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.

Older person holding a stabilising bar
The commission determined aged care work was undervalued.
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.

Nursing students practise their skills
Aged care will need to attract workers from other sectors.
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. The Conversation

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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  • What are heart rate zones, and how can you incorporate them into your exercise routine?

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    If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates.

    Heart rate zones reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute.

    But what are the different heart rate zones, and how can you use these zones to optimise your workout?

    The three-zone model

    While there are several models used to describe heart rate zones, the most common model in the scientific literature is the three-zone model, where the zones may be categorised as follows:

    • zone 1: 55%–82% of maximum heart rate
    • zone 2: 82%–87% of maximum heart rate
    • zone 3: 87%–97% of maximum heart rate.

    If you’re not sure what your maximum heart rate is, it can be calculated using this equation: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute.

    There are also other models used to describe heart rate zones, such as the five-zone model (as its name implies, this one has five distinct zones). These models largely describe the same thing and can mostly be used interchangeably.

    What do the different zones involve?

    The three zones are based around a person’s lactate threshold, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic.

    Aerobic exercise uses oxygen to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time.

    On average your lactate threshold tends to sit around 85% of your maximum heart rate, although this varies from person to person, and can be higher in athletes.

    A woman with an activity tracker on her wrist looking at a smartphone.
    Wearable technology has taken off in recent years. Ketut Subiyanto/Pexels

    In the three-zone model, each zone loosely describes one of three types of training.

    Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace.

    Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences.

    Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3.

    Striking a balance

    To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout.

    While zone 3 is thought to produce the largest improvements in maximal oxygen uptake – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much.

    Training in different heart rate zones improves slightly different physiological qualities, and so by spending time in each zone, you ensure a variety of benefits for performance and health.

    So how much time should you spend in each zone?

    Most elite endurance athletes, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3.

    Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate more than 250 kilometres per week, which would be impossible to recover from if it was all performed in zone 2 or 3.

    Of course, most people are not professional athletes. The World Health Organization recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week.

    If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines.

    What if I don’t have a heart rate monitor?

    If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training.

    The three heart rate zones discussed in this article can also be prescribed based on feel using a simple 10-point scale, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce.

    With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10.

    Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.

    Hunter Bennett, Lecturer in Exercise Science, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Pregnant women can now get a free RSV shot. What other vaccines do you need when you’re expecting?

    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.

    From today, February 3, pregnant women in Australia will be eligible for a free RSV vaccine under the National Immunisation Program.

    This vaccine is designed to protect young infants from severe RSV (respiratory syncytial virus). It does so by generating the production of antibodies against RSV in the mother, which then travel across the placenta to the baby.

    While the RSV vaccine is a new addition to the National Immunisation Program, it’s one of three vaccines provided free for pregnant women under the program, alongside ones for influenza and whooping cough. Each offers important protection for newborn babies.

    voronaman/Shutterstock

    The RSV vaccine

    RSV is the most common cause of lower respiratory infections (bronchiolitis and pneumonia) in infants. It’s estimated that of every 100 infants born in Australia each year, at least two will be hospitalised with RSV by six months of age.

    RSV infection is most common roughly between March and August in the southern hemisphere, but infection can occur year-round, especially in tropical areas.

    The vaccine works by conferring passive immunity (from the mother) as opposed to active immunity (the baby’s own immune response). By the time the baby is born, their antibodies are sufficient to protect them during the first months of life when they are most vulnerable to severe RSV disease.

    The RSV vaccine registered for use in pregnant women in Australia, Abrysvo, has been used since 2023 in the Americas and Europe. Real-world experience there shows it’s working well.

    For example, over the 2024 RSV season in Argentina, it was found to prevent 72.7% of lower respiratory tract infections caused by RSV and requiring hospitalisation in infants aged 0–3 months, and 68% among those aged 0–6 months. This research noted three deaths from RSV, all in infants whose mothers did not receive the RSV vaccine during pregnancy.

    This was similar to protection seen in a large multinational clinical trial that compared babies born to mothers who received this RSV vaccine with babies born to mothers who received a placebo. This study found the vaccine prevented 82.4% of severe cases of RSV in infants aged under three months, and 70% under six months, and that the vaccine was safe.

    A young baby sleeping under a yellow blanket with a toy bunny.
    Vaccinating mothers during pregnancy protects the newborn baby. StoryTime Studio/Shutterstock

    In addition to the maternal vaccine, nirsevimab, a long-acting monoclonal antibody, provides effective protection against severe RSV disease. It’s delivered to the baby by an intramuscular injection, usually in the thigh.

