Why Ageing is Not for Sissies: Dr. Stephanie Ward | Club Sandwich
Ageing parents? You’ve got them. We’ve got you.
One minute you’re living your life, and the next, you look at your parents and realise everything has changed. Whether it’s a sudden health event or a slow "crumble," navigating the aged care system while holding down everything else - work, kids, grandkids, or just your own sanity - is the hardest job you’ll ever do.
In this debut episode, host Sarah Macdonald is joined by geriatrician Dr. Stephanie Ward (Old People’s Home for 4-Year-Olds). They dive into the visceral reality of being "squashed" in the middle, the physiological changes our parents face, and why the Silent Generation and Baby Boomers present unique challenges for the Gen X carers looking after them.
JOIN THE CLUB: Visit clubsandwich.community to join the tribe, access resources, and find our private Facebook community.
SEND US YOUR QUESTION: hello@clubsandwich.community
In this episode, we discuss:
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The "Squishy" Middle: Transitioning from the mosh pit to the layers of responsibility.
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Why Geriatrics? Dr. Stephanie explains the holistic "safe port" for older Australians.
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The Rumble: Understanding biological ageing and why it feels like it happens overnight.
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Ageism as Prejudice: Why we need to stop being patronising to our elders.
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Parenting in Reverse: Navigating the grief of shifting roles.
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Self-Care Corner: Sarah’s "funnel web" hospital trip and Dr. Stephanie’s double bass.
Meet the regular Clubbers:
- Melissa Reader - CEO of Vera and expert on Australia's ageing crisis.
- Dr. Jo Lamble - Clinical psychologist specializing in guilt and family dynamics.
- Dr. Ginni Mansberg - GP and women's health advocate who tells it straight.
- Dr. Stephanie Ward - Geriatrician helping you understand when "old" becomes a crisis.
- Kerry Milligan - Gogglebox star bringing humor and honesty to the sandwich generation.
Credits
Club Sandwich is brought to you by Vera, helping families caring for ageing parents navigate this stage of life — so you don't have to do it alone.
Sarah Macdonald - Host + Executive Producer
Melissa Reader - Commissioning Editor, Executive Producer + Clubber
Rachel Fountain - Executive Producer
Audio + video edits by Fountain Media Group
Thanks and kudos to Sean Wayland for our awesome theme music Club Sandwich - hear more from Sean at seanwayland.com
See omnystudio.com/listener for privacy information.
Transcript
Club Sandwich is recorded on Gadigal Land, home of the EORA Nation. We pay our respects to elders past and present. Always was, always will be. Hello, welcome to the first episode of Club Sandwich. Now this is a podcast for you. If not so long ago you were kind of dancing in nightclubs or you are being squished in a mosh pit and now suddenly you're being squashed between layers of responsibility. You may have a mum or a dad you're looking after or an auntie or an uncle. You might have kids still at home, you might have grandkids, you might have a really full time job that is pretty taxing. So your dance card is pretty full and we are here to help. You're gonna get hacks, you're gonna get help and you're gonna get a lot of information on this podcast that we hope will make this a little less squishy or more like a squishy hug. My name is Sarah McDonald. My mum is 92, my mother in law is 94, my dog Shaggy is 105 and he's doing pretty well, but life is pretty full on. I'd like to welcome to the club Dr. Stephanie Ward. Now Stephanie Ward is a geriatrician. You may have seen her on Old People's Home for four year old and the one they did with teenagers as well, which was just. Well, I just cry every episode really. She's also a conjoint associate professor at unsw. Welcome to the show.
I'm very excited to be here. Sarah.
So good to have you. So good to have you. Now here's the thing. You are a brain on a stick. You got like 100% tertiary entrance mark. Why did you become a geriatrician? Because it's not a profession that a lot of people really see or, or lord or value I think. So why did you go into this?
It's an incredibly rewarding branch of medicine actually. So geriatrician is a medical specialist for people who are older. And I think what really appealed to me when I was training is the fact that it's explicitly holistic. So, you know, we know that we have a lot of older people might see their cardiologist, they might see an ophthalmologist, they might also have to go and see an orthopedic surgeon. But what I love about being a geriatrician is that we look after the whole person and we don't just look after all of the medical issues. We also take into consideration things like people's day to day function Their cognition, their mental health and well being and social structure and supports as well. And as a clinician, it's really empowering to be able to say, you know what, I can deal with all of this complexity. I don't mind it. And it's really lovely as well. I think when we go on this aging journey to be at a temporary safe port of call and support for older people and for their family members as well.
