Life Uncut - We Need to Talk About Ageing - Uncut with Melissa Levi

Episode Date: October 16, 2023

Hi Lifers, Today is an episode really close to Laura's heart. It's an episode she has wanted to do for a long time. Initially we thought this was going to be a chat about dementia, but it ended up being so much more than just a focus on dementia. This episode is important for anyone who has a loved one that will hopefully be lucky enough to grow old.Melissa Levi is a clinical psychologist with over a decade of experience. She is also the author of "We need to talk about ageing." If you have a loved one that is ageing, you need to listen to this conversation!We chat about ageing: -How to approach conversations with loved ones about changes you've noticed in their behaviour or memory -The importance of knowing what they want out of their life as they age -Navigating other family members to work together for the wishes of your loved person -End of life conversations We also chat about dementia: -What it is and all of the different types -How we can try to prevent dementia -Whether it's actually worth making effort to spend time with loved ones who will likely not remember the experience -Bringing joy into the lives of loved ones with dementia If you'd like to check out any of the free resources that Melissa collated you can find them here! Melissa's book "We need to talk about ageing" can be found here!   Patient names, identities and situations have been changed. Any similarity between the people referred to in this podcast episode and any person living or dead is purely coincidental.This podcast episode was created for informational purposes only. It is not intended to be a replacement for professional medical, psychological, psychiatric, financial or legal advice. Always consult your own healthcare professional.  See omnystudio.com/listener for privacy information.

Life Uncut acknowledges the traditional custodians of country whose lands were never ceded. We pay our respects to their elders past and present. Always was, always will be Aboriginal land. This episode was recorded on Darug Wollamutta land. Hi guys and welcome back to another episode of Life Uncut. I'm Laura. I'm Brittany. And we have such a special interview for you today. We are talking to Melissa Levi. She is a clinical psychologist, and she has written the book, We Need to Talk About Aging. Now,

this is a conversation that has been very long awaited for me, and we will get into the reasons why it is such a personal and important conversation for me. But more so than that, if you have someone in your life experiencing dementia, a grandparent, a parent, you are going to get so much out of this chat but for anyone who isn't and doesn't have someone and can't relate to that experience I so hope that you listen to this episode as well and the reason for that is is because this is truly a conversation around how we deal with our parents aging and the thing is if we are lucky enough all of us are going to experience our parents aging and if we don't get to experience that then we're certainly going to have to experience our parents dying at some point

time. And it sounds grim and it sounds like an unbelievable reality, but something that Melissa talks about in this chat is how ignoring those conversations and never ever preparing for that reality, which is a reality that we're all going to be faced with one day, is actually so much more detrimental to your family ties. It's so much more detrimental to your healing than what it is if you're actually able to have those conversations with the people who you love the most. Something else I found really interesting about this is it's not just a chat for the people that have someone in their life with dementia but it's a chat around how to prevent dementia which I think is really important especially up the back of we've seen Chris Hemsworth recently with his

documentary where he discovered that he is more predisposed to early onset Alzheimer's I think that hits different when someone in the public eye comes out and says wow no one's exempt from this kind of stuff and it can really get anyone and these are the things I'm going to change in my life, to improve my life and to try and prevent that. So the conversation around prevention is just as important as the conversation around dealing with it. Totally. And I think for anybody who has it in their family, you live with this fear of like, what if that's going to happen to me? Or what if that's where I'm going to end up? We cover everything in this chat from what successful aging looks like, how you can make and really support your family members. And I think

mostly like how you can have conversations with your parents. It's a beautiful chat and we hope you enjoy. Recently, we were having a discussion on the podcast around dementia and aging and it came up in conversation. My grandma is currently in a nursing home. She was, she still is, it's such a hard thing to navigate, but she was like my second mom growing up and she would be the person that I would go to for everything. I lived with my grandparents, so I was incredibly, incredibly close with them. And dementia is something that runs really, really prolifically in my family. I don't really remember there ever being someone elderly on my mum's side that hasn't ended up having dementia. So for me, it's always also been a fear that I have. And one of the things that we

spoke about, Britt, was how I feel like my relationship with my nan has changed over the years because she just isn't the person that she used to be. She's not there anymore. And I've really struggled with how to be present when she doesn't understand that she has grandchildren and sometimes it feels like she doesn't know whether I'm there or I'm not there or I visited or I haven't visited and you know it's so easy once your grandparents move into a home and they're being cared for and you still make time to go and see them but you're kind of like are they getting anything out of this that was the big question that I had been asking and really grappling with and when we had this conversation there were so many people who wrote in who said that they were

