May 21, 2024 • 27 mins
When it comes to their health, how are your parents faring? If they’re in their late 60s, 70s or 80s, you might have noticed a few physical and mental changes, or perhaps an increase in the number of healthcare appointments they need to attend.
Helping your parents keep on top of it all can be a daunting and challenging journey—for all of you.
Performer, author and host of ‘Parenting Up with Australian Unity’, Jean Kittson's mother and father are 99 and 96, respectively. And although they've each experienced their share of health concerns, they're still living independently, thanks in part to the dedication of their personalised care team.
But it hasn’t always been easy. In this episode, Jean and Dr Jeannie Yoo, Chief Medical Officer at Australian Unity, swap tips on how to help our older loved ones stay as well as possible for as long as possible.
To learn more about parenting up, visit: https://www.australianunity.com.au/wellbeing/community-and-relationships/talking-to-your-parents-about-in-home-help
See omnystudio.com/listener for privacy information.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jean Kittson (00:00):
This is Parenting Up with Australian Unity, a podcast where
we're talking about ageing, and we're looking at some of
those essential conversations that we need to have with our
loved ones as they get older. I'm Jean Kittson, and
(00:21):
this is a subject that is particularly close to my heart.
Having been through this process with my own parents. My
mum is 99 almost and dad is 96, so I
know what a minefield it can be. I've even written
a book about it. We need to talk about Mum
and Dad. A guide to parenting our ageing Parents. Each episode,
(00:44):
I'm going to be joined by expert guests who can
help us navigate these challenging conversations with care and compassion
and empathy and respect. This episode is all about managing healthcare.
As we get older, and in particular helping our elders
manage their health. All those health checks and tests we
(01:06):
need to stay on top of how to discuss medical
care with an elder, then assembling the right team of
health care professionals. Because it's all collaborative, we have to
stay on all different aspects of their health and all,
just all the different options that are also available for
managing health care at home. It's been 20 years since
(01:26):
I first started worrying about whether my parents were coping
in their own home, whether, you know, and how they
were in the time since I started worrying about my parents.
Between them they have had a broken hip, a broken shoulder,
a broken femur, two two strokes, prostate cancer, two heart events,
(01:47):
various skin cancers and chronic wounds. I don't think we
call them sores anymore. They're called wounds. As you get older,
kidney failure, heart fibrillation and both have lost their sight.
My mother is legally blind, and my father now uses
a jeweler's loupe to peel the potatoes. Both of them
wear hearing aids. They've gone from being mobile and driving
(02:09):
to no car, and both of them pushing frames. They've
been to hospitals and rehabs and transition care. They've seen
specialists and GPS. And of course, in the meantime, they've
made the huge decision to sell the family home and
move to a unit in a retirement village that has
some nurses on hand, which has been amazing Anyway, health
(02:31):
care of our elders is incredibly complex and important, but
there's also some really simple things that we can put
in place. You know, if we know if we have
the right information. With me today is Doctor Jeannie Yoo.
Jeannie's background is as a GP, and she's now chief
medical officer at Australian Unity. So we're in very good hands.
(02:54):
She knows everything there is to know about this topic. Welcome, Jeannie.
Jeannie Yoo (02:59):
Thanks very much, Jean. Lovely to be with you today.
Jean Kittson (03:02):
It's great to have you here to help us navigate
one of the most fraught aspects of aged care, and
that is health that can really affect us so emotionally,
especially if you've if you feel when you're caring for
someone that you've missed something that you shouldn't have missed
or you've you've allowed some health event to take place
(03:23):
that you should have been aware of. So I guess
my first question is to you is, um, how can
we best help our elderly loved ones to maintain the
best health possible?
Jeannie Yoo (03:36):
Well, that's a that's a really big question. Um, Jean.
And it's one that's faced by, um, many, um, uh,
aging members of the community, if you like. Um, and
they're concerned families. So I'd say the first step really
is about recognizing that, uh, if it's your own parents
that they're moving into that stage of life, um, where
(03:59):
health concerns are going to become a bigger part of
their life, um, and where their ability to manage all
of those concerns and manage their own health is something
that you will be needing to support, and it's at
that stage, um, that it can be really helpful to
work out. Like, who is it in the family who's
best placed to support those those parents, you know, is
(04:21):
it yourself or is it someone else, one of your siblings? Um,
to start to support them, to, um, have a look
at what's going on with their health, support them as they, um,
you know, see their GP or their specialist as they
develop problems. And so I'd say the conversation and deciding
who is going to be that primary support person, um,
(04:43):
in the family, um, that's able to be with them
at appointments, able to understand what doctors, um, you know,
say and advise, um, able to work with them to
explain what the results of their investigations mean and to
help them through those difficult times, you know, times when
they might end up needing to be in hospital. Um,
(05:03):
times when they're really very unwell. Um, and not able
to look after everything themselves. So that's the very first step.
And it sounds like that's the sort of decision that
you made 20 years ago, that you were the right
person to be helping your parents through that, this, you know,
this stage of their lives.
Jean Kittson (05:18):
Well, it wasn't we didn't really have that conversation as such.
It evolved and it mainly evolved because I'm the one
who lives closest to them. And also I was very
happy to do it. I had more flexible working arrangements,
and my siblings and I could shift work around quite often.
(05:40):
My own children were older and independent, so that helped.
