Dementia programs for men – Why we need a gendered approach

Greg Millan, Men’s Health Consultant & Director, Men’s Health Services

men’s health SERVICES

I would like to show my respect and acknowledge the traditional

custodians of the land on which we meet today and pay my respects

to them and their culture, and to the elders both past and present.

I provide a range of male friendly services with a focus on improving the state of male health and wellbeing, thus improving the wellbeing of the whole community.

• Professional Training Programs – ENGAGING MEN

• Men’s programs – Meaning for Men, Managing Depression & Anxiety, Understanding Relationships, Understanding Difficult Emotions, Men’s Sexual Health & Wellbeing

• Healthy Men at Work

• Men’s health event management services – Conferences, Seminars, Men’s Health Trivia Nights

• Project and research work – Beyond Blue, PCFA, wide range of clients

MY BACKGROUND

Health Social Worker 34 years | Men’s health worker 28 yrs

President, Men’s Health Forum NSW Inc

Vice President, Australian Men’s Health Forum Inc. (AMHF)

Casual Academic, School of Medicine and Public Health, University of Newcastle

Affiliate Member, The Australian Association of Buddhist Counsellors and Psychotherapists

Member, Board of Advisors, Men’s Health Network USA

Author of “Men’s health & wellbeing: an a-z guide”

Completed Men Alive Men’s Health Training Course USA 2015

HOLISTIC HEALTH MODEL or biopsychosocial model

physical / biological

psychological

social spiritual

cultural

Also known as social determinants of health

Men’s health in Australia - the big picture

• Life expectancy for men lower 79.7 (84.2 for women) AIHW Figures

• Men in all age ranges die at greater rates

• 8 men suicide in Australia every day (total 10 > 8 men 2 women)

• Men’s use of health services is lower (both preventative and acute)

• Men get into more risk taking

• Men experience emotional stress but don’t seek out support easily

• An estimated 298,000 Australians had dementia in 2011, 62% women 38% men

Why don’t men use services?

• Perceived reason is that men are not in touch with their needs

• But we don’t deliver messages to men that their health and wellbeing

is important and services are not geared to men’s needs and are not “men-friendly”

If I have a party and people don't come,

shouldn't I be asking what is wrong with the

party not what is wrong with those who

don't come?

This perspective should lead us to think and

plan differently around men's health needs

and make health, welfare and community

services more men friendly.”

DEBUNKING A FEW MYTHS.

DEBUNKING A FEW MYTHS.

Men’s Health Survey of 2,046 men found

• 55% had a health check in last 12 months

• Of those who had a health check, 74% rated the experience as good

• 73% talked about their health with their family & friends at social gatherings, family functions and work

• 82.3% of men were very likely to participate in a health check in the workplace if one is offered

Men aren’t interested in their health & wellbeing!

WHY EQUALITY FOR MEN? Equality is for everyone but most conversations about equality tend to focus on everyone but men and boys. There are many areas of life when men on average aren’t doing as well a women – areas where men and boys are unequal. Supporting equality for men does not mean opposing equality for women. Both men and women experience inequality. WHY IS EQUALITY IMPORTANT? The worlds most equal countries are happier, healthier, safer places for people to live in. WHY FOCUS ON MEN AND BOYS When we think about tackling inequality we tend to focus on everyone but men and boys. We tend to look at groups like women, LGBTI people, black people, disabled, unemployed, underpaid, unhealthy etc.

Source: “Equality For Men” Glen Poole

Gender is the strongest and most consistent predictor of health and longevity. Unfortunately it’s not good news for men and boys.

A recent World Health Organisation article on men’s health states "health outcomes among men and boys continue to be substantially worse than among girls and women, yet this gender-based inequality in health has received little

national, regional or global acknowledgement or attention from health policy-makers or health-care providers“.

The article states on the whole women are outliving men by an average of almost six years. It also argues that including both men and women in efforts to reduce these gender disparities would improve everyone’s health and well-being.

Why Help Men?

Because we want a world that works for everyone where every person of every gender can flourish and reach their individual

potential in ways that help us collectively create a world that works for everyone

Source: “Equality For Men” Glen Poole

Help Men How?

