Who will look after us in our final years? A pay rise alone won’t solve aged-care workforce shortages
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Aged-care workers will receive a significant pay increase after the Fair Work Commission ruled they deserved substantial wage rises of up to 28%. The federal government has committed to the increases, but is yet to announce when they will start.
But while wage rises for aged-care workers are welcome, this measure alone will not fix all workforce problems in the sector. The number of people over 80 is expected to triple over the next 40 years, driving an increase in the number of aged care workers needed.
How did we get here?
The Royal Commission into Aged Care Quality and Safety, which delivered its final report in March 2021, identified a litany of tragic failures in the regulation and delivery of aged care.
The former Liberal government was dragged reluctantly to accept that a total revamp of the aged-care system was needed. But its weak response left the heavy lifting to the incoming Labor government.
The current government’s response started well, with a significant injection of funding and a promising regulatory response. But it too has failed to pursue a visionary response to the problems identified by the Royal Commission.
Action was needed on four fronts:
- ensuring enough staff to provide care
- building a functioning regulatory system to encourage good care and weed out bad providers
- designing and introducing a fair payment system to distribute funds to providers and
- implementing a financing system to pay for it all and achieve intergenerational equity.
A government taskforce which proposed a timid response to the fourth challenge – an equitable financing system – was released at the start of last week.
Consultation closed on a very poorly designed new regulatory regime the week before.
But the big news came at end of the week when the Fair Work Commission handed down a further determination on what aged-care workers should be paid, confirming and going beyond a previous interim determination.
What did the Fair Work Commission find?
Essentially, the commission determined that work in industries with a high proportion of women workers has been traditionally undervalued in wage-setting. This had consequences for both care workers in the aged-care industry (nurses and Certificate III-qualified personal-care workers) and indirect care workers (cleaners, food services assistants).
Aged-care staff will now get significant pay increases – 18–28% increase for personal care workers employed under the Aged Care Award, inclusive of the increase awarded in the interim decision.
Shutterstock/Toa55
Indirect care workers were awarded a general increase of 3%. Laundry hands, cleaners and food services assistants will receive a further 3.96% on the grounds they “interact with residents significantly more regularly than other indirect care employees”.
The final increases for registered and enrolled nurses will be determined in the next few months.
How has the sector responded?
There has been no push-back from employer groups or conservative politicians. This suggests the uplift is accepted as fair by all concerned.
The interim increases of up to 15% probably facilitated this acceptance, with the recognition of the community that care workers should be paid more than fast food workers.
There was no criticism from aged-care providers either. This is probably because they are facing difficulty in recruiting staff at current wage rates. And because government payments to providers reflect the actual cost of aged care, increased payments will automatically flow to providers.
When the increases will flow has yet to be determined. The government is due to give its recommendations for staging implementation by mid-April.
Is the workforce problem fixed?
An increase in wages is necessary, but alone is not sufficient to solve workforce shortages.
The health- and social-care workforce is predicted to grow faster than any other sector over the next decade. The “care economy” will grow from around 8% to around 15% of GDP over the next 40 years.
This means a greater proportion of school-leavers will need to be attracted to the aged-care sector. Aged care will also need to attract and retrain workers displaced from industries in decline and attract suitably skilled migrants and refugees with appropriate language skills.
nastya_ph/Shutterstock
The caps on university and college enrolments imposed by the previous government, coupled with weak student demand for places in key professions (such as nursing), has meant workforce shortages will continue for a few more years, despite the allure of increased wages.
A significant increase in intakes into university and vocational education college courses preparing students for health and social care is still required. Better pay will help to increase student demand, but funding to expand place numbers will ensure there are enough qualified staff for the aged-care system of the future. 
Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Coughing/Wheezing After Dinner?
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The After-Dinner Activities You Don’t Want
A quick note first: our usual medical/legal disclaimer applies here, and we are not here to diagnose you or treat you; we are not doctors, let alone your doctors. Do see yours if you have any reason to believe there may be cause for concern.
Coughing and/or wheezing after eating is more common the younger or older someone is. Lest that seem contradictory: it’s a U-shaped bell-curve.