having similar experiences, whether it was with their mom or their parent or like all their grandparents. But I think that it is so incredibly prevalent, this idea not just of dementia, but obviously aging is something that we all go through and understanding what is the best way to support your parents, to navigate that changing in relationship is something that I have such an interest in. And I know so many of you did, which is why we have Melissa Levi, who was a clinical psychologist with over a decade of experience at St. Vincent's Hospital. She's helped thousands of families navigate the aging journey. And she's also written a book, which was fabulous. And it's called We Need to Talk About Aging because we absolutely do. It's this thing that we all shy

away from, but it's where we're all going to end up if we're lucky enough to end up there. Melissa, welcome to Life Uncut. I am so excited to be here. And I love that a podcast like yours is bringing ageing and dementia into the spotlight. Straight off the bat, Melissa, I think the most important question on everyone's lips is how do we not age? If you can figure that out, you can go buy an island, retire. Oh, no, it was funny because we were talking about this guy that was viral on the news recently because ageing has this negative connotation

but he's been viral on the news because he's spending over $2 million a year trying to stop ageing and slow ageing and he's got like penis injections. He's doing all sorts of things, but it's to the point that our society is so petrified of aging. And what do you say to that? It's so funny because firstly, I get it. And I think before I started working with older people, I think a lot of our thoughts about aging are sort of driven by a lot of myths and stereotypes. What I've come to realize though, is that aging is actually something where we can design our own journey to a large extent. And I think we'll get into that as, you know, we can't always

control the twists and turns. We can't always control whether we get dementia. We can't always control, you know, those changes in health, but how do we respond to that? How do we still design a life that can be sort of meaningful and joyful in spite of that and recognizing that, oh my God, that's actually a possibility. And the other thing is a client said this to me and she said, darling, if none of us were to age, if none of us were to die, if time was infinite, what would ever be special? And I will always remember her saying that because I just think it's true. I think, you know, what makes life interesting and special, what allows us to grow as people is the passage of time and getting older. But I think we also really need to shift

what we think of as the possibilities for later life. What was it about aging and working with people who are elderly that drew you to that occupation? So funnily enough, when I was doing my master's of clinical psychology, I wanted to work with kids. I always wanted to work with kids. Clearly you get a sense. This isn't how it played out. Basically at uni, I just drew the short straw. I was told that I'd be spending six months working in an older people's mental health service. So I called my mom, had a massive cry. And what I realized was I was crying because I was scared. Like I knew, like you, Laura, on a really personal level at the time my Zader, my grandfather was living with dementia. And a few weeks earlier, I had spent the weekend with

him in Melbourne, come back to Sydney, landed on the tarmac, turned on my phone. There were about a half a dozen missed calls from him. I called him back and he was really agitated. And he just said like, Melissa, I don't see you anymore. I don't hear from you anymore. When are you going to come and visit me. And of course I realized in that moment that he had no recollection of having spent days and days together, like living in his home. And I was shattered and I was just so scared of confronting that same sense of loss and struggle and illness in, you know, other families on this placement. And I was also scared of, you know, what am I going to do for them? How can I make a difference? You know, it was this belief that, you know, well, I can't change this for them.

but what I learned really quickly is that we can actually make a huge impact and that totally changed the course of my life and working now you know for the past decade I've now worked with more than a thousand families and it's been an absolute privilege and it's what inspired the book and now I'm working with my hubby who's a lot more tech savvy than me and we're actually building these online courses to take all of the education and you know strategies and everything I give to families face to face, to families all over the world? You know, for me, I remember watching, it was an episode of You Can't Ask That. And I was standing in my kitchen just doing the washing up and it was on the TV and it was all about dementia. And I think for me, even though it has

been something that has run in my family, something that my grandma has dementia, her sister died of Alzheimer's, I didn't understand it properly. And I understood it from the logical sense of what it actually is, like how she was experiencing it. But I'd never, ever heard anybody who had been diagnosed with dementia speak about their own experience of dementia. Someone who was cognizant enough to talk about it and was accepting enough of the diagnosis that they could explain how they were experiencing it. And for anyone who hasn't seen, you know, who's struggling with someone in their family who has this, I so recommend going and watching that episode of You Can't Ask That because it was so amazing to me. And it gave me so much more empathy around