• By identifying, developing and supporting pathways to potential for men and boys

• By helping those who Help Men

• By inspiring others to Help Men

Source: “Equality For Men” Glen Poole

HUMANISE

EDUCATE

ASSUME THE WORST

LOCATE SUPPORTS

TAILOR PLANS

HIGHLIGHT STRENGTHS

H.E.A.L.T.H. – a model for developing male friendly health & wellbeing strategies

The 6 Point HEALTH Plan – why?

Humanise Because men are taught to be self-reliant and to conceal weakness. When they do need help or feel pain, they often think they shouldn’t and that these things are unmanly. Educate Because men are less knowledgeable than women about health in general and about their specific health risks. And because a lack of knowledge can increase men’s risks. Assume the worst Because men deny and minimize their symptoms, making accurate assessment and effective treatment difficult. And because men think they’re invulnerable to disease and injury – which increases their health risks.

Locate Supports Because men have fewer friendships and smaller social networks than women do – factors linked with health and living longer – and because men often hesitate to use the social support they do have i.e. they don’t want to be a bother. Tailor Plans Because men are more likely to have maintenance plans for their cars or their computers than themselves. And because health plans improve men’s chances of coming back, having tests and maintaining their health. Highlight Strengths Because many of men’s attitudes and behaviours can benefit their health and by highlighting strengths we are giving men the opportunity to take control of their health and not feel it is something out of their control.

The 6 Point HEALTH Plan – why?

HUMANISE

EDUCATE

ASSUME THE WORST

LOCATE SUPPORTS

TAILOR PLAN

HIGHLIGHT STRENGTHS

Using the HEALTH model – what you can do?

Humanise Communicate to men that asking for help, admitting pain, expressing concerns, crying or getting rest are

normal, human experiences – they’re not unmanly Educate Give men the health education they’ve never been taught. Show them that following good health habits

can be manly as well as lifesaving. Include men friendly specific health risks, screening, self exams, diet and nutrition info etc

Assume the worst We need to compensate for the tendency among both men and clinicians/healthworkers to overlook or

understate health risks and illness in men. Locate supports Help men to identify their sources of support and suggest ways for them to use these more effectively Tailor Plan Help men devise a realistic health/wellbeing maintenance plan that they can follow with clear

information and dates to follow up on. Include regular check ups, diet plan, self care and protective behaviours etc

Highlight Strengths Capitalise on the attitudes and behaviours of men that can improve their health. Highlight the benefits of

an intellectual style, a problem solving approach, autonomy and control and a teamwork approach

The 6 Point HEALTH Plan – what you can do

Humanise

“I know it’s hard to ask for help, but feel free to call me anytime you feel you need to.”

“You don’t get medals for putting up with pain. So let me know if it bothers you – even slightly”

Educate

“Most of the things that have the biggest impact on your health are completely within your control”

“Did you know that one of the main causes of erectile problems for men over 40 is smoking?

The 6 Point HEALTH Plan – communication strategies, what you can say…

Assume the worst

“Things at work and home sound really busy, how are you handling the stress of all that’s going on?”

“Most guys with this disorder have pain. Is it bothering you at all?”

Locate supports

“Who’s around to help you get back home today?”

“You’ve always helped out lots of people. Remember your friends are happy to help you out as well.”

The 6 Point HEALTH Plan – communication strategies, what you can say…

Tailor Plans

“What’s a good way to remember to test your blood sugar levels each day?”

“What kinds of things can cause you to miss an appointment?”

Highlight Strengths

“It’s great that you’re determined not to give up despite the pain”

“Even though you’ve been down a bit by having to manage your depression look at all the great things you’ve been doing for the kids lately”

The 6 Point HEALTH Plan – communication strategies, what you can say…

40 % of Australian men over 18 are single

How can we effectively work with them to improve their health and wellbeing?

