Placeholder Content Image

Dog care below freezing − how to keep your pet warm and safe from cold weather, road salt and more this winter

<p><em><a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a></em></p> <p>Time outside with your dog in the spring, summer and fall can be lovely. Visiting your favorite downtown café on a cool spring morning, going to a favorite dog park on a clear summer evening or going on walks along a river when the leaves are changing color are all wonderful when the weather is favorable. But in much of the country, when winter rolls around, previously hospitable conditions can <a href="https://theconversation.com/is-winter-miserable-for-wildlife-108734">quickly turn chilly and dangerous</a> for people and pups alike.</p> <p>Winter brings some unique challenges for dog owners, since dogs still need activity and socialization during colder seasons. Studies have shown that dog owners are almost 50% less likely to walk their dogs <a href="https://doi.org/10.3390/ani11113302">when the weather gets cold</a>. Knowing the basics of winter safety is critical to maintaining a healthy lifestyle for your dog.</p> <p>I am an <a href="https://www.vetmed.ucdavis.edu/faculty/erik-olstad">assistant professor</a> at the University of California Davis School of Veterinary Medicine who weathered polar vortexes with my dog while living in Michigan early in my career. While I’ve since moved to sunny California, I’ve seen how quickly frigid temperatures can turn dangerous for pets.</p> <h2>Breed and age differences</h2> <p>Not all dogs have the same abilities to deal with cold weather. A short-coated dog like a Chihuahua is much more susceptible to the dangers of cold weather than a thick-coated husky. When the weather dips below 40 degrees Fahrenheit (4 degrees Celsius), the well-acclimated husky may be comfortable, whereas the Chihuahua would shiver and be at risk of hypothermia.</p> <p>Additionally, if your dog is used to warm weather, but you decide to move to a colder region, the dog will need time to acclimate to that colder weather, even if they have a thick coat.</p> <p>Age also affects cold-weather resilience. Puppies and elderly dogs can’t withstand the chill as well as other dogs, but every dog is unique – each may have individual health conditions or physical attributes that make them more or less resilient to cold weather.</p> <h2>When is my dog too cold?</h2> <p>Pet owners should be able to recognize the symptoms of a dog that is getting too cold. Dogs will shiver, and some may vocalize or whine. Dogs may resist putting their feet down on the cold ground, or burrow, or try to find warmth in their environment when they are uncomfortable.</p> <p>Just like people, <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">dogs can get frostbite</a>. And just like people, the signs can take days to appear, making it hard to assess them in the moment. The most common sites for frostbite in dogs are their ears and the tips of their tails. Some of the initial signs of frostbite are skin discoloring, turning paler than normal, or purple, gray or even black; red, blistered skin; swelling; pain at the site; <a href="https://www.britannica.com/science/ulcer">or ulceration</a>.</p> <p>Other <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">serious signs of hypothermia</a> include sluggishness or lethargy, and if you observe them, please visit your veterinarian immediately. A good rule to live by is if it is too cold for you, it is too cold for your dog.</p> <p>Getting your dog a <a href="https://www.cnn.com/cnn-underscored/pets/best-winter-dog-coats-jackets">sweater or jacket</a> and <a href="https://www.akc.org/expert-advice/vets-corner/protect-dogs-paws-snow-ice-salt/">paw covers</a> can provide them with protection from the elements and keep them comfortable. Veterinarians also recommend closely monitoring your dog and limiting their time outside when the temperature nears the freezing point or drops below it.</p> <h2>Road salt dangers</h2> <p>Road salt that treats ice on streets and sidewalks <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/ice-salt-toxic-for-pets-1.5020088">can also harm dogs</a>. When dogs walk on the salt, the sharp, rough edges of the salt crystals can irritate the sensitive skin on their paws.</p> <p>Dogs will often lick their feet when they’re dirty, wet or irritated, and if they ingest any salt doing that, they may face GI upset, dehydration, kidney failure, seizures or even death. Even small amounts of pure salt can <a href="https://www.petpoisonhelpline.com/pet-tips/my-dog-ate-road-salt-will-they-be-okay/">disrupt critical body functions</a> in dogs.</p> <p>Some companies make pet-safe salt, but in public it can be hard to tell what type of salt is on the ground. After walking your dog, wash off their feet or boots. You can also keep their paw fur trimmed to prevent snow from balling up or salt collecting in the fur. Applying a thin layer of petroleum jelly or <a href="https://www.akc.org/expert-advice/lifestyle/how-to-make-your-own-paw-balm-for-winter/">paw pad balm</a> to the skin of the paw pads can also help protect your pet’s paws from irritation.</p> <h2>Antifreeze risks</h2> <p><a href="https://www.britannica.com/science/antifreeze-chemical-substance">Antifreeze, or ethylene glycol</a>, is in most vehicles to prevent the fluids from freezing when it gets cold out. Some people pour antifreeze into their toilets when away from their home to prevent the water in the toilet from freezing.</p> <p>Antifreeze is an exceptionally dangerous chemical to dogs and cats, as it tastes sweet but can be deadly when ingested. If a pet ingests even a small amount of antifreeze, the substance causes a chemical cascade in their body that results in severe kidney damage. If left untreated, the pet may have <a href="https://www.petpoisonhelpline.com/pet-owner-blog/antifreeze-poisoning/">permanent kidney damage or die</a>.</p> <p>There are safer antifreeze options on the market that use ingredients other than ethylene glycol. If your dog ingests antifreeze, please see your veterinarian immediately for treatment.</p> <p>When temperatures dip below freezing, the best thing pet owners can do is keep the time spent outside as minimal as possible. Try some <a href="https://www.akc.org/expert-advice/lifestyle/great-indoor-games-to-play-with-your-dog/">indoor activities</a>, like hide-and-seek with low-calorie treats, fetch or even an interactive obstacle course. Food puzzles can also keep your dog mentally engaged during indoor time.</p> <p>Although winter presents some unique challenges, it can still be an enjoyable and healthy time for you and your canine companion.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221709/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, Health Sciences Assistant Professor of Clinical Veterinary Medicine, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dog-care-below-freezing-how-to-keep-your-pet-warm-and-safe-from-cold-weather-road-salt-and-more-this-winter-221709">original article</a>.</em></p>

Family & Pets

Placeholder Content Image

The dos and don’ts of caring for your hearing aids

<p>Proper care and maintenance of your hearing aids is important. It will ensure you to get the most out of your aids, prevent problems and maintain optimum hearing conditions. Here are some guidelines to help you care for them.</p> <p><strong>DO</strong>: clean your hearing aids regularly with a dry cloth or tissue.</p> <p><strong>DON’T</strong>: get your hearing aids wet. That means no wearing them in the shower or when swimming. If they happen to get wet, dry it off immediately.</p> <p><strong>DO</strong>: put your hearing aids in their case when you’re not using them</p> <p><strong>DON’T</strong>: wear your aids when using aftershave, hairspray, perfume, sunscreen, insect repellent and so on. They contain chemicals that could damage it. Allow time for drying before putting back on hearing aids.</p> <p><strong>DO</strong>: use a moisture protection kit/anti-humidity kit. They help with moisture problems (which can affect performance of hearing aids) and extend life of hearing aids.</p> <p><strong>DO</strong>: keep out of reach of pets and visiting grandkids. Dogs have been known to chew them up and if swallowed by either pet or grandkid, can be very dangerous.</p> <p><strong>DON’T</strong>: expose your device to extreme heats. Don’t leave them in a parked car, near a heater or wear while using a hairdryer. </p> <p><strong>DO</strong>: Store your hearing aid in a safe place that's dry and cool.</p> <p><strong>DON’T</strong>: leave your hearing aids switched on when you’re not using them.</p> <p><strong>DO</strong>: change batteries often so you won’t be stuck with aids that have suddenly run out of power.</p> <p><strong>DON’T</strong>: ever insert anything into the sound outlet as it could damage the receiver. If you can’t clean it properly, ask your hearing professional.</p> <p><strong>DO</strong>: remove any earwax that gets into your hearing aid. It could cause permanent damage.</p> <p><em>Image credits: Getty Images </em></p>

Hearing

Placeholder Content Image

Longing for the ‘golden age’ of air travel? Be careful what you wish for

<p><em><a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a></em></p> <p>Long lines at security checkpoints, tiny plastic cups of soda, small bags of pretzels, planes filled to capacity, fees attached to every amenity – all reflect the realities of 21st century commercial air travel. It’s no wonder that many travelers have become nostalgic for the so-called “golden age” of air travel in the United States.</p> <p>During the 1950s, airlines promoted commercial air travel as glamorous: stewardesses served full meals on real china, airline seats were large (and frequently empty) with ample leg-room, and passengers always dressed well.</p> <p>After jets were introduced in the late 1950s, passengers could travel to even the most distant locations at speeds unimaginable a mere decade before. An airline trip from New York to London that could take up to 15 hours in the early 1950s could be made in less than seven hours by the early 1960s.</p> <p>But airline nostalgia can be tricky, and “golden ages” are seldom as idyllic as they seem.</p> <p>Until the introduction of jets in 1958, most of the nation’s commercial planes were propeller-driven aircraft, like the DC-4. Most of these planes were unpressurized, and with a maximum cruising altitude of 10,000 to 12,000 feet, they were unable to fly over bad weather. Delays were frequent, turbulence common, and air sickness bags often needed.</p> <p>Some planes were spacious and pressurized: the <a href="http://everythingnice.org/wp-content/uploads/2009/07/PanAm-cutawayS.jpg">Boeing Stratocruiser</a>, for example, could seat 50 first class passengers or 81 coach passengers compared to the DC-3’s 21 passengers. It could cruise at 32,000 feet, which allowed Stratocruiser to fly above most bad weather it encountered. But only 56 of these planes were ever in service.</p> <p>While the later DC-6 and DC-7 were pressurized, they still flew much lower than the soon-to-appear jets – 20,000 feet compared to 30,000 feet – and often encountered turbulence. The piston engines were bulky, complex and difficult to maintain, which contributed to frequent delays.</p> <p>For much of this period, the old saying “Time to spare, go by air” still rang true.</p> <p>Through the 1930s and into the 1940s, almost everyone flew first class. Airlines did encourage more people to fly in the 1950s and 1960s by introducing coach or tourist fares, but the savings were relative: less expensive than first class, but still pricey. In 1955, for example, so-called “bargain fares” from New York to Paris were the equivalent of just over $2,600 in 2014 dollars. Although the advent of jets did result in lower fares, the cost was still out of reach of most Americans. The most likely frequent flier was a white, male businessman traveling on his company’s expense account, and in the 1960s, airlines – with young attractive stewardesses in short skirts – clearly catered to their most frequent flyers.</p> <p>The demographics of travelers did begin to shift during this period. More women, more young people, and retirees began to fly; still, airline travel remained financially out-of-reach for most.</p> <p>If it was a golden age, it only was for the very few.</p> <figure><iframe src="https://www.youtube.com/embed/bKqQgNZylLw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Jet planes were introduced in the late 1950s, resulting in shorter flight times. But their ticket prices out of reach for the average traveler.</span></figcaption></figure> <p>People also forget that well into the 1960s, air travel was far more dangerous than it is today. In the 1950s and 1960s US airlines experienced at least a half dozen crashes per year – most leading to fatalities of all on board. People today may bemoan the crowded airplanes and lack of on-board amenities, but the number of fatalities per million miles flown has dropped dramatically since since the late 1970s, especially compared to the 1960s. Through at least the 1970s, airports even prominently featured kiosks selling flight insurance.</p> <p>And we can’t forget hijackings. By the mid-1960s so many airplanes had been hijacked that <a href="http://www.latinamericanstudies.org/hijackers/flying-high.htm">“Take me to Cuba”</a> became a punch line for stand-up comics. In 1971 <a href="http://nymag.com/news/features/39593/index2.html">D.B. Cooper</a> – a hijacker who parachuted from a Boeing 727 after extorting $200,000 – might have been able to achieve folk hero status. But one reason US airline passengers today (generally) tolerate security checkpoints is that they want some kind of assurance that their aircraft will remain safe.</p> <p>And if the previous examples don’t dull the sheen of air travel’s “golden age,” remember: in-flight smoking was both permitted and encouraged.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/34177/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/janet-bednarek-144872"><em>Janet Bednarek</em></a><em>, Professor of History, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/longing-for-the-golden-age-of-air-travel-be-careful-what-you-wish-for-34177">original article</a>.</em></p>

