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HomeCultureBooks‘We need to talk about ageing?’ – an interview with Melissa Levi

‘We need to talk about ageing?’ – an interview with Melissa Levi

Author Melissa Levi says, “We Need to Talk About Ageing is the very book I wish my own family had been able to access, throughout my Zaida’s ageing journey.” Her hope in writing it, she adds, is to help families know they’re not alone and can find the information and support they need.

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Over the past decade in your career as a Clinical Psychologist specialising in older people’s mental health and dementia, you say you’ve been “fortunate” to help more than a thousand older people and their families navigate the ageing journey. Why “fortunate”?

I feel very fortunate to do the work that I do. To be invited into an older person’s life, their family’s lives, at a time that is often so vulnerable and sacred, is a privilege. I also feel incredibly fortunate to be able to empower these families to have a better journey through ageing – to give them clarity as to what they’re experiencing, help them understand their options, make values-aligned, informed decisions and plan for the future. Ultimately, giving families greater confidence, peace of mind, knowledge and strategies to make this stage of life that bit easier, and afford their loved ones an ageing journey that is most consistent with their wishes.

The poetry is also not lost on me, that in striving to change my patients’ lives for the better, they have undoubtedly changed mine. For good. I have learned through their stories and shared wisdom what really matters in life, and it has profoundly shaped my own priorities, values and perspective.

I love how, throughout the book, you weave your own journey with your beloved grandfather Zaida as he slips into dementia. How crucial was this personal experience in sparking your determination to write a book that could help other families like yours as they broached the heartache, tricky conversations and decision-making that come with ageing?

My Zaida’s journey was the inspiration and catalyst for this book. At the time of my Zaida’s dementia diagnosis, I was only just beginning my career specialising in older people’s mental health and dementia. While I tried to offer my family support and advice, it was so difficult to extricate my voice as young professional from that of granddaughter. So I went in search of a What to Expect When Your Father Is Ageing and Has Dementia and Can No Longer Live On His Own and Is Dying and You Have No Idea What to Do sort of book. I came up empty-handed.

Over the past decade, having worked with over a thousand older people and their families, I’ve come to know that while every family’s story is unique, we all share the same fears and questions about ageing. My hope in writing this book is that it would allow families to feel seen, to know that they’re not alone in their struggles or heartache, and perhaps most importantly, to give them the information and practical strategies to know what to do and where to seek help. We Need to Talk About Ageing is the very book I so wish my own family had been able to access, throughout my Zaida’s ageing journey.

You’ve realised over time that while every family’s story is unique, we all share the same questions and fears about the ageing journey. Such as: “What’s the difference between Alzheimer’s disease and dementia?”, “Is she safe living at home alone?”, “Is it normal to feel depressed as you get older?” “What are our options for care?”, “How can I ensure that I don’t suffer at the end of my life?”, “How can I take control of the way I age?” After working in the field for so long and having encountered the grief of a beloved one dying, what question most preys on your own mind now? What do you fear most about growing old yourself?

For a very long time, the question that weighed most heavily on my mind was, “If my family had our time again with my Zaida, what would we or should we have done differently?” I suppose it speaks to the grief that I was carrying (and, in some ways, still carry) about the hardest moments of my Zaida’s journey, our family’s journey. In time, though, I’ve reframed this question to, “How can I best help and support other families, so that they can experience a better journey through ageing, than we did? What lessons can we learn from my Zaida’s story?”

I love this question because it sparks a fire in my belly to always want to seek better for the families I work with, and it helps me – on a personal level – to make meaning of my Zaida’s journey.

In terms of what I fear most about growing old myself, I suppose my greatest fear is that, for whatever reason, I won’t get to experience later life. It’s something that I’m genuinely looking forward to, as well as the wild ride that lies between now and then. I can’t wait to be the sort of grandparent to my children’s children that my grandparents were to me. What a gift!

We Need to Talk About Ageing provides a really comprehensive view of how to age well and find the care you or your loved one might need at various points along the way. This means it is quite a large book. How have you made it easy for people to zone in on the information they need and leave the rest for when they arrive at a different stage in the journey?

I appreciate that many readers will be reading We Need to Talk About Ageing because they’re already in the midst of a difficult time or crisis, and are desperately in search of answers (and quickly!). In fact, the prospect of finding the time and headspace to read an entire book might feel out of reach. For this reason, We Need to Talk About Ageing can be read in one of two ways.

