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Nick Baker and Paul Barclay for Big Ideas

From tackling loneliness to ending stigmas: How can Australians live better in older age?

Australia's older population is rapidly growing. (Getty Images: Resolution Productions)

He may be 87 years old, but Alan Hopgood doesn't really like the idea of downtime.

So, when the COVID-19 pandemic hit, this octogenarian actor and writer found himself at a loss.

"Up until two years ago, I was extremely busy touring with my plays. But then the lockdowns happened. I was forced into [temporary] retirement, along with many other actors," he tells ABC RN's Big Ideas.

Alan Hopgood on stage in one of his plays about ageing. (Supplied: Lachlan Woods)

Mr Hopgood has been in show business for more than six decades and in recent years, he has written and toured plays that deal with health issues faced by older Australians.

His plays tackle serious topics like Alzheimer's disease and his own experience of prostate cancer, but humour is a mainstay of the works (he made his Melbourne Comedy Festival debut at age 82).

"Because [the plays] are comedies, people stay in their seats, they don't run for the exits … There are comic aspects to all these problems — you can have a terrible disease and still find something to laugh about," he says.

Mr Hopgood is one of many Australians shining a light on the often harsh realities of old age and asking, how can we all live better in the later years of life?

And with a rapidly ageing population, it could be one of the country's biggest questions in the years ahead.

Time to talk about loneliness

Dr Barbara Barbosa Neves is a senior lecturer in sociology at Monash University who researches loneliness in later life.

She says loneliness is one of the most important aspects to address when considering the mental and physical health of older Australians.

"How do we age well? As a sociologist, I'd say [it's about] meaningful social connections," she says.

Dr Barbara Barbosa Neves says Australia needs to address loneliness among older people. (Supplied)

One of Dr Barbosa Neves' recent studies involved looking at loneliness among older people living in care homes. The title of the study was a quote from one participant, It's the Worst Bloody Feeling in the World, which summed up the feeling of many.

"[Many participants said] that loneliness is worse for them than any of the health issues that they are facing. They feel devalued. They feel forgotten. They feel rejected. They feel abandoned. A lot of my participants cry themselves to sleep," she says.

"There's an immense emotional suffering that loneliness entails, which also has serious consequences in terms of our health. Lonely older people experience, for example, an increased risk of depression, and of cognitive and physical decline."

It's a point echoed by Professor Cassandra Szoeke, the director of the Healthy Ageing Program at the University of Melbourne and author of the book Secrets of Women's Healthy Ageing.

"[Loneliness] is not just something in the head," she says.

"When we've measured the blood of people who are lonely, we can actually see higher stress hormones in their blood; we see sleep disturbances; we actually can pick up and detect lowered immune systems, which means you're more likely to get infections."

So, she says, "anything [older people] do together with others makes them better."

Bigger social and cultural challenges

Both Dr Barbosa Neves and Professor Szoeke say there are bigger social and cultural challenges that are often missed when talking about ageing in Australia.

"In our Western contemporary societies, we're obsessed with looking and being young … There's this conception of old age as a biomedical problem, something that we need to fix," Dr Barbosa Neves says.

She says a lot of her research participants "actually have this constant internalisation of ageism. They internalise and normalise ageism … They don't want to be seen as dependent or a burden."

So, she says, "there's two important dimensions here: At the individual level, we need to embrace ageing, embrace our ageing selves, our ageing bodies. At the collective level, we need to be a more inclusive society."

"We know that older people who have more positive beliefs about ageing actually live better and longer lives."

And Dr Barbosa Neves says it's not just the individual that suffers when ageist attitudes persist.

"Many older people are disengaged socially, politically and publicly. So they miss out on the positive elements of public participation. And communities and societies miss out on their wealth of experience and knowledge."

The Indigenous experience

Ian Hamm is a Yorta Yorta man and a member of Victoria's Stolen Generations, who has worked in policy development for the Federal and Victorian governments.

Mr Hamm says there are many under-recognised issues around Indigenous communities and ageing.

He says addressing intergenerational trauma should be a top priority, especially among Stolen Generations survivors and their families.

Ian Hamm has highlighted the importance of truth-telling. (Supplied)

"I don't think we're giving enough credence to understanding the impact of the Stolen Generations on those who were taken and also those who come after them," he says.

One Australian Institute of Health and Welfare report found Stolen Generations survivors aged 50 and over are more likely to be worse off than other Indigenous Australians of the same age in a range of health outcomes.

And Mr Hamm says a discussion around Indigenous people and ageing needs to involve the concept of truthtelling, either in a collective or individual way.

He says when Indigenous people are reaching older age, "it's important for them to be able to reconcile their past."

"A key part of that is being able to tell their story, so as they age, they feel that they finally find some modicum of peace in their lives. It's really, really important."

And he also says when discussing any Indigenous issue, the framing should be far more positive than it currently is.

"We are a people who have much to contribute [at all ages], a people of great capability and great capacity."

What can individuals do?

Professor Szoeke is also the principal investigator of the Women's Healthy Ageing study, which has examined how a cohort of more than 300 women have aged over more than 30 years.

Professor Szoeke says there are some key takeaways from the study about staying healthy and fulfilled in older age.

"Having purpose is just so important — and that really is that kernel of truth that makes people happy at all ages," she says.

Professor Cassandra Szoeke is the director of the Healthy Ageing Program at the University of Melbourne. (Supplied)

She says when it comes to physical health, "moving is really important — it's the number one thing that was really great in our cohort over the 30 years."

"We actually came in as doctors expecting that intense exercise would be the most important activity that would give people the best health over 30 years, but we were wrong," she says.

"It was actually people who just did something every day — that could be vacuuming, it could be walking the dog. People who did something active every day were the people who did best."

Professor Szoeke adds "eating a healthy diet [has a big impact] … suffice to say, eat lots of green leafy vegetables, fruits and nuts, don't have processed foods and sugars, and you'll be right."

And she says that "brain health is central to healthy ageing."

She says "cognitive processing speed and brain capacity is so important for us as we get older" and recommends Dementia Australia's healthy brain resources.

Do You Know Me?

Actor and writer Mr Hopgood has written 11 plays around health and ageing in total. One in particular sums up what he and other older Australians feel about ageing with dignity.

"One of them was called, Do You Know Me? It was to remind doctors, nurses [and others] that a body in the bed is not just a body — it's a person who has a story and a history. And often nobody knows about it, because nobody asks them," he says.

"[Getting to know them] can make such a difference."

And as Mr Hopgood continues to explore his newfound downtime, he says he's learnt some important lessons.

"What I've learnt is how important it is to find a reason to get up each day … I exercise, I walk as much as I can, and I write," he says.

"It's lovely in bed and you can find all these excuses, particularly if you're 87, to stay there. But I think it's most important to get up and give yourself a normal life."

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