Travel Trouble

Placeholder Content Image

How do I handle it if my parent is refusing aged care? 4 things to consider

<p><em><a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>It’s a shock when we realise our parents aren’t managing well at home.</p> <p>Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.</p> <p>You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?</p> <p>Here are four things to consider.</p> <h2>1. Start with more help at home</h2> <p>Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.</p> <p>Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.</p> <p>Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.</p> <p>Call <a href="https://www.myagedcare.gov.au/">My Aged Care</a> to discuss your options.</p> <h2>2. Be prepared for multiple conversations</h2> <p>Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.</p> <p>Ideally, the older person feels supported rather than attacked during these conversations.</p> <p>Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.</p> <p>Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.</p> <h2>3. Understand the options when help at home isn’t enough</h2> <p>If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be <a href="https://academic.oup.com/gerontologist/article/60/8/1504/5863160">considering a nursing home</a> (also known as residential aged care in Australia).</p> <p>Every person has a legal right to <a href="https://humanrights.gov.au/our-work/9-your-right-choose-where-you-live">choose where we live</a> (unless they have lost capacity to make that decision).</p> <p>This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.</p> <p>It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).</p> <p>Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?</p> <p>Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.</p> <p>Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826495/">Research</a> suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.</p> <p>Mum and Dad should be involved in the decision-making process about where they live, and when they might move.</p> <p>Some families start looking “just in case” as it often takes some time to <a href="https://www.abc.net.au/everyday/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">find the right nursing home</a> and there can be a wait.</p> <p>After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.</p> <p>We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.</p> <p>For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.</p> <p>Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.</p> <h2>4. Understand the options if a parent has lost capacity to make decisions</h2> <p>If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.</p> <p>If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.</p> <p>Mum or Dad may have appointed an <a href="https://www.tag.nsw.gov.au/wills/appoint-enduring-guardian/what-enduring-guardian">enduring guardian</a> to make decisions about their health and lifestyle decisions when they are not able to.</p> <p>An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.</p> <p>If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can <a href="https://www.tag.nsw.gov.au/guardianship/information-about-guardianship">appoint</a> that person a private guardian (usually a family member, close friend or unpaid carer).</p> <p>If no such person is available to act as private guardian, a public official may be appointed as public guardian.</p> <h2>Deal with your own feelings</h2> <p>Families often feel <a href="https://link.springer.com/article/10.1007/s12144-023-04538-9">guilt and grief</a> during the decision-making and transition process.</p> <p>Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221210/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/lee-fay-low-98311"><em>Lee-Fay Low</em></a><em>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-handle-it-if-my-parent-is-refusing-aged-care-4-things-to-consider-221210">original article</a>.</em></p>

Placeholder Content Image

Legendary broadway icon passes away

<p>Iconic Broadway performer Chita Rivera has passed away at the age of 91. </p> <p>The dynamic dancer, singer and actress scored two Tony awards throughout her career, while blazing a trail for Latin American artists to shine on stage. </p> <p>On Wednesday morning, Rivera's daughter Lisa Mordente confirmed the news of her passing, sharing that her mother had died in New York after a brief illness. </p> <p>Rivera's representative Merle Frimark also shared a statement about her death, writing, "It is with immense personal sorrow that I announce the death of the beloved Broadway icon Chita Rivera. My dear friend of over 40 years was 91."</p> <p>"She is also survived by her siblings Julio, Armando and Lola del Rivero, (her older sister Carmen predeceased her), along with her many nieces, nephews and friends."</p> <p>"Her funeral will be private. A memorial service will be announced in due course."</p> <p>Rivera's breakout role came in 1957 as she starred as Anita in the original production of <em>West Side Story</em>, and she stayed performing in a multitude of roles until 2015.</p> <p>Chita starred in Broadway shows such as <em>Bye Bye Birdie</em>, <em>Chicago</em>, <em>Merlin</em>, <em>Jerry's Girls</em>, <em>Nine</em>, and many more. </p> <p>She also released two solo albums during her career, and was awarded the Presidential Medal of Freedom from former US president Barack Obama.</p> <p>Rivera won Tonys for <em>The Rink</em> in 1984 and <em>Kiss of the Spider Woman</em> in 1993, and when accepting a Tony Award for Lifetime Achievement in 2018, she said, "I wouldn't trade my life in the theatre for anything, because theatre is life."</p> <p>In 2015, she told <em>The Associated Press</em>, "I wouldn't know what to do if I wasn't moving or telling a story to you or singing a song." </p> <p>"That's the spirit of my life, and I'm really so lucky to be able to do what I love, even at this time in my life."</p> <p><em>Image credits: Getty Images </em></p>

Caring

Placeholder Content Image

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

<p><em><a href="https://theconversation.com/profiles/sophie-scott-1462197">Sophie Scott</a>, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>It’s getting towards the time of the year when you might feel more overwhelmed than usual. There are work projects to finish and perhaps exams in the family. Not to mention the pressures of organising holidays or gifts. Burnout is a real possibility.</p> <p>Burnout is defined by the <a href="https://www.who.int/standards/classifications/frequently-asked-questions/burn-out-an-occupational-phenomenon#:%7E:text=Burn%2Dout%20is%20defined%20in,has%20not%20been%20successfully%20managed.">World Health Organization</a> (WHO) as having three main symptoms – exhaustion, loss of empathy and reduced performance at work.</p> <p>Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> argues for a broader model, particularly as the WHO’s third symptom may simply be a consequence of the first two.</p> <p>So what is burnout really? And how can you avoid it before the holidays hit?</p> <h2>More than being really tired</h2> <p>The Australian research model endorsed exhaustion as the primary burnout symptom but emphasised burnout should not be simply equated with exhaustion.</p> <p>The second symptom is loss of empathy (or “compassion fatigue”), which can also be experienced as uncharacteristic cynicism or a general loss of feeling. Nothing much provides pleasure and <em>joie de vivre</em> is only a memory.</p> <p>The third symptom (cognitive impairment) means sufferers find it <a href="https://www.abc.net.au/news/2023-02-13/gordon-parker-says-the-burnout-definition-needs-to-broaden/101920366">difficult to focus</a> and retain information when reading. They tend to scan material – with some women reporting it as akin to “baby brain”.</p> <p>Research <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">suggests</a> a fourth symptom: insularity. When someone is burnt out, they tend to keep to themselves, not only socialising less but also obtaining little pleasure from interactions.</p> <p>A potential fifth key feature is an unsettled mood.</p> <p>And despite feeling exhausted, most individuals report insomnia when they’re burnt out. In severe cases, immune functioning can be compromised (so that the person may report an increase in infections), blood pressure may drop and it may be difficult or impossible to get out of bed.</p> <p>Predictably, such features (especially exhaustion and cognitive impairment) do lead to compromised work performance.</p> <p>Defining burnout is important, as rates have <a href="https://dspace.library.uu.nl/bitstream/handle/1874/420608/Burnout_Fatigue_Exhaustion.pdf?sequence=1&amp;isAllowed=y">increased</a> in the last few decades.</p> <h2>‘Tis the season</h2> <p>For many, the demands of the holidays cause exhaustion and risk burnout. People might feel compelled to shop, cook, entertain and socialise more than at other times of year. While burnout was initially defined in those in formal employment, we now recognise the same pattern can be experienced by those meeting the needs of children and/or elderly parents – with such needs typically increasing over Christmas.</p> <p>Burnout is generally viewed according to a simple stress-response model. Excessive demands lead to burnout, without the individual bringing anything of themselves to its onset and development. But the Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> has identified a richer model and emphasised how much personality contributes.</p> <p>Formal carers, be they health workers, teachers, veterinarians and clergy or parents – are <a href="https://www.taylorfrancis.com/books/mono/10.4324/9781003333722/burnout-gordon-parker-gabriela-tavella-kerrie-eyers">more likely</a> to experience burnout. But some other professional groups – such as lawyers – are also at high risk.</p> <p>In essence, “good” people - who are dutiful, diligent, reliable, conscientious and perfectionistic (either by nature or work nurture) – are at the <a href="https://journals.lww.com/jonmd/Abstract/2020/06000/A_Qualitative_Reexamination_of_the_Key_Features_of.4.aspx">greatest risk</a> of burnout.</p> <h2>6 tips for avoiding seasonal burnout</h2> <p>You may not be able to change your personality, but you can change the way you allow it to “shape” activities. Prioritising, avoiding procrastination, decluttering and focusing on the “big picture” are all good things to keep in mind.</p> <p>Managing your time helps you regain a sense of control, enhances your efficiency, and reduces the likelihood of feeling overwhelmed by responsibilities.</p> <p><strong>1. Prioritise tasks</strong></p> <p>Rank tasks based on urgency and importance. The Eisenhower Matrix, <a href="https://www.amazon.com.au/7-Habits-Highly-Effective-People/dp/0743269519">popularised</a> by author Stephen R Covey, puts jobs into one of four categories:</p> <ul> <li> <p>urgent and important</p> </li> <li> <p>important but not urgent</p> </li> <li> <p>urgent but not important</p> </li> <li> <p>neither urgent nor important.</p> </li> </ul> <p>This helps you see what needs to be top priority and helps overcome the illusion that everything is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159458/">urgent</a>.</p> <p><strong>2. Set realistic goals</strong></p> <p>Break down large goals into smaller, manageable tasks to be achieved each day, week, or month – to prevent feeling overwhelmed. This could mean writing a gift list in a day or shopping for a festive meal over a week. Use tools such as calendars, planners or digital apps to schedule tasks, deadlines and appointments.</p> <p><strong>3. Manage distractions</strong></p> <p>Minimise <a href="https://psycnet.apa.org/record/2023-66900-001">distractions</a> that hinder productivity and time management. <a href="https://www.journals.uchicago.edu/doi/full/10.1086/691462">Research</a> finds people complete cognitive tasks better with their phones in another room rather than in their pockets. People with phones on their desks performed the worst.</p> <p>Setting specific work hours and website blockers can limit distractions.</p> <p><strong>4. Chunk your time</strong></p> <p>Group similar tasks together and allocate specific time blocks to focus on them. For example, respond to all outstanding emails in one stint, rather than writing one, then task-switching to making a phone call.</p> <p>This approach <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075496/">increases efficiency</a> and reduces the time spent transitioning between different activities.</p> <p><strong>5. Take breaks</strong></p> <p>A <a href="https://psycnet.apa.org/record/2022-90592-001">2022 systematic review</a> of workplace breaks found taking breaks throughout the day improves focus, wellbeing and helps get more work done.</p> <p><strong>6. Delegate</strong></p> <p>Whether at home or work, you don’t have to do it all! Identify tasks that can be effectively delegated to others or automated.</p> <p>To finish the year feeling good, try putting one or more of these techniques into practice and prepare for a restful break.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216175/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/sophie-scott-1462197"><em>Sophie Scott</em></a><em>, Associate Professor (Adjunct), Science Communication, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, Scientia Professor, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/its-beginning-to-look-a-lot-like-burnout-how-to-take-care-of-yourself-before-the-holidays-start-216175">original article</a>.</em></p>

