Caring Conversations

Liz Lewington, LPN (00:01)
Welcome to Caring Conversations, episode three. We are going to be talking about how to initiate conversations with loved ones about in-home care. It's an interesting topic today, Melissa, what do you think?

Melissa Therrien, RN (00:16)
Yeah, definitely a challenging one, but what I'm really, really excited to chat about today for sure.

Liz Lewington, LPN (00:20)
I know, I know there's so many different ways that it can be breached, know, good, bad, ugly. And I think we've all interacted with that situation in various forms. So it's nice to have a chat about how to actually.

lead the conversation in a healthy way where the person involved feels that they're actually being supported and listened to. So what do you think? we dive right in? Why would you need to have this conversation? We'll start at step one. Why would you need to have it?

Melissa Therrien, RN (00:48)
Yeah!

yeah, mean, I think, you know, whether it be like post Christmas holidays and you've spent a lot of time with your loved one and you're like, whoa, this, you know, like the house was a disaster or, you know, you're noticing short-term memory deficits. you know, it could be any number of things. It could be very proactive. It could be really late in the game, like a fall leading to a crisis. Who knows? but I think it's really important to have the conversation. It's really interesting. You know, I was thinking.

preparing for this topic. And we talk a lot about like what you want your death to look like, right? We talk a lot about how you would like to die, where you would like to die, what it looks like after death, but we don't talk about what life looks like leading up to that. What does care look like when support is needed? And I think this is a really great topic for that very reason. We just have a really hard time talking about it. And most often we don't talk about it until it's absolutely necessary.

Whereas if we could make it part of regular conversations, just like we do more and more so about what death looks like for people and their wishes, talking about mom and dad's wishes around what care looks like. Does mom wanna stay home? Great. Does mom or dad have a budget that would support that? What does that look like? Modifications to the home, are we okay with that? All of those logistics, I think if we start talking about it really pragmatically.

Liz Lewington, LPN (01:52)
Yeah.

Melissa Therrien, RN (02:20)
can really understand what their wishes are and leave families less in alert when it comes time.

Liz Lewington, LPN (02:27)
Yeah, absolutely. That's always the goal is to of plant that seed or let the conversation marinate so that the person doesn't feel like it's being sprung on them. It's often a time of grief, whether it's grief with a loss of their primary caregiver or grief of loss of your license. You can be forced into having that conversation at an inopportune time. So I think the idea of being able to let them marinate in it, have the conversation while they're still

Melissa Therrien, RN (02:36)
Yeah.

Liz Lewington, LPN (02:57)
very capable and healthy and just say, know what? Well, what happens if you can't take the garbage out or those little steps? When we get to this point, we're going to need to talk about what it would look like. Like you say, do you want to stay at home? Do you want to look at moving? this where you want to age? Do want to age at home or do you want to move? What do we want to do here?

So yeah, I mean, and also doing your own research, know, preparing for that conversation so that you can have the answers that maybe your loved one won't be. They, you know, they're not going to have to do their digging themselves.

Melissa Therrien, RN (03:32)
sure, like coming with a short list, I think is so important to write where, you know, you're not bombarding them with information, you almost come armed to the conversation with like two choices. You know, here are the options, here is what's reasonable, here's what's sustainable. Let's talk about what you want. You know, instead of like, just like, what do want to do? You're like, I don't know. Okay, great. We have not made any progress. So and it's so emotionally charged.

Right? So people don't think pragmatically. They think with their emotional brain versus, you know, their rational brain. And they're like, this is what I want. Okay. So what does that actually look like? What is that actually going to cost? What is the sustainability of that plan? Working through all of those bits and pieces, I think is so important. And thinking rationally.

Liz Lewington, LPN (04:22)
Yeah. Yeah.

That's where a lot of the taboo comes in is talking about finances and then supporting somebody when they are having a reduction in their abilities. Nobody wants to openly admit that, I'm not okay right now. I had a fall, but I'm not going to tell you because you're going to put me in a home. That's always been this overtone in people's minds is, well, you're going to throw me in a home. You're going to throw me in a home. That's one of many options.

Melissa Therrien, RN (04:29)
Yeah, totally.

Yeah. Yeah.

Liz Lewington, LPN (04:54)
So yeah, that educating yourself, going for tours of the facilities that are closest to your loved ones so that you do have a picture in your mind to sort of reduce that anxiety that comes with maybe having to move one day. yeah, have the conversation early and not in a time of grief or anxiety or unless it's absolutely necessity, really. Yeah, yeah.

