Aspirin, CVD Risk, & Potential Counter-Risks
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Aspirin Pros & Cons
In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:
- About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
- About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
- About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”
So, what does the science say?
Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?
True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:
- decreases the risk of atherothrombosis
- increases the risk of bleeding, especially in the gastrointestinal tract
When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither
While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.
In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones
The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.
In the words of the Journal of the American College of Cardiology:
❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).
Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).
Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞
~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)
Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology
Or if you’d prefer a more pop-science presentation:
Many older adults still use aspirin for CVD prevention, contrary to clinical guidance
Aspirin can cause liver and/or kidney damage: True or False?
True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.
Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).
Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.
For numbers, symptoms, and treatment, see this very clear and helpful resource:
An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Habits of a Happy Brain – by Dr. Loretta Graziano Breuning
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
There are lots of books on “happy chemicals” and “how to retrain your brain”, so what makes this one different?
Firstly, it focuses on four “happy chemicals”, not just one:
- Serotonin
- Dopamine
- Oxytocin
- Endorphins
It also looks at the role of cortisol, and how it caps off each of those just a little bit, to keep us just a little malcontent.
Behavioral psychology tends to focus most on dopamine, while prescription pharmaceuticals for happiness (i.e., most antidepressants) tend to focus on serotonin. Here, Dr. Breuning helps us understand the complex interplay of all of the aforementioned chemicals.
She also clears up many misconceptions, since a lot of people misattribute the functions of each of these.
Common examples include “I’m doing this for the serotonin!” when the activity is dopaminergic not serotoninergic, or considering dopamine “the love molecule” when oxytocin, or even something else like phenylethylamine would be more appropriate.
The above may seem like academic quibbles and not something of practical use, but if we want to biohack our brains, we need to do better than the equivalent of a chef who doesn’t know the difference between salt and sugar.
Where things are of less practical use, she tends to skip over or at least streamline them. For example, she doesn’t really discuss the role of post-dopamine prolactin in men—but the discussion of post-happiness cortisol covers the same ground anyway, for practical purposes.
Dr. Breuning also looks at where our evolved neurochemical responses go wrong, and lays out guidelines for such challenges as overcoming addiction, or embracing delayed gratification.
Bottom line: this book is a great user-manual for the brain. If you’d like to be happier and more effective with fewer bad habits, this is the book for you.
Click here to check out Habits of a Happy Brain, and get biohacking yours!
Share This Post
Women want to see the same health provider during pregnancy, birth and beyond
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Hazel Keedle, Western Sydney University and Hannah Dahlen, Western Sydney University
In theory, pregnant women in Australia can choose the type of health provider they see during pregnancy, labour and after they give birth. But this is often dependent on where you live and how much you can afford in out-of-pocket costs.
While standard public hospital care is the most common in Australia, accounting for 40.9% of births, the other main options are:
- GP shared care, where the woman sees her GP for some appointments (15% of births)
- midwifery continuity of care in the public system, often called midwifery group practice or caseload care, where the woman sees the same midwife of team of midwives (14%)
- private obstetrician care (10.6%)
- private midwifery care (1.9%).
Given the choice, which model would women prefer?
Our new research, published BMC Pregnancy and Childbirth, found women favoured seeing the same health provider throughout pregnancy, in labour and after they have their baby – whether that’s via midwifery group practice, a private midwife or a private obstetrician.
Assessing strengths and limitations
We surveyed 8,804 Australian women for the Birth Experience Study (BESt) and 2,909 provided additional comments about their model of maternity care. The respondents were representative of state and territory population breakdowns, however fewer respondents were First Nations or from culturally or linguistically diverse backgrounds.
We analysed these comments in six categories – standard maternity care, high-risk maternity care, GP shared care, midwifery group practice, private obstetric care and private midwifery care – based on the perceived strengths and limitations for each model of care.
Overall, we found models of care that were fragmented and didn’t provide continuity through the pregnancy, birth and postnatal period (standard care, high risk care and GP shared care) were more likely to be described negatively, with more comments about limitations than strengths.
What women thought of standard maternity care in hospitals
Women who experienced standard maternity care, where they saw many different health care providers, were disappointed about having to retell their story at every appointment and said they would have preferred continuity of midwifery care.
Positive comments about this model of care were often about a midwife or doctor who went above and beyond and gave extra care within the constraints of a fragmented system.
The model of care with the highest number of comments about limitations was high-risk maternity care. For women with pregnancy complications who have their baby in the public system, this means seeing different doctors on different days.
Some respondents received conflicting advice from different doctors, and said the focus was on their complications instead of their pregnancy journey. One woman in high-risk care noted:
The experience was very impersonal, their focus was my cervix, not preparing me for birth.
