Be part of this research project

By simply spending 30 minutes of your time answering these questions about yourself, you can make a contribution to research about ageing and Australian women.

What is AgeHAPPY?

The Healthy Ageing Project Population Youth-senior (AgeHAPPY) is an online heath survey for Australians. The Healthy Ageing Project (HAP) mission is to improve the understanding of health across a lifespan to promote healthy ageing and prevent disease.

This round of the survey commenced in 2020. It started with a pilot study called HAP. Data on self-reported health, lifestyle, mood, and vascular risk factors is being collected from male and female participants aged 18 years and over. AgeHAPPY is a continuation of the Women’s Healthy Ageing Project (WHAP).

WHAP commenced in 1990 as a study examining the health of Australian women from midlife (then aged 45-55 years) before the menopausal transition and into ageing. The study has almost 30 years of data on mood, dietary intake, risky behaviours, physical activity and social connectedness among other factors. WHAP continues to follow up these women, who are now all aged over 70 years. The children of the original participants have now joined the study as of 2021 commencing the WHAP generations study.

AgeHAPPY is a study into the lifelong effects of lifestyle and habits on health and the progression of ageing. Everyone over 18 years of age can participate in the online health questionnaire. This research ultimately contributes to promoting healthy ageing in Australia and to improve the wellbeing of all Australians.

Chronic disease is the largest cause of death and disability in Australian society and throughout the western world. The information collected will enable greater understanding of the impact of social and behavioural factors on health and influence policies toward better prevention and early detection of health issues, including Parkinson’s and Alzheimer’s disease.

Most studies on “ageing” are usually limited to the elderly. HAP defines ageing as a phenomenon that occurs continuously throughout all stages of life – and presents its health challenges at all ages. Many studies show that indicators for chronic disease occur years before onset.

Through this online health survey, HAP can collect valuable demographic, clinical, behavioural and lifestyle data which allows them to analyse the impact of factors on health and ageing at every age.

Get involved in the AgeHAPPY study

The first section of the study is an online questionnaire covering areas such as demographic information, general health history, family health history, mood, quality of life, physical activity, sleep, diet, alcohol intake, smoking, physical function, social relationships, and negative life events.

The second section is a cognitive component which tests thinking skills, a bit like a brain game. A participant will be invited to complete the online cognitive testing from the Healthy Brain Initiative – Brain Health Registry (HBI-BHR). The Brain Health Registry is a web-based study that enables researchers to efficiently identify, assess and monitor the brain changes associated with the progression of neurodegenerative diseases and brain ageing more efficiently.

In 12 months’ time, HAP will contact you to complete a follow-up online questionnaire.

To participate, please follow the link:
https://medicine.unimelb.edu.au/research-groups/medicine-and-radiology-research/royal-melbourne-hospital/healthy-ageing-program/healthy-ageing-project

Australia’s health by socio-economic status

However you describe it, being poor, disadvantaged, or living in a low socioeconomic area is more likely to make you more susceptible to preventable chronic diseases such as heart disease, arthritis and diabetes.

Australia’s Health Tracker by Socioeconomic Status 2021 reports on the health status of Australians based on their socioeconomic standard which the study has found has a major impact on people’s health. Families and individuals with limited resources not only have more chronic disease, they are at greater risk of dying prematurely as a result of chronic health conditions. People living with mental ill-health are less likely to participate in employment, which in itself, is associated with an improvement in general mental health levels.

The ten million people living in the 40% of communities with lower and lowest socioeconomic status have much higher rates of preventable cardiovascular diseases, cancer, diabetes or chronic respiratory diseases than others in the population. These communities also have the highest rates of suicide throughout the nation.

Risk factors that are likely to contribute to this higher rate of illness and premature death include:
• Physical inactivity
• Lifetime alcohol consumption
• Daily tobacco use
• Unemployment as a result of mental health issues.

These health disparities within the Australian population are persistent despite considerable policy reform and efforts to improve services in recent decades. The targets for a healthier Australia were developed by the Australian Health Policy Collaboration, a national network of leading health experts and organisations. The Collaboration has worked with the support of the Mitchell Institute, Victoria University since 2014 to influence public and policy awareness and action to reduce high rates of preventable chronic disease in the Australian population.

