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 the benefits of mindfulness? They include reducing stress, pain, and fatigue, improving quality of life, and providing relief from digestive and sleep disorders. The evidence supports its effectiveness.

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  • An Apple (Cider Vinegar) A Day…

    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.

    An Apple (Cider Vinegar) A Day…

    You’ve probably heard of people drinking apple cider vinegar for its health benefits. It’s not very intuitive, so today we’re going to see what the science has to say…

    Apple cider vinegar for managing blood sugars

    Whether diabetic, prediabetic, or not at all, blood sugar spikes aren’t good for us, so anything that evens that out is worth checking out. As for apple cider vinegar…

    Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets?

    …the answer found by this study was “yes”, but their study was small, and they concluded that more research would be worthwhile. So…

    The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance

    …was also a small study, with the same (positive) results.

    But! We then found a much larger systematic review was conducted, examining 744 previously-published papers, adding in another 14 they found via those. After removing 47 duplicates, and removing another 15 for not having a clinical trial or not having an adequate control, they concluded:

    ❝In this systematic review and meta-analyses, the effect of vinegar consumption on postprandial glucose and insulin responses were evaluated through pooled analysis of glucose and insulin AUC in clinical trials. Vinegar consumption was associated with a statistically significant reduction in postprandial glucose and insulin responses in both healthy participants and participants with glucose disorder.❞

    ~ Sishehbor, Mansoori, & Shirani

    Check it out:

    Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials

    Apple cider vinegar for weight loss?

    Yep! It appears to be an appetite suppressant, probably moderating ghrelin and leptin levels.

    See: The Effects of Vinegar Intake on Appetite Measures and Energy Consumption: A Systematic Literature Review

    But…

    As a bonus, it also lowers triglycerides and total cholesterol, while raising HDL (good cholesterol), and that’s in addition to doubling the weight loss compared to control:

    See for yourself: Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial

    How much to take?

    Most of these studies were done with 1–2 tbsp of apple cider vinegar in a glass of water, at mealtime.

    Obviously, if you want to enjoy the appetite-suppressant effects, take it before the meal! If you forget and/or choose to take it after though, it’ll still help keep your blood sugars even and still give you the cholesterol-moderating benefits.

    Where to get it?

    Your local supermarket will surely have it. Or if you buy it online, you can even get it in capsule form!

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  • Eat All You Want (But Wisely)

    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.

    Some Surprising Truths About Hunger And Satiety

    This is Dr. Barbara Rolls. She’s Professor and Guthrie Chair in Nutritional Sciences, and Director of the Laboratory for the Study of Human Ingestive Behavior at Pennsylvania State University, after graduating herself from Oxford and Cambridge (yes, both). Her “awards and honors” take up four A4 pages, so we won’t list them all here.

    Most importantly, she’s an expert on hunger, satiety, and eating behavior in general.

    What does she want us to know?

    First and foremost: you cannot starve yourself thin, unless you literally starve yourself to death.

    What this is about: any weight lost due to malnutrition (“not eating enough” is malnutrition) will always go back on once food becomes available. So unless you die first (not a great health plan), merely restricting good will always result in “yo-yo dieting”.

    So, to avoid putting the weight back on and feeling miserable every day along the way… You need to eat as much as you feel you need.

    But, there’s a trick here (it’s about making you genuinely feel you need less)!

    Your body is an instrument—so play it

    Your body is the tool you use to accomplish pretty much anything you do. It is, in large part, at your command. Then there are other parts you can’t control directly.

    Dr. Rolls advises taking advantage of the fact that much of your body is a mindless machine that will simply follow instructions given.

    That includes instructions like “feel hungry” or “feel full”. But how to choose those?

    Volume matters

    An important part of our satiety signalling is based on a physical sensation of fullness. This, by the way, is why bariatric surgery (making a stomach a small fraction of the size it was before) works. It’s not that people can’t eat more (the stomach is stretchy and can also be filled repeatedly), it’s that they don’t want to eat more because the pressure sensors around the stomach feel full, and signal the hormone leptin to tell the brain we’re full now.

    Now consider:

    • On the one hand, 20 grapes, fresh and bursting with flavor
    • On the other hand, 20 raisins (so, dried grapes), containing the same calories

    Which do you think will get the leptin flowing sooner? Of course, the fresh grapes, because of the volume.