It can happen at any age and for any of a number of reasons, but there are patterns to the distribution:
Mostly affects younger people:
Allergies, asthma
Young people are less likely to have a body that’s fully adapted to all foods yet, and asthma can be triggered by certain foods (for example sulfites, a common preservative additive):
Adverse reactions to the sulphite additives
Foods/drinks that commonly contain sulfites include soft drinks, wines and beers, and dried fruit
As for the allergies side of things, you probably know the usual list of allergens to watch out for, e.g: dairy, fish, crustaceans, eggs, soy, wheat, nuts.
However, that’s far from an exhaustive list, so it’s good to see an allergist if you suspect it may be an allergic reaction.
Affects young and old people equally:
Again, there’s a dip in the middle where this doesn’t tend to affect younger adults so much, but for young and old people:
Dysphagia (difficulty swallowing)
For children, this can be a case of not having fully got used to eating yet if very small, and when growing, can be a case of “this body is constantly changing and that makes things difficult”.
For older people, this can can come from a variety of reasons, but common culprits include neurological disorders (including stroke and/or dementia), or a change in saliva quality and quantity—a side-effect of many medications:
Hyposalivation in Elderly Patients
(particularly useful in the article above is the table of drugs that are associated with this problem, and the various ways they may affect it)
Managing this may be different depending on what is causing your dysphagia (as it could be anything from antidepressants to cancer), so this is definitely one to see your doctor about. For some pointers, though:
NHS Inform | Dysphagia (swallowing problems)
Affects older people more:
Gastroesophagal reflux disease (GERD)
This is a kind of acid reflux, but chronic, and often with a slightly different set of symptoms.
GERD has no known cure once established, but its symptoms can be managed (or avoided in the first place) by:
- Healthy eating (Mediterranean diet is, as usual, great)
- Weight loss (if and only if obese)
- Avoiding trigger foods
- Eating smaller meals
- Practicing mindful eating
- Staying upright for 3–4 hours after eating
And of course, don’t smoke, and ideally don’t drink alcohol.
You can read more about this (and the different ways it can go from there), here:
NICE | Gastro-oesophageal reflux disease
Note: this above page refers to it as “GORD”, because of the British English spelling of “oesophagus” rather than “esophagus”. It’s the exact same organ and condition, just a different spelling.
Take care!
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Real Superfoods – by Ocean Robbins & Nichole Dandrea-Russert
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Of the two authors, the former is a professional public speaker, and the latter is a professional dietician. As a result, we get a book that is polished and well-presented, while actually having a core of good solid science (backed up with plenty of references).
The book is divided into two parts; the first part has 9 chapters pertaining to 9 categories of superfood (with more details about top-tier examples of each, within), and the second part has 143 pages of recipes.
And yes, as usual, a couple of the recipes are “granola” and “smoothie”, but when are they not? Most of the recipes are worthwhile, though, with a lot of good dishes that should please most people.
Bottom line: this is half pop-science presentation of superfoods, and half cookbook featuring those ingredients. Definitely a good way to increase your consumption of superfoods, and get the most out of your diet.
Click here to check out Real Superfoods, and power up your health!
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Will there soon be a cure for HIV?
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Human immunodeficiency virus, or HIV, is a chronic health condition that can be fatal without treatment. People with HIV can live healthy lives by taking antiretroviral therapy (ART), but this medication must be taken daily in order to work, and treatment can be costly. Fortunately, researchers believe a cure is possible.
In July, a seventh person was reportedly cured of HIV following a 2015 stem cell transplant for acute myeloid leukemia. The patient stopped taking ART in 2018 and has remained in remission from HIV.
Read on to learn more about HIV, the promise of stem cell transplants, and what other potential cures are on the horizon.
What is HIV?
HIV infects and destroys the immune system’s cells, making people more susceptible to infections. If left untreated, HIV will severely impair the immune system and progress to acquired immunodeficiency syndrome (AIDS). People living with untreated AIDS typically die within three years.
People with HIV can take ART to help their immune systems recover and to reduce their viral load to an undetectable level, which slows the progression of the disease and prevents them passing the virus to others.
How can stem cell transplants cure HIV?
Several people have been cured of HIV after receiving stem cell transplants to treat leukemia or lymphoma. Stem cells are produced by the spongy tissue located in the center of some bones, and they can turn into new blood cells.
A mutation on the CCR5 gene prevents HIV from infecting new cells and creates resistance to the virus, which is why some HIV-positive people have received stem cells from donors carrying this mutation. (One person was reportedly cured of HIV after receiving stem cells without the CCR5 mutation, but further research is needed to understand how this occurred.)