And although I gave that, you know, terrifying list of
what happened has happened to mum and dad, all those things,
they're in quite good health now. But it requires an
advocate like me to be able to go along to,
(06:02):
first of all, get a really good GP. Would you
agree with that? That might be one of the first
steps to get a good GP.
Jeannie Yoo (06:08):
Well, the GP is absolutely central to managing health and
also managing the overall health team. Uh, so, uh, the
GP has an important role. Nurses and allied health practitioners
also have an important role and the specialists are important,
but they're only there for part of the time and
for some of the the patient's problems. So it's actually
(06:30):
the GP that holds the whole picture if you like. Um,
and is the one that has that continuity of relationship
with the patient and with their family. So absolutely I say,
you know, the GP is is key. And once you
find a good GP, um, then really investing in that
relationship is worthwhile as well.
Jean Kittson (06:50):
That is so right. I thank the GP more than
I thank my family. I always make sure I go
to the GP with them and I always sit with
a notebook, I take notes well, I sit with my
iPhone and I tell the GP I'm not on Instagram,
I'm taking notes because you never remember everything the GP says.
(07:11):
If you don't write it down, well, I don't, so
I write everything down. But I make sure that I'm,
you know, sort of riding shotgun. I'm not. The GP
doesn't talk to me if if the GP asks me
a question, I immediately ask Mum and Dad or refer
to Mum and Dad. I would never talk for them
unless they wanted me to, so it's really great in
(07:33):
that way. If you are taking some responsibility for the
health of your elders, you are across everything. I remember
coming home from a visit and mum was very quiet
and I said, what's wrong mum? And she said, well,
I have cancer don't I? And I said, no mum,
you've got a small beak on your foot and we're
(07:54):
going to get rid of it. Oh she hadn't, she
just heard the word cancer and thought that was it.
So it's really important when helping your elders maintain a
positive attitude about their health, that things are very clear
to them. So do in terms of their health. How
important would you say how they live and how they
(08:17):
think and feel is.
Jeannie Yoo (08:19):
Look, there are a range of things which can be
done to to help one's health in general, and they
apply when you're older, um, to the same extent that
they do when you're younger as well. So, uh, throughout
our lives, we're given advice around the importance of, um,
you know, a good diet of regular physical activity, not smoking, uh,
(08:43):
minimizing alcohol and looking after our sleep. I mean, those
are some of the basic things, uh, and they are
equally important when you're older. And in fact, if we
think about some of the common problems that, um, people
experience is that as they get older, they include difficulties
with memory, what we know, what we can call cognitive impairment.
(09:05):
So difficulties with memory or thinking or planning or organizing, um,
and of course, when those difficulties become more severe, um, then,
you know, that may end, end in a diagnosis of
dementia and dementia is a, you know, is an is
an increasing issue, um, in the older population. Uh, And
what researchers found is that actually looking after your cardiovascular risk. So, um,
(09:31):
doing those things which are going to improve your diet, um, to, um,
you know, improve your levels of physical activity, uh, those
kinds of things are actually beneficial in reducing your risk
of that type of cognitive impairment as well. On top
of that, when we're talking about brain function and where
(09:52):
we all want to make sure that our, you know,
our minds are working as well as they as they
can do when we get older. Um, are other kinds
of activities that exercise the brain. So, um, thinking about
the way in which we live so that we remain
socially connected, uh, is really important. So improving social engagement,
thinking about the activities and the hobbies and things we
(10:15):
engage in so that we're exercise our brains. So sort
of cognitive kind of training of different kinds can be
really helpful as well, making sure, uh, that if, for example,
as we get older, it's very common to have difficulties
with hearing, but addressing problems with hearing and considering using
hearing aids is, is actually really important as well. So
(10:38):
there is an association. Yes, there is an association between
poor hearing and, um, faster cognitive decline. Uh, so being
able to communicate effectively with others is really important for
our cognitive function to, you know, looking after our senses
using whatever aids are available to improve those. Um, I
(10:58):
know that there is a social stigma associated with wearing
hearing aids, and yet hearing aids can be so small
and discreet these days. Uh, and if we thought of
them as something that can actually help us to maintain our,
you know, our cognitive function and our social engagement, um,
then perhaps we'll be less reluctant. It's not a sign
(11:18):
of aging. It's a, you know, it's a useful kind of, um,
device and aid so that we can stay, you know,
engaged with and enthusiastic about life.
Jean Kittson (11:26):
Um, there are other services that our elders could access
and should access to keep them healthy, too, aren't there?
Jeannie Yoo (11:36):
Sure. So, um, as you as you get older, you know,
your risk of a variety of medical conditions increases. And
also the members of your, you know, the people that
you would consider to be members of your health care
team also expand. So, you know, we've talked a lot
about about the GP and the GP is central. Um,
(11:57):
but also playing a really important role, nursing and allied
health practitioners. So, you know, I have a team of, um,
really sort of smart, talented people who help me with the, um,
with the design and evaluation of, um, Australian Unity's clinical
programs and services, and they come from a variety of
(12:17):
backgrounds in addition to the GP. There are really important
roles to be played by, for example, physiotherapists, um, to
help with mobility and reducing the risk of falls, you know,
build up, balance, strength, you know, all of those kinds
of things. Important role also to be played by occupational therapists, um,
(12:38):
who look at how well someone is functioning within their
own environment and whether any aids or modifications to a
home will will help them. Um, so examples, you know,
of what an occupational therapist might do would be, you know,
if someone is in within their own home but a
little unsteady or, or at risk. Um, they might need
(13:01):
grab rails or they might need a, you know, a
ramp instead of steps. You know, those those kinds of
of changes.