how people who struggle with dementia experience it. And also how you might think that they don't remember something, but they still have lucid moments of memory, how it's not always just completely gone and they can come in and out of that. Absolutely. And I think it goes back to what you said at the beginning, which was that you still make time to go visit your nan, but you have this sort of feeling of like, does it matter? Does it mean something? And I guess the biggest piece of advice that I often give to families is, you know, with dementia, I think it's really about stepping into their world. So it may be a fleeting moment, but if you can give someone meaning, if you can bring someone joy in that moment, that that's a moment well spent and

they may not remember it, but you will. This will ultimately, like Laura for yourself, one day become your sort of highlight reel, your photo album of your time with your nan. And I think of a gentleman who I'm going to call Nico just to protect his privacy and I'll change some details, but he was living with dementia. And when I first gave him the diagnosis, he was this big sort of larger than life Greek man with this huge family. And he just wept. He just broke down and wept because he thought that I had given him a death sentence. And what he thought was that like most of us, when we think of dementia, we think of the worst case scenario. We think of someone who is may be sort of non-verbal and doesn't recognize their family anymore. And I guess there's a few

things to know. I think the first is, and this is what I said to Nico and his family, is that dementia can be a really long journey, but also a really individual journey. For some people, it can progress really slowly. For other people, it progresses more quickly. But for the majority of the patients that I've seen, most of them don't reach that sort of end stage that comes to mind when we hear the word dementia. And even for those that do, we can still give them quality of life. And for him and his family, just educating them. And I think, you know, I wish he could have seen that episode of You Can't Ask That, because I think it would have really shifted his thinking about what was possible for him. And he lived for, I think,

six years after his diagnosis at home and continued to function, you know, really well and independently, still do things, you know, spend time with the grandkids, go to the local club, you know, do things that made his life meaningful. And then his daughters had always assumed that his wish would be to stay at home at all costs. But he actually said to them that after his wife passed away, that he didn't want his daughters looking after him at home if he needed sort of 24-7 care. So when the time came that he did need more care, he actually chose to move into a Greek speaking residential aged care home, a nursing home. And I went to visit him there and I said, you know, Nico, how is it? And he said, you know, everything here is so good.

You know, this is good, but there's one problem, Melissa. He said, everyone here is Greek. I said, Nico, you're Greek. He said, shit, am I? And what we did for him as his dementia progressed was he had been a handyman he'd been a painter you know so in the courtyard of this nursing home they gave him pots of paint he would pass the days painting the back fence you know starting from one end to the other and then going again you know gardening fixing bits of furniture they let him have a cigar in the back corner even though he wasn't meant to they just sort of turned a blind eye so he didn't always remember how he had spent the day but if you went and visited him at any given moment he was in sort of a joyful place he was in flow he was doing stuff that

made him feel like himself and there was another lady that I saw just to I guess acknowledge that sort of worst case scenario who I'll call Sophia and when I first met her she was in the high care dementia unit of her nursing home her residential aged care home and when I met her she was sort of slumped over in her chair her face was like inches away from the tray in front of her and she had been non-verbal for a long time and I spoke with the family and they said you know she'd always been a really devout catholic who loved going to church so we started playing some hymns and songs and she couldn't articulate the words but she would hum along and she lifted her her head and with the help of the care staff, sat up in her chair and, you know,

we got the care staff to massage her arms and her shoulders. She'd sit there going like, mmm, mmm. You know, it was so pleasurable for her. And she used to love brandy custard and she was on a special diet so that she wouldn't aspirate, wouldn't choke. And the family said, you know what, we would rather take the risk of her choking on brandy custard and dying than foregoing it. And that was the decision they made.