The report sets health targets for medical conditions such as:
Obesity – Obesity is a risk factor for cardiovascular disease, high blood pressure, type 2 diabetes, asthma, back pain and some cancers.
High cholesterol – High levels of low-density lipoprotein cholesterol are a risk factor for heart disease. National data from 2011-12 is the most recent available data and indicated that close to one-third of all socioeconomic groups were estimated to have high cholesterol levels.
High blood pressure – Rates of reported high blood pressure are relatively consistent across socioeconomic groups. High blood pressure is often caused by poor diet, physical inactivity, obesity and excessive alcohol consumption. It is a risk factor for chronic conditions including stroke, heart diseases, and chronic kidney disease
Diabetes – Hospitalisations and deaths related to diabetes are, respectively, 2 and 2.3 times as high in the lowest socioeconomic communities compared to the highest.

Australia’s Health Tracker by Socioeconomic Status 2021 report, The Mitchell Institute at Victoria University. Australia’s Health Tracker by Socioeconomic Status 2021 report

COVID-19 impacts during 2020

Grandparents reported feeling disconnected and isolated from their children and grandchildren during the COVID restrictions imposed during 2020.

In two surveys conducted by the Australian Institute of Family Studies during each half of 2020, three out of 10 grandparents said that prior to the COVID-19 outbreak, they provided childcare to their grandchildren at least weekly. Of those grandparents, 14% of respondents with grandchildren aged under 13 years provided child care daily or several times a week, another 16% provided child care about once a week and around half provided care at least once per month.

Grandparent care and care for grandparents were most impacted during the pandemic, with respondents reporting that for many families, grandparents did not provide the usual care to their grandchildren for some months during the pandemic. Care for grandchildren ceased because of restrictions imposed on visiting family members or because parents increased their work from home.

Many grandparents reported feeling disconnected from their family and missing out on family traditions during the lockdown period. While some grandparents were able to access technological solutions to connect with family, others found the technology frustrating.

There were 7,306 respondents in the first survey of whom 6,435 completed all survey questions. In the second survey, 4,866 participants responded, of which 3,627 completed all survey questions. Over 80% were female respondents, tertiary-educated, ranging in age from over 18 years to 60+ years who lived either in a capital city, a major regional city or regional area.

Impacts on caring for others

In addition to generalised fears as to how the virus might affect the physical and mental health of family members, the pandemic forced changes to the availability of in-home support services. Caring hours for family members increased significantly over the year for 70% of respondents, nearly half of the respondents saying they spent over 30 hours per week in relation to child care and home schooling, while about 20% of respondents reported spending over 60 hours per week on caring activities which included caring for a parent or a partner.

Respondents also referred to giving assistance to non-household members which could include friends or work colleagues. This could include giving emotional assistance, or providing help with shopping, transport, house or garden maintenance and sometimes financial help.

Community volunteering was also impacted by the pandemic during 2020 in that in many volunteer-reliant charities, older volunteers were restricted in the types of volunteer work they could do and, at the same time, demand for services from charities increased due to the impact of COVID on employment and income.

Community volunteers were more likely to be older people. Survey results showed that over a quarter (27%) of respondents or their partners had engaged in some form of voluntary work in the past year, including half of those aged 70-79, 36% of those living alone, and 40% of those living in remote areas.

Of those who volunteered at some time during 2020, almost two in three (62%) continued to volunteer throughout the year, 20% volunteered before COVID but had yet to return to volunteering, 6% started volunteering after COVID, 4% stopped volunteering during COVID but have returned to volunteering, and 4% volunteered only during COVID. (The remaining 5% is other combinations.)

Report no. 1: Connection to family, friends and community, Families in Australia Survey, May 2021, https://aifs.gov.au/publications/connection-family-friends-community

Serious Incident Response Scheme begins in aged care facilities

With the release of the final report of the Royal Commission Into Aged Care, one of its most frightening details is that in 2019-20, over 851 alleged sexual assaults were reported in aged care facilities. However, as resident-on-resident assaults for the most part go unreported, the real figure is likely “as high as 2,520, or almost 50 per week”.

Despite such high statistics, the report’s 148 recommendations make no specific recommendations as to how that issue that predominantly affects older women should be managed.

The issue is expected to be managed by an enhanced reporting system known as the Serious Incident Response Scheme (SIRS) that begins on 1 April.

The scheme requires aged care providers to identify, record, manage, resolve and report all serious incidents that occur, or are alleged or suspected to have occurred.

Aged care providers also need to have in place an effective incident management system to manage all incidents, respond to incidents, and take steps to minimise the risk of preventable incidents reoccurring. The incident management system covers a broader range of non-reportable incidents and includes incidents that involve staff or visitors.

Under the existing system, aged care providers do not have to report incidents that involve a perpetrator who has a cognitive impairment and the operators have got strategies in place because it is felt that an impaired person cannot be successfully prosecuted.