    Nirsevimab is recommended for babies born to women who did not receive an RSV vaccine during pregnancy, or who are born within two weeks of their mother having received the shot (most likely if they’re born prematurely). It may also be recommended for babies who are at higher risk of RSV due to a medical condition, even if their mother was vaccinated.

    Nirsevimab is not funded under the National Immunisation Program, but is covered under various state and territory-based programs for infants of mothers who fall into the above categories.

    But now we have a safe and effective RSV vaccine for pregnancy, all pregnant women should be encouraged to receive it as the first line of prevention. This will maximise the number of babies protected during their first months of life.

    Flu and whooping cough

    It’s also important pregnant women continue to receive flu and whooping cough vaccines in 2025. Like the RSV vaccine, these protect infants by passing antibodies from mother to baby.

    There has been a large whooping cough outbreak in Australia in recent months, including a death of a two-month-old infant in Queensland in November 2024.

    The whooping cough vaccine, given in combination with diphtheria and tetanus, prevents more than 90% of whooping cough cases in babies too young to receive their first whooping cough vaccine dose.

    Similarly, influenza can be deadly in young babies, and maternal flu vaccination substantially reduces hospital visits associated with influenza for babies under six months. Flu can also be serious for pregnant women, so the vaccine offers important protection for the mother as well.

    COVID vaccines are safe in pregnancy, but unless a woman is otherwise eligible, they’re not routinely recommended. You can discuss this with your health-care provider.

    When and where can you get vaccinated?

    Pregnant women can receive these vaccines during antenatal visits through their GP or in a specialised antenatal clinic.

    The flu vaccine is recommended at any time during pregnancy, the whooping cough vaccine from 20 weeks (ideally before 32 weeks), and the RSV vaccine from 28 weeks (before 36 weeks).

    It’s safe to receive multiple vaccinations at the same clinic visit.

    A pregnant woman sitting on a couch using a laptop.
    The RSV vaccine is now available for pregnant women under the National Immunisation Program. Olga Rolenko/Shutterstock

    We know vaccination rates have declined in a variety of groups since the pandemic, and there’s evidence emerging that suggests this trend has occurred in pregnant women too.

    A recent preprint (a study yet to be peer-reviewed) found a decrease of nearly ten percentage points in flu vaccine coverage among pregnant women in New South Wales, from 58.8% in 2020 to 49.1% in 2022. The research showed a smaller drop of 1.4 percentage points for whooping cough, from 79% in 2020 to 77.6% in 2022.

    It’s important to work to improve vaccination rates during pregnancy to give babies the best protection in their first months of life.

    We know pregnant women would like to receive information about new and routine maternal vaccines early in pregnancy. In particular, many pregnant women want to understand how vaccines are tested for safety, and their effectiveness, which was evident during COVID.

    GPs and midwives are trusted sources of information on vaccines in pregnancy. There’s also information available online on Sharing Knowledge About Immunisation, a collaboration led by the National Centre for Immunisation Research and Surveillance.

    Archana Koirala, Paediatrician and Infectious Diseases Specialist, University of Sydney; Bianca Middleton, Senior Research Fellow, Menzies School of Health Research; Margie Danchin, Professor of Paediatrics and vaccinologist, Royal Childrens Hospital, University of Melbourne and Murdoch Childrens Research Institute (MCRI); Associate Dean International, University of Melbourne, Murdoch Children’s Research Institute; Peter McIntyre, Professor in Women’s and Children’s Health, University of Otago, and Rebecca Doyle, Adjunct Research Fellow, School of Nursing, Midwifery and Social Work, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Eggs: Nutritional Powerhouse or Heart-Health Timebomb?

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    Eggs: All Things In Moderation?

    We asked you for your (health-related) opinion on eggs. We specified that, for the sake of simplicity, let’s say that they are from happy healthy backyard hens who enjoy a good diet.

    Apparently this one wasn’t as controversial as it might have been! We (for myth-busting purposes) try to pick something polarizing and sometimes even contentious for our Friday editions, and pick apart what science lies underneath public perceptions.

    However, more than half (in fact, 60%) of the subscribers who voted in the poll voted for “Eggs are nutritionally beneficial as part of a balanced diet”, which very moderate statement is indeed pretty much the global scientific consensus.