Why women favoured continuity of care
Overall, there were more positive comments about models of care that provided continuity of care: private midwifery care, private obstetric care and midwifery group practice in public hospitals.
Women recognised the benefits of continuity and how this included informed decision-making and supported their choices.
The model of care with the highest number of positive comments was care from a privately practising midwife. Women felt they received the “gold standard of maternity care” when they had this model. One woman described her care as:
Extremely personable! Home visits were like having tea with a friend but very professional. Her knowledge and empathy made me feel safe and protected. She respected all of my decisions. She reminded me often that I didn’t need her help when it came to birthing my child, but she was there if I wanted it (or did need it).
However, this is a private model of care and women need to pay for it. So there are barriers in accessing this model of care due to the cost and the small numbers working in Australia, particularly in regional, rural and remote areas, among other barriers.
Women who had private obstetricians were also positive about their care, especially among women with medical or pregnancy complications – this type of care had the second-highest number of positive comments.
This was followed by women who had continuity of care from midwives in the public system, which was described as respectful and supportive.
However, one of the limitations about continuity models of care is when the woman doesn’t feel connected to her midwife or doctor. Some women who experienced this wished they had the opportunity to choose a different midwife or doctor.
What about shared care with a GP?
While shared care between the GP and hospital model of care is widely promoted in the public maternity care system as providing continuity, it had a similar number of negative comments to those who had fragmented standard hospital care.
Considering there is strong evidence about the benefits of midwifery continuity of care, and this model of care appears to be most acceptable to women, it’s time to expand access so all Australian women can access continuity of care, regardless of their location or ability to pay.
Hazel Keedle, Senior Lecturer of Midwifery, Western Sydney University and Hannah Dahlen, Professor of Midwifery, Associate Dean Research and HDR, Midwifery Discipline Leader, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder) and how much does it matter for health e.g. waist size etc?❞
Let’s break it down into two parts:
Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder)?
Short answer: no
First, a quick anatomy lesson: while “abs” (abdominal muscles) are considered in the plural and indeed they are, what we see as a six-pack is actually only one muscle, the rectus abdominis, which is nestled in between other abdominal muscles that are beyond the scope of our answer here.
The reason that the rectus abdominis looks like six muscles is because there are bands of fascia (connective tissue) lying over it, so we see where it bulges between those bands.
The main difference genes make are as follows:
- Number of fascia bands (and thus the reason that some people get a four-, six-, eight-, or rarely, even ten-pack). Obviously, no amount of training can change this number, any more than doing extra bicep curls will grow you additional arms.
- Density of muscle fibers. Some people have what has been called “superathlete muscle type”, which, while prized by Olympians and other athletes, is on bodybuilding forums less glamorously called being a “hard gainer”. What this means is that muscle fibers are denser, so while training will make muscles stronger, you won’t see as much difference in size. This means that size for size, the person with this muscle type will always be stronger than someone the same size without it, but that may be annoying if you’re trying to build visible definition.
- Twitch type of muscle fibers. Some people have more fast-twitch fibers, some have more slow-twitch fibers. Fast-twitch fibers are better suited for visible abs (and, as the name suggests, quick changes between contracting and relaxing). Slow-twitch fibers are better for endurance, but yield less bulky muscles.
- Inclination to subcutaneous fat storage. This is by no means purely genetic; hormones make the biggest difference, followed by diet. But, genes are an influencing factor, and if your body fat percentage is inclined to be higher than someone else’s, then it’ll take more work to see muscle definition under that fat.
The first of those items is why our simple answer is “no”; because some people are destined to, if muscle is visible, have a four-, eight, or (rarely) ten-pack, making a six-pack unobtainable.
It’s worth noting here that while a bigger number is more highly prized aesthetically, there is literally zero difference healthwise or in terms of performance, because it’s nothing to do with the muscle, and is only about the fascia layout.
The density of muscle fibers is again purely genetic, but it only makes things easier or harder; this part’s not impossible for anyone.
The inclination to subcutaneous fat storage is by far the most modifiable factor, and the thus most readily overcome, if you feel so inclined. That doesn’t mean it will necessarily be easy! But it does mean that it’s relatively less difficult than the others.
How much does it matter for health, e.g. waist size etc?
As you may have gathered from the above, having a six-pack (or indeed a differently-numbered “pack”, if that be your genetic lot) makes no important difference to health:
- The fascia layout is completely irrelevant to health
- The muscle fiber types do make a difference to athletic performance, but not general health when at rest
- The subcutaneous fat storage is a health factor, but probably not how most people think
Healthy body fat percentages are (assuming normal hormones) in the range of 20–25% for women and 15–20% for men.