Caring

Placeholder Content Image

Olympic hero "fighting for her life" in intensive care

<p>xx<span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">In the world of gymnastics, few names shine as brightly as that of Mary Lou Retton. The Olympic gold medallist and legendary American gymnast has long been celebrated for her incredible contributions to the sport, etching her legacy into the annals of history. But now, a dark cloud of concern hovers over this American icon, as she battles a rare and relentless adversary: a severe form of pneumonia.</span></p> <p>The shocking news has shaken the hearts of fans and sports enthusiasts worldwide, as the daughter of the 55-year-old Retton shared the news that she is "fighting for her life" in an intensive care unit, unable to breathe on her own for over a week now.</p> <p>McKenna Kelley, Retton's daughter, recently set up a <a href="https://www.spotfund.com/story/a2e0582c-e62f-4e5b-a586-18349014f761" target="_blank" rel="noopener">fundraising account</a> to share her mother's grave situation and the urgency of her need for support. The emotional plea disclosed that Mary Lou Retton was uninsured, leaving the burden of her healthcare costs in the hands of her loved ones and well-wishers.</p> <p>In an emotionally charged post on the fundraising platform, Kelley wrote: "My amazing mom, Mary Lou, has a very rare form of pneumonia and is fighting for her life."</p> <p>While respecting her mother's privacy, Kelley refrained from divulging further details about the nature of the pneumonia that has gripped Retton's life, instead requesting the one thing we can all offer – our prayers.</p> <p>Mary Lou Retton's remarkable gymnastics career needs no introduction. She etched her name into the annals of history during the 1984 Los Angeles Olympics, securing her place as one of the greatest gymnasts in history.</p> <p>At those Summer Games, Retton achieved an astonishing feat by winning five medals, including a groundbreaking gold in the individual all-around competition, a first for any American woman. Her achievements garnered her the title of Sportsperson of the Year by <em>Sports Illustrated</em> in 1984, a testament to her indomitable spirit and unparalleled dedication to her craft.</p> <p>At the time of writing, the fundraising account dedicated to supporting Mary Lou Retton had received an overwhelming outpouring of love and support. With more than 2,000 donors and counting, the campaign has already raised over $US300,000, surpassing its original goal of $US50,000.</p> <p>The outpouring of generosity underscores the enduring impact and admiration that Mary Lou Retton has left in the hearts of many.</p> <p>Beyond the gymnasium, Retton's influence extended into the world of entertainment, appearing in movies and TV shows, including a memorable stint on <em>Baywatch</em> in 1993 and the film Naked<em> Gun 33 ¹/₃: The Final Insult</em> in 1994. She also served on the President's Council on Physical Fitness and Sports during President George W. Bush's administration, underscoring her enduring commitment to promoting physical health and well-being.</p> <p>In recognition of her remarkable contributions to the world of gymnastics, Mary Lou Retton was inducted into the International Gymnastics Hall of Fame in 1997 and became the first woman to be honored by the Houston Sports Hall of Fame in 2020. Her legacy extended to the National Italian-American Sports Hall of Fame, inducted in 1992, and in her hometown of Fairmont, West Virginia, a street and park bear her name, a lasting tribute to her enduring impact.</p> <p><em>Images: Instagram</em></p>

Caring

Placeholder Content Image

What actually is palliative care? And how is it different to end-of-life care?

<p><em><a href="https://theconversation.com/profiles/samar-aoun-1437641">Samar Aoun</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p>Although it is associated with dying, palliative care is an approach focused on improving <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405258/#:%7E:text=QOL%20can%20also%20be%20defined,QOL%20(2%E2%80%934).">quality of life</a> – or how people feel about and respond to facing a life-threatening illness.</p> <p>Palliative care aims to prevent and relieve physical, social, emotional, spiritual and existential distress. Palliative care also supports family caregivers during the disease journey and bereavement phase. You might have heard it mentioned for cancer, but it is beneficial for the majority of life-limiting conditions. It has been shown to reduce health-care costs by <a href="https://palliativecare.org.au/publication/kpmg-palliativecare-economic-report/">preventing</a> unnecessary hospital admissions.</p> <p>Palliative care is not voluntary assisted dying. It does not aim to hasten or prolong death. It is not just for people who are about to die and seeking palliative care does not mean “giving up”. In fact, it can be a profound and positive form of care that the World Health Organization (WHO) has <a href="https://www.who.int/news-room/fact-sheets/detail/palliative-care">recognised</a> as a basic human right. But what does it involve?</p> <h2>Not just for someone’s final days</h2> <p>Palliative care is often seen as a “last resort” rather than a service that empowers terminally ill people to live as well as possible for as long as possible.</p> <p>The full benefit of this holistic approach can only be realised if people are referred early to <a href="https://palliativecare.org.au/resource/what-is-palliative-care/">palliative care</a> – ideally from the time they are diagnosed with a terminal illness. Unfortunately, this rarely happens and palliative care tends to blur with <a href="https://www.nia.nih.gov/health/providing-comfort-end-life">end-of-life care</a>. The latter is for people who are likely to die within 12 months but is often left to the last few weeks.</p> <figure><iframe src="https://www.youtube.com/embed/qMbq0fP9kr4?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Palliative is not just for the very end of someone’s life.</span></figcaption></figure> <h2>Palliative care can involve difficult conversations</h2> <p>Palliative care provides a time to ask some usually taboo questions. What kind of death do you want to experience? Who is in your personal network? How will they respond to your life ending? What kind of support can they offer?</p> <p>Palliative care can be provided at home, hospital, hospice or residential aged care facility, depending on the preference and circumstances of patients and their family carers.</p> <p>In general, patients are referred by their treating specialist, health professional or GP. Patient preferences for care and what matters most to them are discussed with their doctor or other health professionals and with their loved ones with <a href="https://www.advancecareplanning.org.au/">advance care planning</a>. These discussions can include information on their preferred place of care, preferred place of death, personal care needs such as dietary preferences and religious and spiritual practices.</p> <p>This helps those caring to make decisions about the patient care when the patient cannot anymore. However, advance care planning can start at any time in life and without a diagnosis.</p> <h2>How palliative care delivery has changed</h2> <p>Once upon a time, we were born at home and we died at home. Death was a social event with a medical component. Now it is close to the opposite. But research indicates a solely clinical model of palliative care (mainly symptom management funded through the health system) is <a href="https://www.mdpi.com/2227-9032/9/12/1615">inadequate</a> to address the complex aspects of death, dying, loss and grief.</p> <p>A <a href="https://www.phpci.org/">public health</a> palliative care approach views the community as an equal partner in the long and complex task of providing quality health care at the end of someone’s life. It promotes conversations about patients’ and families’ goals of care, what matters to them, their needs and wishes, minimising barriers to a “good death”, and supporting the family post-bereavement.</p> <p>These outcomes require the involvement of family carers, friendship networks and not-for-profit organisations, where more detailed conversations about life and death can happen, instead of the “pressure cooker” rushed environment of hospitals and clinics. Investment could develop stronger <a href="https://pubmed.ncbi.nlm.nih.gov/29402101/">death literacy</a> and grief literacy in the community and among health professionals, who may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312518/#:%7E:text=Some%20struggle%20with%20the%20limitations,lead%20in%20opening%20a%20dialogue">reluctant</a> to raise or discuss these topics. This would likely see the take up of advance care planning increase, from the current low levels of <a href="https://www1.racgp.org.au/newsgp/clinical/advance-care-planning-in-an-ageing-population#:%7E:text=A%20paper%20exploring%20the%20cognitive,advance%20health%20directive%20in%20place.">less than 15%</a> of Australians (<a href="https://theconversation.com/only-25-of-older-australians-have-an-advance-care-plan-coronavirus-makes-it-even-more-important-144354">25% of older Australians</a> accessing health and aged-care facilities).</p> <p>One such successful approach is the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720808/">Compassionate Communities Connectors Program</a> in Western Australia, using trained <a href="https://comcomnetworksw.com/compassionate-connectors-program/">community volunteers</a> to enhance the social networks of terminally ill people.</p> <p>Our research trial trained 20 community volunteers (“connectors”) and 43 patients participated over 18 months. In sourcing others to help (who we called “caring helpers”), connectors built the capacity of the community and social networks around patients in need. Caring helpers assisted with transport, collecting prescriptions, organising meals and linked clients to community activities (such as choirs, walking groups, men’s shed). And they helped complete advance care planning documentation. About 80% of patients’ needs were social, particularly around reducing feelings of isolation.</p> <p>Patients in the trial had fewer hospital admissions and shorter hospital stays.</p> <h2>Tailored to need</h2> <p>Palliative care should be tailored to each person, rather than a one-size-fits-all clinical model that doesn’t respect autonomy and choice.</p> <p>Many people are dying in a way and a place that is not reflective of their values and their end-of-life is interrupted with preventable and costly admissions to hospital where control and even dignity are surrendered. Palliative care hospitalisations have <a href="https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia/contents/summary">increased</a> in recent years compared to all hospitalisations, with 65% of such admissions ending with the patient dying in hospital.</p> <p>It is unrealistic and unaffordable to have a palliative care service in every suburb. There needs to be a shift to a more comprehensive, inclusive and sustainable approach, such as Compassionate Communities, that recognises death, dying, grief and loss are everyone’s business and responsibility.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205488/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/samar-aoun-1437641">Samar Aoun</a>, Perron Institute Research Chair in Palliative Care, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-actually-is-palliative-care-and-how-is-it-different-to-end-of-life-care-205488">original article</a>.</em></p>