    So if you’ve ever seen those photos that show two foods side by side with the same number of calories but one is much larger (say, a small slice of pizza or a big salad), it’s not quite the cheap trick that it might have appeared.

    Or rather… It is a cheap trick; it’s just a cheap trick that works because your stomach is quite a simple organ.

    So, Dr. Rolls’ advice: generally speaking, go for voluminous food. Fruit is great from this, because there’s so much water. Air-popped popcorn also works great. Vegetables, too.

    Water matters, but differently than you might think

    A well-known trick is to drink water before and with a meal. That’s good, it’s good to be hydrated. However, it can be better. Dr. Rolls did an experiment:

    The design:

    ❝Subjects received 1 of 3 isoenergetic (1128 kJ) preloads 17 min before lunch on 3 d and no preload on 1 d.

    The preloads consisted of 1) chicken rice casserole, 2) chicken rice casserole served with a glass of water (356 g), and 3) chicken rice soup.

    The soup contained the same ingredients (type and amount) as the casserole that was served with water.❞

    The results:

    ❝Decreasing the energy density of and increasing the volume of the preload by adding water to it significantly increased fullness and reduced hunger and subsequent energy intake at lunch.

    The equivalent amount of water served as a beverage with a food did not affect satiety.❞

    The conclusion:

    ❝Consuming foods with a high water content more effectively reduced subsequent energy intake than did drinking water with food.❞

    You can read the study in full (it’s a worthwhile read!) here:

    Water incorporated into a food but not served with a food decreases energy intake in lean women

    Protein matters

    With all those fruits and vegetables and water, you may be wondering Dr. Rolls’ stance on proteins. It’s simple: protein is an appetite suppressant.

    However, it takes about 20 minutes to signal the brain about that, so having some protein in a starter (if like this writer, you’re the cook of the household, a great option is to enjoy a small portion of nuts while cooking!) gets that clock ticking, to signal satiety sooner.

    It may also help in other ways:

    Clinical Evidence and Mechanisms of High-Protein Diet-Induced Weight Loss

    As for other foods that can suppress appetite, by the way, you might like;

    25 Foods That Act As Natural Appetite Suppressants

    Variety matters, and in ways other than you might think

    A wide variety of foods (especially: a wide variety of plants) in one’s diet is well recognized as a key to a good balanced diet.

    However…

    A wide variety of dishes at the table, meanwhile, promotes greater consumption of food.

    Dr. Rolls did a study on this too, a while ago now (you’ll see how old it is) but the science seems robust:

    Variety in a Meal Enhances Food Intake in Man

    Notwithstanding the title, it wasnot about a man (that was just how scientists wrote in ye ancient times of 1981). The test subjects were, in order: rats, cats, a mixed group of men and women, the same group again, and then a different group of all women.

    So, Dr. Rolls’ advice is: it’s better to have one 20-ingredient dish, than 10 dishes with 20 ingredients between them.

    Sorry! We love tapas and buffets too, but that’s the science!

    So, “one-pot” meals are king in this regard; even if you serve it with one side (reasonable), that’s still only two dishes, which is pretty good going.

    Note that the most delicious many-ingredient stir-fries and similar dishes from around the world also fall into this category!

    Want to know more?

    If you have the time (it’s an hour), you can enjoy a class of hers for free:

    !

    Want to watch it, but not right now? Bookmark it for later

    Enjoy!

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  • The Calorie Myth – by Jonathan Bailor

    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.

    First we’ll mention: the author is not a doctor, but the book is endorsed by assorted well-known doctors in the field, and the science described is consistent with current scientific consensus (and, for that matter, consistent with what we wrote in our mythbusting feature: Are You A Calorie-Burning Machine?).

    It’s often (correctly) said that “not all calories are created equal”, but how should we quantify them? He proposes his “SANE solution”, which is based around the ideas of:

    • Satiety: how quickly calories fill us up
    • Aggression: how likely calories are to be stored as fat
    • Nutrition: how many micronutrients calories bring with them, and how much
    • Efficiency: how easily calories are converted

    To this end, he recommends a diet high in foods that score well on his “SANE” factors, and provides such things as recipes, meal plans etc to help, as well principles for exercising more usefully in the context of metabolic base rate, and moving (rather than fighting) one’s “set point”, which is usually associated with one’s weight but it really has more to do with metabolic base rate. In fact, Bailor recommends throwing out the bathroom scale and focusing on pursuing good health itself, rather than obsessing over changing one’s relationship with the Earth’s gravitational field.