Jean Kittson (13:08):
That's right. It was an occupational therapist who suggested the
electric bed. Um, my parents slept in a double bed,
and they liked cuddling, but they got to the point
where they it was advised to them that they have
an electric bed that could go up and down with
to ease of getting in and out. That was a
really big change they had to make. They finally agreed
(13:33):
to get an electric beard and it was two single beds,
of course, and there was a crack in the middle
and they used to spooning and dad's elbow kept going down.
The crack took them a while to adapt to that change.
And there's also an expression when we're caring for or
(13:53):
looking after or helping our elders, and that is the
dignity of risk. So you might say to your elder,
this doesn't look safe, this isn't good for your health,
or you've got to stop eating those donuts or whatever
it is, but it's their human right to make a
decision about whether they want to do that or not.
Jeannie Yoo (14:15):
Absolutely. You know, I think you touch on some really
important themes. Um, Jean, in terms of the way we
relate to older people. So I think empathy and aiming
for empathy is is really key also. Um, that, you know,
a medical advocate or family member very much their role
(14:35):
is to try and ensure that that individual is as
informed as possible. Um, it can be hard to accept
the choices that are made, but of course, um, ultimately
it's up to the individual. It is their decision.
Jean Kittson (14:48):
That's right. I mean, we have to just say, what
would what would we want if we were, as you say,
in their shoes? Would we want to be listened to?
The other the other compelling argument, I think, for, you know,
helping our parents remain as safe and healthy as possible
is everyone wants to stay in their own homes. My
(15:10):
parents are still in their own home. They, you know,
they don't want to go into residential aged care. So
now they're at the point where all their health care
comes to them. So and nurses come as well to
the house. Dad has regular blood tests so someone else can.
Pathology comes to the house and now the GP comes
(15:30):
to the house once a month for a checkup. So
these sort of services, like you say, it's a team
and it's a team of professionals. And the podiatrist comes hearing,
comes to do a test. So because they can't really
it's it's a really big ordeal for them to get
out and about. And we shouldn't forget podiatry. Oh, that's
(15:54):
really important. Your feet keeping. You know them healthy? Yes.
And not letting your nails grow like claws. That's good too.
Jeannie Yoo (16:03):
Yes. Absolutely. Crucial feet. Um, and, uh, feet are important.
And feet are essential for staying on your, you know,
stay on your feet. Yes. Staying on your feet and
being mobile is essential to being able to live independently.
So yes, podiatrists play a very important role as well
as part of the broader team.
Jean Kittson (16:21):
Um, is there anything else you think we should know
about helping? You know, there's keeping them well and then
treating them in a timely fashion, getting a team together.
What else would you advice would you give us in
helping our parents?
Jeannie Yoo (16:37):
Um, so another thing to keep in mind is that, um,
having planned regular health checks when you're older, um, is
a really good investment in your health. So, for example,
you know, the government provides funding for health assessments for
those who are 75 and older. Um, and those are comprehensive,
(16:59):
holistic assessments usually carried out by a GP with um,
for example, a practice nurse. So, you know, with a
member of the, the broader, um, the multidisciplinary team looking
at all the aspects of, um, how someone's physical and, um,
mental and emotional health is going, how are they going
(17:20):
with medications, immunizations, how are they functioning within, we know
within within their own environment. Are there any issues with
vision and hearing so many of the things that we've
talked about are part of a structured health assessment. And
I would really encourage, you know, older community members and
the family that are supporting them to make the most
(17:42):
of this. This is something that we can all access,
something supported by the by the government. And it means
that your GP and the rest of the Praxis team
get that opportunity to have a good, thorough, comprehensive look
at how things are going to identify any areas where
we could prevent conditions developing, or we could do something
(18:03):
about those. I mean, that's the whole idea of that
health check. So being proactive about your health, you know,
people have varying relationships with their health and health care
over the over the years. Some people are very proactive.
Other people are more passive and might just go and
see the the doctor when something goes wrong. But I
think as you get older there's a lot of value
(18:26):
in being proactive, systematic saying, okay, you know, and I
had my last health check a year ago, I'm due
for it. You know, the next one, you know, come
along with me, whoever, whoever my sort of family member
is who helps me. And let's get it all checked out,
see how things are going. Is there anything that should
be done or could be done differently, so I can
(18:46):
stay as healthy as possible for as long as possible?
Jean Kittson (18:49):
That's a good attitude. I mean, my parents are of
the generation that they would find it almost incomprehensible to
go to the doctor just for a checkup. You know,
they have to have a boa constrictor around one leg
and an arrow through the other before they would go
to the doctor. So it can be a bit of
a struggle sometimes, but it makes a huge difference if
(19:10):
you stay on top of your health at any age,
but especially when you're getting older and there's so many
wonderful things that just can give you a lift ourselves.
Jeannie Yoo (19:20):
Um, within Australian unity we found, particularly across the pandemic,
we adapted the way in which we delivered our services. So, um,
more of our services can be delivered virtually. Um, as
well as face to face than was the case before.