Source: Australian Institute of Family Studies

The changing structure of Australian Families

49 % Traditional, Mum, Dad and kids

51% Other forms Single Parent – majority women Same sex couples with children Couples with out children

Men’s Social Connectedness

1. Nearly a quarter of men (23%, approximately 1.1 million men) in their middle years score low on the Duke Social Support Scale and may be at risk of isolation

2. One quarter (25%) of men have no one outside their immediate family whom they can rely on

3. Over one in three men (37%) are not satisfied with the quality of their relationships, typically because they do not feel they are emotionally connected or supported.

4. Men experiencing a lack of social connectedness would rarely feel able to bring their ‘neediness’ up in conversations and it is rarely, if ever, a topic of public discourse.

5. These men often lack the skills, the pathways and frequently the drive to remedy their lack of social connection and instead tend to bear the misery and shame of their situation with a stoic, masculine pride.

FAST FACT: 56% OF LIFELINE CALLS ARE FROM THOSE LIVING ALONE

Social Connectedness may be a protective factor against depression for Men in their Middle Years (30-65) Beyond Blue report conducted 14 qualitative discussion groups & quantitative online survey with 4100 men

Men’s Social Connectedness

1. A majority (61%) have lost contact with more friends than they

would like in the past few years

2. Changes in family circumstances, injury, illness, mental health,

finances, change in work circumstances and simply not having the

time to maintain relationships were all seen as contributing to the

path of becoming dissatisfied with their level of social

connectedness

3. Men also face practical barriers (e.g. financial and health) to

increasing their social connections, and any programs need to be

understanding of the particular financial restraints and health

barriers faced by many of these men. This includes illness and

disability, which may be a trigger for poor social connectedness.

4. Half of men (50%) claim to rarely talk about deeper personal

issues with friends, while 31% don’t spend much time talking with

their friends in general.

Gender Differences: Independence versus social connectedness

• The difference surfaces in childhood. Boys strive for independence; they define their identities in separation from the caregiver, usually their mother.

• Girls welcome interdependence; they define their identities through their social connections.

Men’s Social Connectedness Suggested interventions programs and tools 1. Helping men to build resilience via programs for those in danger of becoming disconnected. This has

dual benefits – reducing psychological distress, and increasing ability to maintain and grow relationships through tough times.

2. Helping guide men into a variety of social channels. In this way, men can initiate new relationships with like-minded individuals over a shared or common purpose, which will also help provide the relationship ‘breadth’ from which ‘depth’ can be built.

3. Reminding men (and partners) that men need social connections. Public acknowledgement of the importance of social connectedness and the need to devote some time to improving and developing male-male relationships.

Gay, Bi, Trans men

Small Acts of Love

A National Symposium on Dementia and Love

13th – 15th February 2017, Ballarat, Victoria

Mainly women presenting - one male speaker

LGBTI – Lesbians taking the lead on aging issues

NEW MALE NATIONAL MALE HEALTH CONFERENCE

March 2 & 3, 2017 HOLIDAY INN HOTEL PARRAMATTA, SYDNEY

Focusing on

Saying Yes To Family Peace Stopping Male Suicide

The New Male and the Future of Men’s Health Improving Aboriginal & Torres Strait Islander Men’s Health & Wellbeing

Working with men of the future

All information on the website at www.menshealthservices.com.au

Key Approaches to Men’s Health • Focusing on a philosophy of health care that promotes wellness

and a positive image of men and boys

• Developing male friendly health strategies

• Building on and increasing opportunities for partnership work

• Talk with men and boys rather than at them

• Go to males in their own environment

• Show them the way to better health don’t tell them what to do

• Establish the need for improvement in male health

• Have a passion for the needs of male health in your community

Some Resources…

Men’s Health & Wellbeing Resource

e m a l e Australia’s largest free national bi monthly e bulletin which provides people with the latest information and resources on men’s health and wellbeing. A promotional copy will be sent to you after today but you need to send an email with “subscribe” in subject line to be added to the mailing list. To subscribe visit the website at www.menshealthservices.com.au

Dementia programs for men – Why we need a gendered approach

Greg Millan, Men’s Health Consultant & Director, Men’s Health Services

Questions and Discussion?