It's so true. Because when you go into hospital, you kind of get from department to department to department to department, and it doesn't look like sometimes people are seeing them as a whole person and a whole unit with all these different things going on. So it is a lovely job and good on you because it's a really, it's a really important one.
It is, yeah. And it's also incredibly rewarding to spend your time with older people because these are people who've got a lot of lived experience of life. They're experts on life, and you get a really unique perspective on life and what's important and maybe what. What isn't so important. So I think that's, it's a real gift, to be honest. Yeah.
What have you let go since you've started working with older Australians?
Look, I'm. I'm not as knowledgeable or as skillful as I'd like to be.
Yeah.
But you, I think you learn to value what's really important.
Yeah. You're not a Buddha yet, you have more Zen, but you kind of. Yeah, you get life. You kind of get the perspective of life. Yeah, yeah. And I want to talk about what's going on for them. But just before that, this is a podcast for the sandwich generation. Like, who do you see coming in with some of the people that come to see you? Is there often a daughter or a son with them? Who's with them?
In addition to the fact that I love working with older people, I also really love working with their family members and I love being with the children of older people because often as we get older, we start to need a bit of help from a spouse. But quite often it's children and it's middle aged women like us who are also trying to manage the care of our older, older family member with the. Our children with jobs, with all those other responsibilities that come with adult life. It's really inspiring to work with women our age who are veritable superwomen, in my opinion.
Yeah. We have to be really, don't we? Yeah.
Yes, yes.
So much going on.
And I'll just share with you. The other day in. I saw a lady coming into a clinical environment. I wasn't involved in her care, but I. I looked at this woman walk in and I could see on her face worry. I could see on her face that she was juggling an enormous amount of material. Coordinating care probably has some work issues going on. And what I saw as this woman walked in is I saw someone who was just utterly brilliant. And I thought, wherever you go from this moment on, I just hope someone acknowledges that and tells you what a fantastic job you're doing and says, you're not alone here. Because I think what really worries me is that the caregiver isn't being seen. You don't get Instagram likes, right? You don't get an income, you don't get an Oscar or a prize. And sometimes you don't even get gratitude or thanks.
You don't often get acknowledgement. Like when you were saying that, I was like, oh, my gosh. Just to be acknowledged.
Yes.
Is so powerful. So you. So do you say that to the carer often? That's with one of your patients routinely.
And I feel like that is my responsibility. It's to see what this person is doing and to say to them, you are doing an amazing job. And I mean, every time I say it, I mean it. To care for somebody is one of the more challenging things you can do in your life, but also one of the most beautiful and magnificent things that us as human beings are capable of. And not everything's gonna be perfect. And I think women especially, we're always so self critical. But if you're turning up, if you're worrying, if you're asking questions, if you're thinking, maybe I'm not getting this right, if you're listening, let me tell you right now, what you're doing matters. And you are doing an awesome job. And you need to hear it.
That's amazing. Thank you. You are doing an awesome job. I think that needs to be kind of our tagline and our tattoo on our mantra that we kind of say to each other every day because it is really hard. And yes, it is a great gift. Unless you sometimes, when it's not so stressful, you can really, I think, get so much out of this. But. And we don't need to get a medal just for showing up, but just to be valued. Thank you. That's like, that's so. That's lovely. Clubbers say that to yourself every day. Stephanie says you're doing a great job. You are. But I Suppose this podcast is about helping them do an even better job keeping all those things, you know, wheels spinning and looking after yourself to some extent.
Absolutely.
Which we'll talk about down the track with other clubbers. The sort of, you know, looking after yourself so the wheels don't fall off. So to be acknowledged is great, but to also know what's going on is really important. So what should we expect as our parents get older? It's a very generic question. And I know, you know, there's specific instances here that everybody is really different.
Yes.
But what do you think is the hardest thing often for the sandwich carer about their parent ageing?