Despite this promising news, experts warn that stem cell transplants can be fatal, so it’s unlikely this treatment will be available to treat people with HIV unless a stem cell transplant is needed to treat cancer. People with HIV are at an increased risk for blood cancers, such as Hodgkin lymphoma and non-Hodgkin lymphoma, which stem cell transplants can treat.
Additionally, finding compatible donors with the CCR5 mutation who share genetic heritage with patients of color can be challenging, as donors with the mutation are typically white.
What are other potential cures for HIV?
In some rare cases, people who started ART shortly after infection and later stopped treatment have maintained undetectable levels of HIV in their bodies. There have also been some people whose bodies have been able to maintain low viral loads without any ART at all.
Researchers are studying these cases in their search for a cure.
Other treatment options researchers are exploring include:
- Gene therapy: In addition to stem cell transplants, gene therapy for HIV involves removing genes from HIV particles in patients’ bodies to prevent the virus from infecting other cells.
- Immunotherapy: This treatment is typically used in cancer patients to teach their immune systems how to fight off cancer. Research has shown that giving some HIV patients antibodies that target the virus helps them reach undetectable levels of HIV without ART.
- mRNA technology: mRNA, a type of genetic material that helps produce proteins, has been used in vaccines to teach cells how to fight off viruses. Researchers are seeking a way to send mRNA to immune system cells that contain HIV.
When will there be a cure for HIV?
The United Nations and several countries have pledged to end HIV and AIDS by 2030, and a 2023 UNAIDS report affirmed that reaching this goal is possible. However, strategies to meet this goal include HIV prevention and improving access to existing treatment alongside the search for a cure, so we still don’t know when a cure might be available.
How can I find out if I have HIV?
You can get tested for HIV from your primary care provider or at your local health center. You can also purchase an at-home HIV test from a drugstore or online. If your at-home test result is positive, follow up with your health care provider to confirm the diagnosis and get treatment.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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What’s behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000s—and the reasons why aren’t always clear.
Here’s what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Why Psyllium Is Healthy Through-And-Through
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Psyllium is the powder of the husk of the seed of the plant Plantago ovata.
It can be taken as a supplement, and/or used in cooking.
What’s special about it?
It is fibrous, and the fiber is largely soluble fiber. It’s a “bulk-forming laxative”, which means that (dosed correctly) it is good against both constipation (because it’s a laxative) and diarrhea (because it’s bulk-forming).
See also, because this is Research Review Monday and we provide papers for everything:
In other words, it will tend things towards being a 3 or 4 on the Bristol Stool Scale ← this is not pretty, but it is informative.
Before the bowels
Because of how it increases the viscosity of substances it finds itself in, psyllium slows stomach-emptying, and thus improves feelings of satiety.
Here’s a study in which taking psyllium before breakfast and lunch resulted in increased satiety between meals, and reduction in food-related cravings:
Satiety effects of psyllium in healthy volunteers
Prebiotic benefits
We can’t digest psyllium, but our gut bacteria can—somewhat! Because they can only digest some of the psyllium fibers, that means the rest will have the stool-softening effect, while we also get the usual in-gut benefits from prebiotic fiber first too:
The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls
Cholesterol-binding
Psyllium can bind to cholesterol during the digestive process. Why only “can”? Well, if you don’t consume cholesterol (for example, if you are vegan), then there won’t be cholesterol in the digestive tract to bind to (yes, we do need some cholesterol to live, but like most animals, we can synthesize it ourselves).
What this cholesterol-binding action means is that the dietary cholesterol thus bound cannot enter the bloodstream, and is simply excreted instead:
Heart health beyond cholesterol
Psyllium supplementation can also help lower high blood pressure but does not significantly lower already-healthy blood pressure, so it can be particularly good for keeping things in safe ranges:
❝Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.❞
Read in full: The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials ← you can see the concrete numbers here
Is it safe?
Psyllium is first and foremost a foodstuff, and is considered very safe unless you have an allergy (which is rare, but possible).
However, it is still recommended to start at a low dose and work up, because anything that changes your gut microbiota, even if it changes it for the better, will be easiest if done slowly (or else, you will hear about it from your gut).
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)
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There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:
Under pressure
When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.
Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower
*10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.
Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.
Dr. Dhand’s advice for patients and families is:
- Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
- Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
- Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Insider’s Guide To Making Hospital As Comfortable As Possible
Take care!
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