, Nat revealed that it was her feet “Feet. Well, specifically my feet. I’ve had a bunion operation. But, even before that, I’ve never liked them,” she said. Just two years ago, Nat was against any cosmetic injections saying she wasn’t a fan of them. “I am not one of those people who panics about looks,” she previously told Stellar Magazine. “I keep reasonably fit, I haven’t had botox - though no judgement if you do.” Images: Instagram

Beauty & Style

Viral infections including COVID are among the important causes of dementia – one more reason to consider vaccination

With more of us living into old age than at any other time, dementia is increasing steadily worldwide, with major individual, family, societal and economic consequences. Treatment remains largely ineffective and aspects of the underlying pathophysiology are still unclear. But there is good evidence that neurodegenerative diseases – and their manifestation as dementia – are not an inevitable consequence of ageing. Many <a href="https://blogs.otago.ac.nz/pubhealthexpert/dementia-update-on-causes-and-prevention-including-the-role-of-covid-19/" target="_blank" rel="noopener">causes of dementia</a>, including viral infections, are preventable. COVID and other viral infections are centrally involved in insults to the brain and subsequent neurodegeneration. COVID-positive outpatients have a more than three-fold higher risk of Alzheimer’s and more than two-fold <a href="https://www.frontiersin.org/articles/10.3389/fneur.2022.904796/full" target="_blank" rel="noopener">higher risk of Parkinson’s disease</a>. A study of almost three million found risks of psychiatric disorders following COVID infection returned to baseline after one to two months. But other disorders, including “<a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext" target="_blank" rel="noopener">brain fog</a>” and dementia, were still higher than among controls two years later. <blockquote class="twitter-tweet"> 🚨I wrote about “brain fog”—one of the most common & disabling symptoms of long COVID (and many other pre-pandemic conditions), and one of the most misunderstood. Here’s what brain fog actually is, and what it’s like to live with it. 1/ <a href="https://t.co/Gq8iylgfBr">https://t.co/Gq8iylgfBr</a> — Ed Yong is on sabbatical (@edyong209) <a href="https://twitter.com/edyong209/status/1569302974811308032?ref_src=twsrc%5Etfw">September 12, 2022</a></blockquote> Among more than six million adults older than 65, individuals with COVID were at a <a href="https://content.iospress.com/articles/journal-of-alzheimers-disease/jad220717" target="_blank" rel="noopener">70% higher risk than the uninfected</a> for a new diagnosis of Alzheimer’s disease within a year of testing positive for COVID. More than 150,000 people with COVID and 11 million controls have been involved in a <a href="https://www.nature.com/articles/s41591-022-02001-z" target="_blank" rel="noopener">study</a> of long-term consequences of acute COVID infection. A year after infection, there was an overall 40% higher risk (an additional 71 cases per 1000 people) of neurologic disorders, including memory problems (80% higher risk) and Alzheimer’s disease (two-fold higher risk). These risks were elevated even among those not hospitalised for acute COVID. SARS-CoV-2, the virus that causes COVID, can <a href="https://rupress.org/jem/article/218/3/e20202135/211674/Neuroinvasion-of-SARS-CoV-2-in-human-and-mouse" target="_blank" rel="noopener">invade brain tissue</a>. Other viruses can also cause direct damage to the brain. A study of almost two million people showed the <a href="https://pubmed.ncbi.nlm.nih.gov/35723106/" target="_blank" rel="noopener">risk of Alzheimer’s was markedly lower</a> in those who had been vaccinated against influenza. The cost of dementia Dementia is characterised by <a href="https://www.who.int/en/news-room/fact-sheets/detail/dementia" target="_blank" rel="noopener">progressively deteriorating cognitive function</a>. This involves memory, thinking, orientation, comprehension, language and judgement, often accompanied by changes in mood and emotional control. It is one of the major causes of disability among older people. Worldwide prevalence exceeds 55 million and there are almost ten million new cases annually. It is the seventh leading cause of death. In 2019, the estimated global cost of dementia was US$1.3 trillion and rising. The best known form of dementia – Alzheimer’s – was <a href="https://pubmed.ncbi.nlm.nih.gov/8713166/" target="_blank" rel="noopener">first described in 1907</a>. Dementia is generally described as developing in three stages: <ul> <li> impairment of memory, losing track of time and becoming lost in familiar places </li> <li> further deterioration of memory with forgetfulness of names and recent events, becoming confused at home, losing communication skills and personal care habits, repeated questioning, wandering </li> <li> increased difficulty walking, progressing to inactivity, marked memory loss, involving failure to recognise relatives and friends, disorientation in time and