“In some cases, family members encourage their loved ones to move into residential care because they felt that it would be safer for them”, the report notes. “But, on the contrary, people living in residential aged care likely face a much higher risk of assault than people living in the community.”

Under SIRS, there is a wider range of serious incidents that are reportable than those reported under current compulsory reporting requirements. Importantly, providers will have to report incidents of abuse and aggression between consumers, including where the resident who commits the incident has a cognitive or mental impairment.

Under the SIRS protocol, aged care must report all ‘Priority 1’ incidents within 24 hours to the Aged Care Quality and Safety Commission. ‘Priority 1’ incidents include those that cause or could reasonably have caused physical or psychological injury or illness requiring some form of medical or psychological treatment. Instances of unexplained absence from care and any unexpected death of a consumer are always to be regarded as Priority 1 reportable incidents.
From 1 October 2021, all ‘Priority 2’ incidents, that is reportable incidents that do not meet the criteria for ‘Priority 1’, must also be reported within 30 days.

In addition, the SIRS requires every residential aged care service to have in place an effective incident management system – a set of protocols, processes, and standard operating procedures that staff are trained to use.

For further information, refer to the Aged Care Quality and Safety Commission website, https://www.agedcarequality.gov.au/sirs

Author talk at Dennis Johnson Library Stanhope Gardens

Come along to join in the retirement conversation on

Join Alice and have a retirement conversation.
Saturday, 24 October 2020 at 1:30 pm – 3:00 pm.
At the Dennis Johnson Library, Cnr Stanhope Parkway & Sentry Drive, Stanhope Gardens, NSW 2768

Women experience retirement differently to men. Women generally live longer, have less money and volunteer more than their male counterparts. A practicing lawyer for over 30 years, Alice Mantel encourages making better decisions, giving advice on topics such as:

Inspiring women to make the most of their retirement opportunities, Every Woman’s Guide to Retirement encourages an active, connected lifestyle, staying healthy, lifelong learning, de-cluttering, and even online dating to make the most of this time.

Community attitudes to aged care explored

Following In-depth interviews and focus groups, the Royal Commission into Aged Care Quality and Safety has released a report, They look after you, you look after them: Community attitudes to ageing and aged care .

The researchers interviewed a range of focus groups to identify current community attitudes to ageing; community understanding of the aged care system and how individuals were planning for their own older age. Interviews were conducted with both younger and older people, diverse economic groups, Indigenous and culturally diverse groups and younger people with disabilities who already resided in aged care facilities.

Written before the pandemic, the report explores how people view entering an aged care facility, what their expectations were and most relevantly, what were the experiences of actual residents.

Post-Covid, the relatively negative comments of most interviewees about their fear of entering the aged care system, seems justified in light of the relatively high number of deaths in care facilities which appear to reflect the inadequate training and equipment available to care for older people.

The report found that as people became older, they were better informed about the complexities of the aged care system but they remained concerned about the cost and quality of care provided. There was a widespread, strong preference across the different age groups and communities to remain living independently as they age and making use of support to do so.

Most interviewees were critical of aged care facilities and saw them as being run as businesses that prioritised profit over high quality care. The prevalence of religiously affiliated organisations running facilities was seen as effectively limiting their choices, as they did not want to spend their older years living in an institution run by a religious body.

Most people described aged care facilities negatively, saying they were depressing, bleak places that felt clinical and sometimes were overcrowded. Moving to aged care was seen as ‘the beginning of the end’ that precipitated a rapid decline in one’s life expectancy and quality of life.

Specific negative factors mentioned included a lack of meaningful mental stimulation, social isolation and loneliness, poor quality personal care, insufficient staffing levels and staff training, and poor quality nutrition. These factors were interrelated with overstretched staff rushing residents through meals and personal care.

While some interviewees mentioned pleasant high end facilities, others mentioned budget facilities that provided a small per resident food budget, or residents being heavily sedated to reduce staff workload. The effect of having to provide a bond to ensure a place in a facility and the ongoing cost was of great concern to most as was the inadequate regulatory system.

Younger people with physical or mental disabilities living in aged care facilities were particularly critical of the care they received, mentioning issues of cleanliness, personal hygiene, stimulation and respect for residents and appropriate social engagement.

This qualitative research included 274 people from the general community and targeted diversity groups. It was conducted primarily to understand the perspectives of these diversity groups and to complement a national survey for the Royal Commission that has been charged with considering the design of Australia’s future aged care system.

May her death not be in vain

The death of Ann-Marie Smith, who died from serious illnesses that developed while receiving full-time care in her home provided by an employee of a disability care provider is a stark warning to potential users of the home care system.