Melissa Therrien, RN (05:21)
Yeah, for sure. And so you mentioned it, like, you know, we talk about home care versus moving into that dreaded home, the seniors home that nobody wants to go to, right? So like, in your experience, what's the conversation like? How do you compare that to what does that? How do you pose that to your clients?

Liz Lewington, LPN (05:44)
For me, I like to say this isn't a forever thing. If we're coming in, you can have support while you need it. Maybe they don't need it long term. Maybe they'll improve and we reduce it and then eventually we're no longer in there. When you tell that person, and this is in my experience, when you tell them it's just for right now while you need it, it's a little bit easier of a pill to swallow instead of saying, know what, you need it. This is what's happening. This is what's

you're getting and whether you like it or lump it there's no way around it. giving those, giving options and being able to have the education around again like you said the financial costs and you know allowing them to absorb the information, think about it.

Go and see the places. Moving into a care home is never, it's not really a wonderful thing that people are looking forward to themselves. But yeah, definitely making sure that they're as involved as possible in their own decision making. And it can look different for everybody. really, knowing who you're talking to, knowing their capacity and giving them the respect that they deserve around their own decision making for their care is really the foundation of getting the conversation going.

Melissa Therrien, RN (07:04)
For sure. And I think some people are hesitant to broach the conversation about home care because they don't believe it's a feasible option, right? Where they believe that in-home long-term care is the only option. They need that 24-hour nursing support or they need that around-the-clock care. What I think is missed in that conversation and that streamlining into long-term care, whether it be public or private, is the one-to-one.

Liz Lewington, LPN (07:17)
Yes.

Melissa Therrien, RN (07:33)
Right? When you're in home care, you get that one-to-one support, whether it's 24 hours a day, overnight, whatever, it's your loved one and a caregiver. And I think there's so many advantages to that part of it, especially as we're dealing with that grieving process of loss of independence or otherwise, you know, having that relationship one-to-one that you can build and yeah, it's that sustainable relationship too. Sometimes it is

feasible to stay at home till end of life and right through your end of life journey. Other times it may not be possible and again I think to your point that's where the education comes in. But not feeling like you're just in one line and long-term care is the only choice.

Liz Lewington, LPN (08:12)
Mm-hmm.

Mm-hmm. And I think that's where that like resistance or the denial that you, don't need this, you you're forcing this on me can often be the undertone of the conversation and

I mean, for me, it's always highlighting, you know what, your daughter, your son has brought me in here because they love you and they want you to stay home. I'm not here to do anything that you're not on board with, but being able to support you to stay where you want to be. And that's the goal. So saying, yes, I understand where you're coming from and really coming at it with...

all the empathy that you can muster up as a loved one to just come and say, know what, mom, I love you deeply and this is why you need this support. I've noticed these things and bring up specifics and that can be volatile because there will be a denial like, you know what, I had a fall. It wasn't that bad. I got myself up. It's fine. Or, you know what, I don't need to take my medication every day. And there can be that denial, the excuses and that resistance that

but just sort of letting the conversation unfold.

as like, I love you and this is why I brought this person in to talk about the care. yeah, resistance, 100 % of the time, very rarely do I get somebody that isn't somewhat hesitant, somewhat resistant to having that support. It is often the case. So if you're a loved one and you're facing this and you get the resistance, it's normal. It's a normal part of the process. So don't feel like your loved one is being difficult. This is a major

Melissa Therrien, RN (09:49)
Yeah.

Liz Lewington, LPN (10:03)
major thing for them to face. It's it's a change. my gosh, it's such a huge change to somebody's life to admit and accept that they, I need somebody to come in and make sure I'm safe in the shower. Yeah, yeah, I am, I mean, I do this for a living and I'm not looking forward to having my kids tell me that. No. Yeah, yeah.

Melissa Therrien, RN (10:07)
milestone almost. Yeah.

No, no, for sure, for sure. Yeah, and sometimes the caregiver or the family member have to pull the selfish card. know, sometimes that's the only way to break through to your loved one to say like, I cannot continue to do this, right? I don't want you to be a burden. We are leaning that direction. I want to spend quality time with you and enjoy the time that we have together.

Liz Lewington, LPN (10:41)
percent.

Melissa Therrien, RN (10:54)
and we're not in a place where that's happening currently. And you hate to pull that card, you hate to take the selfish route, but as we've learned through doing this for so many years, you can't care for someone if you're not caring for yourself. And so many people appreciate that, right? That caregiver burnout is such a real thing. Who hasn't heard about it? God, post COVID, everyone's heard about caregiver burnout, right? And so to pull that card and to say like,

Liz Lewington, LPN (11:09)
you

So, yep.