And that's what she did. And it's just this idea that your story, even if it's really, really hard, I think with the right education and support, there are so many possibilities for your family and for the people you love. I think right now, a lot of the general population are learning just how prevalent it is from crazily enough, Hollywood stars that are coming out and talking about their dementia or their families have talked about their dementia. And I talk about Bruce Willis, who has frontotemporal dementia, Robin Williams, who I think it was

Lewy body dementia. How many different types of dementia are there? So the way that I think about dementia, because it is really confusing, one of the most common questions families ask me is, you know, what is the difference between dementia and Alzheimer's disease? So I think of dementia as an umbrella term. it's an umbrella that basically tells us that something has changed in someone's brain there is some sort of disease process in the brain that's affecting their ability to think and

function day to day and their behavior but we don't really know much more than that under that umbrella there are over a hundred different subtypes of dementia wow so alzheimer's is the most common it accounts for about 70 of all dementia cases which is why people confuse the terms. But it's only one type. And each type has its own sort of pathology, like a different cause of the changes in the brain, and therefore its own symptom profile. So a lot of people think that for dementia, everybody gets memory loss. But the examples that you've given, memory loss is typically the first sort of clinical symptom of Alzheimer's. But for Bruce Willis, his first symptoms were language-based. And aphasia also, I think. Correct, correct, aphasia. And, you know,

for Robin Williams, I think it was a lot more to do with sort of his mood and personality and psychological sort of symptoms. So yeah, there's huge variability. And just briefly, Laura, maybe to put your mind a little bit at ease, is that another big question I get asked is around if mum has dementia, if granddad had dementia, will I get dementia? Totally. And it's a huge fear people have. The short answer is no. And the long answer is, but there are sort of exceptions to that. So if mum or dad have Alzheimer's disease or vascular dementia, which is the second most common type, and it was diagnosed maybe after the age of 65, the likelihood that it is inherited is really slim. So there are some genes that are involved. You might have heard of like the APOE4

gene, for example. Certainly have not, but have not. How? How do you live your life not hearing? Yeah, Laura. Everyone knows about APOE4. I was just thinking about it over breakfast this morning. That APOE4 gene. But basically what we know from the research now is that there are so many other factors, lifestyle factors, other factors that have a much stronger bearing on whether you will get dementia than carrying that gene. There are certain dementias where there is a stronger hereditary component. And just as an example, that would be like early onset Alzheimer's. So when mum or dad have been diagnosed before age 65, and then some of the other subtypes that are less common can have a stronger genetic component. But if mum or dad has sort of Alzheimer's vascular,

i would not be concerned that it's then inevitable that you're going to get it i believe that's why chris hemsworth did his documentary recently and why he's publicly come out and said i'm going to take a step back from acting and be with my family because they found a genetic link for him like a predisposition to it so that is i guess what you're talking about where there are sometimes this genetic link and predisposition what about if it's a looser linkage i mean we've just touched on if it's your direct parents but what if it's say like so for me that was something that is in my family. My Nana's sister, she passed away of Alzheimer's in her sixties. So she had a very aggressive and was diagnosed extremely young. And that genetic link has kind of always been the one

that scared me. And I think that that is where it's prevalent in my family, for example. And your Nan with her dementia was diagnosed later in life. I think you'd have to speak to a geneticist on this because it gets quite complicated. But my understanding, whenever we would take sort of clinical histories and look at genetics, we'd really be looking at people's parents, maybe grandparents. And then I think the sort of genetic component gets weaker and weaker as it sort of disperses out from there. I mean, because we all think about it, right? We're like, oh, do we have to do an extra Sudoku a week? Like what is it that we do to prevent dementia or what can bring dementia on? So I love this question because in 2017 and then in 2020, there was a

report published in The Lancet, which is one of the most prestigious medical journals in the world. And it was really exciting because it was a huge, huge report looking at, you know, an enormous amount of data. And what they concluded is that about 40% of diagnosed cases of dementia are due to modifiable risk factors. So about 40% of cases are preventable. Wow. And these are things that we can take action on. So some of them seem sort of really basic and intuitive, but basically the way that I boil it down. And for those people that have maybe seen the documentary on Netflix about the blue zone, you'll notice that some of these strategies sort of, you know, cross over with what Dan Buettner learned by visiting these blue zones. The first

is basically, you know, if it's good for your heart, it's good for your brain. So good cardiovascular health is a huge asset in preventing dementia, both vascular dementia, but Alzheimer's disease, other types of dementia so you know keeping blood pressure in check cholesterol in check and you don't need to freak out if you know oh my gosh but high blood pressure runs in my family just go see the gp take medication to regulate it you know exercise eat well which we all can do we just a lot of us choose not to it's because it's so easy to kick the can down the road right like it's so and we all do it it's so easy to be like i know what i'm supposed to do but then i'll just start next year when I have, you know, the next new year's resolution. But I want to eat these 25

pieces of KFC right now. Or I want to drink that wine or, you know, it's so easy for us to kind of just keep on pushing it down the track with the intention that you'll do it later. And then all of a sudden you're in your late fifties and you haven't done any of the stuff that you thought you were going to do from the time that you were 30 because time just kind of gets away from you. The research shows that these strategies are most helpful. I mean, they're all, it doesn't matter when you start, it's never too late, but if you want to optimize it, it is in mid life. So you don't, it's not, okay, well, when I get into my seventies, you know, I'm going to like become a triathlete. These are things that you want to do in midlife to have the greatest protective effect,