place, changes in behaviour, including lack of personal care and emergence of aggression. </li> </ul> Treatments largely unsuccessful There are no cures and no resounding treatment successes. Management involves support for patients and carers to optimise physical activity, stimulate memory and treat accompanying physical or mental illness. Dementia has a <a href="https://www.who.int/en/news-room/fact-sheets/detail/dementia" target="_blank" rel="noopener">disproportionate impact on women</a>, who account for 65% of dementia deaths and provide 70% of carer hours. We may know less about the pathology of dementia than we imagined: some key data are under scrutiny for <a href="https://www.science.org/content/article/potential-fabrication-research-images-threatens-key-theory-alzheimers-disease" target="_blank" rel="noopener">possible inappropriate manipulation</a>. But we do know about many of the causes of dementia and therefore about prevention. In addition to viral infections, there are at least four other contributing causes: <a href="https://pubmed.ncbi.nlm.nih.gov/19782001/" target="_blank" rel="noopener">cardiovascular disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/30833374/" target="_blank" rel="noopener">type 2 diabetes</a> (especially if untreated), <a href="https://pubmed.ncbi.nlm.nih.gov/29653873/" target="_blank" rel="noopener">traumatic brain injury</a> and <a href="https://www.bmj.com/content/357/bmj.j2353" target="_blank" rel="noopener">alcohol</a>. The brain has its own immune system – cells called microglia. These play a role in brain development, <a href="https://www.nature.com/articles/s41588-022-01149-1" target="_blank" rel="noopener">account for 5-10% of brain mass</a> and become activated by damage and loss of function. They are also <a href="https://pubmed.ncbi.nlm.nih.gov/23622250/" target="_blank" rel="noopener">implicated in Alzheimer’s</a> and their inflammation has been shown to be <a href="https://pubmed.ncbi.nlm.nih.gov/23254930/" target="_blank" rel="noopener">central to its pathology</a>. Dementia is preventable In the absence of effective treatment, prevention is an important goal. The association with viral infections means we should pay careful attention to vaccine availability and uptake (for influenza, COVID and any future variants) and place greater emphasis on combatting misinformation regarding vaccines. The association with atherosclerosis and stroke, as well as diabetes, supports primary prevention that involves healthier diets (plant-based diets low in salt and saturated fats), physical activity and weight control. Alcohol consumption is a major problem globally. We have allowed high intake to be normalised and talk about no more than two glasses per day as though that is innocuous. Despite the myth of some beneficial aspects of alcohol, the <a href="https://www.thelancet.com/article/S0140-6736(18)31310-2/fulltext" target="_blank" rel="noopener">safest intake is zero drinks per week</a>. <blockquote class="twitter-tweet"> My article speaks about a study that showed that people who chronically consume alcohol and become unconscious because of it, their chances of having dementia increase 10 fold. <a href="https://t.co/0DOFf9X5Zx">https://t.co/0DOFf9X5Zx</a> <a href="https://twitter.com/mrcopsych?ref_src=twsrc%5Etfw">@mrcopsych</a> — Hannah (@Hannah46221416) <a href="https://twitter.com/Hannah46221416/status/1575274580788355074?ref_src=twsrc%5Etfw">September 29, 2022</a></blockquote> This requires a complete <a href="https://pubmed.ncbi.nlm.nih.gov/19560606/" target="_blank" rel="noopener">national rethink</a> around the availability and acceptability of alcohol as well as assistance with alcohol addiction and treatment of alcohol-related disorders. Traumatic brain injury is associated with sport and, more importantly, falls and car crashes. It is recognised as a global priority and there is increasing awareness of the preventability of falls among older people. The management of head injuries is being ramped up in contact sports. However, data on the impact of best management of the initial injury on subsequent risk of dementia are lacking and <a href="https://pubmed.ncbi.nlm.nih.gov/29381704/" target="_blank" rel="noopener">risk remains elevated</a> even 30 years after the initial trauma. The evidence that dementia has preventable causes, including viral infection, should better inform policy and our own behaviour.<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/190962/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-donne-potter-1275983" target="_blank" rel="noopener">John Donne Potter</a>, Professor, Research Centre for Hauora and Health, <a href="https://theconversation.com/institutions/massey-university-806" target="_blank" rel="noopener">Massey University</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/viral-infections-including-covid-are-among-the-important-causes-of-dementia-one-more-reason-to-consider-vaccination-190962" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Mind

I’m considering an interest-only home loan. What do I need to know?

