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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  • The Tiniest Seeds With The Most Value

    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.

    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):

    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:

    Oh, and about diabetes? There’s more, this time pertaining to reducing after-dinner blood sugars (or “postpranidial glycemia”, in sciencese):

    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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  • Dangers Of Root Canals And Crowns, &  What To Do Instead

    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. Michelle Jorgensen, a dentist, tells us that it’s a lot rarer than people think to actually need a crown or a root canal; there are ways of avoiding such:

    The tooth, the whole tooth, and nothing but the tooth?

    First, some of the problems with the treatments that are most popular, especially in the US:

    Problems with root canals:

    • Involves cleaning and filling the tooth’s main canal but leaves microtubules that can harbor dead tissue and attract bacteria.
    • This can lead to infections, often undetected for a long time due to the nerve removal, potentially harming overall health and weakening the tooth.
    • Root canals often result in brittle teeth that can break, necessitating crowns.

    And then…

    Problems with crowns:

    • A crown requires significant removal of tooth structure (up to 1.5 mm of enamel), making the tooth more vulnerable and sensitive.
    • Crowns can also lead to new cavities underneath due to weak bonding to dentin.
    • The cycle often leads from a healthy tooth to fillings, crowns, root canals, and eventual extraction (and then, perhaps, an implant in its place). That’s great for the dentist, but not so great for you.

    Biomimetic dentistry the exciting name currently being used for what has been more prosaically called “conservative restorative dentistry”, which in turn has also been known by other names in recent decades, and its goal is to strengthen and preserve natural teeth as much as possible.

    Methods it uses:

    • Treats affected but still living teeth with non-invasive procedures.
    • Uses ozone treatment to kill bacteria in deep cavities, avoiding direct nerve exposure.
    • Applies conservative partial restorations like onlays instead of full crowns.

    Benefits of this approach:

    • Preserves enamel, minimizes trauma, and reduces the risk of tooth death.
    • Maintains long-term tooth structure and health.
    • 95% success rate in saving affected teeth without resorting to root canals.

    In short, Dr. Jorgensen says that 60–80% of traditional crowns and root canals can be avoided. Which is surely a good thing.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    Tooth Remineralization: How To Heal Your Teeth Naturally

    Take care!

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  • The Spice Of Life

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    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

    ❝Great newsletter. Am taking turmeric for inflammation of hips and feet. Works like magic. Would like to know how it works, and what tumeric is best combined with – also whether there any risks in longterm use.❞

    Glad you’re enjoying! As for turmeric, it sure is great, isn’t it? To answer your questions in a brief fashion:

    • How it works: it does a lot of things, but perhaps its most key feature is its autoxidative metabolites that mediate its anti-inflammatory effect. This, it slows or inhibits oxidative stress that would otherwise cause inflammation, increase cancer risk, and advance aging.
    • Best combined with: black pepper
    • Any risks in long-term use: there are no known risks in long-term use ← that’s just one study, but there are lots. Some studies were prompted by reported hepatotoxicity of curcumin supplements, but a) the reports themselves seem to be without evidence b) the reported hepatoxicity was in relation to contaminants in the supplements, not the curcumin itself c) clinical trials were unable to find any hepatotoxicity (or other) risks anyway. Here’s an example of such a study.

    You might also like our previous main feature: Why Curcumin (Turmeric) Is Worth Its Weight In Gold

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  • Science of Stretch – by Dr. Leada Malek

    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.

    This book is part of a “Science of…” series, of which we’ve reviewed some others before (Yoga | HIIT | Pilates), and needless to say, we like them.

    You may be wondering: is this just that thing where a brand releases the same content under multiple names to get more sales, and no, it’s not (long-time 10almonds readers will know: if it were, we’d say so!).

    While flexibility and mobility are indeed key benefits in yoga and Pilates, they looked into the science of what was going on in yoga asanas and Pilates exercises, stretchy or otherwise, so the stretching element was not nearly so deep as in this book.

    In this one, Dr. Malek takes us on a wonderful tour of (relevant) human anatomy and physiology, far deeper than most pop-science books go into when it comes to stretching, so that the reader can really understand every aspect of what’s going on in there.

    This is important, because it means busting a lot of myths (instead of busting tendons and ligaments and things), understanding why certain things work and (critically!) why certain things don’t, how certain stretching practices will sabotage our progress, things like that.

    It’s also beautifully clearly illustrated! The cover art is a fair representation of the illustrations inside.

    Bottom line: if you want to get serious about stretching, this is a top-tier book and you won’t regret it.

    Click here to check out Science of Stretching, and learn what you can do and how!

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  • Can you get sunburnt or UV skin damage through car or home windows?

    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.

    When you’re in a car, train or bus, do you choose a seat to avoid being in the sun or do you like the sunny side?

    You can definitely feel the sun’s heat through a window. But can you get sunburn or skin damage when in your car or inside with the windows closed?

    Let’s look at how much UV (ultraviolet) radiation passes through different types of glass, how tinting can help block UV, and whether we need sunscreen when driving or indoors.

    Zac Harris/Unsplash

    What’s the difference between UVA and UVB?

    Of the total UV radiation that reaches Earth, about 95% is UVA and 5% is UVB.

    UVB only reaches the upper layers of our skin but is the major cause of sunburn, cataracts and skin cancer.

    UVA penetrates deeper into our skin and causes cell damage that leads to skin cancer.

    Graphic showing UVA and UVB penetrating skin
    UVA penetrates deeper than UVB. Shutterstock/solar22

    Glass blocks UVA and UVB radiation differently

    All glass used in house, office and car windows completely blocks UVB from passing through.

