Older people’s risk of abuse is rising. Can an ad campaign protect them?
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Elder abuse is an emerging public health and safety issue for communities of high-income countries.
The most recent data from Australia’s National Elder Abuse Prevalence Study, which surveyed 7,000 older people living in the community, found one in six self-reported being a victim of some form of abuse. But this did not include older people living in residential aged care or those with cognitive impairment, such as dementia – so is likely an underestimate.
This week the Australian government announced a multi-million dollar advertising campaign it hopes will address this serious and abhorrent abuse.
But is investing in community awareness of elder abuse the best use of scarce resources?
What is elder abuse?
The World Health Organization (WHO) defines elder abuse as
[…] a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.
Australia usually defines older people as those over 65. The exact age varies between countries depending on the overall health status of a nation and its vulnerable population groups. The WHO definitions of an older adult for sub-Saharan Africa, for example, is over 50. And there are communities with poorer health status and shorter lifespans within country borders, including our First Nations people.
Elder abuse can take on many different forms including physical, sexual, psychological, emotional, or financial abuse and neglect.
Living longer and wealthier
The number of older people in our society is greater than it has ever been. Around 17% Australians are aged 65 and over. By 2071, older Australians will make up between 25% and 27% of the total population.
People are living longer, accumulating substantial wealth and are vulnerable to abuse due to cognitive, physical or functional limitations.
Longer lifespans increase the time of possible exposure to abuse. Australian men aged 65 can expect to live another 20.2 years, while women aged 65 are likely to live another 22.8 years. (Life expectancy for First Nations men and women remains significantly shorter.)
Australian men are now 143 times more likely to reach the age of 100 than they were in 1901. Women are 82 times more likely.
Older people hold a large proportion of our nation’s wealth, making them vulnerable to financial abuse. Recent research by the Australian Council of Social Service and UNSW Sydney reveals older households (with people over 65) are 25% wealthier than the average middle-aged household and almost four times as wealthy as the average under-35 household.
Finally, older people have higher levels of impairment in their thinking, reasoning and physical function. Cognitive impairment, especially dementia, increases from one in 67 Australians under 60 to almost one in two people aged over 90.
Over half of Australians aged 65 years and over have disability. A particularly vulnerable group are the 258,374 older Australians who receive government-funded home care.
Who perpetrates elder abuse?
Sadly, most of the perpetrators of elder abuse are known to their victims. They are usually a member of the family, such as a life partner, child or grandchild.
Elder abuse causes significant illness and even early death. Financial abuse (across all ages) costs the community billions of dollars. Specific data for financial elder abuse is limited but indicates massive costs to individual survivors and the community.
Despite this, the level of awareness of elder abuse is likely to be much lower than for family violence or child abuse. This is partly due to the comparatively recent concept of elder abuse, with global awareness campaigns only developed over the past two decades.
Is an advertising campaign the answer?
The federal government has allocated A$4.8 million to an advertising campaign on television, online and in health-care clinics to reach the broader community. For context, last year the government spent $131.4 million on all media campaigns, including $32.6 million on the COVID vaccination program, $2 million on Japanese encephalitis and $3.2 million on hearing health awareness.
The campaign will likely benefit a small number of people who may be victims and have the capacity to report their perpetrators to authorities. It will generate some heartbreaking anecdotes. But it is unlikely to achieve broad community or systemic change.
There is little research evidence to show media campaigns alter the behaviour of perpetrators of elder abuse. And suggesting the campaign raises awareness of the issue for older people who are survivors of abuse sounds more like blaming victims than empowering them.
We don’t know how the government will judge the success of the campaign, so taxpayers won’t know whether a reasonable return on this investment was achieved. There may also be opportunity costs associated with the initiative – that is, lost opportunities for other actions and strategies. It could be more effective and efficient to target high-risk subgroups or to allocate funding to policy, practice reform or research that has direct tangible benefits for survivors. https://www.youtube.com/embed/DeK2kaqplTI?wmode=transparent&start=0 The Australian Human Rights Commission’s campaign from last year.
But the campaign can’t hurt, right?
Actually, the dangers that could come with an advertising campaign are two-fold.
First it may well oversimplify a highly complex issue. Identifying and managing elder abuse requires an understanding of the person’s vulnerabilities, their decision-making capacity and ability to consent, the will and preferences of victim and the role of perpetrator in the older person’s life. Abuse happens in the context of family and social networks. And reporting abuse can have consequences for the victim’s quality of life and care.
