S1E11: Vertigo

SummaryDr. Des speaks with Dr. Anthony Marinucci, a specialist GP focused on older people and aged care in Australia, about how a trusted GP can help older adults stay healthy and independent. They explain continuity of care, MyHealthRecord and MyMedicare, the 75+ health assessment, medication reviews, and practical ways to make GP appointments more useful.KeywordsHealthy ageing, GP role, older adult healthcare, continuity of care, MyMedicare, MyHealthRecord, 75+ health assessment, medication review, deprescribing, aged care AustraliaKey topics(1) A GP’s role is to understand the whole person, coordinate specialists, and tailor care to the older adult’s priorities, independence, and quality of life.(2) MyHealthRecord is a national health-information repository; MyMedicare is a free, voluntary registration linking a person to a preferred practice and GP, with access to certain additional Medicare arrangements.(3) A 75+ health assessment should cover function, falls, mobility, memory, mood, medications, nutrition, continence, support, wishes, and preventive care, then produce an agreed plan.(4) To get the most out of a GP visit, state the main concern and priorities, bring an accurate medication and health-information list, and leave knowing the next steps.(5) A home medicines review brings a GP and pharmacist together to assess actual medication use, identify risks or practical barriers, and agree on possible changes.Action items(1) If your regular GP is retiring, ask whether you can continue with the practice and establish a relationship with another clinician there.(2) Ask your GP practice whether you are due for a 75+ health assessment; book it specifically as an assessment and allow the appropriate time.(3) Before an appointment, identify your main concern and priorities; bring an up-to-date list of medications, vitamins, supplements, and relevant medical records.(4) Before leaving the GP appointment, confirm the plan: tests, medication changes, referrals, follow-up timing, and what to do if symptoms worsen.(5) Ask your GP whether a home medicines review is appropriate, particularly if you take multiple medications or have difficulty managing them.Chapters00:00 Why the GP matters more as healthcare needs grow03:43 The specialist GP and the whole-person approach06:10 Why continuity helps clinicians notice change08:03 Finding a healthcare home when your GP retires11:47 MyHealthRecord versus MyMedicare16:13 The 75+ assessment as proactive healthcare18:07 What a thorough older-adult health assessment covers20:31 How to book and prepare for the annual assessment24:17 Three ways to get more from a GP appointment29:31 Home medicines reviews and deprescribing34:06 Care coordination and treatment aligned with personal goals

SummaryDr. Des explains what geriatricians do, why their whole-person approach differs from care focused on a single condition, and why an assessment can be useful before a health crisis. He also outlines five signs to watch for, how to arrange and prepare for a consultation, and practical questions to ask.KeywordsGeriatrician, healthy aging, older adults, falls prevention, medication review, polypharmacy, aging wellKey topics(1) A geriatrician is a specialist in the health of older people, trained to understand how ageing affects multiple body systems.(2) Geriatricians connect the dots across health issues, medications, mobility, memory, and independence.(3) A review by a geriatrician covers memory, mood, sleep, falls risk, medical history, medications, physical health, services, and personal priorities.(4) Five possible reasons to ask about geriatric care: a fall or near-fall, a pattern of memory changes, five or more medications, two or more hospital admissions in a year, or declining independence and carer strain.(5) A geriatrician complements rather than replaces the GP, who remains the primary care doctor and coordinates ongoing care.(6) To prepare, bring every medicine and supplement, a list of questions, notes about falls and assessments, and a trusted friend or family member if possible.(7) At the appointment, advise what matters most to you, which medicines still help, what you can start doing, what warning signs to watch for, and who will follow up.Action items(1) Put every prescription, over-the-counter medicine, supplement, cream, eye drop, and inhaler in one bag and take it to your next appointment for review.(2) Write down every fall or near-miss from the past year.(3) Bring written questions and key health details, and consider bringing a family member or friend.(4) At the consultation, ask which medicines are still helping, what warning signs to watch for, and who will follow up the plan.Chapters00:00 Why a geriatrician is more than a nursing home doctor02:14 How aging changes the body, and what geriatricians specialize in03:21 Why whole-person care connects problems other specialists treat separately04:14 What happens during a full-picture assessment06:00 Evidence for comprehensive geriatric assessment and the GP's role07:11 Medicine 3.0: prevent the crisis before it happens09:16 Five signs to consider a geriatrician13:13 Why earlier care can reduce harm, cost, and access barriers15:44 Getting a referral and preparing for the appointment18:27 What to expect and five questions to ask your geriatrician23:41 The myth that geriatricians are only for frailty25:10 Three steps to take this week