    Yes, it says “lose weight” in the subtitle, but the idea is that this will be a by-product rather than the thing actively pursued. After all, we can control our actions, so that input variable is where we should put our focus, not the output variable of the numbers on the scale which can often be misleading (muscle weighing more than fat, tendency to water weight fluctuations, etc).

    The style is a little flashy and salesy for this reviewer’s personal taste (a lot of references to his own businesses and neologisms associated with such), but it doesn’t take away from the quality of the content, and in terms of science, study references come at a rate of about one per page on average.

    Bottom line: if you’d like to rethink your relationship with calories, then this book can help give you a much more practical angle.

    Click here to check out The Calorie Myth, and take control of your metabolic base rate!

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  • What Omega-3 Fatty Acids Really Do For Us

    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.

    What Omega-3 Fatty Acids Really Do For Us

    Shockingly, we’ve not previously covered this in a main feature here at 10almonds… Mostly we tend to focus on less well-known supplements. However, in this case, the supplement may be well known, while some of its benefits, we suspect, may come as a surprise.

    So…

    What is it?

    In this case, it’s more of a “what are they?”, because omega-3 fatty acids come in multiple forms, most notably:

    • Alpha-linoleic acid (ALA)
    • Eicosapentaenoic acid (EPA)
    • Docosahexanoic acid (DHA)

    ALA is most readily found in certain seeds and nuts (chia seeds and walnuts are top contenders), while EPA and DHA are most readily found in certain fish (hence “cod liver oil” being a commonly available supplement, though actually cod aren’t even the best source—salmon and mackerel are better; cod is just cheaper to overfish, making it the cheaper supplement to manufacture).

    Which of the three is best, or do we need them all?

    There are two ways of looking at this:

    • ALA is sufficient alone, because it is a precursor to EPA and DHA, meaning that the body will take ALA and convert it into EPA and DHA as required
    • EPA and DHA are superior because they’re already in the forms the body will use, which makes them more efficient

    As with most things in health, diversity is good, so you really can’t go wrong by getting some from each source.

    Unless you have an allergy to fish or nuts, in which case, definitely avoid those!

    What do omega-3 fatty acids do for us, according to actual research?

    Against inflammation

    Most people know it’s good for joints, as this is perhaps what it’s most marketed for. Indeed, it’s good against inflammation of the joints (and elsewhere), and autoimmune diseases in general. So this means it is indeed good against common forms of arthritis, amongst others:

    Read: Omega-3 fatty acids in inflammation and autoimmune disease

    Against menstrual pain

    Linked to the above-referenced anti-inflammatory effects, omega-3s were also found to be better than ibuprofen for the treatment of severe menstrual pain:

    Don’t take our word for it: Comparison of the effect of fish oil and ibuprofen on treatment of severe pain in primary dysmenorrhea

    Against cognitive decline

    This one’s a heavy-hitter. It’s perhaps to be expected of something so good against inflammation (bearing in mind that, for example, a large part of Alzheimer’s is effectively a form of inflammation of the brain); as this one’s so important and such a clear benefit, here are three particularly illustrative studies:

    Against heart disease

    The title says it all in this one:

    A meta-analysis shows that docosahexaenoic acid from algal oil reduces serum triglycerides and increases HDL-cholesterol and LDL-cholesterol in persons without coronary heart disease

    But what about in patients who do have heart disease?

    Mozaffarian and Wu did a huge meta-review of available evidence, and found that in fact, of all the studied heart-related effects, reducing mortality rate in cases of cardiovascular disease was the single most well-evidenced benefit:

    Read more: Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events

    How much should we take?

    There’s quite a bit of science on this, and—which is unusual for something so well-studied—not a lot of consensus.

    However, to summarize the position of the academy of nutrition and dietetics on dietary fatty acids for healthy adults, they recommend a minimum of 250–500 mg combined EPA and DHA each day for healthy adults. This can be obtained from about 8 ounces (230g) of fatty fish per week, for example.

    If going for ALA, on the other hand, the recommendation becomes 1.1g/day for women or 1.6g/day for men.

    Want to know how to get more from your diet?