So it's a really great question. And you're right, everyone's aging journey is different and everyone's family structure is different. But I think one of the more difficult sources of conflict and challenge is when a caregiver, a child of an older person, can start to see some changes and can start to see some problems or risks emerging and has some ideas about how those can be addressed, and the parent has a different take on it. They perhaps don't appreciate or share the same viewpoint, that there are issues. Some people might call this denial, or sometimes it might be a lack of awareness, or sometimes it might be a change in priorities as well. Accepting a little bit more risks than they. Than they used to. And that can be a really difficult interface.
It's the one thing I think a lot of people find the hardest, and it's so hard. Can you come back and do another episode in a week or two, just specifically on denial? I'm calling it denial. You can call it awareness. And again, it's depending on who's got the feeling. But I think we need to do a deep dive into that because that's a big one. So stay tuned for that one.
Yes.
But generally the thing I think that happens is to get back to the sort of general thing about ageing and perception. It kind of seems to happen so suddenly, you know, like, you don't. You like. And with ourselves, you don't notice them aging. And then all of a sudden you look at your mum and you go, she looks really different to yesterday. She's actually not going so well. Like, what's going on there? Is that perception, or is it true that we just don't age much and then we age suddenly and it goes in kind of up and down bursts, or mostly down, but not necessarily down.
Not all down. Something's not all down.
Some things are great.
And I know there was recently an epidemiological study that looked at a longitudinal group of people, people up to the age of 75, and it suggested that in the course of normal, healthy human lifespan, there are a couple of age groups where we did seem to have more accelerated biological aging. And from memory, that was around our mid-40s and around the age of 60. But I think we're talking a little bit more about people who are even at an older age, maybe 70, 80, 90, even 100. And everyone's journey is different. But often what I see, and perhaps you might have some experience too, is sometimes there's an event that happens. It could be a major health event, a fall, a hospitalization, a fracture. It could be a major life event, such as a loss, a loss of a spouse or significant illness or stress in another family member. And my experience, and I think perhaps that of a lot of peers, is that instead of it being more of a gradual change at that point, it's a sudden change.
Yes.
And it can be somewhat confronting, particularly when it's your parent and for them as well.
So I remember when my mom, when my dad died, he died overnight. And I went and told Mum and it was like. It was like sort of half her body disappeared. It was like half her spirit left her and she just shrunk instantly in front of my eyes and she did. Yeah. Things got harder for her after that because this ballast, this life companion, this difference that, you know is going to happen eventually and this loss that you've navigated the world so long for, it's just. Yeah, grief, the power of grief is. Is really strong. So that can kind of. Yeah. Shift things onto a new. Onto a new paradigm. And often you don't come back from. I mean, you'll come back a bit, but you're never gonna kind of really come back. I mean, is that what ageing is? It's just accepting that while you can slow it down, some things, like skipping dancing on the dance floor perhaps might not come back.
That's a really good point. And I'm really sorry for your loss as well, for us and your family.
Yeah, he was a beautiful man, but, you know, we still honour him a lot. But Mum still says, why did he leave me? I'm like, he didn't leave you, he died. He didn't want to leave you. Poor old dad.
But anyway.
Yeah, like that kind of a grief.
Even at the change in function.
Yeah.
That we have. But it is.
There's. Is there a grief in losing something and not getting back? Like the natural grief of. Of loss of Yourself, parts of yourself.
Absolutely. I think we all cope with that differently. But it's, it's really confronting when you can't do things that you used to be able to do. Maybe, maybe it was marathons, maybe it was dancing, maybe it was skipping, maybe it was being on 50 different committees. But when our physical body, where our physical health or cognitive health means we can't do the things we used to be able to do, it's upsetting. There's a grief with that. And you're right, we can do a lot of things that can help us age in a, in a healthier way, but we can't control everything. So it's understandable. I mean, I often try and put my own self in that position because we work so hard during our life to become independent, to develop all of these skills, to be in control, so much in control that we're capable of caring for parents, caring for kids, working at the same time. But think about in 10, 20, 30 years, what it would be like if you were struggling just with some simple things and how hard it would be to acknowledge that.
Yeah, well, we're getting back to that denial, which, which we'll talk about down the track. I think that a friend of mine's dad said, we don't age, we crumble. And I thought that's really interesting. It's sort of little bits crumbling away. I mean, what is going on in the body that is grumbling? I mean, it's basically kind of, I suppose it's just loss of certain skills really. Like we need to be aware of this as a hack, like to try and put ourselves in their framework.
