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The other day I was talking to a friend who regularly takes her 85 year old father to medical appointments. She says some of the medics are OK but others just ignore her father and talk to her and she has to politely point out to them that her father is actually the patient and he is perfectly capable of speaking for himself.
Once again this week we have been reminded in the news of how many older people there are in Australia and how many more there will be in the future. This information is provided merely on a cost basis (in this instance how much our pensions will cost) with no indication that we are anything but a burden on the community or the positive ramifications of our numbers. We are actually a huge industry with many opportunities both in marketing terms and in specialised industries including the health industry. There are enough of us now to warrant a Department of Ageing Health as I mentioned last time. If we don’t recognise the situation intelligently costs go up.
I wonder how the medics who engage in the behaviour above would feel if they were treated like this? I wonder if they realise that it makes us feel useless and worthless. Engendering such feelings in their patients can only add to our health problems and therefore health costs. Depression among older people is a major problem which situations like this only contribute to. I remember reading a comment by an older person about her doctor, she reckoned he was OK but he had a deathbed manner! With a feisty reaction like this using a deathbed approach towards her was entirely inappropriate.
Some branches of medicine, such as psychologists, do include training in this field for people entering the profession but even in branches of health where this is provided I suspect it isn’t available as supplementary training for those who have been in the profession for a while. Many people currently practising medicine would have entered the profession before the relatively sudden increase in the number of older people was recognised. They would have had no training in this quite different branch of their profession.
The present situation outlined above causes anguish amongst older people and isn’t the most efficient way to provide medical care for this growing part of the population. It adds to cost.
I also heard about workers in a particular group of residential care facilities being reminded in their induction that they must always treat the residents with respect because after all this is their home. I wish I could feel that this was the instruction given to all staff working in aged care facilities, particularly those who work amongst the frail.
If we don’t recognise older people as the same as the rest of the community but older and perhaps a bit more frail we older people are given the impression that we are useless and add to the costs of helping us.

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For the past 8 years I have been working towards the goal of gaining a Ph D from my study of ageing, which was mainly focussed on establishing a base for aging successfully. Most of the study was part-time and I combined it with part-time work for most of the time. I’ve now reached that goal with a memorable graduation last week in which the University certainly knew how to make us feel special, particularly as it was held in the great hall at Parliament House.
I now need to work on new goals. I started writing a book about my studies some time ago and am now waiting for the reject slip from the first publisher! Several people have told me that I have bestseller material on my hands but getting a publisher to recognise this is another matter as they have to reduce the situation to dollars and cents. I am frequently reminded that the author of the Harry Potter books had something like 14 rejections before she was accepted (wonder how many heads rolled on that one!). I’m not sure I could be that persistent.
Meanwhile what are my new goals? Mainly I would like to work through a University to see if what I found in my research, the main requirements for successful ageing, could help to stop the incidence of, or reduce the progress of, Alzheimer’s disease. Baroness Susan Greenfield, a British expert in the field, lent her support to my research by arranging with Alzheimer’s Australia to allow me access to their members. All I need now is a University to agree to back this work. So far I have approached 3 Australian Universities and been met by a wall of silence, with not even an acknowledgement. Not only is this bad manners but suggests that their own research record is not what it could be. I don’t think that applying to an overseas University would be very practical. Do I let an idea which could prevent people either getting this horrific disease or at least slow its progress go to waste? I wonder if there is still a bias against me by the Universities because I am a woman and/or because I am an older person?
Meanwhile on a more positive front I have been aware that my research was restricted to older people living in the community because this was the only group I could have access to statistics on. After all, most people who go into residential care do so because they are unable to look after themselves physically so in theory they should still be able to lead fulfilling lives, particularly on the internet if that is their limitation. I now have the invitation to access such a centre which I am looking forward to. Maybe my research will progress in this direction.
Certainty in life would be desirable but we can never be sure the extent to which bias works against us. Such behaviour works against countries reaching their full potential.

