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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Pistachios vs Peanuts – Which is Healthier?
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Our Verdict
When comparing pistachios to peanuts, we picked the peanuts.
Why?
The choice might be surprising; after all, peanuts are usually the cheapest and most readily available nuts, popularly associated with calories and not much else. However! This one was super-close, and peanuts won very marginally, as you’ll see.
In terms of macros, pistachios have slightly more fiber and nearly 2x the carbs, while peanuts have slightly more protein and fats. What we all as individuals might prioritize more there is subjective, but this could arguably be considered a tie. About the fiber and carbs: peanuts have the lower glycemic index, but not by much. And about those fats: yes, they are healthy, and the fat breakdown for each is almost identical: pistachios have 53% monounsaturated, 33% polyunsaturated, and 14% saturated, while peanuts have 53% monounsaturated, 34% polyunsaturated, and 14% saturated. Yes, that adds up to 101% in the case of peanuts, but that’s what happens with rounding things to integers. However, the point is clear: both of these nuts have almost identical fats.
In the category of vitamins, pistachios have more of vitamins A, B1, B2, B6, and C, while peanuts have more of vitamins B3, B5, B9, E, and choline, So, a 5:5 tie on vitamins.
When it comes to minerals, pistachios have more calcium, copper, phosphorus, and potassium, while peanuts have more iron, magnesium, manganese, selenium, and zinc. So, a marginal victory for peanuts (and yes, the margins of difference were similar in each case).
Adding up the tie, the other tie, and the marginal victory for peanuts, means a marginal victory for peanuts in total.
A quick note in closing though: this was comparing raw unsalted nuts in both cases, so do take that into account when buying nuts, and at the very least, skip the salted, unless you are deficient in sodium. Or if you’re using them for cooking, then buying salted nuts because they’re usually cheaper is fine; just soak and rinse them to remove the salt.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Which Osteoporosis Medication, If Any, Is Right For You?
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Which Osteoporosis Medication, If Any, Is Right For You?
We’ve written about osteoporosis before, so here’s a quick recap first in case you missed these:
- The Bare-bones Truth About Osteoporosis
- Exercises To Do (And Exercises To Avoid) If You Have Osteoporosis
- We Are Such Stuff As Fish Are Made Of
- Vit D + Calcium: Too Much Of A Good Thing?
All of those look and diet and/or exercise, with “diet” including supplementation. But what of medications?
So many choices (not all of them right for everyone)
The UK’s Royal Osteoporosis Society says of the very many osteoporosis meds available:
❝In terms of effectiveness, they all reduce your risk of broken bones by roughly the same amount.
Which treatment is right for you will depend on a number of things.❞
…before then going on to list a pageful of things it will depend on, and giving no specific information about what prescriptions or proscriptions may be made based on those factors.
Source: Royal Osteoporosis Society | Which medication should I take?
We’ll try to do better than that here, though we have less space. So let’s get down to it…
First line drug offerings
After diet/supplementation and (if applicable) hormones, the first line of actual drug offerings are generally biphosphates.
Biphosphates work by slowing down your osteoclasts—the cells that break down your bones. They may sound like terrible things to have in the body at all, but remember, your body is always rebuilding itself and destruction is a necessary act to facilitate creation. However, sometimes things can get out of balance, and biphosphates help tip things back into balance.
Common biphosphates include Alendronate/Fosamax, Risedronate/Actonel, Ibandronate/Boniva, and Zolendronic acid/Reclast.
A common downside is that they aren’t absorbed well by the stomach (despite being mostly oral administration, though IV versions exist too) and can cause heartburn / general stomach upset.
An uncommon downside is that messing with the body’s ability to break down bones can cause bones to be rebuilt-in-place slightly incorrectly, which can—paradoxically—cause fractures. But that’s rare and is more common if the drugs are taken in much higher doses (as for bone cancer rather than osteoporosis).
Bone-builders
If you already have low bone density (so you’re fighting to rebuild your bones, not just slow deterioration), then you may need more of a boost.
Bone-building medications include Teriparatide/Forteo, Abaloparatide/Tymlos, and Romosozumab/Evenity.
These are usually given by injection, usually for a course of one or two years.
Once the bone has been built up, it’ll probably be recommended that you switch to a biphosphate or other bone-stabilizing medication.
Estrogen-like effects, without estrogen
If your osteoporosis (or osteoporosis risk) comes from being post-menopausal, estrogen is a very common (and effective!) prescription. However, some people may wish to avoid it, if for example you have a heightened breast cancer risk, which estrogen can exacerbate.
So, medications that have estrogen-like effects post-menopause, but without actually increasing estrogen levels, include: Raloxifene/Evista, and also all the meds we mentioned in the bone-building category above.
Raloxifene/Evista specifically mimics the action of estrogen on bones, while at the same time blocking the effect of estrogen on other tissues.
Learn more…
Want a more thorough grounding than we have room for here? You might find the following resource useful:
List of 82 Osteoporosis Medications Compared (this has a big table which is sortable by various variables)
Take care!
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The Tiniest Seeds With The Most Value
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If You’re Not Taking Chia, You’re Missing Out
Last Tuesday, we wrote about nutritional psychiatry, and the benefits of eating for one’s mental health.