Yeah, great question. It sounds, really, sounds somewhat frightening though, doesn't it, that we all crumble. So there are.
I feel like I'm crumbling every day.
I hope I don't crumble in this interview. But we all do have some normal physiological changes that happen with ageing across all of our body systems. So, you know, our muscles change in terms of their bulk and in terms of their strength, our bones change, we lose bone density, our hormone systems start to change. And even in healthy aging, our thinking skills change a little bit. What happens as we get older though is that often we also start to get age related diseases start to creep up as well. So things like dementia become more and more common the older we get. It's not a normal part of aging, but the older we are, it becomes particularly common, the more likely it is to. Yeah, and some people don't have dementia but have some cognitive changes. We Call mild cognitive impairment that are still quite a nuisance. It's quite common to have changes in our hearing. I think we've all experienced that.
Too much on the dance floor, One of them's gone already.
But too much of the moshfield.
I'll be like, what's that digious idea? I'll be totally that person.
But that's a really tricky one because it's frustrating for communication. It can make you more isolated, can make it more harder to go out. Changes in vision as well. So a lot of different visual issues like macular degeneration, for example, glaucoma, other changes in vision that make it harder, you know, to perceive the world around us. What can be really frustrating for a lot of older people, particularly at the extremes of their age, is changes in imbalance and feeling just confident on your feet. We take our balance so much for granted. Right. But being able to say, I'm actually really scared of going out of my house because I might fall over, or I don't feel very confident even getting dressed, you know, just put yourself in that position about how hard that would be. And our immune system can change. So, you know, illnesses that, you know, might have made us a little grumpy when we were younger, might have made us a bit tired, can have huge effects on our function when we get older. And then some people even get what we call a delirium where the brain gets really overwhelmed and confused when you get sick. And that's terrifying for the person. And that can happen often with urinary.
Tract infections which become more common, can't it?
Yeah. So there's a range of sort of what we call normal changes with aging, but then also these common diseases that can accumulate with age that just can at a certain point make day to day life. You know, it's, it can make it a real, a real battle. And often what I say to people and I don't, I think you might have mentioned to me before, I'm not original with this. I thought I was very original, but I just sat down with someone one day and I said, getting old is not for the faint hearted, is it? And that really resonates with older people.
And aging is not for sissies. This totally is hard bloody work. The hardest job I've ever done.
Yes, it really is. I mean, imagine all the things that you need to do day to day life. If, for example, you can't hear properly, maybe you can't see properly, maybe you have pain or arthritis and so getting up hurts, maybe you don't feel so steady on your feet. You don't have as much energy as you had before. Maybe it's hard to always remember all the things you have to do.
Oh, it's hard for us to do that.
Well, exactly, because that's really interesting.
Because, Stephanie, because you said, you know, you're doing a great job to the sandwich generation and the carers, which is so wonderful to hear. But also, I suppose we need to acknowledge that if we're looking after a parent or a loved one, because we need to acknowledge that this is hard work, that it is not for sissies, that they are brave and they are strong and they are handling this as best they can. And just to be kind of aware of that, like, you're amazing.
Absolutely. I mean, it's a message that I give in my practice to both my patients, the older person and the caregiver as well, because I see these challenges, and they're challenges for everybody. The challenges for the person experiencing it, and they're challenging for the person that's caring and trying to help this person as best they can.
Yeah, yeah. And it is. You've got to be tough and you've got to be strong, and I think at the same time, you're trying to, for a lot of older people, maintain their dignity and their grace.
Yes.
In a society that treats them pretty badly, you know, silly old thing, old codger, you know, is kind of either like that, sometimes dismissive or often just really patronizing. Oh, aren't you a dear old thing. Like that must be so aggravating. They must kind of want to get all the remaining strength. And people for that, like, that kind of stuff must hit hard, too.
Absolutely. I think that ageism is probably the most socially acceptable type of prejudice in society.
It is.
We're just okay with a lot of it, and we shouldn't be. And sometimes I obviously don't share those views, but I want other people to understand, hey, you try and get through the day like this. And what's interesting in some healthcare training settings is, is trying to help younger healthcare professionals understand what life is like for an older person. So having glasses on that mimic what it's like to see with cataracts or with macular degeneration and having gloves on and having heavy things on your feet, so you know what it is like what someone else might be going through.