Yesterday I attended a conference on Aged Care Policy at Australia’s top university, The Australian National University, with many of its senior staff members attending plus a couple of overseas expert visitors. I was so disappointed with the standard. Three of the speakers didn’t use power point which, given that approximately 75% of the population learn visually, meant that many of the audience were disadvantaged. Even some of those who did use it misused it. The golden rule is to only have up to 7 lines of text on any slide- many presenters put as much as they can on a slide and keep on talking. I prefer to either listen or read- I find it difficult to do both at once. When graphs are used audiences should be given time to absorb anything other than a very simple graph and the speaker needs to explain what the graph is showing. I sometimes think that with some speakers the purpose of a slide is an attempt to impress the audience, not to actually tell them anything. At one point yesterday the convener of the session kept asking questions about a particular slide- obviously he was having problems with it too. Given his academic history the fault was obviously with the speaker. None of these errors makes for professional presentations. Those making them go to great lengths to research their fields but then try to explain their work to others through amateur presentations and don’t apply the same standard of professionalism to this latter aspect of their work. The result of yesterday’s conference was a missed opportunity for the audience to learn.

Needless to say this lack of professionalism lowered the tone of the conference. Add to this the invitation only seemed to have gone to a selected few people in academia and the members of the public service (I stumbled on it by accident) which obviously reduced the extent of contributions from the floor. Even though it was on Aged Care (and supposed to be a dialogue) there were few older people participating and apparently the invitation had not been extended to aged care providers so there were even fewer of them, if any. Aged Care is a huge and expensive part of both state and national budgets and involves a large section of the population, particularly when we include workers in the industry, and needs a much wider involvement from all relevant sections than we had yesterday.

What really concerns me is that none of the suggestions made and ideas canvassed makes a contribution to older people believing in themselves and being made to feel that they and their lives are worthwhile, when they are not involved. Even if we can come up with a recipe for acceptable and appropriate standards in health care for older people this approach only meets their physical needs. The way it is being organised, if this conference is typical, does nothing for their self-esteem. The days of Universities indulging in Ivory Tower knowledge and politics belong to the last century.

Next June I will be travelling to Seoul for an International Conference organised by the Gerontology and Geriatrics Associations which will hopefully be more inclusive. I entered 4 abstracts in the hope that one would be accepted and have ended up being asked to make 1 oral presentation and 3 posters. From what I have heard about South Korea I am expecting a high standard as they seem to be making great progress in so many areas. It will be interesting to see firstly their attitude towards their own older people and secondly the provision they make for them, both at family and state level. Conferences invite contributions from all over the world yet the attributes of the host country still seems to shine through.

In aged care, and any aspects of ageing, it is vitally important that older people are involved throughout the process for it to make a meaningful contribution to successful ageing. This is largely reflected in the extent to which older people are invited to, and do, participate in any form of conference.

Currently I am awaiting the examiners comments on my thesis. There won’t be much difference in my plans after that except that if I have the title ‘Doctor’ in front of my name it will give more credibility to what I say, particularly among researchers into ageing and the public at large. Whichever way the verdict goes I feel as though as an older person I have a split personality, my past and my age (now 75), and the two tend not to be compatible in the eyes of society. I often worry about people in old people’s homes (under whatever up-graded title these places now operate!) who are assessed on their wrinkles, not for the brains behind them. The concept of ‘old and senile’ is hard to change.

I have just been reading the work of people like Friedan and Butler, which applied to the situation of the ageing in the US. Like so many academics in this field they operated in a ‘sheltered workshop’ in which they were able to continue on with their work which largely meant mixing with younger people and the realties of life for other older people was not something they encountered. This seems to apply to the many older people who are able to continue with their work long past retirement age, including the older Australians I was privileged to interview for my thesis. It is the majority, the ones who retire without being able to replace work with something comparable, who are the visible sign of the ageing in the community.

These are the people who society groups as useless and a burden on the community. This is what I want to change by giving older people a belief in themselves and their capabilities. As I have pointed out before, this ageism attitude has parallels with sexism and racism. It seems as though society has to have a pecking order. If we can abolish ageism the world (and older people) will be much better but will society need to look around for another group to put at the bottom of its pecking order or will it learn to manage without such a hierarchy? We need to be alert for this but let’s get rid of ageism first.

 

I think many of us expected a great new world to accompany the 21st century, particularly compared with the huge changes last century. We are already a decade into it and we seem to be ignoring so much of our new knowledge. Maybe as an older person I am more conscious of  changes, and the lack of changes which should be happening as a result of new knowledge.