You can check out Dr. Uma Naidoo’s to-dos, here:
The 6 Pillars Of Nutritional Psychiatry
In response, one of our subscribers wrote to mention:
❝Really interesting….just put chia seeds in my diet love them……taking the Drs advice.❞
~ Cindy, 10almonds subscriber
And then! On Friday, our tip at the top of the newsletter was:
Not sure how to incorporate chia seeds into your diet? It’s easier to want the benefits of their many brain-healthy (and otherwise-healthy, too) nutrients, than it is to know what to do with them necessarily, and not everyone enjoys seeds as a snack. So…
When you cook rice, throw in a tablespoon of chia seeds too. The cooking process will soften them and they won’t be texturally any different than the rice, but the nutrients will be all there.
They can also be thrown in with lentils, in the same fashion! Or oatmeal, when cooking it or making overnight oats.
We’ll be honest, it was Cindy’s comment that prompted us to suggest it. But wait! There was more to come in response:
❝You had a teaser ..on Chia seed.would of liked a article on the benefits . I’ve just discovered Chia seeds…❞
~ Cindy, 10almonds subscriber
So, Cindy, this one’s for you:
Nutritional powerhouse
First things first, these tiny seeds have a lot of nutrients. There are not many more nutrient-dense foods than this (there’s a kind of seaweed that might be a contender; we’ll have to do some research and get back to you).
Check them out:
USDA Nutritional Factsheet: Chia Seeds
So much protein and healthy fat, so many vitamins and minerals, and so many miscellaneous other micronutrients that we’d be here all day to list them (which is why we linked the above factsheet instead).
Antioxidants in abundance
These deserve a special mention, because they include quercetin which we’ve written about previously:
Fight Inflammation & Protect Your Brain, With Quercetin
…as well as quite a collection of others (including chlorogenic acid and caffeic acid, which may sound alarming but are great for lowering your blood pressure and against inflammation, respectively):
- The effect of chlorogenic acid on blood pressure: a systematic review and meta-analysis of randomized clinical trials
- Synthesis, preliminary bioevaluation and computational analysis of caffeic acid analogues
There are others too, with cardioprotective effects, liver-healthy effects, and anticancer properties:
Nutritional and therapeutic perspectives of Chia (Salvia hispanica L.): a review
Good for the heart and blood
Check it out:
- Chia flour supplementation reduces blood pressure in hypertensive subjects
- Chia seed (Salvia hispanica L.) supplementation to the diet of adults with type 2 diabetes improved systolic blood pressure: A randomized controlled trial
Oh, and about diabetes? There’s more, this time pertaining to reducing after-dinner blood sugars (or “postpranidial glycemia”, in sciencese):
- Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)
- Effect of whole and ground Salba seeds (Salvia Hispanica L.) on postprandial glycemia in healthy volunteers: a randomized controlled, dose-response trial
Good for the brain
Regular 10almonds readers will know that “what’s good for the blood, is good for the brain” is a very good rule of thumb already, but their highomega-3 content makes them especially so:
What Omega-3 Fatty Acids Really Do For Us
Want some?
We don’t sell them, but you can probably find them in your local supermarket and/or health food store, and if you prefer getting things online, here for your convenience is an example product on Amazon
Enjoy!
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Smarter Tomorrow – by Elizabeth Ricker
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Based heavily in hard science, with more than 450 citations in over 300 pages, the exhortation is not just “trust me, lol”.
Instead, she encourages the reader to experiment. Not like “try this and see if it works”, but “here’s how to try this, using scientific method with good controls and good record-keeping”.
The book is divided into sections, each with a projection of time required at the start and a summary at the end. The reading style is easy-reading throughout, without sacrificing substance.
It proposes seven key interventions. If just one works for you, it’ll be worth having bought and read the book. More likely most if not all will… Because that’s how science works.
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The Worst Way to Wake Up (and What to Do Instead)
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Not everyone is naturally inclined to be a morning person, but there are things we can do to make things go more easily for our brains!
Cause for alarm?
Dr. Tracey Marks, psychiatrist, explains the impact of our first moments upon awakening, and what that can do to/for us in terms of sleep inertia (i.e. grogginess).
Sleep inertia is worse when waking from deep sleep—and notably, we don’t naturally wake directly from deep sleep unless we are externally aroused (e.g. by an alarm clock).
Dr. Marks suggests the use of more gradual alarms, including those with soft melodies, perhaps birdsong or other similarly gentle things (artificial sunlight alarms are also good), to ease our transition from sleeping to waking. It might take us a few minutes longer to be woken from sleep, but we’re not going to spend the next hour in a bleary-eyed stupor.
For more details on these things and more (including why not to hit “snooze”), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Spoon-Fed – by Dr. Tim Spector
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Dr. Spector looks at widespread beliefs about food, and where those often scientifically disproven beliefs come from. Hint, there’s usually some manner of “follow the money”.
From calorie-counting to cholesterol content, from fish to bottled water, to why of all the people who self-report having an allergy, only around half turn out to actually have one when tested, Dr. Spector sets the record straight.
The style is as very down-to-earth and not at all self-aggrandizing; the author acknowledges his own mistakes and limitations along the way. In terms of pushing any particular agenda, his only agenda is clear: inform the public about bad science, so that we demand better science going forwards. Along the way, he gives us lots of information that can inform our personal health choices based on better science than indiscriminate headlines wildly (and sometimes intentionally) misinterpreting results.
Read this book, and you may find yourself clicking through to read the studies for yourself, next time you see a bold headline.
Bottom line: this book looks at a lot of what’s wrong with what a lot of people believe about healthy eating. Regular 10almonds readers might not find a lot that’s new here, but it could be a great gift for a would-be health-conscious friend or relative
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