Melissa Therrien, RN (11:22)
I cannot sustain this anymore. And I want this for you, but it can't be me anymore, I think is definitely an option. One that we shy away from too, right? But it's totally an option. And it's something that I think needs to be discussed. No loved one wants to be a burden to their loved ones. Yeah.

Liz Lewington, LPN (11:42)
No, exactly. And that caregiver burnout, like you say, it's palpable. You know, when you go into a room with someone who is, and it's all done with love.

Melissa Therrien, RN (11:47)
Mmm.

Liz Lewington, LPN (11:51)
and it's that sort of tunnel vision where I have to do all of this. It's often a spouse that also has their own potential illnesses that they're contending with. So they're trying to keep themselves going, but that really gets pushed to the wayside. And that's why you see such a high mortality rate for caregivers, because they're not sleeping, they're not eating, they're not taking their own medications. They're not going to the doctor because they can't leave the house, because they can't leave their loved one alone, and they don't have that support.

And also just socializing. They don't get to socialize like they used to. If you're caring for someone with dementia, you're not having good quality socialization with that person any longer. We know how important it is to our overall health, our overall mental health as well. And then progression of dementia, socializing is so important. So being able to get your loved one that support as well as yourself that support. And like you say, that's often the way that I sort of pivot the conversation. If they don't want it, I say, your daughter or your

spouse needs it and I know you love them. You love them. know, maybe more than you love yourself. You love them and they and they need this and that's why we're we're being here. That's why we have to be here because they need this. Yeah.

Melissa Therrien, RN (13:07)
Yeah, absolutely. And they're going through their own grieving process too, right? And depending on the stage of grief they're in, whether it's their own aging process or seeing their spouse go through that aging and that health deterioration, mean, it's grief. It's very real. And that process is so real as well.

Liz Lewington, LPN (13:25)
Yeah.

Yeah, yeah. And with grief, I know we all know the stages of grief and you can see it unfold in front of your eyes sometimes. And that's why that, you know, letting somebody sit with the thought and not forcing it, if there's time and we're not in an urgent, emergent situation, then let it sit, let the person digest the idea of how it would look.

and then approach it again. you know, know nurses like us will go in and we'll have that conversation. It's difficult. And then the family says, you know what, they're just not ready yet. And we know that it's gonna take six weeks or so for them to get ready. you just really, again, you really hope that you don't get called because they've gone to the hospital. Because often...

Melissa Therrien, RN (14:11)
which happens so often.

Liz Lewington, LPN (14:12)
yeah, yeah. And then you get a family member calling and saying, you know what, if she'd just accepted care, you know, maybe we could have avoided this. unfortunately, that is, it's their decision. You know, it's your decision to make whether you accept care and when you accept it. and knowing that we're there is important for the family so that we can jump in and start the process right away. Yeah.

Melissa Therrien, RN (14:35)
Yeah, and I think it's very dependent on how you pose the conversation, right? The time of day that you choose to have those conversations. You know, if mom or dad is, you know, suffering from dementia and is sundowning, you know, maybe at the end of the day after your work day, where maybe you had a good day, maybe you had a bad day, isn't the best time to have that conversation.

Liz Lewington, LPN (15:00)
Mm-hmm.

Melissa Therrien, RN (15:03)
And maybe having the whole family involved is not the best strategy to have that conversation either. You don't want anyone to feel like they are, it's an intervention. And it may be an intervention, but you want no one to be on guard when you're having these conversations and you want them to be of their best mind. being strategic about time of day, setting how many people are involved is also really important.

Liz Lewington, LPN (15:31)
Yeah, absolutely. Absolutely. And like you say, you don't ever want to have the person feel targeted. That's never the goal. And just sharing the information with your nurse, if you have a nurse coming in to talk about home care options, letting the nurse know because as a professional, and I know that you've gone through this, I have many times the family will say they're not interested in it, but they need it. And so they're kind of relying on the nurse to steer the conversation to a comfortable place.

Melissa Therrien, RN (15:56)
Mm-hmm.

Liz Lewington, LPN (16:01)
So that person feels, you know, okay, this isn't gonna be that scary. This isn't gonna be the worst thing in the world, but letting the nurse know is so important.

So you know how to steer the conversation because it can go in so many different ways. Finances are often a big topic. What's this going to cost me? And so it's nice for the family to know in advance, this is how much it would cost. And don't worry, we're going to handle it. And we've already talked about finances, so we don't need to worry about the long-term effects to your financial future. Yeah, I mean...