For most people, having clearly visible abs requires going below those healthy levels. For most people, that’s not optimally healthy. And those you see on magazine covers or in bodybuilding competitions are usually acutely dehydrated for the photo, which is of course not good. They will rehydrate after the shoot.
However, waist size (especially as a ratio, compared to hip size) is very important to health. This has less to do with subcutaneous fat, though, and is more to do with visceral belly fat, which goes under the muscles and thus does not obscure them:
Visceral Belly Fat & How To Lose It
One final note: fat notwithstanding, and aesthetics notwithstanding, having a strong core is very good for general health; it helps keeps one’s internal organs in place and well-protected, and improves stability, making falls less likely as we get older. Additionally, having muscle improves our metabolic base rate, which is good for our heart. Abs are just one part of core strength (the back being important too, for example), but should not be neglected.
Top-tier exercises to do include planks, and hanging leg raises (i.e. hang from some support, such as a chin-up bar, and raise your legs, which counterintuitively works your abs a lot more than your legs).
Take care!
Share This Post
Related Posts
Support For Long COVID & Chronic Fatigue
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Long COVID and Chronic Fatigue
Getting COVID-19 can be very physically draining, so it’s no surprise that getting Long COVID can (and usually does) result in chronic fatigue.
But, what does this mean and what can we do about it?
What makes Long COVID “long”
Long COVID is generally defined as COVID-19 whose symptoms last longer than 28 days, but in reality the symptoms not only tend to last for much longer than that, but also, they can be quite distinct.
Here’s a large (3,762 participants) study of Long COVID, which looked at 203 symptoms:
Characterizing long COVID in an international cohort: 7 months of symptoms and their impact
Three symptoms stood at out as most prevalent:
- Chronic fatigue (CFS)
- Cognitive dysfunction
- Post-exertional malaise (PEM)
The latter means “the symptoms get worse following physical or mental exertion”.
CFS, Chronic Fatigue Syndrome, is also called Myalgic Encephalomyelitis (ME).
What can be done about it?
The main “thing that people do about it” is to reduce their workload to what they can do, but this is not viable for everyone. Note that work doesn’t just mean “one’s profession”, but anything that requires physical or mental energy, including:
- Childcare
- Housework
- Errand-running
- Personal hygiene/maintenance
For many, this means having to get someone else to do the things—either with support of family and friends, or by hiring help. For many who don’t have those safety nets available, this means things simply not getting done.
That seems bleak; isn’t there anything more we can do?
Doctors’ recommendations are chiefly “wait it out and hope for the best”, which is not encouraging. Some people do recover from Long COVID; for others, it so far appears it might be lifelong. We just don’t know yet.
Doctors also recommend to journal, not for the usual mental health benefits, but because that is data collection. Patients who journal about their symptoms and then discuss those symptoms with their doctors, are contributing to the “big picture” of what Long COVID and its associated ME/CFS look like.
You may notice that that’s not so much saying what doctors can do for you, so much as what you can do for doctors (and in the big picture, eventually help them help people, which might include you).
So, is there any support for individuals with Long COVID ME/CFS?
Medically, no. Not that we could find.
However! Socially, there are grassroots support networks, that may be able to offer direct assistance, or at least point individuals to useful local resources.
Grassroots initiatives include Long COVID SOS and the Patient-Led Research Collaborative.
The patient-led organization Body Politic also used to have such a group, until it shut down due to lack of funding, but they do still have a good resource list:
Click here to check out the Body Politic resource list (it has eight more specific resources)
Stay strong!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Can You Get Addicted To MSG, Like With Sugar?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Hello, I love your newsletter 🙂 Can I have a question? While browsing through your recepies, I realised many contained MSG. As someone based in Europe, I am not used to using MSG while cooking (of course I know that processed food bought in supermarket containes MSG). There is a stigma, that MSG is not particulary healthy, but rather it should be really bad and cause negative effects like headaches. Is this true? Also, can you get addicted to MSG, just like you get addicted to sugar? Thank you :)❞
Thank you for the kind words, and the interesting questions!
Short answer: no and no 🙂
Longer answer: most of the negative reputation about MSG comes from a single piece of satire written in the US in the 1960s, which the popular press then misrepresented as a genuine concern, and the public then ran with, mostly due to racism/xenophobia/sinophobia specifically, given the US’s historically not fabulous relations with China, and the moniker of “Chinese restaurant syndrome”, notwithstanding that MSG was first isolated in Japan, not China, more than 100 years ago.
The silver lining that comes out of this is that because of the above, MSG has been one of the most-studied food additives in recent decades, with many teams of scientists in many countries trying to determine its risks and not finding any (except insofar as anything in extreme quantities can kill you, including water or oxygen).