Caring

Placeholder Content Image

Madonna rushed to intensive care

<p dir="ltr">Madonna was rushed to a hospital in New York and admitted into the ICU on Saturday after being found unresponsive. She has since been treated for a serious bacterial infection.</p> <p dir="ltr">The <em>Material Girl </em>was intubated for at least one night but is now reportedly out of the ICU, alert and recovering, according to Page Six.</p> <p dir="ltr">The singer had her daughter, Lourdes Leon, by her side during the entire ordeal.</p> <p dir="ltr">Madonna’s longtime manager, Guy Oseary, has released a statement on Instagram regarding the incident.</p> <p dir="ltr">“On Saturday June 24, Madonna developed a serious bacterial infection which led to a several day stay in the ICU,” he started the post.</p> <p dir="ltr">“Her health is improving, however she is still under medical care. A full recovery is expected,” he added.</p> <p dir="ltr">Oseary also announced that all of the singer’s current commitments including her upcoming world tour have been “paused” due to the medical emergency, however further details will be provided with new dates for the tour “as soon as we have them”.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CuC6w1TPH_l/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CuC6w1TPH_l/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Guy Oseary (@guyoseary)</a></p> </div> </blockquote> <p dir="ltr">The “Celebration” tour highlighting her greatest hits and the 40th anniversary of her breakout single, <em>Holiday</em> was set to kick off on July 15 in Vancouver and wrapped up in Amsterdam on December 1.</p> <p dir="ltr">Fans and celebrities alike have sent their love and report for the recovering star in the comment section of Oseary’s post.</p> <p dir="ltr">“Hope she feels better very soon!” commented <em>New Girl</em> actor Zoey Deschanel.</p> <p dir="ltr">“Sending her so much love from us. ❤️❤️❤️” wrote Aussie actress Isla Fisher.</p> <p dir="ltr">“Omg sending her love and healing light! 🙏” commented Ariana Grande’s brother Frankie.</p> <p dir="ltr">“Please send her my love and support. I’ll be sending prayers for her healing ❤️❤️🙏🙏,” wrote one fan.</p> <p dir="ltr">“Health is everything. Take as much time as needed,” commented another.</p> <p dir="ltr"><em>Images: Getty</em></p>

Caring

Placeholder Content Image

The best skin-care routine for oily skin, according to dermatologists

<p><strong>What is oily skin?</strong></p> <p>Oily skin is exactly what it sounds like: skin characterised by the production of a lot of oil. If you’re constantly dealing with shininess, always feel like your face has been hit by an oil slick by the end of the day or tend to notice a bit of oil buildup across your nose and forehead, it may be time to invest in a skin-care routine for oily skin.</p> <p>Need another reason to target oily skin with your daily regimen? Because it produces so much oil (also known as sebum), this skin type often goes hand in hand with acne. But take heart: if you’re battling breakouts, you’re in good company. According to the Australasian College of Dermatologists, acne is the most common of skin diseases and up to 85 per cent of Australians will develop it during their lifetime.</p> <p>Luckily, there are great skin-care formulations that can help oily skin avoid acne and stay healthy, and some formulas may even help curb oil production. Finding the best skin-care routine for oily skin just takes a little know-how, so we reached out to board-certified dermatologists Dr Corey L. Hartman and Dr David Kim to find out what makes a great oily-skin routine.</p> <p><strong>What causes oily skin?</strong></p> <p>“Oily skin is genetic, and it has to do with the size and activity of the oil glands that are associated with the hair follicles,” Dr Hartman explains. “That means if you have thicker hair, you may have thicker or larger oil glands.”</p> <p>Another thing that can impact the amount of oil your skin produces? Hormones. That’s why acne, which is so often associated with oily skin, commonly shows up during puberty, and for those who menstruate, around their periods.</p> <p>Now that you know what triggers oiliness, it’s time to put together your ideal skin-care routine for oily skin – and it’s simpler than it sounds. As Dr Kim notes, when it comes to oily skin types, less is more. “It’s best not to add too many layers for oily skin,” he says. “Otherwise, it can clog your pores and cause acne flares.”</p> <p>If you’re ready to get glowing (but not shiny!) skin, follow the regimen below. Trust us: skin care for oily skin has never been easier.</p> <p><strong>Skin-care routine for oily skin</strong></p> <p>The heart of a good skin-care routine for oily skin has four main daily steps:</p> <p>Cleanser</p> <p>Toner</p> <p>Moisturiser</p> <p>Sunscreen</p> <p>There are additional steps you can add in if necessary or as needed:</p> <p>Exfoliator</p> <p>Acne treatment</p> <p>If hitting all those steps sounds intimidating, don’t worry. We have everything you need to know, including product recommendations.</p> <p><strong>1. Cleanser</strong></p> <p>Every good skin-care routine – including one for oily skin – begins with a good cleanser. You want to use it twice a day: once in the morning to prep your skin to apply your products, and again at night to take off any debris you’ve collected throughout the day.</p> <p>You might’ve heard that you can skip a morning cleansing, but rinsing without washing is better suited to a skin-care routine for dry skin. If yours is oily, go ahead and use a cleanser in the morning and at night.</p> <p>Dr Hartman says that for oily skin, the best face wash is likely “something a little astringent” that uses hydroxy acids or benzoyl peroxide. “You don’t want to do so much that it pushes you in the direction of overly drying,” he explains. That can lead your skin to produce more oil, a process called rebound oiliness.</p> <p>As for the best face wash formulations, Dr Hartman recommends staying away from oils, which can sometimes be comedogenic. (In other words, they can clog your pores.) Instead, look for gel, foam or cream cleansers.</p> <p><strong>2. Toner</strong></p> <p>Toner is technically an optional skin-care step, but many dermatologists recommend it for oily skin because it can help regulate sebum. These watery formulas are meant to eliminate any leftover makeup and grime left after cleansing, while treating the skin with helpful ingredients.</p> <p>What’s the best way to use them? “Once or twice a day on a cotton pad,” says Dr Kim. “Apply to [your] full face.”</p> <p>The best toner for you depends on your goals: Are you aiming for better skin texture? Regulated oil production? A combination of both? According to Dr Kim, if you have oily skin, look for gentle exfoliating acids, such as glycolic or lactic acid, to gently resurface the skin. Or go with salicylic acid to help with sebum control.</p> <p>You’ll know you’ve found the right one when your skin feels soft and smooth after use, not tight or dry. Luckily, unlike the harsh toners of the past, today’s formulas are much gentler and more foolproof.</p> <p><strong>3. Moisturiser</strong></p> <p>Yes, oily skin needs moisturiser. It may sound counterintuitive, but keeping your skin moisturised means it won’t have to work as hard to keep hydration levels up! In fact, Dr Hartman says it’s one of the keys to holding off rebound oiliness. You want to use it morning and night, after cleansing.</p> <p>When looking for the best moisturiser for oily skin, the formula is everything. “I like things that are less creamy and more like a serum or gel base,” says Dr Hartman. “You want something light, nothing too heavy, nothing too emollient,” he explains. In other words, look for terms like daily or sheer, and skip thicker formulas – night creams and bottles marked intense may be too heavy for oily skin. One thing to stay away from: oils, as they can be comedogenic, meaning they may clog pores.</p> <p><strong>4. Sunscreen</strong></p> <p>Sun damage impacts every skin type, including oily skin, so having SPF in your morning routine is non-negotiable. And, yes, that means you need to use it year-round, even on cloudy days and in the winter.   (And don’t forget the scalp sunscreen!)</p> <p>Admittedly, sunscreen can make your skin look a little oily, so finding a nongreasy sunscreen is essential (more on that in a second). But Dr Kim reassures us that’s not impossible. “If you’re using good skin care that helps exfoliate and regulate sebum production, you should be able to wear sunscreen without feeling too greasy,” he says.</p> <p>When it comes to the best face sunscreens for oily types, lightweight daily formulas win. Just be sure yours has an SPF of 30 or higher.</p> <p>Whether you reach for a mineral or chemical sunscreen is a matter of personal preference, and it often comes down to how they wear on your skin (mineral sunscreens can sometimes leave a white cast). “The goal is to find your favourite sunscreen – chemical or mineral – and actually use it every day,” says Dr Kim.</p> <p>Powder sunscreens are a good option for touching up oily skin – they allow you to reapply SPF on the go while soaking up oil. Sunscreen oils, on the other hand, are best avoided. “These can clog the pores,” he says.</p> <p><strong>Exfoliant</strong></p> <p>Exfoliators help remove the dead skin cells that can mix with sebum and clog pores, which is why exfoliating can be an important step in your routine.</p> <p>There are two categories of exfoliants: chemical (like glycolic and salicylic acid or retinols, which increases cell turnover) and physical (scrubs that use friction). Dr Hartman recommends starting with chemical exfoliators, as “they’re a more controlled way of exfoliation,” he says.</p> <p>Apply an exfoliator once or twice a week – or more if your skin can handle it – either in the morning or at night. You may need to start slow, only using it more often if you don’t experience irritation. Beyond that, exfoliate only for very special events, when you really want a glow. That way, you won’t trigger irritation.</p> <p>Dr Hartman’s go-to products for oily skin are prescription retinoids or over-the-counter retinols – not surprising, as these vitamin A derivatives are darlings of the dermatology world. But retinoids are harsh chemicals. “For retinol, start using a pea-size [amount] only twice weekly, and let your skin develop tolerance,” says Dr Kim. You’ll want to apply retinol at night and be extra careful about wearing sunscreen during the day.</p> <p>For people who don’t tolerate them well, Dr Hartman says an alpha hydroxy acid (like glycolic acid) or beta hydroxy acid (like salicylic acid) is a great alternative. If you prefer a physical facial scrub, remember: the finer the particles, the better.</p> <p><strong>Acne treatment</strong></p> <p>First, forget about spot-treating blemishes – if you’re dealing with acne, Dr Kim insists it’s best to treat your whole face. That way, you prevent breakouts before they have a chance to form. And if you’re struggling with breakouts, he says, “you should use at least one prescription cream on your full face to treat existing pimples and prevent new ones.”</p> <p>Heads up: retinoids don’t just aid exfoliation; they can treat acne too. If you’re using a retinoid for acne control and have sensitive skin, you may want to consider this your combo acne and exfoliating treatment. It covers both needs, and including an additional exfoliant in your skin-care routine may cause irritation, especially if your skin is sensitive.</p> <p>If acne is something you grapple with more than occasionally, see your dermatologist for a prescription cream – your doctor will pick the formula that’s best for your skin. If it’s a retinoid, you’ll use this at night.</p> <p>But if you only experience the occasional pimple and would rather go for an over-the-counter option, you’ve got some choices. First things first: you’re going to want a cream rather than a medicated face wash. Sure, face washes offer some acne-fighting ingredients, but you wash them away almost immediately. “Acne wash stays on your face for five seconds, so you need something that will stay on your skin the whole day or night,” Dr Kim explains.</p> <p>While you may see a few other ingredients (like azelaic acid) pop up in the acne world, when it comes to OTC options, there are two all-star ingredients: salicylic acid and benzoyl peroxide. Both are effective, but of the two, benzoyl peroxide tends to get a little more love – it’s especially effective when combined with antibiotics (under a doctor’s care), according to the Mayo Clinic.</p> <p>Just be aware that it can bleach fabrics, so make sure to let it really soak in before getting dressed. And, again, make sure to apply it to your whole face, not just one pimple. Remember, your goal is to avoid pimples in the first place.</p> <p><strong>Skin-care tips experts swear by</strong></p> <p>Armed with our dermatologist-approved skin-care routine for oily skin, you’re well on your way to a less-greasy face. But there are a couple more things to consider as you follow this regimen.</p> <p><strong>Skin care and exercise</strong></p> <p>You know you need to wash your face in the morning and at night. But what if you’re feeling particularly grimy midday? If you work out in the middle of the day, for instance, should you wash your face if you have oily skin? “You probably don’t need to do that,” says Dr Hartman. “Twice a day is enough.”</p> <p>Adding an additional cleansing session may dry your skin out, causing more oiliness. You do want to rinse your face, however. That’ll prevent the sweat, debris and oil from mixing and clogging your pores. And it has the added bonus of leaving you refreshed after a gruelling workout.</p> <p><strong>Smart product use</strong></p> <p>Take your time when introducing ingredients. Before slathering a new product all over your face, do a spot test to make sure your skin can handle it. And when dealing with ingredients like benzoyl peroxide and retinoids, which some people find irritating, start slow to acclimate your face, building to more frequent use as your skin adjusts to the ingredient.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/the-best-skin-care-routine-for-oily-skin-according-to-dermatologists?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Beauty & Style