    Still, we’ve a main feature to write, so let’s look at the science, and what the other 40% had in mind:

    Eggs are ruinous to health, especially cardiometabolic health: True or False?

    False, per best current science, anyway!

    Scientific consensus has changed over the years. We learned about cholesterol, then we learned about different types of cholesterol, and now we’ve even learned about in some instances even elevated levels of “bad” cholesterol aren’t necessarily a cause of cardiometabolic disorders so much as a symptom—especially in women.

    Not to derail this main feature about eggs (rather than just cholesterol), but for those who missed it, this is actually really interesting: basically, research (pertaining to the use of statins) has found that in women, higher LDL levels aren’t anywhere near the same kind of risk factor as they are for men, and thus may mean that statins (whose main job is reducing LDL) may be much less helpful for women than for men, and more likely to cause unwanted serious side effects in women.

    Check out our previous main feature about this: Statins: His & Hers?

    But, for back on topic, several large studies (totalling 177,000 people in long-term studies in 50 countries) found:

    ❝Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.❞

    Source: Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

    Egg whites are healthy (protein); egg yolks are not (cholesterol): True or False?

    True and False, respectively. That is to say, egg whites are healthy (protein), and egg yolks are also healthy (many nutrients).

    We talked a bit already about cholesterol, so we’ll not rehash that here. As to the rest:

    Eggs are one of the most nutritionally dense foods around. After all, they have everything required to allow a cluster of cells to become a whole baby chick. That’s a lot of body-building!

    They’re even more nutritionally heavy-hitters if you get omega-3 enriched eggs, which means the hens were fed extra omega-3, usually in the form of flax seeds.

    Also, free-range is better healthwise than others. Do bear in mind that unless they really are from your backyard, or a neighbor’s, chances are that the reality is not what the advertising depicts, though. There are industry minimum standards to be able to advertise as “free-range”, and those standards are a) quite low b) often ignored, because an occasional fine is cheaper than maintaining good conditions.

    So if you can look after your own hens, or get them from somewhere that you can see for yourself how they are looked after, so much the better!

    Check out the differences side-by-side, though:

    Pastured vs Omega-3 vs “Conventional” Eggs: What’s the Difference?

    Stallone-style 12-egg smoothies are healthy: True or False?

    False, at least if taken with any regularity. One can indeed have too much of a good thing.

    So, what’s the “right amount” to eat?

    It may vary depending on individual factors (including age and ethnicity), but a good average, according to science, is to keep it to 3 eggs or fewer per day. There are a lot of studies, but we only have so much room here, so we’ll pick one. Its findings are representative of (and in keeping with) the many other studies we looked at, so this seems uncontroversial scientifically:

    ❝Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2-3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults.❞

    Source: Intake of up to 3 Eggs per Day Is Associated with Changes in HDL Function and Increased Plasma Antioxidants in Healthy, Young Adults

    Enjoy!

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  • The Little-Known Truth…

    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.

    Myth-Buster, Myth-Buster, Bust Us A Myth (or three!)

    Let’s can this myth for good

    People think of “canned foods” as meaning “processed foods” and therefore bad. But the reality is it’s all dependent on what’s in the can (check the ingredients!). And as for nutrients?

    Many canned fruits and vegetables contain more nutrients than fresh ones! This is because the way they’ve been stored preserves them better. For example:

    • Canned tomatoes contain more bioavailable lycopene than fresh
    • Canned spinach contains more bioavailable carotene than fresh
    • Canned corn contains more bioavailable lutein than fresh
    • The list goes on, but you get the idea!

    Don’t Want To Take Our Word For It? Read The Scientific Paper Here!

    Gaslight, Gymkeep, Girl-loss?

    Many women and girls avoid doing weight-training as part of their exercise—or use only the smallest weights—to avoid “bulking up” and “looking like a man”.

    Many men, meanwhile, wish it were that easy to bulk up!

    The reality is that nobody, unless you have very rare genes, packs on a lot of muscle by accident. Even with the genes for it, it won’t happen unless you’re also eating for it!

    Resistance-based strength training (such as lifting weights), is a great way for most people to look after an important part of their long-term health: bone density!

    You can’t have strong muscles on weak bones, so strengthening the muscles cues the body to strengthen the bones. In short, your strength-training at age 45 or 55 (or earlier) could be what helps you avoid a broken hip at 65 or 75.

    We’re Not Kidding, It Really Is That Important (Read The Study Here)!

    Something doesn’t smell right about this

    There’s been a big backlash against anti-perspirants and deodorants. The popular argument is that the aluminium in them causes cancer.