An <a href="https://moneysmart.gov.au/home-loans/interest-only-home-loans" target="_blank" rel="noopener">interest-only home loan</a>, as the name suggests, is where you only pay the interest on a loan and not the principal (the original amount you borrowed). While authorities such as the Reserve Bank often <a href="https://www.rba.gov.au/speeches/2018/sp-ag-2018-04-24.html" target="_blank" rel="noopener">see</a> them as risky, interest-only loans can be helpful in some circumstances. If you’re considering an interest-only loan, here’s what you need to know. How long do they go for? These loans are typically last for five years at most, before reverting back to principal and interest (where you have to pay back, through regular payments, both interest and the initial sum you borrowed). You could potentially apply for another interest-only loan after your first one winds up, perhaps by refinancing (where you take a new mortgage to repay an existing loan). But you might not get it – and you’d still have to pay off the principal eventually. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&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/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/480309/original/file-20220822-18038-nyikjs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Interest-only loans can cost you a lot more in interest over time than a regular principal and interest loan. Photo by Andrew Mead on Unsplash, <a class="license" href="http://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">CC BY</a></figcaption></figure> What are the upsides of an interest-only loan? An interest-only loan means you’ll have more cash available to cover other costs, or invest elsewhere. You can use a <a href="https://moneysmart.gov.au/home-loans/mortgage-calculator" target="_blank" rel="noopener">mortgage calculator</a> to work out how much extra cash you’d have if you switched from a principal and interest loan to an interest-only loan. It’s typically hundreds of dollars per week. This may get you a bit more wriggle room for daily expenses. Or, some people use the extra cash to invest in other things – such as shares – in the hope they can make more money overall and pick up some tax benefits along the way. That’s why interest-only loans are often popular among <a href="https://moneysmart.gov.au/home-loans/interest-only-home-loans" target="_blank" rel="noopener">investors</a>. Of course, this strategy comes with risk. An interest-only loan may also have a redraw facility, allowing you to add extra payments into the loan (above and beyond the interest) if you want, and withdraw money later when you need cash. This can allow people to avoid a personal loan, which usually has a much higher interest rate. Regular principal and interest loans may also have a redraw facility but the regular payments of principal are unavailable for redraw. That means less flexibility for the borrower. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&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/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=408&fit=crop&dpr=1 600w, https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=408&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=408&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=512&fit=crop&dpr=1 754w, https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=512&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/480311/original/file-20220822-64666-y67vz3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=512&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>What’s right for one borrower won’t be for the next. Image by Pfüderi from Pixabay, <a class="license" href="http://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">CC BY</a></figcaption></figure> What are the downsides? The interest rates on interest-only loans are generally higher than principal and interest loans. For example, the RBA July 2022 <a href="https://www.rba.gov.au/statistics/tables/xls/f05hist.xls" target="_blank" rel="noopener">indicator rate</a> for owner-occupier interest-only rates is 6.31%. But the equivalent variable rate for principal and interest loans is 5.77% (the indicator rate is just a guide; the actual difference varies from bank to bank). Interest-only loans can cost you a lot more over time than a regular principal and interest loan. This means a borrower needs to manage their finances well to ensure they can cover the interest payments now and still have enough to pay down the principal eventually. So you’ll need a plan for how you’re going to do that when the interest-only loan ends. There is also a risk of a shock – such as job loss, personal crisis or housing crash – causing the borrower to default on the loan altogether. If the borrower defaults on an interest-only loan, they may lose the house and the bank is left with a debt that was not substantially repaid (because the borrower had not yet made a dent in the principal). It’s a lose-lose situation. Are interest-only loans common? Interest-only loans represent <a href="https://www.apra.gov.au/news-and-publications/apra-releases-quarterly-authorised-deposit-taking-institution-statistics-11" target="_blank" rel="noopener">11.3% of all home loans</a> in Australia. This figure has been <a href="https://www.rba.gov.au/publications/fsr/2017/apr/box-b.html" target="_blank" rel="noopener">trending down</a> over the past five years, due in part to tighter <a href="https://www.apra.gov.au/news-and-publications/apra-to-remove-interest-only-benchmark-for-residential-mortgage-lending" target="_blank" rel="noopener">lending restrictions</a> and the fact low interest rates have made principal and interest loans relatively cheap recently. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&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/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/480312/original/file-20220822-65738-za6ht2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Interest-only loans represent 11.3% of all home loans in Australia. Image by sandid from Pixabay, <a class="license" href="http://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">CC BY</a></figcaption></figure> What does the research say? One Dutch <a href="https://link.springer.com/article/10.1007/s11146-013-9453-9" target="_blank" rel="noopener">study</a> found “households that are more risk-averse and less literate are significantly less likely to choose an interest-only mortgage”. This partly due to lower initial repayments and wealthy households preferring the financial flexibility. Interest-only borrowing has also been found to <a href="https://www.sciencedirect.com/journal/journal-of-housing-economics" target="_blank" rel="noopener">fuel</a> <a href="https://doi.org/10.1016/j.regsciurbeco.2018.06.004" target="_blank" rel="noopener">housing</a> <a href="https://www.sciencedirect.com/science/article/pii/S1094202520300776?via%3Dihub" target="_blank" rel="noopener">speculation</a> and reduce housing affordability. A US study found borrowers also tend to <a href="https://doi.org/10.1093/rof/rfy016" target="_blank" rel="noopener">default</a> more. A Danish <a href="https://doi.org/10.1162/rest_a_01146" target="_blank" rel="noopener">study</a> found that once the interest-only lower repayment period is over and the loan reverts to principal and interest, those who didn’t make principal repayments suffered a large drop in disposable income. Financial flexibility comes with a catch With rates rising, interest-only loans may sound like an appealing way to have more cash available to cover other costs in life. But just remember financial flexibility comes with a catch. An interest-only loan could be more expensive in the long run. For some people, that cost will be worth it if it allows them to hold onto the house during a brief tough period or make more money investing elsewhere. But it’s a risk. And when the interest-only loan ends, you’re still stuck with the task of paying off the money you borrowed from the bank in the first place (with interest).<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/188817/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-lee-94688" target="_blank" rel="noopener">Adrian Lee</a>, Associate Professor in Property and Real Estate, <a href="https://theconversation.com/institutions/deakin-university-757" target="_blank" rel="noopener">Deakin University</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-considering-an-interest-only-home-loan-what-do-i-need-to-know-188817" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Money & Banking