    But only laminated glass can completely block UVA. UVA can pass through other glass used in car, house and office windows and cause skin damage, increasing the risk of cancer.

    Car windscreens block UVA, but the side and rear windows don’t

    A car’s front windscreen lets in lots of sunshine and light. Luckily it blocks 98% of UVA radiation because it is made of two layers of laminated glass.

    But the side and rear car windows are made of tempered glass, which doesn’t completely block UVA. A study of 29 cars found a range from 4% to almost 56% of UVA passed through the side and rear windows.

    The UVA protection was not related to the car’s age or cost, but to the type of glass, its colour and whether it has been tinted or coated in a protective film. Grey or bronze coloured glass, and window tinting, all increase UVA protection. Window tinting blocks around 95% of UVA radiation.

    In a separate study from Saudi Arabia, researchers fitted drivers with a wearable radiation monitor. They found drivers were exposed to UV index ratings up to 3.5. (In Australia, sun protection is generally recommended when the UV index is 3 or above – at this level it takes pale skin about 20 minutes to burn.)

    So if you have your windows tinted, you should not have to wear sunscreen in the car. But without tinted windows, you can accumulate skin damage.

    UV exposure while driving increases skin cancer risk

    Many people spend a lot of time in the car – for work, commuting, holiday travel and general transport. Repeated UVA radiation exposure through car side windows might go unnoticed, but it can affect our skin.

    Indeed, skin cancer is more common on the driver’s side of the body. A study in the United States (where drivers sit on the left side) found more skin cancers on the left than the right side for the face, scalp, arm and leg, including 20 times more for the arm.

    Another US study found this effect was higher in men. For melanoma in situ, an early form of melanoma, 74% of these cancers were on the on the left versus 26% on the right.

    Earlier Australian studies reported more skin damage and more skin cancer on the right side.

    Cataracts and other eye damage are also more common on the driver’s side of the body.

    What about UV exposure through home or office windows?

    We see UV damage from sunlight through our home windows in faded materials, furniture or plastics.

    Most glass used in residential windows lets a lot of UVA pass through, between 45 and 75%.

    Woman looks out of sunny window
    Residential windows can let varied amounts of UVA through. Sherman Trotz/Pexels

    Single-pane glass lets through the most UVA, while thicker, tinted or coated glass blocks more UVA.

    The best options are laminated glass, or double-glazed, tinted windows that allow less than 1% of UVA through.

    Skylights are made from laminated glass, which completely stops UVA from passing through.

    Most office and commercial window glass has better UVA protection than residential windows, allowing less than 25% of UVA transmission. These windows are usually double-glazed and tinted, with reflective properties or UV-absorbent chemicals.

    Some smart windows that reduce heat using chemical treatments to darken the glass can also block UVA.

    So when should you wear sunscreen and sunglasses?

    The biggest risk with skin damage while driving is having the windows down or your arm out the window in direct sun. Even untinted windows will reduce UVA exposure to some extent, so it’s better to have the car window up.

    For home windows, window films or tint can increase UVA protection of single pane glass. UVA blocking by glass is similar to protection by sunscreen.

    When you need to use sunscreen depends on your skin type, latitude and time of the year. In a car without tinted windows, you could burn after one hour in the middle of the day in summer, and two hours in the middle of a winter’s day.

    But in the middle of the day next to a home window that allows more UVA to pass through, it could take only 30 minutes to burn in summer and one hour in winter.

    When the UV index is above three, it is recommended you wear protective sunglasses while driving or next to a sunny window to avoid eye damage.

    Theresa Larkin, Associate Professor of Medical Sciences, University of Wollongong

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

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  • The Brain As A Work-In-Progress

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    And The Brain Goes Marching On!

    In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:

    • About 64% of people said “Never”
    • About 16% of people said “25 years”
    • About 9% of people said “65 years”
    • About 5% of people said “13 years”
    • About 3% of people said “18 years”
    • About 3% of people said “45 years”

    Some thoughts, before we get into the science:

    An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:

    • “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
    • When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages

    Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!

    Why we picked those ages

    We picked those ages as poll options for reasons people might be drawn to them:

    • 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
    • 18 years: age of legal majority in N. America and many other places
    • 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
    • 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
    • 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research

    Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!

    Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.

    So, what does the science say?

    Our brains are never finished developing: True or False?

    True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.

    Glossary:

    • Neurogenesis: the process of creating new brain cells
    • Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs

    We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.

    For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:

    How To Grow New Brain Cells (At Any Age)

    Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.

    Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Our brains are still developing up to the age of 25: True or False?

    True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.

    A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:

    ❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞

    ~ Dr. Jay Giedd

    Source: Structural Magnetic Resonance Imaging of the Adolescent Brain

    There are several things to note here:

    • The above statement is talking about the physical size of the brain growing
    • Nowhere does he say “and stops developing at 25”

    However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.

    This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.

    The study didn’t misrepresent this, by the way, but the popular press did!

    Another 2012 study looked at various metrics of brain development, and found:

    • Synapse overproduction into the teens
    • Cortex pruning into the late 20s
    • Prefrontal pruning into middle age at least (they stopped looking)
    • Myelination beyond middle age (they stopped looking)

    Source: Experience and the developing prefrontal cortexcheck out figure 1, and make sure you’re looking at the human data not the rat data

    So how’s the most recent research looking?

    Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:

    Brain charts for the human lifespancheck out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!

    Want to know how not to get caught out by science being misrepresented by the popular press? Check out:

    How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

    Take care!

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