    This led to many people buying “deodo-rocks”, crystal rocks that can be run under water and then rubbed on the armpits to deodorize “naturally”. But, those crystal rocks are actually alum crystals (guess what they contain…).

    The belief that deodorants cause cancer came from studies done by applying deodorant to cells (like the canine kidney cells in this study) in petri dishes. So, assuming you don’t cut out your kidney and then spray it directly with the deodorant, the jury is still out!

    A more recent systematic review sorted out quite clearly the ways in which aluminium was, or was not, harmful, and said:

    ❝Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of Alzheimer’s Disease or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic.❞

    Critical Reviews in Toxicology

    …but also says that you should avoid eating aluminium while pregnant or breastfeeding. We hope you can resist the urge.

    See The Summary For Yourself Here!

    (actually the whole article is there, but we know you value condensed knowledge, so: the abstract at the top will probably tell you all you want to know!)

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  • Exercise with Type 1 Diabetes – by Ginger Vieira

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    If you or a loved one has Type 1 Diabetes, you’ll know that exercise can be especially frustrating…

    • If you don’t do it, you risk weight gain and eventual insulin resistance.
    • If you do it, you risk dangerous hypos, or perhaps hypers if you took off your pump or skipped a bolus.

    Unfortunately, the popular medical advice is “well, just do your best”.

    Ginger Vieira is Type 1 Diabetic, and writes with 20+ experience of managing her diabetes while being a keen exerciser. As T1D folks out there will also know, comorbidities are very common; in her case, fibromyalgia was the biggest additional blow to her ability to exercise, along with an underactive thyroid. So when it comes to dealing with the practical nuts and bolts of things, she (while herself observing she’s not a doctor, let alone your doctor) has a lot more practical knowledge than an endocrinologist (without diabetes) behind a desk.

    Speaking of nuts and bolts, this book isn’t a pep talk.

    It has a bit of that in, but most of it is really practical information, e.g: using fasted exercise (4 hours from last meal+bolus) to prevent hypos, counterintuitive as that may seemthe key is that timing a workout for when you have the least amount of fast-acting insulin in your body means your body can’t easily use your blood sugars for energy, and draws from your fat reserves instead… Win/Win!

    That’s just one quick tip because this is a 1-minute review, but Vieira gives:

    • whole chapters, with example datasets (real numbers)
    • tech-specific advice, e.g. pump, injection, etc
    • insulin-specific advice, e.g. fast vs slow, and adjustments to each in the context of exercise
    • timing advice re meal/bolus/exercise for different insulins and techs
    • blood-sugar management advice for different exercise types (aerobic/anaerobic, sprint/endurance, etc)

    …and lots more that we don’t have room to mention here

    Basically… If you or a loved one has T1D, we really recommend this book!

    Order a copy of “Exercise with Type 1 Diabetes” from Amazon today!

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  • The Four Pillar Plan – by Dr. Rangan Chatterjee

    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.

    Dr. Rangan Chatterjee, a medical doctor, felt frustrated with how many doctors in his field focus on treating the symptoms of disease, rather than the cause. Sometimes, of course, treating the symptom is necessary too! But neglecting the cause is a recipe for long-term woes.

    What he does differently is take lifestyle as a foundation, and even that, he does differently than many authors on the topic. How so, you may wonder?

    Rather than look first at exercise and diet, he starts with “relax”. His rationale is reasonable: diving straight in with marathon training or a whole new diet plan can be unsustainable without this as a foundation to fall back on.

    Many sources look first at exercise (because it can be a very simple “prescription”) before diet (often more complex)… but how does one exercise well with the wrong fuel in the tank? So Dr. Chatterjee’s titular “Four Pillars” come in the following order:

    1. Relax
    2. Eat
    3. Move
    4. Sleep

    He also goes for “move” rather than “exercise” as the focus here is more on minimizing time spent sitting, and thus involving a lot of much more frequent gentle activities… rather than intensive training programs and the like.

    And as for sleep? Yes, that comes last because—no matter how important it is—the other things are easier to directly control. After all, one can improve conditions for sleep, but one cannot simply choose to sleep better! So with the other three things covered first, good sleep is the fourth and final thing to fall into place.

    All in all, this is a great book to cut through the catch-22 problem of lifestyle factors negatively impacting each other.

    Click here to check out “The 4 Pillar Plan” and start improving your life in the most impactful ways!

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    Learn to Age Gracefully

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