Placeholder Content Image

Be careful around the home – children say Alexa has emotions and a mind of its own

<p>Is technology ticklish? Can a smart speaker get scared? And does the robot vacuum mind if you put it in the cupboard when you go on holidays?</p> <div> <p>Psychologists from Duke University in the US asked young children some pretty unusual questions to better understand how they perceive different technologies.</p> <p>The researchers interviewed 127 children aged 4 – 11 years old visiting a science museum with their families. They asked a series of questions seeking children’s opinions on whether technologies – including an Amazon Alexa smart speaker, a Roomba vacuum cleaner and a Nao humanoid robot – can think, feel and act on purpose, and whether it was ok to neglect, yell or mistreat them.</p> <p>In general, the children thought Alexa was more intelligent than a Roomba, but believed neither technology should be yelled at or harmed. </p> <p>Lead author Teresa Flanagan says “even without a body, young children think the Alexa has emotions and a mind.” </p> <p>“Kids don’t seem to think a Roomba has much mental abilities like thinking or feeling,” she says. “But kids still think we should treat it well. We shouldn’t hit or yell at it even if it can’t hear us yelling.”</p> <p>Overall, children rejected the idea that technologies were ticklish and or could feel pain. But they thought Alexa might get upset after someone is mean to it.</p> <p>While all children thought it was wrong to mistreat technology, the survey results suggest the older children were, the more likely they were to consider it slightly more acceptable to harm technology.</p> <p>Children in the study gave different justifications for why they thought it wasn’t ok to hurt technology. One 10-year-old said it was not okay to yell at the technology because, “the microphone sensors might break if you yell too loudly,” whereas another 10-year-old said it was not okay because “the robot will actually feel really sad.”</p> <p>The researchers say the study’s findings offer insights into the evolving relationship between children and technology and raise important questions about the ethical treatment of AI and machines in general. For example, should parents model good behaviour for by thanking technologies for their help?</p> <p>The results are <a href="https://psycnet.apa.org/doiLanding?doi=10.1037/dev0001524" target="_blank" rel="noreferrer noopener">published</a> in <em>Developmental Psychology</em>. </p> </div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/technology/be-careful-around-the-home-children-say-alexa-has-emotions-and-a-mind-of-its-own/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Petra Stock. </em></p> <p><em>Images: Getty</em></p> </div>

Technology

Placeholder Content Image

The truth about video games in aged care homes

<p>Video games sound like a great way to bring senior community homes together, but are they really?</p> <p>A recent study decided to test this theory, based on past studies that have found positive effects as a result of introducing video games into senior homes.</p> <p>Dr. Kathrin Gerling led the project with Dr Regan Mandryk and Dr Conor Linehan. The study implemented a weekly gaming session in two care facilities over a three-month period of time.</p> <p>The games introduced included motion-based games like those of Nintendo Wii and Xbox 360.</p> <p>According to Dr. Gerling, "We were interested in the potential of games to engage older adults in long-term care in group activities. We looked at how people approached video games, to see if they stuck with it and found it enjoyable, and also to find out if this stimulated group activities and resulted in friendships.”</p> <p>The senior users caught on quickly, as Gerling expanded: “Players at the senior residence quickly understood how the games worked and it became an actual group activity. People formed relationships, took more ownership and adapted games to fit in with how they wanted to play.”</p> <p>Still, the experiment brought forth the reality of difficulties the games presented: “We found it more difficult to bring people together at the care home, mostly because of different age-related impairments. In some cases, players needed a lot of support from staff, and depended on them being able to attend gaming sessions."</p> <p>Gerling proposed that while the games benefited some seniors, others may have found more negative results: "You always have a split of people who like playing video games and those who don't, no matter what age. But older people learning to play new games in public may feel particularly uncomfortable if they are experiencing vulnerability over their age-related changes and impairments. Some older adults require extensive support, both to gain access to gaming sessions and throughout play.”</p> <p>Gerling outlined the necessary means for all community members to receive benefit from playing video games: "We need to make sure that video games created for older adults in long-term care are adaptive – there's a fine line between challenging people and giving them something meaningful to accomplish, as opposed to doing harm. To be successful games need to engage players of all abilities and be tailored towards specific groups. It's really important to be mindful of the context in which games will be played and be understanding of the individual abilities of the player. This is particularly important when evaluating the value of games for improving the quality of life, and when creating games with a purpose beyond entertainment, such as therapy and rehabilitation."</p> <p><strong>Related links:</strong></p> <p><strong><span style="text-decoration: underline;"><em><a href="../health/wellbeing/2015/08/start-exercising-when-youre-older/">Start exercising at any age</a></em></span></strong></p> <p><strong><span style="text-decoration: underline;"><em><a href="../health/wellbeing/2015/07/dementia-phone-screening/">Would you consider being screened for dementia over the phone?</a></em></span></strong></p> <p><strong><span style="text-decoration: underline;"><em><a href="../health/wellbeing/2015/07/top-health-worries-of-60-year-olds/">Top 10 health worries when you’re 60-plus (and how to beat them)</a></em></span></strong></p> <p><em>Image credit: Shutterstock</em></p>

Mind

Placeholder Content Image

"Devotion, honesty, caring": Goldie Hawn reveals why she and Kurt never married

<p>Goldie Hawn has honoured Kurt Russell on his 72nd birthday after they revealed why they never married.</p> <p>Hawn shared a photo on Instagram of her partner of 40 years.</p> <p>“Happy birthday to the wacky man in my life! I love you baby ❤️, ” she said.</p> <p>Hawn’s son, Oliver Hudson, took to the comments and wrote, “Love this pic!!! Hahahah … Sums up your entire 40 years of togetherness.”</p> <p>The actress’ daughter Kate Hudson also shared an Instagram post dedicated to Russell, her unofficial stepdad.</p> <p>She posted a sweet video of her daughter Rani helping Russell blow out his birthday candle.</p> <p>“Always a double fun day in our family! St Patrick’s day and Pa’s birthday! Love this man so much! How about some birthday love for Kurt! Happy Birthday Pa,” she captioned the video.</p> <p>The birthday wishes come after Russell and Hawn’s recent interview with Variety where one of Hollywood’s longest-standing relationships revealed they were “constantly” asked why they were never married.</p> <p>“We constantly got asked, ‘When are you going to get married? Why aren’t you married?’” Russell told the outlet, referring to the early years of their relationship back in the 80s.</p> <p>“And we were like, ‘Why does anybody care about that?’” he added. “We’d asked our kids if they cared about it. They didn’t. We didn’t.”</p> <p>The pair first met when they appeared in the 1966 comedy, <em>The One and Only, Genuine, Original Family Band</em>. She was 21 and Russell was 16 at the time. Hawn recalled Russell as being “adorable” but also “much too young” for her to date.</p> <p>The couple got together in 1983 and recently celebrated four decades of partnership on Valentine’s Day 2023.</p> <p>It seems as though the couple’s philosophy on long-standing relationships is to simply not get married.</p> <p>“We have done just perfectly without marrying. I already feel devoted and isn’t that what marriage is supposed to do? So as long as my emotional state is in a state of devotion, honesty, caring, and loving, then we’re fine,” Hawn said in an interview with <em>Woman’s Day</em> in 2007.</p> <p>“We have raised our children brilliantly; they are beautiful people. We did a great job there, and we didn’t have to get married to do that. I like waking up every day and seeing that he is there and knowing that I have a choice,” she shared. “There is really no reason to marry.”</p> <p><em>Image credit: Instagram/Getty</em></p>

Relationships

Placeholder Content Image

5 tips to take the best care of your voice for everyone who sings, from a speech pathologist