What to consider when downsizing

It’s the great Australian dream: to own a house in the suburbs with a big backyard for the kids. But, with the kids gone and you reaching retirement (if you’re not already retired), is it time to downsize? Moving out of the family home to cheaper and smaller accommodation isn’t an easy decision, but in many cases one that has to be made, due to either costs in the upkeep of the home or for health reasons. A study by the Australian Housing and Urban Research Institute found that 43 per cent of survey respondents who had relocated had downsized, with around half downsizing or moving only once since turning 50. It also revealed that out of its respondents, 91 per cent of downsizers reported being either mostly satisfied or very satisfied. Now, that’s good news. While the motivation for downsizing is different for everyone, the most common reasons for relocating was a change in lifestyle, being closer to family and financial gain. By moving into smaller and more affordable housing, insurance premiums may be reduced and for those who haven’t finished paying off their mortgage, it could mean a lower mortgage repayment or paying it off outright. If downsizing is starting to sound appealing, here’s what you need to know. What’s best for you? Talk to your partner and your family to gauge your motivations for wanting to move. Is it financial? Would you like to be closer to your grandchildren? Or, would you like to live by the coast? Whatever your reasons, be mindful of why you want to downsize. That way, if you experience challenges along the way, you’ll always have that picture in the back of your mind of why you’re making the move. Make the tough calls The family home carries within its walls a lifetime of memories so it can be difficult to say goodbye to it. In many cases, you’ll need to sell or give away some of your belongings because a smaller home means limited space. However, take this opportunity to look at what you have and what you really need. This can be a great way to finally say goodbye to those old lawnmowers in the garage that no longer work. Ask for help from your family, friends and neighbours since this should be a time of celebrating the old and embracing the new. Do your homework The internet has made it much easier to find housing anywhere in Australia. While many suburbs are dominated by large family homes, there are growing pockets in all capital cities and large regional areas, particularly those towns popular with retirees, which have medium-density housing suitable for older couples. Write down what you’re looking for in terms of location, property and price to narrow down your search and then keep on top of available listings, either online or with a real estate agent in the area you want to move into. Will downsizing affect my pension? Selling the family home is one way to free up cash for retirement, which can then be reinvested into shares, term deposits or superannuation. However, if you’re receiving any kind of government pension, then this is going to be affected. While the family home is exempt from the assets test, if you sell your home and come up ahead with a profit of say $300,000, the money will need to be included in the assets test. As the age pension depends on what your assets are worth in this test, it’s best to speak to a Department of Human Services Financial Information Service officer. Whatever your reason for downsizing, make sure you’re fully aware of what you want, what’s best for you and how moving may impact your current circumstances. If in doubt, speak to family and friends or seek professional advice from a financial planner. Image credits: Getty Images

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I’m considering an interest-only home loan. What do I need to know?

What to consider when downsizing

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