And dietetics is an example of that. It's a it's
a service that we commonly deliver virtually. Um, can be
(19:42):
delivered of course, face to face as well. Um, GP
based telehealth is is more common. Uh, and some form
of some forms of allied health can also be delivered
via telehealth. So one of the things that have surprised us,
I mean, the stereotype would be that older patients are
not tech savvy enough to be able to to manage
video conferencing. And, you know, those, those kinds of techniques,
(20:06):
but they can surprise us, you know, they can blow
away those stereotypes. So even if, um, if an older, um,
client is is not able to manage all the technology
themselves if they have a family member or a carer
with them, um, then that also can be managed. So
there are many ways to make the most of the
new technologies that are available now. Yes.
Jean Kittson (20:27):
And they're getting more and more incredible all the time.
You know, you can get smart houses. So hopefully by
the time, you know, we baby boomers get into our, um, older,
older ages, we'll have smart houses where we can just
voice activate everything and we'll be nice.
Jeannie Yoo (20:47):
Ah, well, I mean, you know, you you mentioned the
sort of the benefits of virtual virtual services. One of the,
one of the programs that we're now delivering is, uh,
called our virtual home health service, and that the program
that we have currently is about supporting people that have
been in hospital with a diagnosis of heart failure. and
(21:10):
when they come out of hospital, they can be referred
into our program. And it's a fully virtual program. So
it's our, you know, expert heart failure nurses. It's a physiotherapist,
it's the dietician. It's all the different multidisciplinary team members
all engaging with and supporting that person to make a
(21:31):
full and excellent recovery from their heart failure. Medications is
a big part of that, and adjusting medications and making
sure that that they're optimized is a is a big
part of that. And we've found it to be a
really beneficial service. Um, you know, great from a clinical
perspective and achieving good clinical outcomes and lots of positive
(21:54):
feedback from patients and their families as well about the
benefits of having that service come to them and help
them in that, you know, that vulnerable period when someone's
just come out of hospital after a serious hospital admission
and just needs a bit of extra education and coaching
and support and, and help with their medications and other
aspects of their life.
Jean Kittson (22:13):
Definitely. That's a great service. That's wonderful. As a family member,
you can feel like you're just not equipped to be
able to cope with that aspect. You know, when someone
is so vulnerable. So to have that back up team
is just great, and it probably means you could come
home earlier and that's what we all want. Get out
of that hospital and get them home.
Jeannie Yoo (22:36):
Yeah. So it sounds like your parents have, you know, uh,
incredibly well supported and and that's the way we like
to see things working. You know, you've supported your, your
parents for, um, you know, 20 years now through, through
many different kinds of medical events. But one of the
things that we know is as people get older is
that their ability to look after their affairs, you know,
(23:00):
they make medical decisions and, um, you know, financial decisions, um,
can be affected as they get older. And, um, sometimes,
for example, substitute medical decision makers are needed and conversations around,
you know, in the future, should they be in a
position where they can't make a decision about whether to
receive a particular medical intervention or not, you know, to
(23:22):
have a plan about what they would like to be
done in that situation. So and how was it for
you having that conversation with your parents? Um, you know,
to talk about the future that way and to talk
about that situation where you might need to make a
decision on their behalf.
Jean Kittson (23:38):
With my mother, it was fine. She's really happy to
talk about those things. But my father is gets upset
talking about mortality and end of life. So that was
much more difficult. But the advanced directives now in the
old days, when I started talking to them about ten
years ago about this, they were really complex forms and
(23:58):
they had complex questions, but now they're much more simplified.
You basically just have, you know, do you want the
doctors to do their best within reason, but not go
too far? You know, something simple like that. And you go, yeah,
that's what I want. That's what I don't. And it was. Yeah,
it's really it was sad. It was quite a sad conversation, uh,
(24:22):
especially with my dad. That was sad to think of him,
but those sort of questions are really important. I mean,
we have to. We can't be afraid of dying. I mean,
we often are, but we can't be. We should have
the courage to talk about it and not, um, not
just for ourselves, but for our loved ones. The late,
(24:44):
great comedian Bob Hope. When he turned 100, his wife
said to him, where do you want to be buried?
And he said, surprise me. Hahahahahahaha! So there's some humor
in End of Life at all. It's not grim. It
can be. There's mourning, of course, but there can be
celebration and and love. A lot of love for health care.
(25:07):
Our key takeaways are keep an eye on your elders health,
whether they like it or not, because they will need it.
It can take a village of professionals to keep our
elders healthy and well. But it all starts with your GP,
so make sure your elder is happy with the GP
and comfortable with the GP and trust the GP and
(25:28):
you to go with your elders to medical appointments. This
is really essential. It will give the GP confidence that
the elder is supported, but it's important that you ask
lots of questions and you take lots of notes and
you keep your elder informed at every step. So you
may not say anything when you're in the GP, but
(25:50):
when you come home you can tell your elder everything
that happened. So check their medications, check their teeth, eyes
and ears. Check their car for dents, check their life
for purpose and meaning, and go for walks. Eat together,
visit often. Have fun. This is all about keeping them well.
Jeannie Yoo (26:13):
That sounds like a wonderful recipe for success and clearly
one that's really worked for for you and for your parents. Jean.
Jean Kittson (26:20):
Thank you. Thanks, doctor Chinezu, thank you so much for
chatting today. It's been great. Thank you so much for
joining me for this podcast series, Parenting Up with Australian Unity.