For many of us the revelations in Wikileaks is showing us a very different side of our world leaders – a side we prefer didn’t exist. People we put our trust in are expected to have personal standards that we can endorse but this no longer seems to be the case. Worse still, I’m not convinced that their behaviour will improve. The only thing that may change is that they may be a bit more careful about what they commit to paper. Otherwise they will continue with the same unacceptable behaviour. What interests me is that Obama hasn’t been implicated in any of it, at least according to the Australia media, yet his popularity is low. Does that mean that we now expect our leaders to behave unconscionably and accept them if they do? Does this imply that society is not moving forward with each new generation having higher standards than the last? I always wince at the thought of people flooding to see public hangings in the past and hope that as a society we are moving upwards in our standards.

One area in which we ignore progress is the idea that we will get much better results in projects if we involve the users of the project right from the start. I am aware that this doesn’t happen with older people because society’s pecking order designates us as second class citizens, without knowledge or views, but the behaviour stretches beyond this. I recently attended a meeting about the new Super Clinic the Federal government is providing seeding money for in Canberra. The senior government officer leading the discussion was surprised at how many members of the community had views on the project. If you don’t involve the community, in a project designed for the community, right from the start then you will get less successful outcomes. I asked if the selection criteria for the group to set it up would include their ability to meet major health problems, such as the epidemics in obesity and diabetes. I was told they wouldn’t be. So they are not going to provide for the needs of  the community, nor are they going to address major health needs. Shouldn’t this be ringing alarm bells for a government frequently accused of badly managing projects? It’s wonderful fodder for the opposition, but I suspect they prefer to bring our attention to it when it is too late.

We learned so much in the last century yet we ignore so much of it. I wonder if, now that the characters of our leaders are being exposed, if we will continue to be apathetic. Don’t we want a better society, one we can be proud of? No doubt the many millions across the world who are starving and homeless already know the answer to this.

I have always felt that having my research sitting in a thesis on a dusty shelf was a bit of a waste and I have always been determined to publish it as a populist book. I have now even abandoned the thought of publishing articles in appropriate journals they usually have limited circulation and the audience is almost 100% younger people who wouldn’t appreciate the relevance of it.

Currently my thesis is with three examiners, hopefully with intimate knowledge of older people, and not obtained from what other younger researchers have written. There are too many holes in this type of research, all theory and no practice.

Meanwhile I am having a fruitful time putting my research into a book which is aimed at older people themselves, and also pre-aging people. It is so different writing in a more personal style, in which there is no word limit and no longer does each word have to be formal and necessary. What makes it easier is that I am not writing about ‘them’ but about ‘us’ as an older person myself. By continuing my career until the age of 73 I know what is possible because I am doing it myself.

I am continuing to read the latest books about brain plasticity and how increasingly important this is to older people. The old ‘use it or lose it’ saying has now been amended to ‘use it as much as possible’. With an anticipated 1.13 million Australians predicted to have Alzheimer’s disease by 2050 a scary picture is presented. One author pointed out that we have got ourselves into an unacceptable predicament and we need to work towards extending brain health to that of life expectancy. I still feel that research into Alzheimer’s disease focusses on finding a cure, not prevention. This is cynically tied in with the fact that the organisations doing the research are all medical people who can’t look outside the square, nor does their careers support a non-medical prevention approach.

We are in the midst of an election in Australia. It really saddens me that neither party has announced a policy on our Aboriginal people, in spite of world condemnation of our treatment of them. Presumably the politicians don’t feel that their votes are worth chasing.

Since the voice of older people is only heard through the young people employed by the major senior organisations, the situation as regards this section of the population is much easier, although the policies are often irrelevant as far as genuine older people are concerned.

I hope I can find an international publisher for my book as I think its relevance stretches beyond Australia.

I recently flew down to Melbourne to attend the 14th Kenneth Myer lecture sponsored by the Florey Neuroscience Institutes. This lecture is given by a different world leader in different aspects of brain research and is always of the highest standard. This year it was on memory and how our brains create and store memory, and was given by renowned British Neurophysiologist Professor Tim Bliss who is not only a brilliant researcher but is also able to use language which a layman can understand.