So they do that in your training. So you kind of like. Yeah, like people who will put on a suit to kind of understand what it's like operating as a bigger person.
Exactly.
Oh, that's so good.
Yeah. Just to help people really understand.
Viscerally understand.
And when you do understand that you should never ever be pejorative or patronizing to an older person. These people are, you know, they're superheroes. To keep, you know, giving things a go despite often some challenging physical issues. So I always like to remind people of that and congratulate people for facing these challenges and doing the best they can. That's all we really can do. Right? The best we can.
Absolutely. So I think that's a good thing for us as a sandwich generation, to put yourself in there, imagine what it's like for them, or put some bad glasses on or. Yeah, understand that. And to not be patronizing ourself. And I think sometimes when we're rushed and we're hurry, we can be a bit dismissive or, you know, we've got to be very careful about our language as well, don't we? Because even if they can't hear very well, they're going to hear the one thing you say that's wrong or that sucks, that is a bit mean or is patronizing. The antenna will be up and they'll all of a sudden have the hearing of a cat and you stuff up. And I think we all do that.
Occasionally we do stuff up. And I think we've got to also cut ourselves a little bit of slack as well because we often go in with that mindset of not wanting to do those things. But at the end of the day, sometimes patience is going to be tested. You're rushed, we're human, we get frustrated. And it's the same as parenting too, right?
Yeah, that's right. Absolutely. It's similar, isn't it? Like it is. And that's why I think it's so confronting for us, because it's often like parenting in reverse a bit. And you're parenting your parent who parented you and they changed your nappies and helped you learn to walk and now you're helping them walk. And I sometimes do kind of look around the aged care place and I think, oh my gosh, it is like a bit like childcare, you know, instead of the little walking thing, they've got to learn to walk. They've got the walkers.
Yep.
And you know, there's toileting issues and there's all these things that are a bit like kids and that, but there's awareness. Whereas for kids everything's exciting and like, I'm learning this, aren't I amazing? And they're going, oh, I'm doing this. This is. Yeah, yeah.
Although it is hard and it's. And it's. I think it's a good comparison. But when I think back to, you know, parenting structures in society, we know that parenting and caring role is. It's a really important one. We know it's a really hard one. We know that it's a young, incredibly valuable.
There's all the styles, there's all the books, there's all the websites. Yeah.
And there's also, I guess perhaps there could be a lot more recognition of parenting and how important it is. But there are structures in place. There are parent groups. Right. There's social supports like through schools and preschools that bring other parents together so that you're experiencing this with. Within a social structure. It can be different, though, when you're caring for older parents, in that you can be more isolated.
Yes.
And you don't, you know, we don't have as many carers groups, for example, structures in which we can connect with other people going through what we're going through. But that's often the most powerful and supportive way we can get through these challenging roles.
And that's why we're doing this podcast and the Club Sandwich community, which is on Facebook and on Instagram. I hopefully that that will develop into that, and we'll do a lot more of that. So what do you think about this generation? Because what's happening this year is the first baby boomers are turning 80, the first generation X are turning 60, about to hit our own ageing cliff. Thank you very much. So what do you think specific and interesting about this generation that we need to be mindful for as we kind of head out on this dance floor together?
Each generation has had different experiences growing up, and the baby boomers are likely to be more of a discerning and assertive age group. I think that's a great thing, to be honest. I think that it's great to have such an important demographic getting into the older age and really setting the agenda about what they expect and what ageing can look like, because aging can be a great experience as well. There's a lot of things that can get better as we get older and a lot of richnesses in life that you get more of as you live longer and longer.
Yeah.
But it might change the dynamic as well.
It's going to. And we're going to talk more about that in another episode with Kerry. She's like, we're going to take charge, boomers. We've taken charge of sex, drugs, and rock and roll. Let's do aging. But what about the generation that are older? Who are the. Sometimes people call them the silent generation or the greatest generation. Like, what do you find specific about them? That kind of exacerbates sometimes that generation gap between them and their carers and their kids that are looking after.