I guess. And the other thing is it can also be simplified. So if you look at Dan Buettner's work, it isn't about running marathons or joining CrossFit or F45, like you don't have to do anything vigorous. So if you look at these blue zones and like the world's healthiest, longest living people, it's more just constant movement every day. So literally like a 30 minute walk and doing house chores and gardening and swimming and dancing, like do stuff that you enjoy that's not onerous. And with diet, it's also that sort of Mediterranean inspired diet. I mean, who doesn't love Italian food? Like this is a great diet and you can have red wine, but you've hit the nail on the head because a lot of people say like, if I do Sudoku,

if I do this, you know, can I prevent dementia? One of the best things you can do. So you might have heard of neuroplasticity. It's basically, we used to think that when you were a kid, that you got your brain had this burst of new brain cells and then your brain cells just gradually sort of died off over the course of your life. Like our eggs. They just gradually die off. Correct. Correct. Look, it's all, it's all a bit bleak, but no, that is not true anymore. So what we know now is that actually your brain has the potential to create new brain cells and new connections between those cells basically until the day you die. So that is neuroplasticity. So then everybody's like, okay,

I want a piece of that. How do I promote neuroplasticity? It is by getting your brain to do something new, something that your brain cannot currently accommodate. So if you were being forced out of your comfort zone at work to do things that were really new, to learn information that was completely novel to you, your brain is just on fire. It is creating new cells, new connections, new networks. And with Sudoku, I always think it's great. Do puzzles, do Sudoku. But the problem is when you become really good at it and really proficient at it, either you need to up-level and try something a lot more complex or you need to switch to something else. So I think, you know, we often stay in our lanes and we stick to what we're

good at, but I've had like my grandmother-in-law who's now 94 decided to take up line dancing in her seventies. Oh, it's so good. You know, so it can be anything. It actually doesn't matter what the activity is. It can be learning a language, learning an instrument, learning to dance. Anything that you cannot currently do really well and intuitively will promote sort of more brain cells. And just on this topic of like, how do we protect against dementia? Another really strong protective factor is our sort of social connections. And it also speaks to one of my favorite studies, which is the Harvard study of adult development. It's sort of the, one of the longest running studies of adult life in the world. I think it's been running for over 80 years.

basically back in the 1930s they decided to follow a group of harvard men and a group of men from some of boston's most disadvantaged suburbs and they checked on them every couple of years you know examined their family life medical records brain scans blood tests professional achievements socioeconomic status everything mental health and they asked the question in real time of like what creates or what predicts a healthy happy long life and they had i think hundreds of thousands of data points and they found that there was actually one factor that separated the men that had these happy healthy long lives and those that didn't and it wasn't their iq and it wasn't their blood pressure and it wasn't their financial success it was the quality

of their close relationships oh shit we need more friends laura that's what i'm hearing but it's so i mean this is something that's covered just going back to the series the blue zone we recommended it on our vibes the other week. Some of the communities that had the most centurions were the communities where they prized friendship and they prized this sense of having a community, which I think for a lot of us, especially as the years progress, we lose friends. I mean, studies show that each year you lose, your friendship network gets smaller. And that could be because work pressures get bigger or you have children. And just like the realities of all of the things that we take on means that we can't put our time and energy into our friendship

circles? Often it's not the quantity of the friendships, but the quality of the friendships. So you can have fewer, but they have to be like really good. Like Brené Brown would say, like bury the body friends, you know? Like I've made a big mistake. I need you to comment. Melissa, I would love to know if someone's listening to this and they think that their parent has, or someone who's close to them has dementia or is worried about their parent's memory or lack thereof, how do you broach that conversation with a loved one that you're worried about their, not just their aging, but that you're worried about how cognizant they are and worried that maybe they do have dementia? So in terms of how to broach, and I love that we're talking