<p>The care of your singing voice is crucial to maintain a healthy and long-life voice. </p> <p>Professional singers often have teams of people keeping their voices healthy, and they have received lots of training in how to take care of their voice.</p> <p>But everyone who sings – from young students to passionate amateurs – should be taking care of their voice.</p> <p>If you are a singer, here are five crucial tips to prevent vocal problems.</p> <h2>1. Keep hydrated</h2> <p>Hydration is the most important fact to be considered when singing. </p> <p>When we are dehydrated, the biomechanical properties of our vocal folds are impacted, decreasing our vocal range and increasing the stress on these folds.</p> <p>Singers who do not hydrate well are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925668/">at risk</a> of developing voice disorders such as nodules and polyps.</p> <p>An easy way to stay hydrated is to keep up your water consumption. Singers can complement this by using nebulisers and humidifiers.</p> <p>Humidifiers balance out dry air caused by heating or air conditioning. </p> <p>Nebulisers assist with hydration directly. By breathing in a saline water solution or purified water, we can see an immediate influence on our vocal folds. </p> <p>You don’t need fancy equipment. You can also breathe in steam from boiled water. Make sure to be careful with the temperature, as steam can burn our airway when it is too hot. Pour boiled water into a bowl, wait 5-7 minutes, place a towel over your head and then breathe in as many times as you like. </p> <h2>2. Warm-up and cool-down your voice</h2> <p>Vocal warm-up and cool-down exercises are <a href="https://www.sciencedirect.com/science/article/pii/S0892199717300176">crucial</a>: these will have a positive benefit on your voice in the moment and prevent future injuries. </p> <p>An easy warm-up you can try only requires a straw. With a straw between your lips into the air or a cup of water, make a “u” sound. Working for five minutes, change the pitch and frequency of making this sound. The added resistance of singing through a straw will give your vocal folds a good work out.</p> <p>You can also add resistance by speaking or singing into a CPR mask.</p> <p>Other exercises don’t require these materials. You can try lips or tongue trills, humming and blowing raspberries. </p> <p>While there are many internet tutorials on how to do these exercises, I suggest you practise under professional supervision to avoid damaging your voice by going beyond your vocal limits. </p> <h2>3. Watch your lifestyle factors</h2> <p>Lifestyle is fundamental when taking care of our voices.</p> <p>In order to avoid injuries or develop any voice disorders, we should monitor external factors such as maintaining <a href="https://wp.stolaf.edu/musician-health/nutrition-eating-and-singing/">a balanced diet</a>, having <a href="https://wp.stolaf.edu/musician-health/resting-your-voice/">periods of rest</a> and reducing the consumption of <a href="https://tobaccofreelife.org/resources/smoking-singing/">cigarettes</a>, <a href="https://www.openmicuk.co.uk/advice/alcohol-and-singers/">alcohol</a>, <a href="https://www.openmicuk.co.uk/advice/how-much-can-recreational-drugs-affect-singing/">drugs</a>, <a href="https://www.openmicuk.co.uk/advice/is-coffee-good-or-bad-for-singers/">caffeine</a> and <a href="https://www.openmicuk.co.uk/advice/are-fizzy-drinks-good-or-bad-for-singers/">soft drinks</a>. </p> <p>By changing these habits, you can preserve good vocal health and keep your body running properly. You can also guard against developing reflux.</p> <p>Reflux occurs when acids from your stomach travel back up your throat. Symptoms include a burning sensation in your chest (heartburn), backwash (regurgitation) of food or sour liquid, upper abdominal or chest pain, trouble swallowing (dysphagia) or a sensation of a lump in your throat. </p> <p>This stomach acid can <a href="http://www.healthsystem.virginia.edu/docs/per/diet-tips-for-gastroesophageal-reflux-disease-gerd/handout_view_patient/@@getDocument">dry and irritate</a> your vocal folds. </p> <p>If you do experience any of these symptoms, keep up your water intake, try to avoid lying down for at least two to three hours after a meal and keep your head elevated using an extra pillow or two while you sleep. </p> <p>If these symptoms persist, visit your doctor for further examination.</p> <h2>4. Listen to your body</h2> <p>Sometimes our body sends signals when struggling. We should pay close attention to what our bodies are telling us.</p> <p>Negative warning signs can include a reduced tonal range, constant throat clearing, vocal fatigue, pain during or after singing or talking, mild or moderate abdominal tension, unstable voice, pitch breaks, difficulty singing or speaking softly. </p> <p>Speaking or singing should not present with any negative symptoms or conditions. </p> <p>It’s important to note home remedies like tea with honey, lemon and ginger, and gargles with salty water – or even alcohol – <a href="https://theconversation.com/how-to-actually-fix-a-lost-voice-according-to-science-hint-lemon-and-honey-doesnt-work-158230">do not</a> fix your voice. These will go directly to the oesophagus and will not have any effect on your vocal folds.</p> <p>If you are experiencing symptoms like these, pay more attention to things like your warm up, your cool down, periods of rest and your levels of hydration. If they persist, visit a doctor or a speech pathologist.</p> <h2>5. See a professional</h2> <p>Don’t try and push through any pain or difficulties you are facing.</p> <p>When facing any vocal difficulty, you should visit an ear, nose and throat doctor (ENT) or a speech pathologist. </p> <p>An ENT can check your larynx and other structures to make sure you do not have any organic or functional disorders impacting your voice.</p> <p>If you would like to practise new techniques – like belting or voice distortions – consult with voice specialists like speech pathologists, vocal coaches or music teachers who are experts on these areas. </p> <p>Last but not least, check your voice with professionals once a year. This will help with the prevention of future injuries and help you maintain a healthy voice.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/5-tips-to-take-the-best-care-of-your-voice-for-everyone-who-sings-from-a-speech-pathologist-193222" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Music

Placeholder Content Image

"OMG that's Nicole Kidman!": Magic moment at Hugh Jackman's Broadway fundraiser

<p dir="ltr">Nicole Kidman surprised fans when she appeared at fellow Aussie Hugh Jackman’s Broadway show. </p> <p dir="ltr">The actress attended New York's The Winter Garden Theatre to watch Hugh’s <em>The Music Man</em> show and was ready to dig deep into her pockets to support a charity. </p> <p dir="ltr">During a break in the show, Hugh came back on stage and announced that he will be auctioning off his signed hat.</p> <p dir="ltr">The winning bidder will see their proceeds going to Broadway Cares – a nonprofit US organisation that helps provide medicine, health care, and meals to those in need. </p> <p dir="ltr">As the bidding started, Nicole could be heard offering a huge US$100,000 (AU$150,000) for the hat and was met with cheering from the crowd. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CldqPWVOr1z/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CldqPWVOr1z/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Hugh Jackman (@thehughjackman)</a></p> </div> </blockquote> <p dir="ltr">Nicole won the bid and made her way to the stage as the crowd applauded her generosity. </p> <p dir="ltr">Later on Instagram, Hugh thanked her for her generosity in a post that showed him handing over the hat to her. </p> <p dir="ltr">“The generosity and love emanating from @nicolekidman leaves me speechless. Thank you Nic for your friendship and support! @musicmanbway @nicholastheward @bcefa,” he wrote.</p> <p dir="ltr">She replied: “Darling Hugh, To my friend of 30 years. Right back at you such a generous gorgeous man, it was a brilliant night in the theatre and an honor to be able to donate to @bcefa! + Congratulations to the talented cast.”</p> <p dir="ltr"><strong>Check out the amazing moment in full <a href="https://celebrity.nine.com.au/latest/nicole-kidman-hugh-jackman-the-music-man-broadway-show-bids-150000-for-hat/5d6a88fc-a056-4d33-9a66-a66e41c3ddb9" target="_blank" rel="noopener">here</a>. </strong></p> <p dir="ltr"><em>Image: Instagram</em></p>

Caring

Placeholder Content Image

“People are going to die”: Over 1000 uncared for after council aged care services end

<p dir="ltr">More than 1000 elderly residents on Victoria’s Mornington Peninsula have been left without care after the local council stopped providing care services and made more than 110 staff redundant.</p> <p dir="ltr">In July, private aged care service providers took over the care of more than 3500 residents who had previously been cared for by the council, with 2063 people transferred to Mecwacare and 1554 to Bolton Clarke, per <em><a href="https://www.watoday.com.au/national/victoria/nobody-s-checked-i-m-alive-more-than-1000-stranded-as-council-retreats-from-aged-care-20220808-p5b81l.html" target="_blank" rel="noopener">WA Today</a></em>.</p> <p dir="ltr">Aimee Bonfield, a spokeswoman for Bolton Clarke, said “essential services” were being provided for 300 residents, with services starting or scheduled for another 200.</p> <p dir="ltr">“All remaining clients have been contacted and we remain in touch on a regular basis to update on progress and to address any immediate needs,” she said. </p> <p dir="ltr">“Bolton Clarke has a strong track record of understanding local needs and supporting wellbeing and independence for older people on the Mornington Peninsula.”</p> <p dir="ltr">But, at least 1000 residents have been left without care, including Barbara Rimington, who has a fused back from spinal surgery and has undergone surgery for lung cancer and was receiving assistance with cleaning from the council.</p> <p dir="ltr">Since Bolton Clarke took over on July 1, the 77-year-old said she hasn’t received any care and is “one of the luckier ones” because she is still relatively independent.</p> <p dir="ltr">“The council said they are monitoring,” she said. “Pig’s arse they are. Nobody has contacted me to see if I am still alive.”</p> <p dir="ltr">Rimington said she was worried for others who needed help with shopping, since there are limited delivery options available on the peninsula.</p> <p dir="ltr">“Are any of these people eating?” she said. “People are going to die. Some people are totally isolated. It’s an indictment on the whole of society.”</p> <p dir="ltr">89-year-old Michael Nolan said he and his wife, 85, were left in the lurch by Mecawacare and haven’t received care for more than a month.</p> <p dir="ltr">The council used to provide assistance to Nolan once a fortnight, helping with cleaning and tasks around the home, such as checking smoke alarms, changing light bulbs, and changing bed sheets.</p> <p dir="ltr">“[Mecwacare] has been on the job since July 1 and nothing is happening,” he said. </p> <p dir="ltr">“We have to try and do the cleaning ourselves and we tackle it a little bit at a time, but it takes us days and days to do because I can’t bend down, otherwise I fall over.</p> <p dir="ltr">“Mecwacare has had months and months to prepare for this. </p> <p dir="ltr">“It is typical of the former federal government, they want to give everything over to private enterprise.”</p> <p dir="ltr">Anthony Marsh, the mayor of Mornington Peninsula, said the council decided to “transition” away from using its own staff to prepare for the federal government’s open-market system, and that the council had no say in the providers that would replace them.</p> <p dir="ltr">“The peninsula had no provider other than council delivering these services and we needed to ensure our residents had choice and the advantage of a competitive market environment,” he said. </p> <p dir="ltr">“We did not get a say in the appointment of new providers; that was done by the federal government.”</p> <p dir="ltr">Marsh said the council was assured by both providers and the government that essential services would continue from July 1, and that an offer to keep some staff on “to help with the transition” was turned down.</p> <p dir="ltr">“The welfare of our older residents is a major priority for council, and we will continue to advocate to the federal government to make sure older people receive the support they need to remain independent and involved in the community,” he said.</p> <p dir="ltr">A government spokesman said the government was “continually reviewing” the transition and selection process for councils that chose to exit the Commonwealth home support program and was aware of the situation on Mornington Peninsula.</p> <p><span id="docs-internal-guid-e0887fa8-7fff-732a-46d4-1c85b94eac52"></span></p> <p dir="ltr">“The department is aware of the transition of clients from Mornington Peninsula Shire council to Mecwacare and Bolton Clarke and is actively working with My Aged Care and the providers on outstanding transition issues,” he said.</p> <p dir="ltr"><em>Image: Getty Images</em></p>

