In this episode Liz Lewington and Melissa Therrien discuss the importance of aging well through preventative care. They cover various aspects of senior care, including home safety, fall prevention, medication management, nutrition, staying active, mental health, and accessing support resources. The discussion emphasizes the need for a holistic approach to senior care, focusing on maintaining independence and quality of life.
Episode Transcript
Liz Lewington, LPN (00:02)
Welcome to Caring Conversations, it’s been a bit of a hiatus.
Melissa Therrien, RN (00:09)
Yeah, we’ve been busy doing other things, in-person things. It’s been exciting.
Liz Lewington, LPN (00:13)
I know, I know it’s nice. It’s nice to actually see you in the flesh. That sounded wrong, but we’ll go with it.
So I’m Liz Lewington. I’m one of the nurses here with Ohana Care and we have Melissa Therrien. She’s also one of our nurses out in Alberta and today our topic is going to be aging well and the prevention of supportive care. That’s not the word, preventative care for seniors and how we can help to support seniors before they actually need any additional care. Keep them home, keep them safe. All of those bits and pieces that we love doing on a daily basis.
We’ll just talk about that and how our seniors can best keep themselves healthy and create that net of folks around them to help to support them.
Melissa Therrien, RN (00:59)
Yeah, safe environment to be part of that too, right?
Liz Lewington, LPN (01:02)
Yeah, yeah. So, I mean, safe environment, that’s a great place to jump in. Preventing falls, because we know a lot of our seniors, falls are what ends up being that sort of catastrophic catalyst to change and decline. what’s a way that you, you know, what’s something that you look for when you’re going into somebody’s home that has a high risk of falls?
Melissa Therrien, RN (01:28)
Yeah, so lovely homes, right? We all go into these lovely, well-established, beautifully decorated homes, rugs everywhere, coffee tables, trinkets, love it. It’s all very much part of what creates those comforts of home. A lot of those things are safety risks when it comes to someone who has mobility issues or maybe vision deficits, all of those things, know, carpets
on top of carpets, on top of carpets can be one of the worst things ever, often leading to those falls that tend to lead towards hip fractures and as you mentioned, hospital and everything else that comes after that. So yeah, definitely looking at any trip hazards, encouraging people to wear proper footwear. That’s another thing. I actually had a really successful meeting with a client who couldn’t find footwear because
His feet were so large and so he was wearing socks, hardwood floor, made the suggestion, let’s look on Amazon and see if there’s like a footwear option for you. know, slippers that may be open from the top, but provide that additional thread. Great success, we thought. know, minimizing that falls risk as much as possible from those simple things, right?
Liz Lewington, LPN (02:45)
Yeah.
Like you say, lighting and then foot footwear. Having somebody that has a lot of swelling in their lower legs and carrying so much extra weight. So mobility is more difficult and that sort of automatic step that they’ve been doing their whole life, their cadence, their gait alters slowly. And so you can have an increased risk when something like congestive heart failure is acting up and you’ve got that peripheral edema. You know, also cognition goes down. Like there’s so many factors that you need to consider. And then as a nurse, you know, polypharmacy. So being
multiple medications for either multiple conditions, you know, bowels being, issues with bowels being caused by being on narcotics for pain due to a previous fall. Like there’s all kinds of that cascade of effects. So it’s not just one area as far as the home safety goes. It’s like the whole team and the whole house and every, you know, everybody needs to be considered in it, including dogs. Dogs are, I love a dog.
me
wrong not besmirching a dog but there’s a lot of falls a lot of injuries caused by these little creatures getting underfoot or you know pulling people down when they’re out for walks so making sure that if they are going out they’ve got that right footwear on the dog is well behaved and that they are going somewhere where the sidewalks are even there’s you know good footing there’s good lighting but yeah preventing falls is a major part of keeping somebody safe and out of hospital
monitoring blood pressure. So if somebody has quite low blood pressure, are a major risk as well. There’s really, it’s like a rainbow of risk when it comes to falls. There’s so many different things to consider and areas of the home. So bathing, huge risk of falls. So is the bathroom safe? Are there grab bars in place? Is there a bath chair? Are there grips on the, I mean, I could bang on forever. I know it’s
Melissa Therrien, RN (04:27)
Totally. Yeah.
Bye.
Liz Lewington, LPN (04:45)
I know it’s annoying, but we do you go into the house and you and you have the same eye every time is is this safe is the toilet high enough are we talking about injuries potential from standing up we’re not being able to get up as well so preventing injuries is the best way to keep yourself healthy
Melissa Therrien, RN (04:48)
What is it?
Yeah, and you talked about
like stairs and you know some people have stairs in their home that’s where you know the master bedroom is perhaps that they’re still sleeping in or stairs down to the laundry and they’re carrying a laundry basket. You know it’s all about being proactive, thinking about that trip. What does that involve? What’s the safest way to go about it? Even when you’re still very independent, you know, I mean a trip or catching a toe on a stair can happen to anybody.
food for myself, really. And a tumble, know, many people will recover really quickly from a tumble and others because of the frailty or the comorbidities that they’re dealing with that that could be the beginning to something that spirals, you know, into something much more. So planning your trip, even in your house and make sure that, you know, the things that are in place need to be in place. And maybe it’s not a necessity for you to go into the basement to do the laundry and carry the laundry basket either up or down.
Maybe you can bring in some support to help with that.
Liz Lewington, LPN (06:06)
Mm-hmm. Absolutely. It’s getting ahead of the concerns before it becomes something that you really need to live around I was like having an OT consult on things like bathroom renovations Or even you know have have do some research for yourself when you’re looking at buying a new house if you are moving One level is always ideal and like you say the laundry on the same level the main living space on the same level doesn’t mean you don’t have you know There’s not options to work around it by having somebody come in to help
Melissa Therrien, RN (06:11)
Uh-huh.
Liz Lewington, LPN (06:36)
but you know making sure that you’re you’re setting yourself up for success for sure.
Melissa Therrien, RN (06:41)
Yeah, and stairs don’t have to be a limitation and moving doesn’t have to be the only option, right? We were at the Home and Garden show a couple of weeks ago and we saw that people are putting elevators in their home with very little change to the footprint of the house. Those options as technology advances become more more available to anybody in the general public and don’t have to necessarily be that cost prohibitive or a dramatic change to your house. Some options for sure.
Liz Lewington, LPN (07:08)
Mm-hmm. And
there’s funding options there as well, depending on which province you’re in, but definitely worth investigating if you are looking at putting something in like that. Should we move on? Because I know we could talk about falls. Yeah.
Melissa Therrien, RN (07:11)
Yeah, absolutely.
Hmm
Yeah, just before
we do, you touched on medication a little bit and making changes to a medication profile doesn’t necessarily mean making substitutions or even removing medications. Sometimes it’s looking at the schedule of those medications, right? So maybe there’s a medication that a diuretic, let’s say that creates the urgency to go to the bathroom. Maybe that’s a better option.
Liz Lewington, LPN (07:37)
you
Melissa Therrien, RN (07:49)
taken during the day instead of right before bedtime when lighting is poor, urgency can lead to getting up in a rush to go to the bathroom and those slip trips falls happen on the way to the bathroom when there’s that urgency that goes behind it. Or maybe there’s a pain medication that can be taken at night so that it’s not affecting the mobility during the day and maybe just to kill two birds with one stone, you’re getting a better sleep as a result.
Liz Lewington, LPN (08:15)
Mm-hmm.
Melissa Therrien, RN (08:16)
So don’t
think of medications just as removing those medications or even making substitutions, but revising the schedule. So many medications are ordered once a day. So let’s look at what time of day it’s best and most appropriate to do that from a mobility and safety perspective as well.
Liz Lewington, LPN (08:32)
And dosages can be altered as well. Yeah, no, that’s a very good point of view. I love that. Should we move on to nutrition? All right.
Melissa Therrien, RN (08:34)
Sure. Yeah.
So, yeah, absolutely. Yeah, so healthy
nutrition. As we talked about the falls, and most of us can fall and bounce right back really quickly, nutrition plays a huge role in that. And that frailty as we age, the calcium deficits, the bone density, you name it. nutrition is a really important part of maintaining that safety in your home and being proactive to prevent those mishaps, let’s say.
Liz Lewington, LPN (09:06)
Yeah.
Nutrition and hydration so keeping fluids up, you so many of our our clients that end up in the hospital They’re there. They have a delirium caused by a urinary tract infection or a chronic urinary tract infection So increasing hydration flushing that bladder out and keeping your electrolytes in balance and and when you are Sensing that there’s something wrong, know trusting your body and and getting some blood work done to make sure that you are hitting all the nutritional requirements like b12 iron
Melissa Therrien, RN (09:10)
Totally.
Liz Lewington, LPN (09:38)
and then fluid intake, making sure that your thyroid is operating correctly. But yeah, getting that consistent blood work done when you’re not feeling well so that you can make sure that you’re adjusting it. We know that B12 really does, some folks have difficulty with processing it through their food, so injectables can be prescribed, loss of iron for various reasons, either medications or illnesses.
or sometimes there’s a slow bleed or hemorrhage, something that they can’t really pinpoint. And so going on iron and staying on it and checking in to see where your levels are at are really important. So nutrition and in recovery, like you said, if you do have a fall, making sure you’re increasing your protein intake so your body can repair itself. You’re not always in a deficit because a lot of lethargy can come from a poor nutrition and poor intake.
Melissa Therrien, RN (10:36)
And think we know as we age, get, creating those meals, those full, covering all the bases kind of meals, making sure you have not just meat and potatoes, what you’re getting, fruits, your fibers, your veggies, everything like that. I think it gets more challenging. mean, not only cooking, but you’re going out and you’re shopping. You have a lack of appetite because you’re not doing as much activity as previously. And so I think those meals start to dwindle.
And so being sure that when you are eating, you’re eating those really fruitful, nutritious meals, or you’re supplementing, you know, with the ensures or the boosts or whatever. Definitely something to talk to your doctor or many physicians office have nutritionists or dietitians that can support that, but really important to, you know, look at what the big picture is and then getting some support, right? If that means support for cooking those meals.
forgetting those groceries and making sure that you’re on top of it so that there’s always quick snacks to choose from as well are really important. Lots of home care support companies offer that. Ohana Care offers that. And who knows, maybe you’ll get someone who likes to cook that’s from a different culture and can introduce you into a whole different group of foods that you’ve never had before. It can be exciting.
Liz Lewington, LPN (11:55)
Yeah, because
I know it and you you get used to eating the same thing and then if you have someone that was always cooking for their spouse or their spouse was always cooking for them when that changes that drive to want to make that healthy meal that consistent, you know meat
starch, veggies, getting your protein in, even keeping track of all those things. turns into, well, I had a piece of toast for lunch and then for dinner, I had another piece of toast. And you think about, know, one day, fine, I can eat, it can be terrible, but I do need to make sure that I’m covering all the bases in the long run. having somebody, I mean…
I would love to have somebody cook for me. And for our seniors, sometimes even the idea of making the meal and then trying to walk the meal to a place to eat it is impossible if they don’t have the right walker to put their food on or making that transit and standing for a long period of time. And then you end up losing weight. And we know losing weight means losing ground. And then we’re in a really rough place to come back from. Regaining muscle mass and regaining your strength again is really
difficult. So staying ahead of it, keeping the nutrition at the forefront of your health is really important at all ages, but especially as you get older because those reserves are reduced substantially with time.
Melissa Therrien, RN (13:16)
Yeah, and it’s also like actually eating the meal. Sometimes that’s not overly enjoyable for people. Their flavor palette changes dramatically, it diminishes. Maybe due to cognitive deficits, it becomes more challenging to find the food on the plate. Maybe it’s chewing in and of itself, right? Poor fitting dentures, difficulty swallowing. Any number of things can…
really change what that dining experience looks like. And so seeking those supports, seeking some recommendations from nutritionists, dietician, nurses, physicians, you name it, can support all of those things to make sure that you can maintain a healthy, really enjoyable dining experience. Enjoyful, that’s not a word, enjoyable dining experience.
Liz Lewington, LPN (14:00)
You know what? Yeah, yeah, I enjoy fold that word. Yeah, absolutely.
Absolutely. A lot of folks do have the ill-fitting dentures or swallowing difficulty. So changing textures of food. I know it’s not something that you would want to do, but if it’s the best way for you to get your nutrition in, then that’s the way that it needs to move forward, of course. And it changes with time. Changes with time, just like everything. Yeah.
Melissa Therrien, RN (14:22)
for
Yeah. Yep. And staying active. Let’s
touch on staying active. It’s best for everybody. We all need to stay active. It’s not just for physical capacity. It’s for our mental capacity too, right? Staying active has good fitness. I’m not one to talk, but good fitness is definitely good for my body and soul. And so I think, especially for our seniors who are maybe…
Liz Lewington, LPN (14:42)
Thank
Melissa Therrien, RN (14:50)
feeling a little less motivated or have that fear of falling, which definitely motivates, demotivates people a lot too. Keeping active and finding activities that you can continue to do to maintain that strength is really important.
Liz Lewington, LPN (15:05)
And there’s altered versions of all the exercises, you know, and there’s groups that get together and they meet each other where they are. So there’s the aqua size so that you have mobility where there’s really a decreased chance of any concerning injuries or strains. Lovely. Plus you get to socialize. It’s great. yeah, there’s chair yoga is really big out here. It’s like it’s a force. So when I get older, that’s like, that’s the goal. Pickleball is huge.
Melissa Therrien, RN (15:09)
Totally.
Liz Lewington, LPN (15:35)
but that’s more of a very active person. But stretching, strength training is huge though. Using weight to help maintain the strength of your bones to prevent or reduce osteoporosis is a big part. And then with doing strength training, you’re building muscle, you’re building that resilience in your body if you do ever have an injury. Recovery is so much easier. You sleep better, you eat better, you poop better. Like the whole…
Melissa Therrien, RN (15:36)
yeah.
Liz Lewington, LPN (16:03)
I should be doing it now that I’m saying it out loud, but yeah, I don’t do it. Yeah, I’ll just go now. Okay, I’ll let you do the rest of it.
Melissa Therrien, RN (16:07)
I’m gonna go do it.
Yeah.
Liz Lewington, LPN (16:14)
Coordination
and balance. Balance really does offer with time and if you are not motivated, not getting up and moving, you really do reduce your balance, reduce your coordination. Yeah, so leaning into staying active, keeping your body and your mind moving, mental health and wellbeing is also connected so deeply with that. We know that now. It is proven. If you exercise, you will be happier, you will socialize more.
Melissa Therrien, RN (16:17)
Ugh.
Liz Lewington, LPN (16:44)
Yeah, there’s nothing negative about it unless you go out and injure yourself. So I’m gonna pretend that’s why I don’t do it.
Melissa Therrien, RN (16:53)
But we should do it together so that we get the social
outlet as well. And I’ll keep you safe.
Liz Lewington, LPN (16:58)
Yeah, so I’ll we’ll do it on for our next podcast. It’ll just be the most awkward thing you’ve ever witnessed Yeah, I don’t think the producer Sean would be super excited about that so I believe that Cherio to the side
Melissa Therrien, RN (17:03)
exercising, chair yoga.
Yeah, but I think mental
health, you know, that’s a big thing too. It’s not just physical health, mental health, emotional well-being. What we saw through COVID, of course, we all saw it. That deconditioning, that social isolation, and how quickly people’s health deteriorated. You know, it’s…
purposeful activities, it’s enjoyable activities, regardless of what the activity is that stimulates that emotional and psychological wellness. That’s so important to being safe and maintaining safety in your life, whether it be independent or with supports, yeah, that mental and emotional wellbeing.
Liz Lewington, LPN (17:46)
You
Yeah, having somebody that checks in on you, feeling like you’re part of the community, making connections with your neighbors, that sort of thing, just so that people keep an eye on you.
You’re not an island and it can be really easy for you to become a lot more depressed and suffer from social anxiety as well as generalized anxiety disorders when you’re no longer actively pursuing life and you’ve know closeted yourself and because Potentially there there was a reason for it at some point or grief as well like there there’s always a reason but digging in and finding that you know, it’s a there’s there’s a purpose to life and Maybe you do need somebody, you know a lot of a lot of times you do need somebody
to come by and pick you up and dust you off and get you moving on the right path so that you can see the bigger picture again. You can start exercising. It’s not as easy as saying we should do it. Otherwise you and I would be in a bodybuilding competition. Which would also horrify Sean.
But if it was as easy as saying these things, would be, we would all be in really good shape. But cognition, yeah, that’s my word of the day. But.
Melissa Therrien, RN (19:01)
Totally.
Liz Lewington, LPN (19:11)
Cognition and movement, it’s always so connected and that mental health goes along with it. So you’re not alone and everyone needs a little help sometimes, whether it’s somebody in your life that you have that can pop by to check on you or if it’s somebody that you do that for, or is it somebody that comes in to help you with these things, to get you out of the house, to motivate you, to help point you in the right direction of motivation and health? Yeah.
Melissa Therrien, RN (19:37)
Yeah, and it doesn’t have to be
a stranger. mean, I think, you know, for us specifically, we offer that companion service. And so many times I hear people like, how do you tell my mom that I’m gonna buy her a friend? You know, like, how does that work? And yeah, that’s a really awkward thing to start with, but because of, you know, consistency of caregivers and building that relationship with them.
you know, that becomes something that people look forward to, that becomes a very enjoyable and sometimes very loving relationship too. It’s a friendship that a lot of people look forward to having. It takes time, absolutely, but it takes time to get to know anyone, whether they’re a contracted service or your neighbour. You know, someone has to make the aftertimes and plan an event. Did you know that we have a caregiver that takes
one of our clients to aqua-size all the time. Like that was just so cool. That’s an option. I can have a caregiver that takes me to swimming. It’s in the pool. How fun. I think that’s pretty cool. I need someone to come to Zumba with me. Okay, I’m not brave enough to do it myself, but I’d sure like to try.
Liz Lewington, LPN (20:44)
Yeah, yeah, I love that. Yeah. Yeah. I know. I know. I would like to try it. You can do it
in the comfort of your own home with a YouTube video. Doesn’t have to be so much fun.
Melissa Therrien, RN (20:58)
Well, then I’ll be sitting on the couch.
No, I need to get out. It’s. Yeah. Yeah, and it’s and it’s building that community to right whether you live at home, you live in a seniors residence or you live in a long term care, you’re creating a community around you of people that may or may not be in the similar similar situation as you. But you’re being a part of that community and you’re building people around you that support you regardless of.
Liz Lewington, LPN (21:03)
Yeah, fair, fair. That’s the hardest part of getting up and getting going. And also, dude, not if it’s easy.
Melissa Therrien, RN (21:27)
where you’re at in that stage.
Liz Lewington, LPN (21:30)
Yeah, and it’s that give and take when you’re having a down day.
Melissa Therrien, RN (21:33)
Absolutely.
Liz Lewington, LPN (21:34)
buy checks on you and you do the same for them. It’s beautiful. Theoretically, know, every neighborhood is different. Yeah, but building that social group around you really does help for your, you know, cognition as far as staving off or reducing symptoms of dementia as well. Being social, being connected, using, know, using that cognition of conversation and following the cadence of conversation and just even being around people helps to stay off or
Melissa Therrien, RN (21:39)
Okay.
Yeah.
Bye
Liz Lewington, LPN (22:04)
reduce the symptoms for people.
Yeah, yeah. So, Ohana care, I mean, something that we do that’s a little bit different as far as supportive care is that live in support. So, providing live in support is a way of preventing further decline as well. So, having somebody that has the same set of eyes day in and day out that can support their client to have the best outcomes moving forward and knowing that there is that option out there also is something to keep in mind too.
Melissa Therrien, RN (22:37)
Yeah, a great deal. I mean, someone’s getting a home to live in and you get 24 hours support out of it, which is wonderful. Yeah. So we talked, you know, about being proactive, how to stay active, healthy, safe in your home. What happens if you need help? What does that look like? Who do you go to to get help?
Liz Lewington, LPN (22:44)
Yeah, yeah, you know, it’s beautiful. It is beautiful. Yeah. So
Yeah, so depending on where you live, mean, OhanaCare, we’re all across Edmonton, Calgary, Vancouver, and the whole lower mainland, Vancouver Island. We are easily reached and we easily can assist you. But, you know, turning to the specialists in the area in whatever sort of part of your life that you feel like may be slipping, because any one of these parts of your life that we’ve discussed can be, unfortunately, the start of something very much worse. So if you’re having
difficulty
with mobility in the home and you think that it’s because of your medication, talk to your pharmacist. If you’re having difficulty in your home because there’s no railing, that could be someone that you bring in for renovating your home to have it made more safe or to put in a stairlift or to put in an elevator. it really, always, it’s like a, know, a la carte situation. So what are you looking for? And calling somebody like OhanaCare, we have been in this
line of work for a very long time and we know how to access supports and who the best person is as far as specialist goes in their certain areas. So a dietitian is going to help you with creating a higher protein meal plan and something that fits in your budget. then talking to us, you can have that additional support to do the laundry and to make sure that the fridge is cleaned out so that you don’t have any GI concerns due to eating food that’s not properly stored or is out of past due. So it’s not
It isn’t a one size fits all, but calling somebody, reaching out and getting all the knowledge that you can before it becomes a house on fire situation is always really important. Reaching out to OhanaCare, if we can’t help you, we can point you in the right direction to get that assistance. that’s, I mean, I would come to us, but I also know you and I trust you implicitly, so there’s that. Where would you direct people, Melissa?
Melissa Therrien, RN (24:52)
Yeah.
yeah, totally to you. But also, you know, there’s there’s funded options, too. I mean, it doesn’t have to be, again, a cost prohibitive thing if it doesn’t fit in the budget. There’s lots of public options that are available either through upward health or through any of the BC health regions, depending on where you live. So lots of options. And it just takes that phone call to ask the question.
Liz Lewington, LPN (25:00)
Good.
Melissa Therrien, RN (25:21)
And sometimes you have to reword the question so that someone can understand, but you know, maybe it’s, have ants on my canter and I can’t figure out how to get rid of them. And it takes a visit of someone to come out and say, it’s just because your bananas are moldy. but also because there’s bananas in your microwave and how did that happen? And it opens, you know, kind of that, just a bigger picture of someone to come in and do an assessment and to better understand.
how to live in your home and to stay safe and maybe bring to light some other challenges that you just didn’t think about.
Liz Lewington, LPN (25:58)
Yeah, yeah, things slip over time and I know that, you know, my baseboards aren’t as clean as they used to be, but so things do, they slowly decline and it may be that you’re living in a home that you feel is safe, but I’ve seen flooring that you go in and the edges of the rugs are rolled and you and then you look over and there’s a pointy edge.
Melissa Therrien, RN (26:01)
Bye.
Liz Lewington, LPN (26:20)
of a coffee table and I just have like a PTSD response to it. The amount of rugs that I’ve rolled up to get them just out of the room as long as the person is comfortable with that. But making sure that you know those little things slowly change over time. you know this light used to have three lights in it. This or light fixture used have three light bulbs in it. Now it only has one because I can’t get up to change it and it’s pretty dark in here so I can’t see the edge of the coffee table and I hit my leg and you know it’s getting somebody in who has
that clinical eye is important and it may be like you say to a health authority like Alberta Health or one of the local health authorities in BC but you know there is a lot of expertise out there that like you say it’s not cost prohibitive we’re not we’re not
forcing anybody to pay anything, but having somebody take a look and make sure you’re safe is never a bad thing. So being proactive in your own care and moving forward in the safest way that works with you and your budget and your family’s ability to assist in your neighbors and creating that full net is, important. It really is an important part of care.
Melissa Therrien, RN (27:32)
Yeah, this was an interesting topic because it kind of talked about like how to avoid having home care, which is great too, right? You know, we want to keep people safe and healthy and comfortable in their own homes for as long as possible. And maybe it starts with companionship. Maybe it’s just an in-home meet and greet just to understand what services are available out there and do that environmental scan just to provide some insight as to know a different perspective as to what safety
Liz Lewington, LPN (27:38)
Yeah. Yeah. Yeah.
Melissa Therrien, RN (28:01)
issues might present itself, but I definitely think that proactive measures go a long way to avoiding that in crisis, needing to make a decision that maybe we weren’t wanting to make in the first place. thank you so much for coming up with this topic, and for chatting with us about it. Always very lovely to chat with you and to learn about your expertise. So thank you so much.
Liz Lewington, LPN (28:27)
Wow, thank you to everybody for coming out listening today and we’d to direct you to our website ohanacare.ca and if you can click the like and follow button we would love that too so you can stay up to date on all of our upcoming podcasts. Thank you so much, Melissa, and we will see you soon.
Melissa Therrien, RN (28:45)
Take care, bye bye.