I've really enjoyed chatting to all these wonderful experts, and
I hope their knowledge and experience has helped you to
support your loved ones and make sure they are healthy, safe,
(26:44):
independent and most importantly, happy for as long as possible.
Thank you. The information provided in this episode of Parenting
(27:06):
Up is general in nature and does not consider your
personal circumstances. Australian unity accepts no responsibility for the accuracy
of any opinions, advice, representations or information contained in this podcast.
Listeners should rely on their own independent advice and inquiries
(27:27):
when making decisions affecting their own or their loved ones finances, health,
wellbeing or other interests.
This is Parenting Up with Australian Unity, a podcast where
we're talking about ageing, and we're looking at some of
those essential conversations that we need to have with our
loved ones as they get older. I'm Jean Kittson, and
(00:21):
this is a subject that is particularly close to my heart.
Having been through this process with my own parents. My
mum is 99 almost and dad is 96, so I
know what a minefield it can be. I've even written
a book about it. We need to talk about Mum
and Dad. A guide to parenting our ageing Parents. Each episode,
(00:44):
I'm going to be joined by expert guests who can
help us navigate these challenging conversations with care and compassion
and empathy and respect. This episode is all about managing healthcare.
As we get older, and in particular helping our elders
manage their health. All those health checks and tests we
(01:06):
need to stay on top of how to discuss medical
care with an elder, then assembling the right team of
health care professionals. Because it's all collaborative, we have to
stay on all different aspects of their health and all,
just all the different options that are also available for
managing health care at home. It's been 20 years since
(01:26):
I first started worrying about whether my parents were coping
in their own home, whether, you know, and how they
were in the time since I started worrying about my parents.
Between them they have had a broken hip, a broken shoulder,
a broken femur, two two strokes, prostate cancer, two heart events,
(01:47):
various skin cancers and chronic wounds. I don't think we
call them sores anymore. They're called wounds. As you get older,
kidney failure, heart fibrillation and both have lost their sight.
My mother is legally blind, and my father now uses
a jeweler's loupe to peel the potatoes. Both of them
wear hearing aids. They've gone from being mobile and driving
(02:09):
to no car, and both of them pushing frames. They've
been to hospitals and rehabs and transition care. They've seen
specialists and GPS. And of course, in the meantime, they've
made the huge decision to sell the family home and
move to a unit in a retirement village that has
some nurses on hand, which has been amazing Anyway, health
(02:31):
care of our elders is incredibly complex and important, but
there's also some really simple things that we can put
in place. You know, if we know if we have
the right information. With me today is Doctor Jeannie Yoo.
Jeannie's background is as a GP, and she's now chief
medical officer at Australian Unity. So we're in very good hands.
(02:54):
She knows everything there is to know about this topic. Welcome, Jeannie.
Jeannie Yoo (02:59):
Thanks very much, Jean. Lovely to be with you today.
Jean Kittson (03:02):
It's great to have you here to help us navigate
one of the most fraught aspects of aged care, and
that is health that can really affect us so emotionally,
especially if you've if you feel when you're caring for
someone that you've missed something that you shouldn't have missed
or you've you've allowed some health event to take place
(03:23):
that you should have been aware of. So I guess
my first question is to you is, um, how can
we best help our elderly loved ones to maintain the
best health possible?
Jeannie Yoo (03:36):
Well, that's a that's a really big question. Um, Jean.
And it's one that's faced by, um, many, um, uh,
aging members of the community, if you like. Um, and
they're concerned families. So I'd say the first step really
is about recognizing that, uh, if it's your own parents
that they're moving into that stage of life, um, where
(03:59):
health concerns are going to become a bigger part of
their life, um, and where their ability to manage all
of those concerns and manage their own health is something
that you will be needing to support, and it's at
that stage, um, that it can be really helpful to
work out. Like, who is it in the family who's
best placed to support those those parents, you know, is
(04:21):
it yourself or is it someone else, one of your siblings? Um,
to start to support them, to, um, have a look
at what's going on with their health, support them as they, um,
you know, see their GP or their specialist as they
develop problems. And so I'd say the conversation and deciding
who is going to be that primary support person, um,
(04:43):
in the family, um, that's able to be with them
at appointments, able to understand what doctors, um, you know,
say and advise, um, able to work with them to
explain what the results of their investigations mean and to
help them through those difficult times, you know, times when
they might end up needing to be in hospital. Um,
(05:03):
times when they're really very unwell. Um, and not able
to look after everything themselves. So that's the very first step.
And it sounds like that's the sort of decision that
you made 20 years ago, that you were the right
person to be helping your parents through that, this, you know,
this stage of their lives.
Jean Kittson (05:18):
Well, it wasn't we didn't really have that conversation as such.
It evolved and it mainly evolved because I'm the one
who lives closest to them. And also I was very
happy to do it. I had more flexible working arrangements,
and my siblings and I could shift work around quite often.
(05:40):
My own children were older and independent, so that helped.
And although I gave that, you know, terrifying list of
what happened has happened to mum and dad, all those things,
they're in quite good health now. But it requires an
advocate like me to be able to go along to,
(06:02):
first of all, get a really good GP. Would you
agree with that? That might be one of the first
steps to get a good GP.