Consider the complexities of a case where an older person declines to have her grandson reported to police for stealing her money and medication because of her fear of becoming socially isolated. She might even feel responsible for the behaviour having raised the grandson and not want him to have a criminal record.
Secondly, a public campaign can create the illusion government and our institutions have the matter “in hand”. This might slow the opportunity for real change.
Ideally, the campaign will strengthen the argument for better policies, reporting procedures, policing, prosecution and judgements that are aligned. But these ends will also need investment in more research to build better communities that take good care of older people.
Joseph Ibrahim, Professor, Aged Care Medical Research Australian Centre for Evidence Based Aged Care, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Are You Stuck Playing These Three Roles in Love?
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The psychology of Transactional Analysis holds that our interpersonal dynamics can be modelled in the following fashion:
The roles
- Child: vulnerable, trusting, weak, and support-seeking
- Parent: strong, dominant, responsible—but also often exhausted and critical
- Adult: balanced, thoughtful, creative, and kind
Ideally we’d be able to spend most of our time in “Adult” mode, and occasionally go into “Child” or “Parent” mode when required, e.g. child when circumstances have rendered us vulnerable and we need help; parent when we need to go “above and beyond” in the pursuit of looking after others. That’s all well and good and healthy.
However, in relationships, often it happens that partners polarize themselves and/or each other, with one shouldering all of the responsibility, and the other willfully losing their own agency.
The problem lies in that either role can be seductive—on the one hand, it’s nice to be admired and powerful and it’s a good feeling to look after one’s partner; on the other hand, it’s nice to have someone who will meet your every need. What love and trust!
Only, it becomes toxic when these roles stagnate, and each forgets how to step out of them. Each can become resentful of the other (for not pulling their weight, on one side, and for not being able to effortlessly solve all life problems unilaterally and provide endlessly in both time and substance, on the other), digging in to their own side and exacerbating the less healthy qualities.
As to the way out? It’s about self-exploration and mutual honesty—and mutual support:
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Further reading
While we haven’t (before today) written about TA per se, we have previously written about AT (Attachment Theory), and on this matter, the two can overlap, where certain attachment styles can result in recreating parent/child/adult dynamics:
How To Leverage Attachment Theory In Your Relationship ← this is about understanding and recognizing attachment styles, and then making sure that both you and your partner(s) are armed with the necessary knowledge and understanding to meet each other’s needs.
Take care!
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Stop Cancer 20 Years Ago
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Get Abreast And Keep Abreast
This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.
What does she want us to know?
Start now
If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.
What this means for those of us without breast cancer (or a history therof) is: start now
Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.
Start what, you ask? Taking away its roots. And how?
Inflammation as the root of cancer
To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.
Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:
“and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”
So, fight inflammation now, and have a reduced risk of a lot of other woes later.
See: How to Prevent (or Reduce) Inflammation
Don’t settle for “normal”
People are told, correctly but not always helpfully, such things as:
- It’s normal to have less energy at your age
- It’s normal to have a weaker immune system at your age
- It’s normal to be at a higher risk of diabetes, heart disease, etc
…and many more. And these things are true! But that doesn’t mean we have to settle for them.
We can be all the way over on the healthy end of the distribution curve. We can do that!
(so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)
If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.
So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:
See: Focusing On Health In Our Sixties
Fast to live
Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.
This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.
See: Intermittent Fasting: We Sort The Science From The Hype
While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.
It’s never too late
All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”
The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.
Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.
Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:
- Knowing stuff
- Doing stuff
So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.
Want to know more?
We recently reviewed her book, and heartily recommend it:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Enjoy!
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Progesterone Menopausal HRT: When, Why, And How To Benefit
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Progesterone doesn’t get talked about as much as other sex hormones, so what’s its deal? Dr. Heather Hirsch explains:
Menopausal progesterone
Dr. Hirsch considers progesterone essential for menopausal women who are taking estrogen and have an intact uterus, to keep conditions at bay such as endometriosis or even uterine cancer.
However, she advises it is not critical in those without a uterus, unless there was a previous case of one of the above conditions.
10almonds addition: on the other hand, progesterone can still be beneficial from a metabolic and body composition standpoint, so do speak with your endocrinologist about it.
As an extra bonus: while not soporific (it won’t make you sleepy), taking progesterone at night will improve the quality of your sleep once you do sleep, so that’s a worthwhile thing for many!
Dr. Hirsch also discusses the merits of continuous vs cyclic use; continuous maintains the above sleep benefits, for example, while cyclic use can help stabilize menstrual patterns in late perimenopause and early menopause.
For more on these things, plus discussion of different types of progesterone, enjoy:
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Want to learn more?