The Institutes always aim for high standards but I found myself concerned by a project they are running on brain fitness. The programme is excellent but the cost to participate is $485 for a team of 5. This automatically rules out large sections of the population, including those who don’t work in institutions where such a team can be formed (and hopefully paid for by the employer) and, in particular elderly people. There are so many myths around about the brains of this latter section of the population that I question the accuracy of research which excludes them. I suspect that this group is a particularly fruitful area of research in so many ways, not least of which is that we are becoming a large and therefore important section of the population. 

My flight back took me to the beginning part of the life cycle. The gentleman behind me paid extra for his early school year children to watch TV during the 45 minute trip. It was a short flight in a relatively small plane so that the ground below was visible for almost all of the trip. Below us was the rich tapestry of geography that is part of the eastern seaboard of our country. Seeing it at our feet would have provided a much richer lesson in so many ways than any school can provide. Instead of looking at it and understanding the country way of life, and how the early pioneers developed the land, these poor kids were glued to cartoons on the TV. Part of the blame for this parental attitude must lie with our schools who give the impression that only they educate our children.

My thesis is still with the examiners so while I wait I am turning my research into a readable book which allows me to move away from the stilted language of academia. This is less urgent and has no deadline so it is giving me time to pursue other things.

I was telling  a friend  that older people needed assistance with the physical aspect of ageing and going to a gym was not often our scene for a number of reasons. The next time I saw her I was given an invitation to attend a training course for community representatives on committees dealing with health issues.

Most of the staff employed in this project have disabilities, as did many of those who attended the training. What surprised me was the wonderful atmosphere. No sign of the competition that I now realise seems to permeate the world. Instead the atmosphere was wonderfully friendly and supportive and people could say what they felt without censure, and that all opinions were valid. It made me realise how much input we miss out on because people are concerned about being ridiculed or dismissed in the competitive atmosphere in which we usually run things.

As a result of this course I was invited to take part in a discussion about what I had previously heard called ‘living wills’. These are the instructions you leave, usually with a family member, in case you are not able to give them yourself, regarding resuscitation, blood transfusions etc. These are particularly important for older people. Do we want to just be left to leave this world in peace or do we want the hassle of drips and forced feeding etc.

The paper we were given to look out is the outcome of different health organisations across the country trying to achieve uniformity in language and format so that our instructions will be followed wherever we are in the country. Currently they only apply in the State or Territory where they are written and they are not available in some places. I hope that the final draft will incorporate community language that everyone can understand. The current document is written in what I call legalese and reflects the areas most of the committee members come from. It is good that it is being addressed at a national level but will be wasted if the community can’t understand it and are therefore reluctant to use it.

What surprised me was that when I mentioned that people would have different needs at different times in their lives the committee representative commented ‘That’s a good idea. I’ll make a note of it’. I would have thought it obvious that when your children are young you would want every effort made to keep you alive whereas when you are towards the end of your life you would just like to go peacefully.

I also came across a document outlining a local road safety strategy for the next couple of years. In thinking about my response I couldn’t help realising that the current dictatorial  (and revenue raising) approach is not a good way to deal with an issue which puts people’s lives at risk. I assume this is due to it being largely under police control and they have never fully endorsed public involvement and cooperation in their work. I believe that a partnership approach to road use and control would be at least worth a try given the number of road deaths and injuries.

An example of this is the announced installation of close traffic speed cameras on a road near where I live, to detect people speeding between them. As soon as they were announced there was a cry of ‘revenue raising’. I travel frequently along this road and rarely see an accident. If it is a high accident area then the police should issue the figures to prove it. Otherwise it is just another ‘us against them’ way of policing, rather than a cooperative way of approaching the problem.

Western countries believe in a democratic system but we are very select in the way they apply it. They don’t realise that cooperation actually results in more influence.

As I get older I am more inclined to question how and why things are done, rather than just accept them. I guess I am inclined to put them in perspective.

The ACT government has published its latest strategic plan  for positive ageing. It is also moving towards becoming an age friendly city. I wish more cities would adopt this policy- details are on the World Health Organisation website. The point is that if cities become age-friendly they are better places for everyone to live in, particularly the elderly, the disabled and children. On a recent trip to Melbourne it was good to see some of the tram stops labelled on the map as having minimal gap between the pavement and the tram. This helps those in wheelchairs as well as the elderly. Read the rest of this entry »

There have always been two sides to my research. Both are concerned with keeping fit, one the brain and the other the body. Read the rest of this entry »