Jeannie Yoo (06:08):
Well, the GP is absolutely central to managing health and
also managing the overall health team. Uh, so, uh, the
GP has an important role. Nurses and allied health practitioners
also have an important role and the specialists are important,
but they're only there for part of the time and
for some of the the patient's problems. So it's actually
(06:30):
the GP that holds the whole picture if you like. Um,
and is the one that has that continuity of relationship
with the patient and with their family. So absolutely I say,
you know, the GP is is key. And once you
find a good GP, um, then really investing in that
relationship is worthwhile as well.
Jean Kittson (06:50):
That is so right. I thank the GP more than
I thank my family. I always make sure I go
to the GP with them and I always sit with
a notebook, I take notes well, I sit with my
iPhone and I tell the GP I'm not on Instagram,
I'm taking notes because you never remember everything the GP says.
(07:11):
If you don't write it down, well, I don't, so
I write everything down. But I make sure that I'm,
you know, sort of riding shotgun. I'm not. The GP
doesn't talk to me if if the GP asks me
a question, I immediately ask Mum and Dad or refer
to Mum and Dad. I would never talk for them
unless they wanted me to, so it's really great in
(07:33):
that way. If you are taking some responsibility for the
health of your elders, you are across everything. I remember
coming home from a visit and mum was very quiet
and I said, what's wrong mum? And she said, well,
I have cancer don't I? And I said, no mum,
you've got a small beak on your foot and we're
(07:54):
going to get rid of it. Oh she hadn't, she
just heard the word cancer and thought that was it.
So it's really important when helping your elders maintain a
positive attitude about their health, that things are very clear
to them. So do in terms of their health. How
important would you say how they live and how they
(08:17):
think and feel is.
Jeannie Yoo (08:19):
Look, there are a range of things which can be
done to to help one's health in general, and they
apply when you're older, um, to the same extent that
they do when you're younger as well. So, uh, throughout
our lives, we're given advice around the importance of, um,
you know, a good diet of regular physical activity, not smoking, uh,
(08:43):
minimizing alcohol and looking after our sleep. I mean, those
are some of the basic things, uh, and they are
equally important when you're older. And in fact, if we
think about some of the common problems that, um, people
experience is that as they get older, they include difficulties
with memory, what we know, what we can call cognitive impairment.
(09:05):
So difficulties with memory or thinking or planning or organizing, um,
and of course, when those difficulties become more severe, um, then,
you know, that may end, end in a diagnosis of
dementia and dementia is a, you know, is an is
an increasing issue, um, in the older population. Uh, And
what researchers found is that actually looking after your cardiovascular risk. So, um,
(09:31):
doing those things which are going to improve your diet, um, to, um,
you know, improve your levels of physical activity, uh, those
kinds of things are actually beneficial in reducing your risk
of that type of cognitive impairment as well. On top
of that, when we're talking about brain function and where
(09:52):
we all want to make sure that our, you know,
our minds are working as well as they as they
can do when we get older. Um, are other kinds
of activities that exercise the brain. So, um, thinking about
the way in which we live so that we remain
socially connected, uh, is really important. So improving social engagement,
thinking about the activities and the hobbies and things we
(10:15):
engage in so that we're exercise our brains. So sort
of cognitive kind of training of different kinds can be
really helpful as well, making sure, uh, that if, for example,
as we get older, it's very common to have difficulties
with hearing, but addressing problems with hearing and considering using
hearing aids is, is actually really important as well. So
(10:38):
there is an association. Yes, there is an association between
poor hearing and, um, faster cognitive decline. Uh, so being
able to communicate effectively with others is really important for
our cognitive function to, you know, looking after our senses
using whatever aids are available to improve those. Um, I
(10:58):
know that there is a social stigma associated with wearing
hearing aids, and yet hearing aids can be so small
and discreet these days. Uh, and if we thought of
them as something that can actually help us to maintain our,
you know, our cognitive function and our social engagement, um,
then perhaps we'll be less reluctant. It's not a sign
(11:18):
of aging. It's a, you know, it's a useful kind of, um,
device and aid so that we can stay, you know,
engaged with and enthusiastic about life.
Jean Kittson (11:26):
Um, there are other services that our elders could access
and should access to keep them healthy, too, aren't there?
Jeannie Yoo (11:36):
Sure. So, um, as you as you get older, you know,
your risk of a variety of medical conditions increases. And
also the members of your, you know, the people that
you would consider to be members of your health care
team also expand. So, you know, we've talked a lot
about about the GP and the GP is central. Um,
(11:57):
but also playing a really important role, nursing and allied
health practitioners. So, you know, I have a team of, um,
really sort of smart, talented people who help me with the, um,
with the design and evaluation of, um, Australian Unity's clinical
programs and services, and they come from a variety of
(12:17):
backgrounds in addition to the GP. There are really important
roles to be played by, for example, physiotherapists, um, to
help with mobility and reducing the risk of falls, you know,
build up, balance, strength, you know, all of those kinds
of things. Important role also to be played by occupational therapists, um,
(12:38):
who look at how well someone is functioning within their
own environment and whether any aids or modifications to a
home will will help them. Um, so examples, you know,
of what an occupational therapist might do would be, you know,
if someone is in within their own home but a
little unsteady or, or at risk. Um, they might need
(13:01):
grab rails or they might need a, you know, a
ramp instead of steps. You know, those those kinds of
of changes.
Jean Kittson (13:08):
That's right. It was an occupational therapist who suggested the
electric bed. Um, my parents slept in a double bed,
and they liked cuddling, but they got to the point
where they it was advised to them that they have
an electric bed that could go up and down with
to ease of getting in and out. That was a
really big change they had to make. They finally agreed
(13:33):
to get an electric beard and it was two single beds,
of course, and there was a crack in the middle
and they used to spooning and dad's elbow kept going down.