SummaryDr. Des, a geriatrician and healthy aging specialist, explains why healthy aging is about preserving wellbeing, independence, and the ability to do what matters, not simply living longer. He introduces five foundations - physical, social, nutrition, mental, and medical - and offers practical steps listeners can start this week, including a chair test, a phone call, and adding protein at breakfast.KeywordsHealthy aging, aging well, geriatrician, strength training for older adults, social connection, protein for seniors, cognitive health, preventive care, older adult healthKey topics(1) Dr. Des contrasts life expectancy in Australia with healthy life expectancy: about 81 years for men and 85 for women, versus about 72 and 74 years in full health.(2) Healthy aging means staying well, independent, and able to do what matters, with care that begins before a crisis.(3) Walking supports heart and lung fitness, but leg strength is vital for standing, climbing stairs, and getting up after a fall.(4) Social isolation and loneliness are associated with poorer health.Older adults may need more protein and energy.(5) Mental stimulation, hearing care, and discussing a persistently low mood with a GP can support brain health.(6) Preventive medical care includes regular GP checkups, eye and hearing tests, and reviewing vaccination needs.(9) Dr. Des frames the decades differently: build reserve in your 60s, protect balance and connection in your 70s, and prioritize function in your 80s and beyond.Action items(1) If safe and comfortable, do five slow sit-to-stands from a chair without using your arms once a day; seek suitable professional guidance if you have health or mobility concerns.(2) Call someone you would normally text and have a conversation by voice.(3) Add a protein food to breakfast each day, such as an egg, yogurt, milk, baked beans, or cheese.(4) Try a new activity that requires focused concentration for at least 30 minutes, and keep challenging your brain.(5) Book a GP appointment to discuss preventive care and which vaccinations are due or appropriate for you.(6) Consider regular checks of hearing and eyesight, and tell your GP if you have felt low for several weeks.Chapters00:00 Why a 85-year-old may outpace her 70-year-old daughter01:45 Season two: a six-part foundation for healthy aging03:32 Why families need a roadmap before an aging-related crisis06:00 Dr. Des’s rural roots and access-to-care mission06:38 The gap between living longer and living well08:45 Why aging care should shift from reactive to preventive10:11 Why walking is not enough to preserve leg strength12:25 Loneliness, social connection, and the call-your-friend challenge14:24 Protein at breakfast: why older adults may need more16:04 Keep challenging your brain, and check hearing and mood18:54 Preventive GP visits, vaccines, and routine health checks21:08 Myth check: strength training can help even at age 9023:07 What to focus on in your 60s, 70s, and 80s24:27 Dr. Des’s three-step prescription for this week

On the Healthy Ageing Podcast, Dr. Des is joined by Nurse Practitioner Kelly Arthurs. With 30 years of nursing experience, Kelly has spent the past two decades specialising in palliative care.Throughout her career, she has worked as both a clinician and educator, delivering expert symptom management and high-quality end-of-life care across diverse settings, including palliative care units, residential aged care, community services, paediatrics, as well as private and public hospitals.

In this episode, Dr. Chris Bollen from Bollen Health joins Healthy Ageing Specialist Dr. Des to address five prevalent myths about ageing and frailty, aiming to enhance the ageing experience for everyone.(1) "You are 85, and there’s nothing we can do to help you…what do you expect at your age?"(2) "Frailty is a part of normal ageing."(3) "You can’t build muscle after age 70."(4) "My doctor told me I should not eat eggs as they are bad for my cholesterol."(5) "I am on this medication for life, because my specialist said so many years ago.The podcast explores the concept of frailty and how it is often misunderstood.

Dr. Des engages in an insightful conversation with Adam, a clinical nurse specialist based in Northern Sydney, about the complexities of delirium. They delve into the various causes of this condition and explore a range of strategies that can be implemented in the hospital setting to provide better care for those affected. The discussion highlights the importance of early recognition and intervention, as well as the role of a multidisciplinary approach in managing delirium effectively.With 17 years of nursing experience, Adam brings a wealth of knowledge to the topic. He is currently dedicated to developing comprehensive educational programs and policies for staff aimed at enhancing the management of delirium in acute care settings.

Dr. Des sits down with Dr. Tim Hucker, a Specialist Pain Medicine Physician and Director of Northern Beaches Pain Management, for an in-depth conversation about chronic pain.Dr. Tim Hucker brings a wealth of expertise as a pain specialist, particularly in managing back and neck pain, joint-related pain, nerve pain, pelvic pain, and cancer-related pain. He is deeply committed to a holistic approach to pain management, striving to enhance the quality of life for his patients and the wider community.

Dr Des speaks with Steve Collins, Founder and CEO, of My Way Up and a physiologist with a BASc degree, dedicated to revolutionising gut health. With over 20 years of experience, Steve developed a deep interest in the intricate connections between the gut, body, and brain.

Dr Des talks with Jordan Loveridge who is a vestibular physiotherapist that has completed several advanced courses in vertigo and vestibular management.  He presents webinars and professional development sessions for GPs and other allied health professionals.  Jordan created South Coast Dizzy Clinic, a dedicated vertigo, dizziness, and balance clinic – with nine locations across the state.

Dr Des chats with Anna Sterken, Anna is the Director of Client Experience and Governance at Home Instead and has nearly 25 years’ experience in community and aged care, including as a Registered Nurse. During her career, Anna has witnessed a huge number of changes in the sector over this time.