Suddenly Senior: Ian Hickie’s philosophy on ageing well

This article is part of a series based on the new podcast from legendary veteran radio personalities Angela Catterns and Ian Rogerson, called Suddenly Senior. In the podcast, Angela and Ian chat to a diverse range of well-known Australians about finding themselves in their 60s and 70s and realising they are ‘Suddenly Senior’. The highs and lows, the glories and indignities – it’s all there in this funny and thoughtful modern take on navigating later life.  Mable is very proud to be the podcast sponsor.

For internationally renowned researcher in clinical psychiatry and leading voice on mental health issues, Professor Ian Hickie, rumours about getting older have been greatly exaggerated.  

In conversation with Angela and Ian in his episode of the Suddenly Senior podcast, Hickie presents as something of a Pollyanna, relentlessly pointing out the bright side, highlighting alternatives to many of the common fears about ageing, and spruiking the way to prevent or reverse them.  

“The reality of getting older has changed dramatically over the course of the last 100 years. People don’t die of many of the things they used to,” he says.

“It used to be rare then to see people live longer than their 60s but that’s changed radically. Now most people in their 60s, 70s and even their 80s are remaining independent, productive and engaged and it’s the minority who don’t.”

There are age-related illnesses that become more common, he readily admits.  But some of them are preventable or at least delayable. Cognitive decline is NOT inevitable, he insists, and the brain doesn’t inevitably shrink as a direct result of growing old. In fact, this is a widely misunderstood assumption about the ageing brain that Hickie is keen to dispel.  

“Brain shrinkage is not an age dependent phenomenon – it’s an engagement dependent phenomenon,” he says, pointing to research on brain shrinkage in people post retirement age. “It can happen to anyone at any age, when you disengage.”  

To keep your brain in optimal condition as long as possible, Hickie recommends staying active and involved and engaged.   

“One of my favourite lines is ‘never retire’…”, he quips.  

“And social engagement is really good. It’s actually hard to read a face or many faces in social situations and that’s great for cognition. The lockdowns have been bad for cognition for older people because they were being told to stay away from people.”

For all his energy and optimism, Hickie, aged 62, is not unfamiliar with some of the common challenges of an ageing body.

“Getting out of bed is a bit slower…. there’s a bit of arthritis,” he says. “Your motor performance slows down so I try to adjust my exercise. I have more time flexibility these days than I used to have, in order to do different things.”

Beyond the ‘average’

Thinking about care and support options in later life, Hickie rejects a one-size-fits-all approach to aged care.

“What we are trying to do is keep in purposeful roles, as active as possible and connected outside their home.  And it should be about being able to access activities and resources that already exist for people in their communities – not inventing new things for an ‘average’, he says.

“We spend a bunch of money on things we don’t want,” says Hickie, referring to the traditional menu-based approach to aged care packages which offer ‘social activities’ and support services that can be organised according to economies of scale. 

“We institutionalise these processes – food, activities, etc – and offer people minimum autonomy. They’re 20^th century planning ideas where you try to create an average in which everyone can be shoe-horned.  

“When you create a system designed to meet people’s actual needs, it’s not necessarily more expensive. It’s a bit harder to organise, but not necessarily higher costs. The costs are in transport and organisation but many of the services are already there and they’re in the community. And there are other savings – you have to count the total cost of what’s going on.”

Individual choice and respect are critical for Hickie.

“The idea that old people have no pleasure in food or sex or outside activity is mad. Don’t tell me I can’t go to the opening night… I don’t want to go to the matinee!” he says.   

Better solutions are possible

Like many people, Hickie was disappointed with the Royal Commission into Aged Care Quality and Safety.

“It all came down to residential aged care, which is a system nobody wants,” he says. 

“Why are we so focused on fixing a situation that nobody wants?  I want to age in a community that I love,” he says.

Hickie is impressed with a support system he has observed in Montreal in Canada near where his son lives.

“There is an aged care-type service next door,” he says.  “It’s in a district closely surrounded by shops and places to go with good transport, etc. The building has different levels. There are apartments with some support available, nursing home levels, restaurants and places to get together. 

“It’s part of the community. Maybe you can have students living there in the same block? Child care? The older people can chat to the kids and vice versa so you get intergenerational opportunities.  

“We can design and build communities where there are people and services.  Opportunities to maintain good physical mobility, health services, communication and telecommunications. People want to be on the internet.  We need really smart broadband. It must be easy and accessible,” he says.

There are some examples of these kinds of developments and directions being explored already in Australia and elsewhere around the world where the emphasis is on enabling people to remain connected and have active, purposeful lives – the critical ingredients for ageing well.

“Purpose, role significance, connection with others, these are so critical. We need to see the value of older people as individuals with roles and purpose – not just to be cared for,” Hickie says.  

Mable supports choice and control

At Mable, we believe clients should have the freedom to choose how they should be supported. As a client, you have the choice to decide who supports you and when, and what you pay for that support.

Whether it’s personal care, social support or domestic assistance, you can find the support service you need through Mable. Find, connect with and book an independent support worker today.

Listen to Ian’s podcast episode.