You can read more about this and other* myths about MSG, here:
Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
*such as pertaining to gluten sensitivity, which in reality MSG has no bearing on whatsoever as it does not contain gluten and is not even made of the same basic stuff; gluten being a protein made of (amongst other things) the amino acid glutamine, not a glutamate salt. Glutamate is as closely related to gluten as cyanocobalamin (vitamin B12) is to cyanide (the famous poison).
PS: if you didn’t click the above link to read that article, then 1) we really do recommend it 2) we did some LD50 calculations there and looked at available research, and found that for someone of this writer’s (very medium) size, eating 1kg of MSG at once is sufficient to cause toxicity, and injecting >250g of MSG may cause heart problems. So we don’t recommend doing that.
However, ½ tsp in a recipe that gives multiple portions is not going to get you anywhere close to the danger zone, unless you consume that entire meal by yourself hundreds of times per day. And if you do, the MSG is probably the least of your concerns.
(2 tsp of cassia cinnamon, however, is enough to cause coumarin toxicity; for this reason we recommend Ceylon (or “True” or “Sweet”) cinnamon in our recipes, as it has almost undetectable levels of coumarin)
With regard to your interesting question about addiction, first of all let’s speak briefly about sugar addiction:
Sugar addiction is, by broad scientific consensus, agreed-upon as an extant thing that does exist, and contemporary research is more looking into the “hows” and “whys” and “whats” rather than the “whether”. It is a somewhat complicated topic, because it’s halfway between what science would usually consider a chemical addiction, and what science would usually consider a behavioral addiction:
The Not-So-Sweet Science Of Sugar Addiction
The reasonable prevailing hypothesis, therefore, is that sugar simply has two moderate mechanisms of addiction, rather than one strong one.
The biochemical side of sugar addiction comes from the body’s metabolism of sugar, so this cannot be a thing for MSG, because there is nothing to metabolize in the same sense of the word (MSG being an inorganic compound with zero calories).
People can crave salt, especially when deficient in it, and MSG does contain sodium (it’s what the “S” stands for), but it contains a little under ⅓ of the sodium that table salt does (sodium chloride in whatever form, be it sea salt, rock salt, or such):
MSG vs. Salt: Sodium Comparison ← we do molecular calculations here!
Sea Salt vs MSG – Which is Healthier? ← this one for a head-to-head
However, even craving salt does not constitute an addiction; nobody is shamefully hiding their rock salt crystals under their bed and getting a fix when they feel low, and nor does withdrawal cause adverse side effects, except insofar as (once again) a person deficient in salt will crave salt.
Finally, the only other way we know of that one might wonder if MSG could be addictive, is about glutamate and glutamate receptors. The glutamate in MSG is the same glutamate (down to the atoms) as the glutamate formed if one consumes tomatoes in the presence of salt, and triggers the same glutamate receptors in the same way. We have the same number of receptors either way, and uptake is exactly the same (because again, it’s exactly the same chemical) so there is a maximum to how strong this effect can be, and that maximum is the same whatever the source of the glutamate was.
In this respect, if MSG is addictive, then so is a tomato salad with a pinch of salt: it’s not—it’s just tasty.
We haven’t cited papers in today’s article, but it’s just because we cited them already in the articles we linked, and so we avoided doubling up. Most of them are in that first link we gave 🙂
One final note
Technically anyone can develop a sensitivity to anything, so in theory someone could develop a sensitivity to MSG, just like they could for any other ingredient. Our usual legal/medical disclaimer applies.
However, it’s certainly not a common trigger, putting it well below common allergens like nuts (or less common allergens like, say, bananas), not even in the same league as common intolerances such as gluten, and less worthy of health risk warnings than, say, spinach (high in oxalates; fine for most people but best avoided if you have kidney problems).
The reason we use it in the recipes we use it in, is simply because it’s a lower-sodium alternative to salt, and while it contains a (very) tiny bit less sodium than low-sodium salt (which itself has about ⅓ the sodium of regular salt), it has more of a flavor-enhancing effect, such that one can use half as much, for a more than sixfold total sodium reduction. Which for most of us in the industrialized world, is beneficial.
Want to try some?
If today’s article has inspired you to give MSG a try, here’s an example product on Amazon 😎
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
How do I handle it if my parent is refusing aged care? 4 things to consider
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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.
1. Start with more help at home
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 My Aged Care to discuss your options.
2. Be prepared for multiple conversations
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”.
3. Understand the options when help at home isn’t enough
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 considering a nursing home (also known as residential aged care in Australia).
Every person has a legal right to choose where we live (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.
Research 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 find the right nursing home 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.
4. Understand the options if a parent has lost capacity to make decisions
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 enduring guardian 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 appoint 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.
Deal with your own feelings
Families often feel guilt and grief 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.
Lee-Fay Low, Professor in Ageing and Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: