Ros Knight · 53 min
A clinical psychologist with 35 years of frontline experience reveals why connection, exercise, and hope are not soft ideals but the hard science of surviving and thriving at every stage of life.
Hear this story
Ros Knight has spent 35 years as a clinical psychologist listening to people's hardest stories. She's never once thought about leaving the work, because talking to someone about their life experiences still feels like a blessing. But she's honest about the cost: when you sit with someone in their worst moment for hours, that weight stays with you. Self-care for therapists isn't optional. It's survival.
For older Australians, Ros has identified loneliness as the single biggest problem. It's not just the grief of losing a long-term partner after 40 or 50 years together, though that's real enough: you lose the person who divided up life's tasks and finished your sentences. It's also losing the structures that once held community together. The church, the local shops, the groups where people naturally gathered. Technology hasn't filled that gap, even though it can help.
But Ros isn't pessimistic. She offers two practical things everyone can do right now. Exercise at 30 minutes three times a week works as well for low-level depression or anxiety as taking a tablet, and it also builds the physical confidence that older people need to feel safe in their own bodies. And connection: make sure you talk to someone else at least every couple of days. That's not soft advice. That's the hard science of what keeps us alive and well at every age.
Her own story shows how to adapt when the world gets smaller. Her mother didn't abandon what mattered when her body changed. She found workarounds. She went from fishing to keyboard to backing tapes. She stayed in the game. That's what aging well can look like: not denial, not surrender, but the stubborn, creative refusal to disappear.
“it has always been a blessing to talk to lots and lots and lots of different people about their life experiences.”
“selfcare was absolutely essential because when we're being a psychologist and joining with the person in the mud puddle where it feels like there's no solutions, there's a cost in that.”
“finding ways to feel purposeful, find meaning, and connect with others. Absolutely crucial. Doesn't matter if you're five or if you're 85.”
The hero, today
Ros Knight has spent 35 years in psychology and says she has never once thought about leaving, because talking to people about their life experiences has always felt like a blessing. The cost of psychological work is real: when you sit with someone in their worst moment for hours, that weight stays with you, which is why self-care for therapists is not optional. For older Australians losing a long-term partner after 40 or 50 years together, the experience is not just grief but a complete loss of the person who divided up life's tasks and finished your sentences. Exercise at 30 minutes three times a week is as good for low-level depression or anxiety as taking a tablet, and it also builds the physical confidence that older people need to feel safe in their own bodies. Loneliness is the single biggest identified problem for older Australians, and community, through neighbours watching, reaching out when someone hasn't been seen, has as much role to play as individual action.
Yes. Ros Knight is a real person who shared their own story in their own words. Kintsugi Heroes is a not-for-profit that shares first-person stories of overcoming adversity, told with the person's consent.
Kintsugi Heroes, a registered Australian not-for-profit. Every story is shared with the hero's own consent and reviewed under Kintsugi Heroes' trauma-informed content standard before it goes public.
Ros Knight has spent 35 years in psychology and says she has never once thought about leaving, because talking to people about their life experiences has always felt like a blessing.
The cost of psychological work is real: when you sit with someone in their worst moment for hours, that weight stays with you, which is why self-care for therapists is not optional.
For older Australians losing a long-term partner after 40 or 50 years together, the experience is not just grief but a complete loss of the person who divided up life's tasks and finished your sentences.
John Milham (Host) · 00:05
Welcome back to Kintsugi Heroes, helping people tell the stories they need to share so you can find the stories that you need to hear. Ros has devoted over 35 years to helping people with both clinical and mental health policy roles, standing out with a passion for community care, sector leadership, and being a dedicated advocate for mental health transformation. Ros shares her belief in how staying connected and active can find hope for everyone, even through life's toughest challenges, in all the ages and stages of life. And with a focus on helping people, we can live our best lives. In the chat today, Ros shares many powerful insights as we talk about mental health, well-being, community care, and the power of kindness. Please join me as we enjoy Ros's story. Ladies Ladies and gentlemen and friends of Kintsugi Heroes, welcome to another Kintsugi Heroes podcast. Today we have the enormous pleasure and the gift of expertise here with the wonderful Ros Knight. Ros, welcome to Kintsugi Heroes. Thank you so much.
Ros Knight (Guest) · 01:22
Oh, thank you, John. It's an absolute pleasure to be here.
John Milham (Host) · 01:25
Fair notice to the listeners, we have spoken before and we both know that there's an enormous amount of interest You are a psychologist. I think I did a good job of reading out your bio last time, but like, I don't have it handy now. But I want to— you're a psychologist, a community supporter, you know, constantly sort of providing both advocacy, policy input and support directly to the community in a range of roles. And, you know, not only that, you have like a, you know, you have a story, a journey to that space. 30 years helping people in a clinical and policy sense. And of course you've held senior positions in community organizations and others, including chairman of the PHN, which is the basically in charge of all of the psychologists in the area.
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Exercise at 30 minutes three times a week is as good for low-level depression or anxiety as taking a tablet, and it also builds the physical confidence that older people need to feel safe in their own bodies.
This conversation includes a listener from the start, the first career that wasn't hers, doing psychology and being a psychologist, the cost of sitting in the mud with someone, a childhood that didn't fit the mold and hope for people isn't always their best friend.
Ros Knight (Guest) · 02:20
That's probably going a stretch, John.
John Milham (Host) · 02:21
Yeah.
Ros Knight (Guest) · 02:22
Yeah.
John Milham (Host) · 02:22
I'm sure none of them would agree to that. The first question I want is a little frivolous, right? So forgive me. What is the group name for a collection of psychologists? Is it a couch of psychologists, right? Or something like that?
Ros Knight (Guest) · 02:38
Yes, that's a very good question, which reminds me of the joke of how many psychologists does it take to change a light globe? And the answer is none, because the light globe's gonna have to want to change. Right. So a collection of psychologists, I think, is just a practice. A practice of psychologists. Yeah. It's just the group who gets together to play our trade and help others.
John Milham (Host) · 03:00
So, so how did you know at some point, we think back to little Ros and you know, you're sitting there and you look at someone and you go, oh, that bloke looks a bit broken. I think I can help him. Right. How did you know you were going to become a psychologist?
Ros Knight (Guest) · 03:19
Listen, no, and childhood is probably not a good combination, but had leadings, right? So. Clearly by, if I just go high school, I was definitely somebody that all the friends would come and talk to when things weren't going well. So I clearly had developed that ability to listen and to not be judgmental. Well, you know, worked on that across the years, of course.
John Milham (Host) · 03:44
Yeah, yeah, yeah. That is a, an advanced skill, of course. Yes.
Ros Knight (Guest) · 03:48
So I think during high school, yes, I was, and I was very interested in how people operated. Now, it wasn't actually my first career, but given my first career really wasn't my gifting, it turned out. Yes, I then went into university and, and studied and trained and did all that. And really with what most psychologists start with, which is they just want to help people. And we have a particular helping by understanding people's brains and what they're trying to do to themselves and how to do it better. So I think, yeah, it's a real privilege for me, probably closer to 35 years now, John, but I go, it's never been a career where I've gone, oh my goodness, you know, how long till I get out of here? It has always been a blessing to talk to lots and lots and lots of different people about their life experiences.
John Milham (Host) · 04:37
So one, one way we tend to describe, you know, like I believe identity and knowing, you know, self-reflection on identity is massively important. Do you do psychology or are you a psychologist?
Ros Knight (Guest) · 04:53
I think it's both actually. And we can broaden that and go, and I'm also a consumer. I'm also somebody with lived experience. I'm also, you know, sometimes we are doing, we are trying to convince somebody to change. Other times we are being and we are working with that person depending on their level of self-reflection and where they're at in the journey of trying to be different, more effective in their world. So, and kinder to themselves, all of those things that become really, really important and hopeful for their future. You know, it's those three fundamentally. So a bit of both, John, I think is the fair answer.
John Milham (Host) · 05:36
So doing and being. Is it a hard job?
Ros Knight (Guest) · 05:42
Yes, I am going to say yes. I think it's often underestimated, the cost for psychologists, psychiatrists, any of the, any of us working in that space. COVID enabled people to see the cost of mental illness and to understand the load. We got to see nurses and doctors just burning out in front of us. And I think in the background, a lot of psychs were also struggling through that and had to own for the first time self-care, was absolutely essential because when we are being a psychologist and joining with the person in the mud puddle where it feels like there's no solutions, there's a cost in that. Yeah. Even though they then walk out at the end of whatever time, that sense of how hard life can be for hours and hours and hours on end. Yeah. Comes at a cost.
John Milham (Host) · 06:34
Just while we're on this subject, right? There are a couple, you know, questions I'd love to ask. Like, you know, we hear quite a lot now, you know, like, you know, the, the dialogue is starting around, say, workplace injury and mental health management and mental health care. And of course, vicarious injury or vicarious trauma is something you hear. How does that work when your job is to invite people vulnerably to go to places that are sort of, you know, steeped in trauma and injury?
Ros Knight (Guest) · 07:05
Yeah, I think it's our obvious hope for the client in front of us, the person in front of us, is that by working it through in a constructive fashion, that they will be relieved of some of the burden, but also that they will be able to see the world, therefore do differently, and therefore future looks different. You know, in a very short nutshell, it is absolutely true. Psychologists and therapists become vicariously traumatized by what they hear, and it changes their view of the world.
John Milham (Host) · 07:36
Yeah.
Ros Knight (Guest) · 07:36
So again, back to the absolute essentials of practicing what we preach and going, well, where is your self-care? Where are your normal friends where you might talk about, you know, the most recent trauma you heard, but actually about the cricket or something, you know, where are the good things you do for yourself that just make you pleased you're alive? So all of those things, absolutely. It is a form of vicarious trauma and we have to look after ourselves. Or one of my jobs, which is on the New South Wales Psychology Council, we see psychologists who are clearly burnt out. Yeah. And that's when things start to go wrong, not just for them, but for their clients.
John Milham (Host) · 08:15
You know, I recently was talking to a doctor who left medicine because of burnout. Is that level of kind of sacrifice necessary? Is professional detachment designed to kind of prevent or mitigate that? And how do you work when you are connecting with people and supporting people closely and yet have to maintain this kind of separation, this disassociation in some ways.
Ros Knight (Guest) · 08:44
I'm not sure I'd use the phrase dissociation. What I think we have to be careful of is understanding our role. So it's about maintaining boundaries in that setting. You know, I'm there for an hour in their week. Yeah. We can do the maths on just how many hours I'm not there for. And while I always go, we know from research, one change will make a huge difference. So if they walk out and don't remember most of it, but they do one thing differently, it will make a difference. I think it's just being aware of that's where my level of responsibility lies.
John Milham (Host) · 09:17
Yeah.
Ros Knight (Guest) · 09:18
I may wish better for them. I might feel momentarily angry that yet again the world has not delivered something nice for somebody, but Ultimately, I do my bit to help and that's all I can be responsible for. So I think it's that maintaining good boundaries is really crucial for both actually. Yeah. You know, the client doesn't want to have the therapist start talking about, you know, what they've been through or what they make of that or whatever. So, so yes, boundaries, absolutely essential.
John Milham (Host) · 09:51
That's good advice. There is this like some people unkindly talk about pseudoscience now with, yes, you know, you know, personal development now and, you know, some of the soft kind of, you know, less clinical views out there and spiritual and all sorts of elements. And then of course there's the empirical, the clinical. How do you see yourself? Are you a more, more clinical, more empiricist than say you know, heart-based or a bit of both, or how does that work?
Ros Knight (Guest) · 10:25
So I'm employed as a psychologist. I'm registered as one, and clinical and counseling or even coaching has scientific basis for what we know works for people with significant mental health issues.
John Milham (Host) · 10:38
Yeah.
Ros Knight (Guest) · 10:39
So ultimately, even if I am a practicing Christian and all of that sort of thing, that's not what somebody is paying me for. I'm not their priest.
John Milham (Host) · 10:50
Yeah.
Ros Knight (Guest) · 10:51
So it is about understanding what I am there to do. Again, sticking to some boundaries around that. Now, having said that, of course there is still room to go. I don't have all the answers. Nobody's got all the answers. If somebody goes to a, you know, yoga camp for a week or something and comes back determined to do more yoga and perhaps changes a couple of thinking points and that makes them feel better, I can put that into a scientific theory. Yeah. And go, Have at it. Yeah. Yeah. Absolutely fine. No, no limits. Clearly the ones that are more dangerous are the ones that would take people out of their scope of practice, actually, you know, talking about the need to use herbs or having to, you know, like we shouldn't be recommending, but I am far from judging anyone finding a way to make this world work better for them that is not hugely risky.
John Milham (Host) · 11:45
Yeah, I can see how there'd be certain you know, like, I always worry about people talking about removing toxic people from their life, and I go, that's not exactly how we're meant to manage that, right? You're like, you're meant to be able to cope with people around you, right? But I get it. Like, I always noticed, interestingly, you know, like, the power of presence, right? There were— there's— and people talk about energetic beings, right? We are you know, a physical force. What level of that kind of non-verbal unconscious connection is important in supporting somebody?
Ros Knight (Guest) · 12:23
Absolutely. I call it the necessary but usually not sufficient ingredient, right?
John Milham (Host) · 12:28
Wow, that's a great—
Ros Knight (Guest) · 12:30
if we are not connected, yeah. And like I say, it depends on the presenting issue and what's going on for the person. Sometimes it is just doing psychology if it's, yeah, Really gotta quit smoking. Let's talk about those strategies versus being on what I call hallowed ground.
John Milham (Host) · 12:45
Yeah.
Ros Knight (Guest) · 12:45
Formative stuff that has happened and defines the person. And we have to sit there in that space together. So, and that connection is absolutely crucial. Now it is in the smoking thing too, you know, nobody's gonna quit if they don't trust you. So yeah, absolutely. It's essential.
John Milham (Host) · 13:04
I love the way you described the curious young Ros, right? Yeah. Like I said, being interested in the people. Was that a feature of intelligent or a feature of something softer?
Ros Knight (Guest) · 13:14
That is a very good question. And having been to an AI conference talk recently and debating what intelligence is and everything, I'm probably not gonna attempt a really strong answer on that one, John. I think it's probably both. It's prob— it has multiple motivations when you think about it.
John Milham (Host) · 13:32
Mm-hmm.
Ros Knight (Guest) · 13:33
Often there is some or enough history in the background to go, why would I want to fix people? Am I really trying to fix myself? Yeah. And all of that. For me, I think I'd done that well before I'd managed to graduate.
John Milham (Host) · 13:46
Yeah.
Ros Knight (Guest) · 13:46
But I think an intellectual curiosity, we are such complex creatures and the brain is such an amazing organ. How can you not be curious about it would be my honest answer.
John Milham (Host) · 13:57
So, yeah, I, I absolutely agree. The idea of how people in a common experience are different in the way they respond and build and understand and know. That's so interesting.
Ros Knight (Guest) · 14:12
Oh, it is. You can have, I always say to my clients, there can be a car accident outside this window. We happen to see it and the police will interview everyone and it'll be different versions from everybody. Our ability to craft what our senses bring in based on a whole lot of stuff in our head. It's just amazing. Really is.
John Milham (Host) · 14:35
Your childhood, you're like, as you grew up and you decided which way to go, and the influences you had. What was important about that that is now— that shaped you and drove you forward? We talk about ACEs a lot, you know, in terms of so many of us get to a certain age and then have to start unpacking the bits that have, you know, didn't go the distance with us, right?
Ros Knight (Guest) · 14:59
So yeah, no, listen, my childhood was far from straightforward, and therefore definitely I think that pressure from a young age that when those of us that don't have the straightforward childhood as it was back then, or perceived straightforward, right?
John Milham (Host) · 15:14
Yeah, yeah, yeah.
Ros Knight (Guest) · 15:16
Is that you do find yourself constantly checking and going, how come they're different to me? How come, yeah, what I wanna do here doesn't fit? So there's a, there is an inherent curiosity that comes from that sense of not fitting the mold that everybody else seems to have around you and deciding a response to that.. And clearly, you know, we watch and go, some people get very angry and very, how dare you? We wonder how much we're watching that playing out right now in various parts.
John Milham (Host) · 15:47
Yeah. Yeah, absolutely.
Ros Knight (Guest) · 15:49
But for me, I think I found some people who were caring and everything else, and therefore probably from a young age really did in my own way go, it's about caring for others.
John Milham (Host) · 15:59
Yeah.
Ros Knight (Guest) · 16:01
So I think that value, moral code, calling, maybe. I understand that's an interesting phrase. Yeah, definitely had its roots. And I genuinely still think that. I think there's a few professions where we are gifted and lucky enough to have responsibility for trying to help others down the runway.
John Milham (Host) · 16:24
What's the best of you in that area? Like, what do you rely on a lot as a strength and a talent?
Ros Knight (Guest) · 16:31
That's a very good question, John, that I probably haven't given a lot of thought to. Off the top of my head, I would say yes, I do try and stick to within boundaries and know what I can do. So there is definitely going, I need to feel that I'm being solid and not jumping off on some tangent. I think the fact that I do value others and see inherent possibility in others is something that I've always fallen back on. And it would be true outside of the counseling sphere, that's not always been my best friend because I see hope for others and then then by definition they're not ready for that.
John Milham (Host) · 17:05
You also always so bloody positive, Ros.
Ros Knight (Guest) · 17:08
Yeah. Well, unfortunately I'm not always because I go, I look around at the world and go, wow, we really do have to help each other because this is a difficult gig. Anyone who says the world is just sunshine is not being realistic. So, no.
John Milham (Host) · 17:25
And you mentioned AI, of course, that's incredibly consequential for the future of our wellbeing, right? Both emotional and financial and physical. What happens if a large, massive part of the community, and particularly those who are already marginalized like Elder Australians, what happens if AI just makes us all useless?
Ros Knight (Guest) · 17:49
Well, I think that's very unlikely, to be perfectly frank. I think there's always going to be a role for human beings. Do I think AI can help some human beings do it better. Sure. Do I think for some people AI is fine as a therapeutic intervention? And while I would've said, and the elderly will be those who don't, that's not actually my experience. I use AI scribing now.
John Milham (Host) · 18:15
Mm-hmm.
Ros Knight (Guest) · 18:16
And elderly are as fine with that as young ones. It's actually other things like slightly paranoid or something.
John Milham (Host) · 18:23
Yeah.
Ros Knight (Guest) · 18:23
Yeah. Yeah. Yeah. And, you know, I, again, I go, I have clients who are in their in their 70s who are tech savvy enough, you know, don't have any problem with all of this stuff, have their own computer, do their own thing. Of course, I have other people in their 40s who struggle to do much more than make a call or send a text. So I do think it really varies. I don't think it has to be an ageist thing, but obviously as we age, keeping up with everything seems more effortful and learning new things seems more effortful. So for some people, yes, they'll find that disconnecting. And again, for elderly, they haven't grown up with talking to a computer, right? That's even Zoom was an adjustment during COVID We had to all learn to do that. And a lot of elderly did. Yeah. As their only form of contact and communication. I watched my mother do that with, as an elderly person with dementia during COVID have to use Zoom. You know, she had to use Zoom. To go to her best friend's funeral because, you know, yeah, there was no possibility of physically being there. So somebody had to come and help set all that up. But it was still, you know, we had to make that adjustment. And for most of us, I think we've become fairly good at making that space work. I do a lot of telehealth, of course, because some people that just works. Opportunity is fantastic for people who can't get in for lots of disability reasons.
John Milham (Host) · 19:54
Yeah.
Ros Knight (Guest) · 19:55
So yes, I'm far from a naysayer, but I just think it needs to be very careful and needs to make sure that if somebody doesn't wanna use AI, doesn't wanna do Zoom, does wanna sit in the room with somebody, that that is absolutely still 100% okay. Yeah.
John Milham (Host) · 20:13
I wonder if AI doesn't represent a threat, not because of its intrinsic capability, like, you know, any kind of psychological program or modality can cause challenge, right? But because of the people who are controlling and creating and manipulating it.
Ros Knight (Guest) · 20:35
Oh, that's a tricky one. Probably longer than what we've got here today, John, because it, it really does depend on the parameters it's given, right? And what it's allowed to do and what its purpose and functionality is. Clearly when its purpose is to keep you engaged and say whatever will keep you engaged, then it's going to hallucinate or basically lie.
John Milham (Host) · 20:55
Yeah, yeah, yeah, yeah.
Ros Knight (Guest) · 20:57
But also align with the wrong things that you're saying and, you know, with some significant consequences if somebody is having suicidal thoughts or something. So I do think it is definitely up to the humans who are using it and developing it to actually be very mindful of the risks. Yeah. It's always about going, great strategies, can see all that. The next question is, and where's the risks? Where is this gonna fall down if we're not careful?
John Milham (Host) · 21:27
Yeah. And it's interesting because, you know, like we're talking about in your practice, you have a number of older Australians and, and, you know, and I, I do recognize that you didn't make it that way that just, you know, people, you know, seek out and probably been with you for quite some time anyway. So, but One of the challenges psychologically, like we've got these new technologies and in some ways we're evolving, you know, not on a bio level but a biotech level, right? You know, the evolution of our act of who we are needs to integrate those technologies. What are some of the real challenges that older Australians face in sort of meeting those new stresses and complications of community and society.
Ros Knight (Guest) · 22:16
Like I say, for some people the new technologies are too hard and it's too far, but even if they can do some of the new technology, they were raised in community.
John Milham (Host) · 22:26
Yeah.
Ros Knight (Guest) · 22:26
Like I think one of the sad things about the deterioration of the church, which, you know, has its very valid reasons. Yeah. And of course some churches are still doing great things like CentreCare, Salvos, you know, all of those. But the deterioration of church as a community. Pillar is that there's nowhere you obviously go anymore. So technology can help you do a bit of a search for what's in my area, assuming that all of that is up to date, which often it's not. But yes, I think for older people who are used to going, well, I would go to my local shopping center and I would have a chat, you know, again, that's much harder now. Most people are in and out quickly in between lots of different tasks. I think finding the ways to really connect with people is what older Australians still need to be able to do and not just feel like a Zoom group chat about a book might be adequate. It needs to be more than that. So I think that is the real challenge. That's how they were raised. And I think that opportunity still needs to be there. We could debate whether it should be there for all of us, but it definitely needs to be there for elderly Australians.
John Milham (Host) · 23:39
What's the impact of not connecting, of not being able to find your interactions and connections?
Ros Knight (Guest) · 23:47
It's huge. So clearly loneliness is one of those big identified problems, identified worldwide, right? You know, England back in the teens, they set up a loneliness minister. Yeah. You know, they took it very seriously. When I was Australian Society President, we did a piece of work with Dr. Michelle Lim, who owns That space in loneliness. Fabulous job.
John Milham (Host) · 24:11
And is she alone in loneliness?
Ros Knight (Guest) · 24:13
Well, I hope not, but she's doing very well. So, you know, I see that as being the biggest problem. And it used to be that elderly seem to do better around loneliness than young people, but I think that's shifted in recent years and it's not so much seen to be easier for them anymore. And I think that is that shift since COVID into technology and other That's my opinion. I'm not quoting science on that last bit. So it is very much how we help them connect. I think that idea of social prescribing and trying to help elderly people find connections, you know, back to what I said earlier, you know, we need to feel good about ourselves or good enough. We need to feel hopeful for the future. But we also need to feel connected to feel human. Very few of us would live comfortably on a desert island for very long, even if there was adequate food and water, right? We need our peeps around us.
John Milham (Host) · 25:15
Definitely.
Ros Knight (Guest) · 25:15
Yeah.
John Milham (Host) · 25:16
And it certainly, maybe some of the generations would need a phone, right?
Ros Knight (Guest) · 25:23
Yes. Yes. They would find that very hard if they couldn't doomscroll. But But yes, I think for the elderly it is still about going— it's, it can be such an isolating time. And I think there is not enough discussion perhaps around what it means when you lose your partner.
John Milham (Host) · 25:42
Yeah.
Ros Knight (Guest) · 25:42
For example, where that's been the person you've sat next to for 40 years or something who, you know, finished your sentences for you, you divided up the tasks.
John Milham (Host) · 25:52
Yeah.
Ros Knight (Guest) · 25:52
And then all of a sudden that person's not there. I mean, it can be incredibly lonely. Feels like half of you gone. And what's more, you've got all these horrible tasks you never knew how to do that you've got to learn. So that sort of, what do you expect, you're old, one of you is going to die first mentality that seems to exist really doesn't encompass the experience of what that is like. No.
John Milham (Host) · 26:18
Uh, it's one of those interesting people are always kind of surprised by the stats that say the fastest growing area in terms of suicide is, you know, over 65, right? And in particular, over 65-year-old men. You can— but it doesn't seem like a huge stretch when we lay out some of those challenges. These men probably haven't made a friend in 50 years, and their partners have provided all of that kind of social and emotional support. Social management and the intimacy of being able to be yourself.
Ros Knight (Guest) · 26:56
Absolutely. And listen, it doesn't, it's not a surprise in the sense we're living longer. Middle-aged men have absolutely been known to be one of the highest populations of suicides for many, many, many years. And you and I could hypothesize around, you know, their role, their sense of responsibility as breadwinner and all of that. And when it comes into retirement, if they haven't taken 2 to 5 years to actually start to see themselves differently, yeah, then it all starts to feel pretty meaningless. And if you then throw in and they lose their partner a few years' time, it starts to feel like, what's the point?
John Milham (Host) · 27:36
Yeah.
Ros Knight (Guest) · 27:36
And genuinely, what's the point? You know, have I done what I came to do and that's enough?
John Milham (Host) · 27:41
Which leads us to the kind of discussion around dignity of risk, right? The requirement of an older Australian who is, you know, in possession of their faculties, has a lifetime history of making sensible and powerful decisions, has contributed to society, their family, and now they might want to take certain decisions that are about how they end their life, right? And of course we have voluntary assisted dying now. How do you support— how do we manage that in this environment? Is that you know, like when we're trying to advise or support people making decisions and being well, you know, that must be a tough place to, to talk.
Ros Knight (Guest) · 28:25
It is, it is. And I think it's— in Australia, we're very clear, we have VAD for people who have illnesses that are going to kill them anyway in 6 months or so, you know. They're not— and this is giving them the option of a more peaceful death rather than just drawing it out for the sake of drawing it out because they still happen to be breathing.
John Milham (Host) · 28:48
Yeah.
Ros Knight (Guest) · 28:49
So we've got a very defined purpose around that for very good reasons. Suicide's always one of those things, you know, like at, at which point is it believable? Which point is it a good enough reason? Not crises, moments. I'm not talking about that sort of, there's something going horribly wrong and it starts to feel like the only way out of it's pain is to do this. That's not what I'm talking about. No, I'm talking about at any age where somebody goes, there is no meaning and there is no purpose, and I'm quite sane. Yep. And I'm enjoying things. It's not that I'm sitting here fully depressed and I think I've done what I want and I'm not sure why I have to be here. What is that about? Then I go, well, that's their call. Now at the moment they have to go overseas to do that, and I'm okay with that. I'm conservative. I think it's the most final decision you make, right? So I would never dare suggest it to anyone. But like you say, for some people, particularly elderly, they feel like they've done everything. And whatever they contribute now for themselves or for others, and they don't see hope for the future because they expect to die in the next few years and they're health to deteriorate. So, you know, that is their prerogative. So not advocating, want to be really clear, but actually I do think it's everybody's choice to think about how they manage elderly. And we do know that couples even make a decision to die together.
John Milham (Host) · 30:25
Yeah. Should society and the people who are thinking around that? Should they be having conversations? Is that something we want to reach out to friends, family, you know, our clinicians?
Ros Knight (Guest) · 30:39
Yes, they should be reaching out and talking about it because that means they're doing what I call their due diligence and going, are you sure you're not just reacting to something? Are you sure that your family aren't going, what do you mean if you disappeared? What am I going to do about XYZ? And I need this, the other from you. And I, you know, So absolutely, decision like that should be discussed widely before any idea of actioning it. Now, I know of course then the risk is somebody blows a horn and before you know it, you've got a mental health team on your doorstep. Again though, being conservative and acknowledging the finality of the decision, I go, walk through it all, make sure you are absolutely crystal before you make that decision.
John Milham (Host) · 31:24
The challenge in that, and it seems to be like, you know, society has decided now that being old is difficult for society, right? So we, you know, we're now being pushed into, you know, enclaves or, you know, institutions behind doors or walls. And of course, the knowledge and wisdom that was so important at one stage is not valued in some ways financially, employing, you know, And of course the system itself in the medical and support system often, you know, treats people as infants, right? Is that fair? Like, is this a necessary kind of, does it happen because we're, you know, we're not capable or is it just, how is this thing happening? You know, once upon a time it wasn't so, was it?
Ros Knight (Guest) · 32:11
I think once upon a time, not all that far ago that you and I couldn't remember, men died in their 60s.
John Milham (Host) · 32:17
Yeah. Yeah.
Ros Knight (Guest) · 32:19
You know, and women definitely lasted a few more years, but not very long. We didn't have an average lifespan of 80.
John Milham (Host) · 32:26
Yeah.
Ros Knight (Guest) · 32:26
It's a huge cost to society on so many levels. And of course we know that the last 10 years or so is not our best health. No. It's not that we're fit and going at it and then suddenly just keel over. We become much more draining for ourselves. For those who are caring for us and on society's systems. So while I don't see it as a fair thing or a necessary thing or any of that, clearly a lot of the structures were not set up to manage somebody who will sit in retirement arguably for 20 years or more. Yeah. And, and how do you do that? I mean, most of us around our age are watching elderly parents trying to manage them. Maybe not having really got rid of the kids even. And it just seems to go on because of course kids can't afford to leave home anymore and they're much older, parents are living older and we sit in the middle going, how do I manage all of this? So it is, yeah, it needs a rethink. And you know, everybody's been saying that how we assist elderly people needs a rethink.
John Milham (Host) · 33:33
On a policy level, as you pointed out, what preparation that you're like, what what energy are we putting into rethinking the model of caring and trying to change the attitudes, like, not just of the community but of the older Australian themselves? Like, you know, can we take more responsibility for making ourselves useful in a different way to how we once operated?
Ros Knight (Guest) · 33:55
Yes, I think is the short answer. I think we can take steps to remind people that we have things to offer. So you and I both know a lady who dresses brightly because she, as an elderly person, expects to be ignored otherwise. And, you know, we know another lady who spends a lot of time assisting in aged care because she knows she can be useful doing that. So finding those ways to be useful at whatever level we can operate at. Again, think it's harder for males because once your body just doesn't allow you to go hoiking bricks and other things around. They've had a manual job, it's very disconnecting. You know, Men's Shed is great. I think Men's Shed is fabulous, should be more of them, but it's not an answer for everyone who's used to tools on, you know, as a trade. Yeah. So finding ways to feel purposeful, find meaning, and connect with others, absolutely crucial. Doesn't matter if you're 5 or if you're, uh, 85. Beautiful.
John Milham (Host) · 35:00
If you're of a certain age and you're sitting there thinking, well, I can't, I don't wanna sit and sort of, you know, waste away. And you mentioned social prescribing before, and for the listeners, you know, who don't know, that's the idea of giving people, well, you know, you do it, don't you?
Ros Knight (Guest) · 35:18
You give people to go and join a group, join a walking group. It's very much that sense of we know people's mental health and dementia and other things all deteriorate when we are not connected and we are not active. So it is actually about going, if we can boost that up, maybe you'll need less of the meds that come with the side effects, all of that. So absolutely, social prescribing is launching around Australia. In fact, it's launching in our area, John, from a hospital level even where there will be link workers doing social prescribing in the LHD. So, you know, there's, there's a sense of hopefulness and somewhat prevention. We're all aging, we're all going to die, right? But that sense of, well, it doesn't have to be so hard or boring or lonely. We could be out doing things to make it much better.
John Milham (Host) · 36:19
Yeah.
Ros Knight (Guest) · 36:19
So anything that engages the brain and you're with others, anything that's a bit of physical activity and you're with others, all of that actually helps us live our best lives for what is possible.
John Milham (Host) · 36:32
You mentioned physical activity and you are talking about it as if it is part of mental health and wellbeing.
Ros Knight (Guest) · 36:38
Yes.
John Milham (Host) · 36:39
Traditionally, and it's not been seen that way, do we need to change our minds about what wellbeing is. It's not just, you know, feeling, you know, having more energy or being able to lift weights, but it's also about having an emotional and, you know, balanced social life as well.
Ros Knight (Guest) · 36:55
Yeah, listen, I would say it's probably been 20 years in psychology now that we have known that if you exercise for 30 minutes 3 times a week, that'll be as good for your mood as taking a tablet. So in fact, for low-level depression or anxiety, exercise is treatment in and of itself. The endorphins and the adrenaline do very well for us as well as helping us as we get elderly, of course, feeling more competent in our space. A lot of anxiety is fear of falling. Yeah. Or, you know, something going wrong when you're stuck at home.
John Milham (Host) · 37:31
Mm-hmm.
Ros Knight (Guest) · 37:31
So actually knowing you have that physical capacity to, you know, reach a light globe to walk quickly 100 meters away from an accident to, you know, all of that stuff.
John Milham (Host) · 37:45
Yeah. Yeah, absolutely. Yeah.
Ros Knight (Guest) · 37:47
It's absolutely crucial. So exercise is a key part of aging well, and that's not just the meds, you know, keeping you off half meds or something, but it is about your mental health and resilience. When we think of ourselves, it's the brain. Yeah. But it's the body too. And if you don't feel in control of your body because your body hurts, won't let you do things, you don't know if you had to suddenly run to get away from something, could you? Yeah, absolutely. It affects your mental health.
John Milham (Host) · 38:20
Is the aging process a worry or is it something that can be really resourceful and interesting and worthwhile? I suppose we don't, we can't avoid it, right?
Ros Knight (Guest) · 38:29
But you know, like, yeah, no, listen, I think it can be all sorts of things, And I don't want to sound like, you know, happy clappy sort of, it's all fantastic. Yeah. Because clearly for some people it is a real struggle and life is not kind. And we can think of a whole lot of social drivers for that at the moment, particularly for elderly women who've separated and have no financial means whatsoever. So there's a lot of difficulties that you can't just go, well, that's all right. I'll get another job. I'll rebuild. It'll be fine. So socially difficult. I do think people who do it well do find new purpose, new meaning. So my mother, when she retired, she'd been a nurse and a teacher. She just connected with groups and she started doing mini traveling. She didn't have a lot of means, but you know, that whole catching a train to Canberra sort of options.
John Milham (Host) · 39:23
And I love that. It's only what, $2.50 now or something, you know?
Ros Knight (Guest) · 39:26
Yeah. So, you know, doesn't cost much. She did a couple of hobbies that, you know, but then she would adjust. So she went back to fishing. Fishing had been one of her things until she couldn't really drag the little boat, the dinghy, up anymore and needed help all the time. And then the dinghy went and that was the end of fishing. So adjusted as things deteriorated rather than going, well, I can't do that and now life's meaningless. She found other hobbies to try and get involved in, ways to buffer it. I think the one that stands out to me was she started playing at her local church piano, and it was piano for a while, then it became keyboard where you could push a button and it did a lot of the background things. So she wasn't having to play as much.
John Milham (Host) · 40:12
Wow.
Ros Knight (Guest) · 40:12
And then she started looking into recordings that she could use for backing tapes instead of playing. Do you know what I mean?
John Milham (Host) · 40:18
So, yeah, so your mum became a DJ at church.
Ros Knight (Guest) · 40:21
Right.
John Milham (Host) · 40:21
Yeah.
Ros Knight (Guest) · 40:21
More or less. She could have just gone, I can't play anymore. That's it. I can't do it. But as the world got smaller, she tried to find fixes and workarounds and, and all of that. So I think that's really important, having a positive attitude of, yeah, no, it's not the same, but it doesn't mean it can't be anything.
John Milham (Host) · 40:40
One aspect of getting old used to be about holding the wisdom for the community. Do you think we do that well now? Like, you know, Is that something we need to explore further? We seem to have lost the art. You mentioned church doesn't operate in the same way, and of course there are many groups that used to be important to how community gathered and connected and supported each other— Rotary, Apex, Lions, you know. Yes, they're not the same anymore, right? So what are we going to do about it?
Ros Knight (Guest) · 41:09
It is very tricky, John. I think the answers are going to be new, and I think that therefore us just going, well, this should be exactly the same again, it's not how it's going to roll. I do think it still happens within families where, yeah, you know, like we talk about power between the joining of child and grandparents because generation's the parent. That still happens.
John Milham (Host) · 41:32
Yeah.
Ros Knight (Guest) · 41:33
And of course people that I see where the stories haven't been very pretty, often a grandparent is the person who still gave them a sense of worth or still anchoring the family.
John Milham (Host) · 41:44
Yeah.
Ros Knight (Guest) · 41:45
Yeah. So I think the family bit probably still works. Works, although we are a much more mobile society these days. No guarantee your grandparents will be even in the same country, let alone, you know, so it's, it is trickier. But again, I think we will find a way to make that work. In the short term, I do think it's about trying to get as many resources together or some you know, easy to find list that people can work with elderly to go, well, why do— what are your interests? Let's talk about that first. Here is a list of possibilities. How about I help you contact them? Maybe I make the phone call.
John Milham (Host) · 42:30
Yeah.
Ros Knight (Guest) · 42:30
You know what I mean? Like just trying to find out what's there and maybe as it becomes apparent, which is what we're hoping in the PHN, of course, where the gaps are, where there's holes, where there's just nothing, that community will then step up and go, well, that can't be enough. We have to set up a thing to fix that hole.
John Milham (Host) · 42:49
Yeah.
Ros Knight (Guest) · 42:50
So I think the answers to a lot of it will come from community, but from a practitioner and a governance level, I think we've gotta have the pathways there to make it easier.
John Milham (Host) · 43:01
Yeah. And in some ways it's, you know, older Australians, the way you want to be done unto, right? So, yeah, let's set up a a way of aging well and gracefully and engaging, right? Because all of us get there. What do you look forward to as you're a long way from aging? I'm an older Australian. Yeah, yeah. Not that there's any wrong age to be. What do you want to do? How do you face that? Is it a frightening prospect? Is it something inevitable? Are you just okay with it?
Ros Knight (Guest) · 43:40
That's a very good question. I was gonna say it's not like I'm not exposed to a myriad of ways this can be perceived and how it can be managed all the time. And I'm unfortunately not as far away from it as I'm very happy to take that.
John Milham (Host) · 43:55
But you know, as you might think, John, so not that I'd ever say, right?
Ros Knight (Guest) · 44:00
Yes. So I think it's a combination as it is for all of us, right? There's moments of disbelief when you go, what do you mean I can't do that without my arm hurting? You know? Yeah.
John Milham (Host) · 44:09
Yeah.
Ros Knight (Guest) · 44:09
Those moments happen to us all and continue to happen semi-regularly as we age. There's moments of relief going, oh, I could retire fairly soon. Gee, that would be a nice thought. And, but then what am I going to do becomes very much the question and people do need to prepare. It is a mix. I'm not sure. Yeah, I look forward to some of it. Definitely don't look forward to some of it. I don't think anybody does really. None of us look forward to the health breakdown part and the mind breakdown part and what that might entail and the journey out the door, right? Most of us aren't scared of dying. No. Well, we're not scared of being dead. The dying bit's not something most people look forward to.
John Milham (Host) · 44:56
No. Look, I love talking about and listening to your thoughts around that and the, you know, the openness you share those, you know, the, the sort of good and the positive and the potential negative. Why aren't we talking about these things more? Right? Like, you know, are there conversations that I'm not listening to or, you know, cuz it doesn't, I don't think we talk about aging very much. Maybe once on Q&A, right?
Ros Knight (Guest) · 45:21
So, yes. No. And it might have been on the show on SBS, Dateline, isn't it?
John Milham (Host) · 45:26
Yeah.
Ros Knight (Guest) · 45:27
Yeah.
John Milham (Host) · 45:27
Dateline.
Ros Knight (Guest) · 45:27
Yeah. Also do shows like that. I think it's an interesting thing. Like you say, John, it wasn't really something we had to do. Gosh, not all that long ago, really. So now that it is really a solid life stage for people that is as long as middle adulthood or childhood, you know.
John Milham (Host) · 45:46
Yeah, yeah, yeah. Much longer. Yeah.
Ros Knight (Guest) · 45:47
Sometimes.
John Milham (Host) · 45:48
Yes.
Ros Knight (Guest) · 45:49
We do need to do more of it. There's clearly, once you're in that zone, if I say you start to notice the movies that are geared towards people in that zone and the TV shows that are geared towards people in that zone.
John Milham (Host) · 46:00
Mm.
Ros Knight (Guest) · 46:01
So there is a conversation and there is a culture in the background, but it's slowly really emerging. One would imagine the huge number of baby boomers that are just really coasting into that is gonna turn all of this upside down, right?
John Milham (Host) · 46:19
Yeah. Yeah, absolutely. 30% of Australians weren't born here. About 50% of Australians can trace at least one generation or less., you know, from not having spoken English, right? So, so Australia is very much now like not a monoculture, and particularly, and as we get older, right, like, uh, you know, it becomes, you know, there are, that's a social complication. What, what do you think that, you know, we need to do to sort of navigate not just the aging challenges but also the social cohesion and DEI challenges.
Ros Knight (Guest) · 46:57
Yeah, no, it's, listen, that's also a really big conversation, isn't it?
John Milham (Host) · 47:00
Yeah.
Ros Knight (Guest) · 47:00
Cause you know, I grew up in a suburb that had a lot of Italians postwar and the kids were at school with me. Sometimes mums at home didn't even speak English, you know, dads did because they were out working, but yeah, often mums didn't. So we've always been a multicultural society. I think it's very sad that there's now lots of chatter about the problem of that. And that is scary for elderly people. When you don't have that control over yourself physically, you don't have unending means, you know, you can't just, like I say, pick up sticks and move somewhere and start working a different way, you know, like that's not available to you. I think it's very scary to have that there. So what I do like the government is trying to do, and the PHN is part of it, is Obviously setting up culturally appropriate services. It can't be one service fits everybody. We have to allow for different backgrounds to work out what works for them, not just what works for us. And also really pleased to see changes to the way AHPRA, which is the Australian Health Regulations Authority, have now mandated all health professionals have to have cultural flexibility. And I'm sure I've done that training over the years. I did it again recently and went, wow, it's really expanded. Like, it's more serious. It's much more nuanced, which is fabulous. I think there is real hope that we can take this seriously. But again, back to the trying to provide services that work will depend on community to say, hey, there's a whole group of Vietnamese over here. Who don't understand what's going on. And again, we saw that in COVID, right, where communities, particularly in Western Sydney, felt completely disenfranchised and also targeted.
John Milham (Host) · 48:52
Yeah.
Ros Knight (Guest) · 48:52
Didn't understand because nobody had put the time in to make sure they understood what was going on. So multiculturalism is a strength for us, and we need to treat it with that much respect when they're elderly, not just when they're 25-year-olds with qualifications coming into the country.
John Milham (Host) · 49:12
Yeah. Wow. One last question, because it's been full of insight. You've really given us a wonderful picture of what's happening and what's possible. What do you think, you know, of all the ills and challenges of aging, right? There, you know, and we know there's a balance. What would be the single thing most of us could think of fairly simply and I know like this is such a dopey question, but that we could all do that would improve not just the, our own ability to, you know, to grow older more comfortably, but to improve the lot of people who are already in that space who it may be challenging. Is there anything that stands out for you that we can all take on?
Ros Knight (Guest) · 49:58
Achieve and give you two. So the first one is exercise, believe it or not. Doesn't matter what the ill is, whether it's, you know, the brain, whether it's the body, whether it's what's going on, exercise really does make a huge difference in and of itself. So that's the cheat one. I do think the loneliness one though is true. And I think going, I have to have social connections. Now, some people only need a couple of people and they feel nicely connected. Other people, as you know, can be lonely in a room of 20. So it just depends on what the need is, but if you have not talked to anybody else for a couple of days, like nobody, then it's time you did.
John Milham (Host) · 50:39
Yeah. Good.
Ros Knight (Guest) · 50:41
And whether that's joining a group, whether it's just talking to your neighbor over the fence or up at the shops, or, you know, whatever you choose to do, we need to talk to others. So do not let loneliness deprive you of an enjoyable later life.
John Milham (Host) · 50:57
And the other bit on that, right, is that, you know, we often put it on the people themselves who are lonely. Like, we— it's almost like saying, well, you're broken, fix it, fix yourself, right? Is there a role for the community itself to reach out and to close, to make it easier for people to have those conversations?
Ros Knight (Guest) · 51:16
Yes. And I think, again, used to see it in churches in Australia, but you also see it in the FRUM model in the UK, where community does track some of the elderly, once they know they're there and will reach out if the person doesn't seem visible, hasn't been seen at the shops for a while or whatever else.
John Milham (Host) · 51:35
Yeah, yeah, yeah. Wow. Yeah.
Ros Knight (Guest) · 51:37
And, you know, and I still think even here in my street, I go, got a couple of elderly people and some of the neighbors are more attentive than others, but nonetheless, we're all watching.
John Milham (Host) · 51:46
Yeah, yeah.
Ros Knight (Guest) · 51:47
Going, are they okay? Are their bins out? What's happening? I think that role for community is there. Clearly can't drag a horse to water and make it drink. So, you know, there's a, a boundary there where we can invite and offer, but the person don't wanna do it, they don't wanna do it. And that's, that's all we can do.
John Milham (Host) · 52:08
So, yeah, ask first and then apologize later, Nick.
Ros Knight (Guest) · 52:13
Well, definitely ask before stepping over so that you don't have to apologize too much later.
John Milham (Host) · 52:18
Yeah. Yeah.
Ros Knight (Guest) · 52:19
Yeah.
John Milham (Host) · 52:20
Fabulous. Thank you so much for such insight, and I know you're a busy person, and it's been really wonderful. Really appreciate on behalf of Kintsugi Heroes and all the people listening, thank you so much for sharing so much of your wisdom and your personal story. Really, really loved it. Thank you, Rod.
Ros Knight (Guest) · 52:37
Thank you, John. It's been an absolute pleasure to be here.
John Milham (Host) · 52:46
Thank you for listening to this episode of Kintsugi Heroes. Thank you to Colin Lilly for permission to use Broken as our theme music for this series. If you enjoyed this conversation, share the podcast with a friend and let us know by leaving a rating and review on Apple Podcasts, Spotify, or wherever you get your podcasts. If you'd like to support Kintsugi Heroes and the stories we share, Head to kintsugiheroes.com.au and follow the instructions to make a tax-deductible donation. Thank you for listening, and we'll see you next time.
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