The 54-year-old Adelaide woman suffered from cerebral palsy and lived alone in Adelaide’s leafy eastern suburbs before dying in what has been described as “disgusting and degrading” conditions.

Ms Smith died in Royal Adelaide Hospital on April 6 from septic shock, multiple organ failures from severe pressure sores, and malnourishment. She had apparently been living and sleeping in the same chair in her lounge room for over a year.

While the carer was sacked by the provider, Integrity Care SA for her “serious and wilful misconduct”, Ms Smith’s death has been declared a major crime.

If your family member died in this situation, do you think simply sacking the employee would be enough? To what extent does the provider carry responsibility for their employee’s conduct?

The ongoing nature of the neglect endured by Ms Smith highlights the need to strengthen the accountability and penalty regulations applying to Commonwealth funded aged care services providers.

Rather belatedly, the federal government has announced that a Serious Incident Response Scheme (SIRS) mandatory reporting framework will be introduced into residential aged care providers from 1 July 2021 which will implement greater reporting of incidents involving residents. Potentially, SIRS may be extended into home and community aged care.

The lack of oversight of both in-home care and residential aged care has been the subject of a number of investigations and reports, with little regulatory action to date.

Under the proposed SIRS framework, care providers will be required to report on a broader range of incidents, including neglect, psychological or emotional abuse and inappropriate physical or chemical restraint. Significantly, it will also lift the current exemption on the reporting of resident on resident incidents, where the perpetrator has an assessed cognitive impairment.

The Aged Care Quality and Safety Commission will receive incident reports and will have enhanced powers to administer the SIRS, including taking regulatory action where needed.
As part of the ongoing feasibility study, funding has been included to investigate the design, implementation and regulation of a worker register for aged care.

A 2019 report done by KPMG, Strengthening protections for older Australians, commissioned by the Department of Health, estimated that there were more than 20,000 unexplained serious injury incidents which were not reported under the current system. Any reform of the current aged care system is seen as increasing the regulatory burden on providers to report and respond to serious incidents with an accompanying increase in staffing of the Commission to deal with reports.

The sooner a mandatory reporting scheme is introduced, more deaths like Ann-Marie Smith’s can be prevented.

Sen R Colbeck media release, https://www.richardcolbeck.com.au/press-releases, 14/06/20
Dept of Health release, https://www.health.gov.au/resources/publications/strengthening-protections-for-older-australians, Feb 2019

Australian women at greater risk during pandemic lockdown

Like the rest of the world, Australia is reporting a greater risk to women and children of experiencing violence during the global health pandemic.

Confirmation of the effect of government-directed restrictions that include stay-at-home orders, physical distancing, working at home and the closure of number of community services, has been explored in the results of two surveys of Queensland domestic violence practitioners.

The surveys were conducted by the Queensland Domestic Violence Services Network over two 10-day periods in April and May 2020 and surveyed the professional views of domestic violence support workers. The surveys found an increase in:
• client numbers;
• the complexity of client needs;
• in reported controlling behaviour and manipulation;
• reported perpetrator anger/violence allegedly due to reduced income or job loss due to COVID-19; and
• additional pressure and stress on practitioners as a result of the transition to remote work and increased service demand as indicated by increased reporting.

These findings were published in a Monash University report Responding to Queensland’s ‘shadow pandemic’ during the period of COVID-19 restrictions and mirror Victorian research published in June 2020. Publication of the report is intended to increase understanding of the impact of the COVID-19 global health pandemic restrictions on women’s experiences of gender-based violence and practitioners’ experiences supporting women.

In April 2020, the United Nations Executive Director of UN Women, Phumzile Mlambo-Ngcuka, labelled violence against women the ‘shadow pandemic’ (UN Women, 2020b), recognising the heightened risk to women and children to all forms of gender-based violence. It has been estimated that for every three months the enforced lockdown restrictions continue, an additional 15 million cases of domestic violence will occur worldwide. One of the ongoing issues is that while the risk to women increases while they are confined to their homes, their access to support is reduced.

Pfitzner, N., Fitz-Gibbon, K., Meyer, S., and True, J. (2020). Responding to Queensland’s ‘shadow pandemic’ during the period of COVID-19 restrictions: practitioner views on the nature of and responses to violence against women. Monash Gender and Family Violence Prevention Centre, Monash University, Victoria, Australia.
file:///I:/Writing/Qld%20Responding%20to%20the%20Shadow%20Pandemic%20Report%2030June20.pdf