about this because dementia and really aging, it's a family journey. This takes a village. And when I think of sort of the families that have a more successful journey versus those that have a less successful journey, I've come to think that families that have a better journey have sort of nailed what I think of as like the care triangle. And in explaining this triangle, I want to answer your question of how to broach that conversation with mom if you're worried about her thinking or her memory. So if you visualize a triangle, I think at one point you've got mom, dad, or your aging loved one. At the other point, you've got the carer, which statistically is really likely to be your listeners you know women currently in their 20s to 40s but as they get a

bit older will become what they sort of call unfortunately like the sandwich generation like caring for aging parents while also caring for kids and then at the other point of the triangle you've got the family and families that have the best journeys are those that have the big conversations with mum and dad to get a sense of understanding what's going on for mum and dad now and what are their wishes for the future? Like mom and dad, what do you want if you get a difficult diagnosis? How do you want to live life in one, five, 10 years? Because I see all too often families that are having these conversations, making huge decisions for their parents in hospital corridors. When it's too late to be having those conversations. It's way too late.

It's so stressful. There's so much pressure. It often leads to family conflict because everyone's got a different opinion and the opinion of the actual person that matters most you know maybe is not available in that moment it's just it just sets you up for so much struggle what do you do though in the instance because I think that this is something a lot of people do deal with on one hand you have parents who will say I don't want to be a burden to my children I want you to put me in a home you know and then there's other parents who say never put me in a home I would rather fall over in a bathtub and die that way than being put in a home. And then you're faced with the challenge that your parents can't take care of themselves. They can't be at home. They

need to be cared for in some capacity, but they've always fought and are still fighting this idea of going quote unquote into a nursing home or a care facility or something like how do families manage that? Because that was very much my situation with my grandma. And also I have a very close friend who's currently dealing with that themselves. And I think that that's something that is so hard to make peace with. Absolutely. So, and I think actually that's the perfect example of why having these conversations early is so helpful because if mum and dad say, you know, or mum says, you know, I never want to be in a home, you know, I'd rather take the risk of, you know, living by myself. It's about then being able as a family to sit down and say, you know,

okay, mom, what's that going to take? And having real talk and sitting around the table and saying, okay, sister, what are you prepared to do for mom? And okay, brother, what are you prepared to do to facilitate this? And some family members will wow you and floor you with what they are prepared to do and others will really disappoint you. But you're better knowing that upfront and having realistic expectations. Okay, mom, if you got dementia, but you still wanted to stay at home and you needed care, what's that going to cost? Like in real terms, what sort of money are we looking at here? And okay, mom, if you want to stay at home, how do we try to best support that? Well, firstly, let's get an aged care assessment early so that you've got access to government

funding for home care. So that if you want to stay at home, it's not just on my shoulders, my sister's shoulders my brother's shoulders we've got people coming into the home because staying at home is a possibility but it does require planning yeah and also in that on the planning side of things with anything that's like government done it requires the time and the processes and if you're then in a position where you need the care and you need the support around you and you need the income to be able to do it but you've filed for that so far down the track that you're in a position now where the care is not going to come as immediately as you need it, that puts so much additional strain on you. A hundred percent. And I think that's why these

conversations are so important is that actually the only thing harder than broaching these topics, and I want to loop back to your question about like, how do you broach it in the first place? The only thing harder than broaching the topic is not because aging is inevitable. It doesn't mean that we can't shape the journey ahead, but it's coming. Like every single one of us is going to be touched by it. So let's go into this prepared. Let's go into this with a plan. And in terms of how you might broach that first conversation, you know, a few things. I think firstly, if you're worried that mum might have dementia, most of the time I've noticed that mum's probably noticed something too, especially in those early stages. She's probably scared,

just like you're scared and possibly in denial, correct, or just not wanting to burden you. Maybe it's like, you know, in her heart and on the tip of her tongue, but she can't bring herself to, you know, speak it to her children. So just a few tips for that. I think the first is I would almost talk about it the same way you'd talk about a broken arm and just be like really calm and confident in how you approach it. Because I think that often allows the other person to feel a bit more at ease. The other big thing to know here is that your job is not to convince mom of a diagnosis.