You might also like to read:
- What Does “Balance Your Hormones” Even Mean?
- What You Should Have Been Told About The Menopause Beforehand
- HRT: Bioidentical vs Animal – A Tale Of Two Approaches
Take care!
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The Autoimmune Cure – by Dr. Sara Gottfried
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We’ve featured Dr. Gottfried before, as well as another of her books (“Younger”), and this one’s a little different, and on the one hand very specific, while on the other hand affecting a lot of people.
You may be thinking, upon reading the subtitle, “this sounds like Dr. Gabor Maté’s ideas” (per: “When The Body Says No”), and 1) you’d be right, and 2) Dr. Gottfried does credit him in the introduction and refers back to his work periodically later.
What she adds to this, and what makes this book a worthwhile read in addition to Dr. Maté’s, is looking clinically at the interactions of the immune system and nervous system, but also the endocrine system (Dr. Gottfried’s specialty) and the gut.
Another thing she adds is more of a focus on what she writes about as “little-t trauma”, which is the kind of smaller, yet often cumulative, traumas that often eventually add up over time to present as C-PTSD.
While “stress increases inflammation” is not a novel idea, Dr. Gottfried takes it further, and looks at a wealth of clinical evidence to demonstrate the series of events that, if oversimplified, seem unbelievable, such as “you had a bad relationship and now you have lupus”—showing evidence for each step in the snowballing process.
The style is a bit more clinical than most pop-science, but still written to be accessible to laypersons. This means that for most of us, it might not be the quickest read, but it will be an informative and enlightening one.
In terms of practical use (and living up to its subtitle promise of “cure”), this book does also cover all sorts of potential remedial approaches, from the obvious (diet, sleep, supplements, meditation, etc) to the less obvious (ketamine, psilocybin, MDMA, etc), covering the evidence so far as well as the pros and cons.
Bottom line: if you have or suspect you may have an autoimmune problem, and/or would just like to nip the risk of such in the bud (especially bearing in mind that the same things cause neuroinflammation and thus, putatively, depression and dementia too), then this is one for you.
Click here to check out the Autoimmune Cure, and take care of your body and mind!
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Why Do We Have Crooked Teeth When Our Ancestors Didn’t?
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Evidence shows that people in ancient times typically had straight teeth set well into strong jaws, with even wisdom teeth fitting properly.
So, what went wrong? Did evolution do us a disservice?
Some information to chew on
Transition from hard-to-chew diets to processed, refined foods over millennia has reduced jaw size while tooth size stayed constant. Smaller jaws lead to tooth crowding, crookedness, and impacted wisdom teeth, requiring braces or extractions in modern times.
However, all is not lost!
Studies on non-human animals show softer diets reduce jaw and facial growth, causing dental crowding. In other words: dental crowding is primarily attributed to dietary and lifestyle changes, though genetics may play a role.
And notably, when it comes to humans, populations with less processed diets experience fewer dental problems, suggesting lifestyle modifications could help prevent tooth crowding.
And no, it is not too late. Remember, you are rebuilding your body all the time, including your bones!
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
The Exercises That Can Fix Sinus Problems (And More) ← this also improves the jaw structure
Take care!
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6 Lifestyle Factors To Measurably Reduce Biological Age
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Julie Gibson Clark competes on a global leaderboard of people actively fighting aging (including billionaire Bryan Johnson, who is famously very focused on such). She’s currently ahead of him on that leaderboard, so what’s she doing?
Top tips
We’ll not keep the six factors a mystery; they are:
- Exercise: her weekly exercise includes VO2 Max training, strength training, balance work, and low-intensity cardio. She exercises outdoors on Saturdays and takes rest days on Fridays and Sundays.
- Diet: she follows a 16-hour intermittent fasting schedule (eating between 09:00–17:00), consumes a clean omnivore diet with an emphasis on vegetables and adequate protein, and avoids junk food.
- Brain: she meditates for 20 minutes daily, prioritizes mental health, and ensures sufficient quality sleep, helped by morning sunlight exposure and time in nature.
- Hormesis: she engages in 20-minute sauna sessions followed by cold showers four times per week to support recovery and longevity.
- Supplements: she takes longevity supplements and bioidentical hormones to optimize her health and aging process.
- Testing: she regularly monitors her biological age and health markers through various tests, including DEXA scans, VO2 Max tests, lipid panels, and epigenetic aging clocks, allowing her to adjust her routine accordingly.
For more on all of these, enjoy:
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Want to learn more?
You might also like to read:
Age & Aging: What Can (And Can’t) We Do About It?
Take care!
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