Legal

Placeholder Content Image

Australian women are less likely to receive pre-hospital stroke care than men

<p>Paramedics are failing to recognise strokes in women as much as they do for men, according to a new <a href="https://newsroom.unsw.edu.au/news/health/women-less-likely-receive-pre-hospital-stroke-care-men" target="_blank" rel="noreferrer noopener">study</a> of New South Wales stroke patients. Researchers suggest that clinician sex bias might be the cause.</p> <p>In 2018 it was <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/heart-stroke-and-vascular-disease-and-subtypes/stroke" target="_blank" rel="noreferrer noopener">estimated</a> that 387,000 Australians aged over 15 years had experienced a stroke at some point in their lives. The success of treatment is very time dependent, so it’s critical that patients suffering from stroke are identified as soon as possible, preferably before arriving at hospital.</p> <p>But according to the study by Australian researchers, women (aged under 70) suffering with stroke were less likely than men to receive stroke care management prior to hospital admission – despite being more likely to arrive at hospital by ambulance.</p> <p>This is concerning, as other research shows stroke outcomes are <a href="https://pubmed.ncbi.nlm.nih.gov/31719135/" target="_blank" rel="noreferrer noopener">generally worse</a> for women than men – with greater stroke-related disability and poorer subsequent quality of life.</p> <p>“Our study suggests that better recognition of stroke symptoms in women by ambulance staff could ensure the right treatment is started as early as possible and give them the best opportunity for recovery,” says lead author Dr Xia Wang, research fellow at The George Institute for Global Health in Sydney.</p> <p>There are two types of stroke: ischaemic stroke occurs when a vessel supplying blood to the brain becomes blocked, and haemorrhagic stroke occurs when one ruptures and begins to bleed. This can cause parts of the brain to die – resulting in impairment that can affect things like speech, movement, and communication – or can often be fatal.</p> <p>Thanks to development in medical research <a href="https://www.nhs.uk/conditions/stroke/treatment/" target="_blank" rel="noreferrer noopener">treatment for stroke</a> is changing, but the efficacy of these treatments is highly time-dependent and rapid and accurate pre-hospital assessment is critical for successful outcomes.</p> <p>“When stroke is not recognised early, delays can have serious consequences,” says co-author Dr Cheryl Carcel, senior research fellow and academic lead of the George Institute’s Global Brain Health Initiative.</p> <p>“Procedures for in-ambulance stroke care ensure patients with stroke symptoms are brought to a high-level specialised facility quickly to receive life-saving treatment.”</p> <p>In a population-based cohort study, researchers analysed data from more than  200,0000 patients (51% women) admitted to NSW hospitals between July 2005 and December 2018 and subsequently diagnosed as having a stroke.</p> <p>Just over half of all stroke patients were taken to hospital via ambulance, with women (52.4%) more likely than men (47.9%) to arrive this way.</p> <p>Despite this, women were less likely to receive stroke care management prior to hospital admission.</p> <p>“Among patients under 70 years of age, women were less likely than men to be assessed by paramedics as having a stroke, but there was no significant difference for older patients,” the authors say.</p> <p>Instead, they were more frequently assessed by paramedics as having conditions which mimic stroke – like headache or migraine, anxiety, and unconsciousness – which contributed to a delay in the recognition and treatment of stroke.</p> <p>There was no significant difference for older patients.</p> <p>Health professionals know that on initial presentation, <a href="https://pubmed.ncbi.nlm.nih.gov/31114842/" target="_blank" rel="noreferrer noopener">atypical clinical symptoms of stroke</a> occur more frequently in women. So, these findings could be due to a difference in symptoms, although it’s also possible that implicit sex bias exists amongst healthcare providers.</p> <p>“While there aren’t any studies looking at clinician sex bias in stroke, we have evidence from other countries where it is happening in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810172/" target="_blank" rel="noreferrer noopener">coronary artery disease</a>,” explains Carcel.</p> <p>This has also been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002870321001885?via%3Dihub" target="_blank" rel="noreferrer noopener">found</a> to be the case for myocardial infarction (heart attack), with women less likely to be assessed by paramedics as having MI than men.</p> <p>“Greater awareness among all health professionals about differences in symptom presentation between men and women could help address this bias,” concludes Carcel. “In the case of stroke, this is particularly important for ambulance staff, so that women are identified early and treatment is commenced even before they reach the hospital.”</p> <p>This article originally appeared on <a href="https://cosmosmagazine.com/people/australian-women-stroke-care/" target="_blank" rel="noopener">Cosmos</a>. </p> <p><em>Image: Getty</em></p>

Caring

Placeholder Content Image

5 self-care practices to help you move through loss

<p dir="ltr">Over the course of our lives, experiencing a loss becomes inevitable. We will all go through the pain of losing someone or something we love and cherish. While the pain of some losses are easier to process, others can feel overwhelming. Either way, self-care practices offer a safe environment where the loss can be explored on an emotional and spiritual level.</p> <p dir="ltr">Experiencing a loss is heart-breaking and the grief which comes with it is often heavy. It may be difficult to process the various emotions you are feeling and the uphill road towards healing may seem hard. However, with the right tools finding healing, inner peace and having the strength to move forward after a loss is possible.</p> <p dir="ltr">A self-care practice is the perfect tool when it comes to healing from deep sorrow. Such practice when performed with no judgement and self-compassion creates a cocoon around you where you can explore the loss without reliving the actual loss. This is because a self-care practice has a clear beginning and a clear ending making exploring emotions, feelings and needs within this setting safe. When you engage in a self-care practice you are saying a big yes to taking care of yourself and your needs. It creates space for you to gain the clarity you are seeking and the inner peace your heart is longing for. Let’s take a look at 5 self-care practices to help you move through the healing process:</p> <p dir="ltr"><strong>1. Take a walk in nature</strong></p> <p dir="ltr">It is a well-known fact that spending time in nature reduces stress, anxiety and uplifts emotional well-being. When you feel overwhelmed, take a break and seek a peaceful moment in nature. Take a companion with you if you feel more comfortable having someone with you. Before you start, set your intention. As you walk, allow yourself to connect with the tranquillity and the beauty which surrounds you. Dedicate this time to your healing.</p> <p dir="ltr"><strong>2. Keep a loss journal</strong></p> <p dir="ltr">Keeping a loss journal provides a space for reflection and soul-searching without judgement. Choose a notebook and pens you want to use for your journal. It is helpful to set a specific day and time in the week or month for journaling. Choose a space where you feel comfortable and can spend some time writing without any distractions. If writing seems daunting, try doodling, using collage, stickers and photos to capture your thoughts and feelings.</p> <p dir="ltr"><strong>3. Relaxation</strong></p> <p dir="ltr">Plan time for relaxation during your day. Create a cosy space at home where you can fully relax. Try this simple 5-minute relaxation: While seated comfortably, gently close your eyes and take a few breaths. When you are ready, place both hands on your heart space and continue to breathe gently. Connect with your breath, the here and now and allow your body to soften with each breath. As your body relaxes, so does your mind. After 5 minutes, you should feel energized as well as calm.</p> <p dir="ltr"><strong>4. Dance</strong></p> <p dir="ltr">When the sorrow you feel is too heavy and you feel stuck, dance. Dancing is an effective way to allow the grief to move through your body. Put your favourite music on and follow the beat. Dance until you feel your mood has lifted and you feel more relaxed.</p> <p dir="ltr"><strong>5. End the day with a grateful heart</strong></p> <p dir="ltr">Days often feel endless and are hard to get through following a loss. Before you go to sleep at night, find one thing you are grateful for. It can be the little things which often go unnoticed. By practising gratefulness you build resilience which in turn helps you move forward.</p> <p dir="ltr">Self-care, an aspect which is often overlooked, is a key element during the grieving and healing process. As you become accustomed to self-care practices, you may be drawn to create your very own practices. The key is to listen to your intuition.</p> <p dir="ltr"><strong>Corinne Laan is the author of The Art of Grieving: Gentle self-care practices to heal a broken heart (Rockpool Publishing, $29.95). Now available where all good books are sold and online at <a href="http://www.rockpoolpublishing.co/">www.rockpoolpublishing.co</a> </strong></p> <p dir="ltr"><em>Image: Shutterstock</em></p>

Caring

Placeholder Content Image

Moral injury: what happens when exhausted health workers can no longer provide the care they want for their patients

<p>Healthcare workers in New Zealand already face life-and-death decisions daily. But as multiple winter illnesses add pressure to a system already stretched by COVID, staff now also have to deal with <a href="https://www.stuff.co.nz/national/politics/local-democracy-reporting/300534812/covid19-union-and-frontline-worker-say-staff-at-middlemore-hospital-facing-increasing-abuse" target="_blank" rel="noopener">daily abuse</a>, acute <a href="https://www.newshub.co.nz/home/new-zealand/2022/05/christchurch-hospital-cancels-surgeries-as-it-hits-112-pct-capacity.html" target="_blank" rel="noopener">staff shortages</a> and <a href="https://www.1news.co.nz/2022/06/17/dhb-clashes-with-union-over-stretched-palmerston-north-ed/" target="_blank" rel="noopener">unsafe working conditions</a>. At times, they cannot provide the care they would like for their patients.</p> <p>The impact on health workers is often described as <a href="https://www.nzherald.co.nz/rotorua-daily-post/news/great-minds-health-workers-on-covid-19-frontlines-burnt-and-bled-by-two-years-of-virus/T7JXOXGXEKKCICUNOMUJYT4QWM/" target="_blank" rel="noopener">stress and burnout</a>. The consequences of this prolonged pressure can be seen in the number of <a href="https://www.nzdoctor.co.nz/article/undoctored/acem-welcomes-111b-health-nz-budget-urges-fixes-health-workforce-crisis" target="_blank" rel="noopener">doctors</a>, <a href="https://www.nzherald.co.nz/nz/nursing-shortage-nurses-broken-while-sector-faces-thousands-of-vacancies/L7NUXOPG4AB472OKXOH5QJSUMU/" target="_blank" rel="noopener">nurses</a> and other <a href="https://capsulenz.com/be/therapist-shortage-nz/" target="_blank" rel="noopener">health professionals</a> leaving their jobs for overseas positions and the private sector, or being lost to their professions completely.</p> <p>Many of these healthcare workers may well be suffering from a more serious form of psychological distress than burnout: moral injury.</p> <p><a href="https://www.phoenixaustralia.org/wp-content/uploads/2020/07/Moral-Stress-Healthcare-Workers-COVID-19-Guide-to-Moral-Injury.pdf" target="_blank" rel="noopener">Moral injury</a> refers to the psychological, social and spiritual impact of events on a person who holds strong values (such as caring for patients) and operates in high-stakes situations (hospital emergency care), but has to act in a way inconsistent with those values.</p> <p>Examples include having to turn patients away despite them being in pain or discomfort; being unable to provide adequate care due to staff shortages; having to care for a dying patient isolated from their loved ones while wearing full protective gear.</p> <p>Symptoms of moral injury can include strong feelings of guilt and shame (about not being able to uphold healthcare values, for example) as well as high levels of anger and contempt towards the system that prevents proper care.</p> <p>High levels of self-criticism, loss of trust in people and organisations and a weakening of personal relationships are further <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00113-9/fulltext" target="_blank" rel="noopener">symptoms</a> of moral injury.</p> <p>It can be viewed as a <a href="https://www.afta.org/wp-content/uploads/2019/07/Physicians-aren%E2%80%99t-%E2%80%98burning-out.%E2%80%99-They%E2%80%99re-suffering-from-moral-injury..pdf" target="_blank" rel="noopener">more severe form of burnout</a>. But while burnout can happen in most workplaces, moral injury requires the three core components listed above.</p> <p><strong>From war to the operating table</strong></p> <p>The term moral injury arose in <a href="https://www.ptsd.va.gov/professional/treat/cooccurring/moral_injury.asp" target="_blank" rel="noopener">military psychology</a> to refer to situations where, for example, soldiers were unable to intervene to save lives in case they risked breaching the rules of engagement. More recently, the term has been adapted to apply to healthcare.</p> <p>Viewing the experiences of health workers through this lens can help us understand why they may experience a seesawing emotional state and the confusing conflict of simultaneously wanting to be at work while wishing they were anywhere but.</p> <p>For healthcare workers, understanding the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752815/#:%7E:text=Over%20time%2C%20these%20repetitive%20insults,is%20in%20some%20way%20deficient" target="_blank" rel="noopener">concept of moral injury</a> may help reframe it as something that is happening to them rather than because they don’t have the skills to cope. The latter can sometimes be a mistaken implication of the term burnout.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Exhausted nurse" /><figcaption><span class="caption">Staff shortages can take health workers beyond exhaustion and burnout.</span> <span class="attribution">Getty Images</span></figcaption></figure> <p>While healthcare workers are largely at the mercy of the organisations they work for, there are some steps individuals can take to alleviate moral injury. Firstly, simply recognising they may be suffering from this condition can reduce confusion and validate their experiences.</p> <p>Secondly, reconnecting back to an individual’s values and beliefs can help refocus and re-energise, at least temporarily. Reminding themselves why they got into this job in the first place is a useful place to start.</p> <p><strong>Organisational responses</strong></p> <p>Organisations and businesses must play a lead role in preventing and treating moral injury. Many of the factors leading to it (lack of resources or staff, a pandemic or peak flu season) are outside the control of individuals.</p> <p>Most modern businesses will be aware they have a legal responsibility under the 2015 <a href="https://www.legislation.govt.nz/act/public/2015/0070/latest/DLM5976660.html" target="_blank" rel="noopener">Health and Safety at Work Act</a> to look after their employees’ mental and physical well-being.</p> <p>At a high level, organisations can advocate for systemic change and increases in funding and resourcing, where needed. But these higher-level changes take time to achieve. In the meantime, it is important healthcare workers are protected and supported.</p> <p>Broad steps an organisation can take to prevent or reduce moral injury include removing the burden of difficult ethical decisions from frontline workers and instead adopting evidence-based policies to guide an organisation-wide response. Where possible, rotating staff between high and low-stress environments may help.</p> <p>Providing funding for workers to access professional psychological supervision is another practical step businesses can consider. At a team level, it can be helpful to have leaders who are visible, validating and can help make sense of the moral conflict. Leaders can also play a role in keeping alive professional values and modelling their own struggles with the situation.</p> <p>The general public also has a role to play in supporting healthcare workers. Any steps we can take to protect our own health and thereby reduce pressure on the system can have a cumulative effect on the well-being of doctors, nurses and allied health clinicians. The health of our nation rests with those who work in this field and it is in all our interest that their health is protected and prioritised.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/185485/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/dougal-sutherland-747623" target="_blank" rel="noopener">Dougal Sutherland</a>, Clinical Psychologist, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200" target="_blank" rel="noopener">Te Herenga Waka — Victoria University of Wellington</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/moral-injury-what-happens-when-exhausted-health-workers-can-no-longer-provide-the-care-they-want-for-their-patients-185485" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Caring