that is not your job in this conversation. Your job is just to communicate your concerns and really to get mom to go to the GP. That's your outcome. So be really clear on your outcome is to get mom to the GP. You can't be expected to diagnose this or to convince mom. And really, instead of focusing on the diagnosis of dementia, I would focus on just the changes you've noticed. You know, mom, I noticed that you've missed a couple of medical appointments lately or mom I noticed that you know there's a couple of scratches on the car you know you you never used to scrape your car or mom you were meant to pick up the grandkids on Thursday and you just seem to forget you know but I've noticed these sort of things are happening a little bit

more or you know mom used to love going to play bridge and I bumped into Margaret the other day and she said she hasn't seen you for a number of months like let's pop down to the doctor and just have a bit of a chat about what's going on because in some cases the changes in mom's memory yeah maybe it is the beginning of something like a dementia process but there are actually a lot of other possibilities and some of them are treatable that could be at play here what is the difference i mean i know that we've spoken a lot about dementia and it's something that i'm like i said genuinely so interested in that what do we deem successful aging like what does it look like for somebody to have like a compromised aging but then on the other hand successfully

age? Because it's all going to, it's going to, hopefully it's the end goal, right? Hopefully we are able to actually age. It's a privilege to be able to get old, even though none of us want to. But what does that look like? So to me, successful aging, when I think about what that is, it's someone being able to live a life that is consistent with their own wishes, values, to still experience a sense, even if it's a momentary sense of meaning, of connection, of joy there's like a beautiful poem by William Ernest Henley called Invictus and the last two lines say like I am the master of my fate I am the captain of my soul and I think successful aging will look different for every single person because we all live completely different lives

but I think it's about and just briefly just to give two stories that in my mind I guess typify successful aging and maybe a sort of less successful journey as a family I think of Bruce who I met he came into hospital into ED into emergency after having a big stroke and the doctors were talking to his kids he didn't have a partner a spouse and saying you know what do you want us to do we can do surgery to relieve the pressure on dad's brain we can do this surgery we can do conservative management you know what would dad want us to do and they just looked I will never ever forget the looks on their faces they were shattered and they just said we've never discuss this as a family. Like the best we got was dad saying, you know, don't ever let me become

a vegetable. Totally. Put a pillow over my head. What does that mean right now? Like, what do we do? And anyway, the doctors supported the family. They made a decision. Bruce ended up surviving the stroke, but he was really, you know, quite disabled after that, you know, his level of function had really taken a big hit. And then the family were faced with other decisions. Okay. So when it was time for dad to go home could dad go home where's he going who's looking at all of these massive decisions they ended up in conflict because the daughter and the son had very different ideas of what was best for dad so they stopped speaking and I just thought like this was a normal family like this could happen to any of us this is why I think this conversation is so important

because you know you don't know you need to have the conversation until you're in it and I know for you Britt like when we started this you're like you know I have not had experience with dementia in my family so it's not something that relates to me it's not something that I've ever thought about but that's just it you don't think about it until you're so far deep in it that you don't know what to do and then there's the guilt about am I supporting my and it makes me truly feel upset like is there the guilt that I'm doing it right because you don't know and we didn't have these conversations with my grandparents and it's because we didn't have the resources and it was because they were very in denial around it as well. And I think our family approached this kind

of topics as though if you put your head in the sand, we'll deal with it when it's a big enough problem. But if you're not happening, if we don't actually talk about it, we don't, we said it's like, it's, it's not real. And you almost don't know what's coming. So we're like, well, we'll deal with it when we have to deal with it. But if you're dealing with it, when you have to deal with it, it is actually too late. And so as much as I know that the specific conversation about dementia may not relate to everyone. The conversation around aging relates to every single person listening to this. And these are conversations we have to have with our parents. I think also, Laura, just to be kind to yourself, like your family is the typical family. Your family was

my family. We didn't talk about this when my Zeta was diagnosed with dementia. I hadn't even started my career. Just giving yourself also grace to know that you are not unusual. And we get stuck in this vicious cycle of like aging scares me also because as you say, I don't have the education and support to even know how to broach this topic. So I'm not going to think about it. I'm not going to talk about it. Then we're going to have to confront it at some point, whether we like it or not, but without planning, without preparation, it's a really difficult journey. It confirms all of our worst fears. So you know what? We're going to go back to not talking about it and thinking about it again. And it's one of those things that in terms of not just dementia, but now just