The crack took them a while to adapt to that change.
And there's also an expression when we're caring for or
(13:53):
looking after or helping our elders, and that is the
dignity of risk. So you might say to your elder,
this doesn't look safe, this isn't good for your health,
or you've got to stop eating those donuts or whatever
it is, but it's their human right to make a
decision about whether they want to do that or not.
Jeannie Yoo (14:15):
Absolutely. You know, I think you touch on some really
important themes. Um, Jean, in terms of the way we
relate to older people. So I think empathy and aiming
for empathy is is really key also. Um, that, you know,
a medical advocate or family member very much their role
(14:35):
is to try and ensure that that individual is as
informed as possible. Um, it can be hard to accept
the choices that are made, but of course, um, ultimately
it's up to the individual. It is their decision.
Jean Kittson (14:48):
That's right. I mean, we have to just say, what
would what would we want if we were, as you say,
in their shoes? Would we want to be listened to?
The other the other compelling argument, I think, for, you know,
helping our parents remain as safe and healthy as possible
is everyone wants to stay in their own homes. My
(15:10):
parents are still in their own home. They, you know,
they don't want to go into residential aged care. So
now they're at the point where all their health care
comes to them. So and nurses come as well to
the house. Dad has regular blood tests so someone else can.
Pathology comes to the house and now the GP comes
(15:30):
to the house once a month for a checkup. So
these sort of services, like you say, it's a team
and it's a team of professionals. And the podiatrist comes hearing,
comes to do a test. So because they can't really
it's it's a really big ordeal for them to get
out and about. And we shouldn't forget podiatry. Oh, that's
(15:54):
really important. Your feet keeping. You know them healthy? Yes.
And not letting your nails grow like claws. That's good too.
Jeannie Yoo (16:03):
Yes. Absolutely. Crucial feet. Um, and, uh, feet are important.
And feet are essential for staying on your, you know,
stay on your feet. Yes. Staying on your feet and
being mobile is essential to being able to live independently.
So yes, podiatrists play a very important role as well
as part of the broader team.
Jean Kittson (16:21):
Um, is there anything else you think we should know
about helping? You know, there's keeping them well and then
treating them in a timely fashion, getting a team together.
What else would you advice would you give us in
helping our parents?
Jeannie Yoo (16:37):
Um, so another thing to keep in mind is that, um,
having planned regular health checks when you're older, um, is
a really good investment in your health. So, for example,
you know, the government provides funding for health assessments for
those who are 75 and older. Um, and those are comprehensive,
(16:59):
holistic assessments usually carried out by a GP with um,
for example, a practice nurse. So, you know, with a
member of the, the broader, um, the multidisciplinary team looking
at all the aspects of, um, how someone's physical and, um,
mental and emotional health is going, how are they going
(17:20):
with medications, immunizations, how are they functioning within, we know
within within their own environment. Are there any issues with
vision and hearing so many of the things that we've
talked about are part of a structured health assessment. And
I would really encourage, you know, older community members and
the family that are supporting them to make the most
(17:42):
of this. This is something that we can all access,
something supported by the by the government. And it means
that your GP and the rest of the Praxis team
get that opportunity to have a good, thorough, comprehensive look
at how things are going to identify any areas where
we could prevent conditions developing, or we could do something
(18:03):
about those. I mean, that's the whole idea of that
health check. So being proactive about your health, you know,
people have varying relationships with their health and health care
over the over the years. Some people are very proactive.
Other people are more passive and might just go and
see the the doctor when something goes wrong. But I
think as you get older there's a lot of value
(18:26):
in being proactive, systematic saying, okay, you know, and I
had my last health check a year ago, I'm due
for it. You know, the next one, you know, come
along with me, whoever, whoever my sort of family member
is who helps me. And let's get it all checked out,
see how things are going. Is there anything that should
be done or could be done differently, so I can
(18:46):
stay as healthy as possible for as long as possible?
Jean Kittson (18:49):
That's a good attitude. I mean, my parents are of
the generation that they would find it almost incomprehensible to
go to the doctor just for a checkup. You know,
they have to have a boa constrictor around one leg
and an arrow through the other before they would go
to the doctor. So it can be a bit of
a struggle sometimes, but it makes a huge difference if
(19:10):
you stay on top of your health at any age,
but especially when you're getting older and there's so many
wonderful things that just can give you a lift ourselves.
Jeannie Yoo (19:20):
Um, within Australian unity we found, particularly across the pandemic,
we adapted the way in which we delivered our services. So, um,
more of our services can be delivered virtually. Um, as
well as face to face than was the case before.
And dietetics is an example of that. It's a it's
a service that we commonly deliver virtually. Um, can be
(19:42):
delivered of course, face to face as well. Um, GP
based telehealth is is more common. Uh, and some form
of some forms of allied health can also be delivered
via telehealth. So one of the things that have surprised us,
I mean, the stereotype would be that older patients are
not tech savvy enough to be able to to manage
video conferencing. And, you know, those, those kinds of techniques,
(20:06):
but they can surprise us, you know, they can blow
away those stereotypes. So even if, um, if an older, um,
client is is not able to manage all the technology
themselves if they have a family member or a carer
with them, um, then that also can be managed. So
there are many ways to make the most of the
new technologies that are available now. Yes.