Placeholder Content Image

Homelessness is common for teens leaving out-of-home-care. We need to extend care until they are at least 21

<p>Young people transitioning from out-of-home care – whether it’s foster, kinship or residential care – are disadvantaged in many ways. Many have experienced abuse, neglect, family hardship or illness. They may feel long-term grief due to family separation.</p> <p>And while some enjoy stable placements with committed foster or kinship carers, others – particularly those in residential care, supervised by rostered staff – may experience instability as friends or support workers come and go.</p> <p>Most exit the out-of-home care system at 18, or younger, without ongoing support.</p> <p>Unfortunately, however, many such young people quickly encounter homelessness, unemployment and contact with the criminal justice system soon after leaving out-of-home care. Instead of leaving these people to fend for themselves at age 18 (or younger), we need a nationally consistent model of extended care that supports care leavers until age 21.</p> <p><strong>A tough transition</strong></p> <p>A 2021 study by <a href="https://create.org.au/wp-content/uploads/2021/05/CREATE-Post-Care-Report-2021-LR.pdf" target="_blank" rel="noopener">the CREATE Foundation</a> (which represents young people who have experienced out-of-home care) found homelessness was common among people exiting the system. Almost 100 of the 325 sampled care leavers aged 18-25 experienced homelessness in the first year after their transition.</p> <p>Another <a href="https://apo.org.au/node/314424" target="_blank" rel="noopener">study</a> found:</p> <blockquote> <p>More than half the 1,848 Victorian care leavers in this study (using data from leavers during 2013 and 2014) accessed homelessness services in the four years after leaving care, while one in three had multiple homeless experiences. Participants with experiences of residential care and multiple foster care placements were more likely to experience housing disruptions.</p> </blockquote> <p><a href="https://www.aihw.gov.au/reports/child-protection/incomesupport-receipt-oohc/summary" target="_blank" rel="noopener">Another national study</a> noted care leavers were three times as likely as other young Australians to have received social security payments.</p> <p>Of course, many care leavers <a href="http://createyourfuture.org.au/wp-content/uploads/2015/09/Stein-M.-ResearchReview.pdf" target="_blank" rel="noopener">do integrate effectively</a> into the social and economic mainstream. Some have difficult lives but still manage to cope, while others struggle to overcome adversity and social exclusion.</p> <p>In general, those who achieve successful transitions tend to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/cfs.12473" target="_blank" rel="noopener">leave care later</a> than 18 years of age and receive ongoing support well into their twenties from, for example</p> <ul> <li> <p>foster or kinship carers</p> </li> <li> <p>extended family members</p> </li> <li> <p>formal mentors or neighbours</p> </li> <li> <p>friends</p> </li> <li> <p>members of sporting, religious, cultural and other community groups.</p> </li> </ul> <p>These supportive relationships, which mirror the assistance that most of their non-care peers naturally access from their parents, provide the social capital needed to acquire housing, food, clothing, a driver’s licence and entry into sustainable education, employment and training.</p> <p>According to <a href="https://apo.org.au/node/314424" target="_blank" rel="noopener">one young person</a> who remained with their foster family in Victoria beyond 18 years:</p> <blockquote> <p>I was in the same home for 11 years, they were like my parents so they didn’t kick me out or anything. It wasn’t like I was in their care; I was like a part of the family.</p> </blockquote> <p>Conversely, those who experience troubled transitions from out-of-home care may experience social isolation, emotional adversity and hardship.</p> <p><a href="https://apo.org.au/node/314424" target="_blank" rel="noopener">One young person from Victoria</a> who was suddenly forced to leave care commented:</p> <blockquote> <p>I mean if you have a kid, you’re not going to kick him out as soon as they turn 16. You’re not going to, you know, tell your kid that ‘oh you have to find your own way to learn how to drive or anything’. You’re going to take them by the hand, you’re going to help them with each of these things. Even after your kid’s left, you’re still going to, you know, check up on them, you’re going to go there make sure they’re eating properly, cleaning the place properly. I had no idea how to clean anything.</p> </blockquote> <p>Young people who have harder transitions often include those in <a href="https://lens.monash.edu/@politics-society/2019/12/13/1378567/from-care-to-custody-the-tragic-trajectory-of-crossover-kids" target="_blank" rel="noopener">youth justice custody</a> when they turn 18 years of age, some <a href="https://www.aracy.org.au/publications-resources/command/download_file/id/465/filename/ARACY_Showing_the_Light_FINAL_20220302.pdf" target="_blank" rel="noopener">young parents</a>, those who have a major <a href="https://daneshyari.com/article/preview/346111.pdf" target="_blank" rel="noopener">cognitive disability</a> or <a href="https://apo.org.au/node/314424" target="_blank" rel="noopener">poor mental health</a> and <a href="https://apo.org.au/node/307306" target="_blank" rel="noopener">some Indigenous young people</a> who have been prevented from forming a connection with their culture, identity and community.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=398&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=398&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=398&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=501&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=501&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/459038/original/file-20220421-18-yi1uh7.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=501&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><em><span class="caption">Those who experience troubled transitions from out-of-home care may experience social isolation, emotional adversity and hardship.</span> <span class="attribution"><span class="source">Shutterstock</span></span></em></figcaption></figure> <p><strong>Extended care as an early intervention strategy</strong></p> <p>The best way to boost the life chances of all care leavers is to introduce a nationally consistent model of extended out-of-home care from 18 to 21 years. This is the model advocated by the <a href="https://thehomestretch.org.au/" target="_blank" rel="noopener">Home Stretch campaign</a> led by Anglicare Victoria.</p> <p>Evidence from evaluations of extended care programs in the <a href="https://www.chapinhall.org/research/calyouth/" target="_blank" rel="noopener">US</a> and <a href="https://repository.lboro.ac.uk/articles/report/Evaluation_of_the_Staying_Put_18_Plus_Family_Placement_Programme_final_report/9580109" target="_blank" rel="noopener">UK</a> confirms providing support until age 21 can improve outcomes for care leavers.</p> <p>As of April 2022, the Home Stretch model has informed the introduction of major extended care safety nets in <a href="https://www.celcis.org/application/files/5716/2263/3274/2021_Vol_20_No_1_Mendes_P_Extending_out-of-home_care_in_the_State_of_Victoria_Australia.pdf" target="_blank" rel="noopener">six out of Australia’s eight</a> states and territories.</p> <ul> <li> <p><a href="https://thehomestretch.org.au/news/the-most-significant-reform-to-child-welfare-in-a-generation-victorian-government-leads-nation-in-announcing-universal-care-for-young-people-to-the-age-of-21" target="_blank" rel="noopener">Victoria</a> and <a href="https://www.ourstatebudget.wa.gov.au/2021-22/fact-sheets/communities.pdf" target="_blank" rel="noopener">Western Australia</a> offer support to young people leaving all forms of out-of-home care until age 21</p> </li> <li> <p><a href="https://thehomestretch.org.au/news/foster-care-payments-to-be-extended-until-age-21-by-new-sa-liberal-government" target="_blank" rel="noopener">South Australia</a>, <a href="https://thehomestretch.org.au/news/first-state-government-extend-care-21-years-australia/" target="_blank" rel="noopener">Tasmania</a> and the <a href="https://www.communityservices.act.gov.au/ocyfs/children/child-and-youth-protection-services/a-step-up-for-our-kids/out-of-home-care-strategy-2015-2020" target="_blank" rel="noopener">Australian Capital Territory</a> fund an allowance to foster and kinship carers only until age 21. South Australia has introduced a <a href="https://www.childprotection.sa.gov.au/news/dcp-news/young-people-leaving-residential-care-to-be-better-supported-with-next-steps" target="_blank" rel="noopener">trial program</a> for residential care leavers in February 2022 - but it is only funded for two years to support 20 young people</p> </li> <li> <p><a href="https://www.qld.gov.au/community/caring-child/foster-kinship-care/information-for-carers/money-matters/carer-allowances" target="_blank" rel="noopener">Queensland</a> offers the same assistance only until 19 years</p> </li> <li> <p>the <a href="https://thehomestretch.org.au/news/push-to-lift-nt-foster-care-age-to-21/" target="_blank" rel="noopener">Northern Territory</a> has promised to legislate universal extended care soon</p> </li> <li> <p><a href="https://thehomestretch.org.au/news/nsw-lags-nationally-on-caring-for-most-vulnerable-young-people-as-victoria-surges-ahead/" target="_blank" rel="noopener">New South Wales</a> is the outlier in currently providing no form of extended care.</p> </li> </ul> <p>No state or territory allows young people living in residential care to remain in their existing homes beyond 18 years of age.</p> <p>Nor have any of them introduced <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/931987/Staying_Close_Break.pdf" target="_blank" rel="noopener">Staying Close</a> programs similar to those trialled in the UK, whereby residential care leavers are supported to live close to their former accommodation and maintain existing relationships with their former carers and support networks.</p> <p>The federal government, via the recently updated <a href="https://www.dss.gov.au/our-responsibilities/families-and-children/programs-services/protecting-australias-children" target="_blank" rel="noopener">National Framework for Protecting Australia’s Children</a>, should establish a nationally consistent model of extended care that would universally assist all care leavers until age 21.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/181167/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/phillip-mendes-101820" target="_blank" rel="noopener">Phillip Mendes</a>, Professor, Director Social Inclusion and Social Policy Research Unit, <a href="https://theconversation.com/institutions/monash-university-1065" target="_blank" rel="noopener">Monash University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/homelessness-is-common-for-teens-leaving-out-of-home-care-we-need-to-extend-care-until-they-are-at-least-21-181167" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Caring