aging in general it is a conversation you need to have with your family even to the point of what are their wishes in terms of burial cremation if it's cremation where do they want to their ashes spread I think these are really important conversations because I've seen exactly the same thing too many times where you get to that point and you're like it's debilitating because you're like I don't know what they want and and it it hurts me that I don't know if I'm going to do the right thing for them I remember I had a conversation with one of my friends lost their parent and this is what made me think of it they didn't know what to do it was unexpected they didn't know what his wishes were and I had the conversation with my parents and people are

going to think this is really weird but there's something that you can do where you can cremate someone and you can have it made into jewelry now I know this sounds crazy no I've had people ask us before yeah so you can put their ashes into like a stone and it doesn't look like it yeah and you wear it and I sort of made the joke like can I do that so that I can you guys can be close to me on a necklace close to my heart or close to and you know they were like at the end of the day but like if that makes you feel better do it and so we had that convo and it was funny and it was light because they're not dying now but we made it in a way that wasn't morbid and at the end of the day I sort of feel a bit more comforting I don't know if they've changed their

mind and they don't want me they don't want to live in a ring for the rest of their life but but I think those conversations in all capacities are really important so that you're not faced with that anguish when the decision comes and I think you've touched on something Brit that's so true and I've seen this play out is that when we have the conversations early and it does feel a little bit further away it is a bit more hypothetical and your level of comfort grows the more you talk about it it grows and you can even laugh about it and I think about my husband Ben his grandfather who we call Pa, we used to sit around the dinner table laughing about like what would happen when he died, what would be written on his tombstone or how he wanted to be cared for. Like he wanted

a hot nurse at the end of his life. He said, he said, this isn't, he said, he said, he used to say like the bald spot on his head, like it's not a bald spot. It's a solar panel for a sex machine. Like he was, you know, vivacious and cheeky and until the very end. But what was so amazing was I look at my family and the grief we had after losing my Zeta because again, we didn't know, we didn't have the resources, the knowledge to know what conversations to have. My Zeta was a Holocaust survivor. All of my grandparents were.

So they were the first generation in our family that we saw getting old. None of us had faced it before. so when he died and the decisions we had to make there was so much stress and complexity along his dementia journey and there was so much grief when he died like complicated grief second guessing i wish i could have done we should have done it was soul destroying whereas when pa died everyone and he's got a big family six kids everyone was in alignment everybody knew his wishes back to front. They had the care lined up so that he could stay at home for as long as possible. They had palliative care lined up. The doctors knew what to do. And when he did pass away, he'd been

married 63 years to grandma. She was phenomenally resilient in her grief and the whole family were. And I was so intrigued by this because they missed him and yearned for him, but they didn't have that layer of second guessing. They were like, we knew that we did everything to give him the end of life that he wanted. And that is a gift. These conversations, I promise, promise as hard as they are, they are a gift. They are a gift to your parent because your parents like, okay, they get my wishes. I have more control over what my life's going to look like as I get older. They're a gift to you because as you say, Brit, there's not that anguish of what to do. and actually they have the power to bring everyone closer

and even prevent family conflict because it gets everyone on the same page. Melissa, thank you so much for coming and being a part of this. This is an episode I have wanted to do for the longest time and I know it was a little bit selfish because it is very like self-healing for me but I do think it's going to help so many people and I think if you take anything from this episode, go and have those conversations

with your parents in a way that allows it to be on the table so that there isn't the fear around ageing because we're all going to fucking end up there if we're lucky enough. If we're lucky, totally. Thank you so much. Even as someone that doesn't have direct link with dementia, I found that very insightful and I know a lot of people will. Thank you so, so much for having me and without wanting

to like self-promote at all, but if there are people listening that really do want more support and they want sort of the nitty-gritty or like templates for having these conversations or anything, you can head over to TalkingAging.com. We're going to put up a page, TalkingAging.com forward slash life uncut with just a bunch of free downloads. Oh, you're amazing. You're amazing.

Also your book, you know, we need to talk about aging for anyone who needs to and wants to learn more. It's phenomenal. Thank you for having me. Guys, all the links for those resources and Melissa's book are all going to be in the show notes. So if you're interested, jump on over and you can find everything you need there and we will be back in your ears tomorrow with Ask Uncut.

Don't forget, tell your mum, tell your dad, tell your dog, tell your friends and share the love because we love love. We'll be right back.