Jean Kittson (20:27):
And they're getting more and more incredible all the time.
You know, you can get smart houses. So hopefully by
the time, you know, we baby boomers get into our, um, older,
older ages, we'll have smart houses where we can just
voice activate everything and we'll be nice.
Jeannie Yoo (20:47):
Ah, well, I mean, you know, you you mentioned the
sort of the benefits of virtual virtual services. One of the,
one of the programs that we're now delivering is, uh,
called our virtual home health service, and that the program
that we have currently is about supporting people that have
been in hospital with a diagnosis of heart failure. and
(21:10):
when they come out of hospital, they can be referred
into our program. And it's a fully virtual program. So
it's our, you know, expert heart failure nurses. It's a physiotherapist,
it's the dietician. It's all the different multidisciplinary team members
all engaging with and supporting that person to make a
(21:31):
full and excellent recovery from their heart failure. Medications is
a big part of that, and adjusting medications and making
sure that that they're optimized is a is a big
part of that. And we've found it to be a
really beneficial service. Um, you know, great from a clinical
perspective and achieving good clinical outcomes and lots of positive
(21:54):
feedback from patients and their families as well about the
benefits of having that service come to them and help
them in that, you know, that vulnerable period when someone's
just come out of hospital after a serious hospital admission
and just needs a bit of extra education and coaching
and support and, and help with their medications and other
aspects of their life.
Jean Kittson (22:13):
Definitely. That's a great service. That's wonderful. As a family member,
you can feel like you're just not equipped to be
able to cope with that aspect. You know, when someone
is so vulnerable. So to have that back up team
is just great, and it probably means you could come
home earlier and that's what we all want. Get out
of that hospital and get them home.
Jeannie Yoo (22:36):
Yeah. So it sounds like your parents have, you know, uh,
incredibly well supported and and that's the way we like
to see things working. You know, you've supported your, your
parents for, um, you know, 20 years now through, through
many different kinds of medical events. But one of the
things that we know is as people get older is
that their ability to look after their affairs, you know,
(23:00):
they make medical decisions and, um, you know, financial decisions, um,
can be affected as they get older. And, um, sometimes,
for example, substitute medical decision makers are needed and conversations around,
you know, in the future, should they be in a
position where they can't make a decision about whether to
receive a particular medical intervention or not, you know, to
(23:22):
have a plan about what they would like to be
done in that situation. So and how was it for
you having that conversation with your parents? Um, you know,
to talk about the future that way and to talk
about that situation where you might need to make a
decision on their behalf.
Jean Kittson (23:38):
With my mother, it was fine. She's really happy to
talk about those things. But my father is gets upset
talking about mortality and end of life. So that was
much more difficult. But the advanced directives now in the
old days, when I started talking to them about ten
years ago about this, they were really complex forms and
(23:58):
they had complex questions, but now they're much more simplified.
You basically just have, you know, do you want the
doctors to do their best within reason, but not go
too far? You know, something simple like that. And you go, yeah,
that's what I want. That's what I don't. And it was. Yeah,
it's really it was sad. It was quite a sad conversation, uh,
(24:22):
especially with my dad. That was sad to think of him,
but those sort of questions are really important. I mean,
we have to. We can't be afraid of dying. I mean,
we often are, but we can't be. We should have
the courage to talk about it and not, um, not
just for ourselves, but for our loved ones. The late,
(24:44):
great comedian Bob Hope. When he turned 100, his wife
said to him, where do you want to be buried?
And he said, surprise me. Hahahahahahaha! So there's some humor
in End of Life at all. It's not grim. It
can be. There's mourning, of course, but there can be
celebration and and love. A lot of love for health care.
(25:07):
Our key takeaways are keep an eye on your elders health,
whether they like it or not, because they will need it.
It can take a village of professionals to keep our
elders healthy and well. But it all starts with your GP,
so make sure your elder is happy with the GP
and comfortable with the GP and trust the GP and
(25:28):
you to go with your elders to medical appointments. This
is really essential. It will give the GP confidence that
the elder is supported, but it's important that you ask
lots of questions and you take lots of notes and
you keep your elder informed at every step. So you
may not say anything when you're in the GP, but
(25:50):
when you come home you can tell your elder everything
that happened. So check their medications, check their teeth, eyes
and ears. Check their car for dents, check their life
for purpose and meaning, and go for walks. Eat together,
visit often. Have fun. This is all about keeping them well.
Jeannie Yoo (26:13):
That sounds like a wonderful recipe for success and clearly
one that's really worked for for you and for your parents. Jean.
Jean Kittson (26:20):
Thank you. Thanks, doctor Chinezu, thank you so much for
chatting today. It's been great. Thank you so much for
joining me for this podcast series, Parenting Up with Australian Unity.
I've really enjoyed chatting to all these wonderful experts, and
I hope their knowledge and experience has helped you to
support your loved ones and make sure they are healthy, safe,
(26:44):
independent and most importantly, happy for as long as possible.
Thank you. The information provided in this episode of Parenting
(27:06):
Up is general in nature and does not consider your
personal circumstances. Australian unity accepts no responsibility for the accuracy
of any opinions, advice, representations or information contained in this podcast.
Listeners should rely on their own independent advice and inquiries
(27:27):
when making decisions affecting their own or their loved ones finances, health,
wellbeing or other interests.
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