“One of the greatest gifts of being a doctor for older adults is the constant reminder that life is fragile, finite and precious,” starts Dr Kate Gregorevic in her new book, Staying Alive: The Science of Living Healthier Happier and Longer.
Humans have long been obsessed with the ageing process and preserving the vigour of youth. The myth of the fountain of youth is as old as the art of storytelling itself and great fiction writers have been similarly interested in the idea of everlasting youth.
Mark Twain is said to have commented that “life would be infinitely happier if we could only be born at the age of eighty and gradually approach eighteen,” and F. Scott Fitzgerald took that idea further with the short story of Benjamin Button, who was born with the appearance of an 80 year old man and ages backwards.
Oscar Wilde’s Dorian Gray avoiding ageing by selling his soul, to ensure that the picture of himself, rather than he, would get old.
Avoiding the dark arts, geriatrician Gregorevic takes a somewhat simpler approach to longevity. Her book focuses on educating people about the small, everyday lifestyle decisions they can make over time that can have a huge impact later in life.
Gregorevic spoke with Aged Care Insite and gave us her top tips for a happier, longer life.
ACI: This book is all about living longer, and that’s obviously intrinsically linked to ageing and older people. As a geriatrician, you have seen the tales of neglect and overall poor standards in certain sections of aged care Where are we falling down, in your eyes?
KG: A lot of the disability that comes with ageing, from people who are older, is invisible. We don’t see people who are very frail, walking the streets. Most people don’t see people with advanced dementia. And so, these people often can’t really advocate for themselves very well. And I think that these people do also need care, and I think it’s become somewhat problematic that with aged care, we don’t have minimum standards for the care ratios and people often aren’t very aware of what’s going on within the care facilities.
At the same time, some of the most amazing people I’ve ever met, some of the most dedicated people I’ve ever met are the aged care workers. And so, it’s really important that we value and support that workforce.
What are some basic improvements, in respect to base health, that you think would be good to implement in aged care?
I think after speaking with a lot of people, some of the things that are really challenging include that a lot of people get very depressed when they go into residential care.
And they can often lose a real sense of their meaning and purpose. And it is harder, because sometimes people have physical or cognitive limitations that mean they can’t do what they used to do. I often speak to people about what they like to do, how they define themselves. The facilities often work with this as well, to try and find things that people can engage with, so they still feel like their lives are meaningful.
It’s interesting that you bring that up. The frailty that comes with ageing is often reinforced by the psychological stressor of being frail, and it’s a bit of a vicious cycle. And we know that mental health is a big issue in aged care because of that.
How do we try and get on top of that as people age?
Mental health is a really complex thing and mental health comes from social factors, psychological factors, medical factors. And we need to address all of those things, and so obviously I do prescribe people antidepressants where it’s appropriate.
Sometimes just acknowledging that someone’s grief is justified and the acknowledging in particular when people go into residential care, acknowledging that that change is difficult. And I guess accepting those emotions and sitting with it a little bit.
But then hopefully it’s about trying to find ways with people who we engaged and to form new social connections and to find things, activities they enjoy.
Because we’re an ageing society, there’s going to be a lot more of us in older age. We’re an expanding population as well. And I wonder what you think about how the government and health departments go about combating ageism?
Ageism is a huge problem within our society and it’s also damaging to ourselves as we’re all getting older. It’s just something that’s a normal biological process. It’s not a bad thing.
But in our society we often really prioritise physical independence and strength, and we often undervalue the wisdom that comes with age. And by not respecting that, by not finding ways to help people contribute and to break down those barriers, as a society, we just lose so much wisdom.
So back to your book, obviously nutrition is a big part of it and a big part of healthy ageing. What should older Aussies and care homes be doing to make sure that people are getting the right nutrients to help them age well?
One thing I think we really lose sight of with nutrition is that the most important thing about food is that it’s enjoyable. Food is one of our first and last pleasures in life and sometimes we can lose sight of this and you can still eat a really nutritious diet within the realms of that.
There are some specific things that are important for older adults. And so people who are older actually have higher protein needs per kilogram of body weight compared to people who are younger.
And it’s still obviously important to get your vegetables, particularly getting enough fibre, because constipation can become a problem with older age.
But as I said, first and foremost, we have to find ways to incorporate these good foods that we enjoy.
Now more than ever a lot of us, and again, a lot of older people are thinking about their immune system. What would your tips for immune health?
I think that what’s really hard with immune health, our immune system does change with age and there are certain components that don’t work as well. So, we’re not as able to produce new antibodies to control new viruses.
What is important with ageing in terms of our immunity is that obviously nothing replaces staying away from others at the moment with COVID-19.
But you’re still getting vaccinations, making sure you’re up to date with that side of things. Getting enough sleep is probably helpful and getting exercise seems to have positive impact on our immune system as well.
And then more broadly, I guess it’s not only about thinking about people in aged care or older people. What about the wider population, what are some big mistakes that maybe we’re all making day-to-day that is detrimental to our long-term health?
While my book is about longevity, in terms of how I apply this to my own life, I do think that it’s really important that we frame it in terms of how much we can enjoy today. And I think we really lose sight of that. And there’s no such thing as a perfect life.
It’s really important we think about things like getting enough sleep, doing exercise, nutrition, things that improve our wellbeing in the present. And I think that is the best motivation to do it. And that that’s a more positive framework to use that can help make these changes sustainable.
Can you distil some of your knowledge down into your top tips for aged care providers to follow to keep their residents healthy and happy?
I think most places do this really well, but speak to people about their own preferences and values and what’s been important to them throughout their lives.
Also integrating family into people’s care and have a family of carers is really important for overall health.
Food, as I said before. That the primary focus of food is around enjoyment.
I also think it’s always worth getting a geriatrician review to look at optimising medical management, particularly because a lot of medications aren’t necessarily still appropriate, and that can be really helpful for quality of life.
And lastly, I think that prioritising enjoyment in a day is important.
Staying Alive: The Science of Living Healthier Happier and Longer is out now through Pan Macmillian Australia.Do you have an idea for a story?
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