For those readers who do have the time, they’re invited to read this book from cover to cover. For those who require more immediate support, We Need to Talk About Ageing can easily be used as a reference book. Simply look up the topic of your question or concern in the index (e.g. dementia, residential aged care, depression, building a care team, etc.), and go straight to those pages. The information has been written in bite-sized pieces, so that it will still make sense and provide practical, actionable steps to take. There are also bullet point summaries at the end of each chapter, if you’re looking for a quick topic overview.

Caring for the carers of ageing people is a huge issue. But what are one or two things you would like carers to hear loud and clear in order for them to maintain their joy in life and their own health?

The first thing that I want carers to know is that caring for your ageing loved one feels hard, because it is hard. I am yet to meet a carer who finds this journey an easy one. The fact that caring is difficult is not a reflection of your ability to care or cope. It’s a reflection of the foreign, difficult situation that you find yourself in, often without much chance to prepare and without the level of support that you might need.

The second thing I want carers to know is that while caring is hard, there are some practical ways to make it that bit easier or more manageable, without having to sacrifice your own health and wellbeing in the process. In We Need to Talk About Ageing, there is a whole chapter dedicated to, and written for, carers, so that both those giving and receiving care can continue to live with quality, meaning and joy. It contains loads of actionable, everyday strategies for reducing carer stress, preventing burnout, and promoting resilience and wellbeing. There is also an online workshop called “Carer Burnout” on my website, www.talkingageing.com.

I love the phrase “relationships are medicine and they are health”. How does this relate to the ageing journey?

I’ve had the privilege of spending time with patients and grandparents, as they near the end of their lives. There is something about coming face-to-face with one’s mortality that cuts out all the noise. And in these moments, every single person – people from all different backgrounds, with diverse life experiences – craves only one thing: the tenderness and love of the people who love them, and whom they love. It is the people who make a life.

While we’ve always intuitively known this, we now have the scientific research to prove it. The Harvard Study of Adult Development may be the longest running study of adult life in the world. For over 80 years, researchers have been tracking the lives of a group of Harvard students, as well as a group of men from Boston’s most disadvantaged suburbs. Scientists investigated the question of what predicts or constitutes a happy, healthy, long life. Researchers comprehensively assessed the participants’ every two years, examining their medical records, including blood tests and brain scans, as well as their professional achievements, financial wealth, family lives and so on.

One factor was found to reliably predict those who lived happy, healthy, long lives and those who did not: the quality of their close relationships. They have the power to make us healthier, happier and to live longer.

Conversely, social isolation and loneliness have been described as silent killers. Not only does loneliness make us more vulnerable to mental health conditions such as depression or anxiety, it can affect physical health, increase the risk of dementia and even reduce life expectancy.

It is our responsibility, as individuals, families, communities and as a society, to increase the opportunities for older people to experience real, rich social connection and support. If you are reading this, because you are on, or anticipating, your own ageing journey, I encourage you to prioritise and invest in your personal relationships with the same importance, discipline and time that you might give to managing your health or finances. And if you are reading this, and you have an older person in your life, I ask this of you: spend time with them. It doesn’t take much; it’s a phone call, a cup of coffee, a visit, an outing. It has the power to change someone’s day, and perhaps, in time, their life.

“We Need to Talk about Dying” is the last part of the book in which you say death needs to become “dinner table conversation”. Why is that? And what are one or two key things about dying that it would be good for families and loved ones to discuss?

I grew up in a family where death was strictly taboo. We never spoke about it. So when my family inevitably had to face the death of my Zaida, we were shattered. We were so confused, overwhelmed and ill-prepared. In hindsight, I think it compounded our grief, as we second-guessed what we could or should have done differently.

My husband’s family, on the other hand, not only spoke about death, they joked about it with the apparently “soon-to-be-deceased” at the dinner table. Initially, I found these conversations confronting and morbid, but in time, I learned how immensely valuable they were. When my husband’s grandfather, Pa, neared the end of his life, his family and his doctors were absolutely clear about his wishes. They were able to afford him a dignified end-of-life journey that was consistent with his wishes. And this knowledge gave them a sense of comfort and resilience in their grief, after he died.

Death needs to become dinner table conversation, because we can’t change what we don’t talk about. It is through expressing and understanding one’s wishes for their end of life, that those who are dying, as well as their loved ones, can experience the gifts of a dignified death. You can find practical strategies, conversation prompts, scripts and questions in the chapter titled, “Creating a Dignified Death”, in We Need to Talk About Ageing.

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We Need to Talk About Ageing by Melissa Levi, Hachette, $34.99

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