I think they're. They're a generation that. I've often gone through the older generation before our current age group, we're gone through the wars and gone through big changes in social structures as well. Perhaps haven't been as assertive or hasn't complained as much and have been more stoic, which maybe has portended some additional challenges for caregivers, but in other ways made it a little bit easier as well. Whereas more newer generations, bit more individualistic as well. And over time, our societies changed a bit as well.
And that can be really bewildering for them. I mean, one of the frustrations, and this again is a whole other episode, but the technology that they're expected to use when they're not a technological organization is just, you know, or they don't have that technological organization. It's just so frustrating.
It just cuts you out of so much of life.
Yeah. And then, like, you need a pin for this. You need to do this on your phone. They're like, I don't know how to use a phone.
I think I'm already feeling like this myself.
So am I. Exactly.
So.
Exactly.
The world is becoming more and more bewildering. And one of the challenges that can also happen is that if people start to lose some of their cognitive abilities or vision, their use of these devices and technology can change as well. So it's a risk.
It's a big thing that we're going through with my mum, you should see what I've done to remote controls with masking tape. It's amazing. You can also buy some in certain clocks and things like that. But you have to get very creative. There's craft involved.
Yes. Are we going to have a podcast dedicated to craft in this space?
Anything is possible. You don't know. We could do a podcast while we're doing crafts.
Yes.
While we're making things together or something like that. Because that might be something that all of a sudden your lovely parent, who's never been interested in, suddenly is. And that's good. You can keep them busy and go with interest. I cut the dog's hair the other day with Mum involved. She just loves it. Yeah. She was just like, yep, I'm useful. I'm really involved in this. And we made a giant mess on her floor. Hey, I want to finish every episode with asking the clubbers, what have you done for yourself this week? Or what are you going to do for yourself this week? So what about for you? Have you done anything for yourself this week?
Well, yes, Sarah, I have. So in the last week, I have actually practiced the double bass. Yes.
Are you a double bass player?
Well, terrible one, Sarah.
Oh, my God.
I mean, in my head, but not actually in real life.
You are just amazing. My son's a double bass player. Are you like, or jazz or are you the bow?
Well, I've got a very complicated relationship with the bow.
Okay.
But we're trying to get back together. That's all I'll say.
Did the bow cheat on you?
I guess you could put it like that. What I noticed is every time I was looking at the bow, my fingers would do something. And every time I looked at the fingers, the bow would, like, go wayward. So I guess it was not on the straight narrow. So now I realize I just need to look straight ahead and equally disadvantage both limbs.
Wow. Are you amazing. Okay, well, here's the thing I did for myself this week. I got bitten by a spider. Got home, turned the light on, it was dark, trod on it. My husband was like, I think that's a funnel web. My daughter was like, no, it's a huntsman. Oh, my goodness. Then we captured it, and we thought it was a funnel web. We went to the hospital. This is really for me. This is a story for me. It's coming. We get to the hospital with this funnel web. The woman who I showed it to leapt across the room in horror, right? And they put me in. And then there was this. The whole staff were thrilled. It was the most exciting thing that happened all day. And then they were like, 60% thought Huntsman, 40% thought Funnel Web. So I had to stay overnight. And this lovely doctor came up to me and he goes, hi to me and my husband. He goes, oh, I see you here all the time. Well done for coming for you because you're usually here with the granny. So you. Well done for actually looking after yourself and coming to hospital for you. And I thought, that's the thing I've done for myself this week, taking myself.
To hospital and survived. Survived a near death experience.
So not a funnel web. I reckon it was Huntsman.
Wow.
Yes.
Congratulations.
Yeah, thanks. I survived and I went to hospital for me.
Good for you, Sarah.
Good for you.
I think you've actually one upped me on playing the double bass. But anyway I don't think so.
I'd love to be able to play double bass. Okay, let's come back in a couple of weeks or so and we'll talk about denial when your parents won't accept help and how you navigate through that. But thank you so much for today.
Thank you. Sarah.
We would love you to jump online and send us a question for Stephanie or one of our clubbers like what do you need help with with the person that you love and look after? What advice do you need? What can we have an episode on and how can we help you? You can go to our Facebook page. You can go to our Instagram, you can go to our email. The email is helloubsandwich.community and you can go to the website too. So check it out and remember you are amazing. Stephanie says so. You're doing a great job and you are amazing.
Sa.