    Here’s a well-sourced article about different high-density dietary sources:

    12 Foods That Are Very High in Omega-3

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  • Why You Can’t Just “Get Over” Trauma

    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.

    Time does not, in fact, heal all wounds. Sometimes they even compound themselves over time. Dr. Tracey Marks explains the damage that trauma does—the physiological presentation of “the axe forgets but the tree remembers”—and how to heal from that actual damage.

    The science of healing

    Trauma affects the mind and body (largely because the brain is, of course, both—and affects pretty much everything else), which can ripple out into all areas of life.

    On the physical level, brain areas affected by trauma include:

    • Amygdalae: becomes hyperactive, keeping a person in a heightened state of vigilance.
    • Hippocampi: can shrink, causing fragmented or missing memories.
    • Prefrontal cortex: reduces in activity, impairing decision-making and emotional regulation.

    Trauma also activates the body’s fight or flight response, releasing stress hormones like cortisol and adrenaline. These are great things to have a pinch, but having them elevated all the time is equivalent to only ever driving your car at top speed—the only question becomes whether you’ll crash and burn before you break down.

    However, there is hope! Neuroplasticity (the brain’s ability to rewire itself) can make trauma recovery possible through various interventions.

    Evidence-based therapies for trauma include:

    • Eye Movement Desensitization and Reprocessing (EMDR): this can help reprocess traumatic memories and reduce emotional intensity.
    • Trauma-focused Cognitive Behavioral Therapy (CBT): this can help change unhelpful thought patterns and includes exposure therapy.
    • Somatic therapies: these focus on the body and nervous system to release stored tension.

    In this latter category, embodiment is key to trauma recovery—this may sound “wishy-washy”, but the evidence shows that reconnecting with the body does help manage emotional stress responses. Mind-body practices like mindfulness, yoga, and breathwork help cultivate embodiment and reduce trauma-related stress.

    In short: you can’t just “get over” it, but with the right support and interventions, it’s possible to rewire the brain and body toward resilience and healing.

    For more on all of this from Dr. Marks, 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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  • How To Keep Your Mind From Wandering

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    Whether your mind keeps wandering more as you get older, or you’re a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyone—and yet (alas!) it remains a required skill for so much in life.

    Today’s edition of 10Almonds presents a nifty trick to get yourself through those tasks! We’ll also be taking some time to reply to your questions and comments, in our weekly interactive Q&A.

    First of all though, we’ve a promise to make good on, so…

    How To Stay On The Ball (Or The Tomato?) The Easy Way

    For most of us, we face three main problems when it comes to tackling our to-dos:

    1. Where to start?
    2. The task seems intimidating in its size
    3. We get distracted and/or run out of energy

    If you’re really not sure where to start, we recommended a powerful tool in last Friday’s newsletter!

    For the rest, we love the Pomodoro Technique:

    1. Set a timer for 25 minutes, and begin your task.
    2. Keep going until the timer is done! No other tasks, just focus.
    3. Take a 5-minute break.
    4. Repeat

    This approach has three clear benefits:

    1. No matter the size of the task, you are only committing to 25 minutes—everything is much less overwhelming when there’s an end in sight!
    2. Being only 25 minutes means we are much more likely to stay on track; it’s easier to defer other activities if we know that there will be a 5-minute break for that soon.
    3. Even without other tasks to distract us, it can be difficult to sustain attention for long periods; making it only 25 minutes at a time allows us to approach it with a (relatively!) fresh mind.

    Have you heard that a human brain can sustain attention for only about 40 minutes before focus starts to decline rapidly?

    While that’s been a popular rationale for school classroom lesson durations (and perhaps coincidentally ties in with Zoom’s 40-minute limit for free meetings), the truth is that focus starts dropping immediately, to the point that one-minute attention tests are considered sufficient to measure the ability to focus.

    So a 25-minute Pomodoro is a more than fair compromise!

    Why’s it called the “Pomodoro” technique?

    And why is the 25-minute timed work period called a Pomodoro?

    It’s because back in the 80s, university student Francesco Cirillo was struggling to focus and made a deal with himself to focus just for a short burst at a time—and he used a (now “retro” style) kitchen timer in the shape of a tomato, or “pomodoro”, in Italian.

    If you don’t have a penchant for kitsch kitchenware, you can use this free, simple Online Pomodoro Timer!

    (no registration/login/download necessary; it’s all right there on the web page)

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