Again, everything is all about love here. That's really what it is. So coming in and approaching it from a place of

I love you and you cared for me for all of these years and you had help. You had members that could come jump in. Exactly, yeah. And it still takes a village. When somebody needs you, they need you all the time. And if you can't be there all the time, and nobody can, nobody can. Yeah, yeah.

Melissa Therrien, RN (16:54)
Yeah, takes a village. Yeah.

Yeah, I like that you touched on sending the professional in to have that conversation because I know many families have tried, right? And they're like, I just can't convince her or him to have care. Like what does that look like? Sometimes it's time. Yeah, absolutely. Sometimes it needs to sit and marinate. Other times it needs to be a professional that comes in and says, this is what is going to keep you out of a home.

Liz Lewington, LPN (17:32)
Yeah.

Melissa Therrien, RN (17:36)
This is what is going to keep you out of a hospital. Let's be proactive. Let's not take away your independence and send in a babysitter. You know, let's, yeah. yeah. Yeah, exactly. Yeah, I don't need a babysitter. No, no. And we're actually trying to encourage you to remain as independent as possible. I mean, that's our greatest goal. As we talked about last week, know, seeing someone continue to maintain their independence.

Liz Lewington, LPN (17:44)
that's the worst. Babysitter people, my god, I don't need a babysitter. it's always... Yeah, we're not babysitters. not at all.

Yeah.

Melissa Therrien, RN (18:06)
whether it's just needing setup support so that, you know, or dad are brushing their teeth with shampoo. I think I used that example last week too. You know, it's the setup so that we can accomplish things and we can stay at home safe and comfortable. And sometimes it takes a professional to say that because it's not emotionally charged. It's very pragmatic. This is the deal. It may be an either or situation. Here's what we're faced with.

Liz Lewington, LPN (18:14)
What?

Melissa Therrien, RN (18:35)
These are your options, one or two, and here's what's going to happen if you choose ARB.

Liz Lewington, LPN (18:41)
Yeah, yeah, I like that. Just break it down very simply. And again, everyone's different. You got to read the room. If you if your loved one, let's say your loved one really used to love going to play golf, and they don't do it anymore.

We have a client that we have looked after in Parksville here and he loves to play golf and he can't anymore, but he can play putt putt. So finding those little things that we can give back to the person. So going in and saying, you know, I know you love golf and let's get back out there. I know it's not the links, but we can go and take you to the green and you can practice your putting. Let's find that thing that you have lost.

Melissa Therrien, RN (19:10)
Nice.

Liz Lewington, LPN (19:27)
and bring it back to you. And that is usually a conversation that goes really well is let the nurse know in advance, dad really loves X, Y, Z, how can we bring that back to him? So we're not task focused like we had said previously, working for private care.

We're able to be more person focused because we have the time and the capacity to do that. And getting to know our clients, like letting the nurses know exactly what that looks like because it is so different for everybody. Yeah. Yeah. Some people love to socialize, other people not so much. Yeah.

Melissa Therrien, RN (20:05)
Yeah.

Yeah, and I think people are reluctant to tell us like, I haven't broached this topic with my loved one yet. Like I'm sending you in and you're gonna be the bad guy. And that's totally okay. Like I'm happy to be the bad guy. I will take that burden off of you so you can maintain that relationship. I will be the bad guy, no problem. And I think people are reluctant to put us in that position. But again, it takes that emotional aspect right out of it.

Liz Lewington, LPN (20:19)
this like, yeah.

Melissa Therrien, RN (20:37)
and then you can continue to talk rationally about things. What is this going to be? Here's your option. We only have the two. So let's talk about how we're going to make this work.

Liz Lewington, LPN (20:47)
Yeah, and it's so much easier as a professional not being emotionally involved in it and you can present things very black and white. I mean soften it obviously, but we can...

Melissa Therrien, RN (20:57)
Love again.

Liz Lewington, LPN (20:58)
We can present it and is what we can provide. Does that sound like what you need? Does that sound like something that's going to support you enough to stay at home? And if the answer is yes, perfect. If the answer is no, then let's look at other options. There's so many other options. But just being told this is what's happening, no one wants to hear that, especially as an adult. You don't want to be told, Melissa, you're going to live in this facility. Although the meals,

Melissa Therrien, RN (21:15)
Totally.

In Hawaii, I will go. No problem. See you later.

Liz Lewington, LPN (21:28)
Well, ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha

Melissa Therrien, RN (21:36)
Yeah, happy hour. Done.

Yeah.

Yeah.

So definitely from a private experience or from a personal experience as I've gone through these conversations in my own family, how do you approach siblings that feel really differently about how things should go down?

Liz Lewington, LPN (22:07)
family dynamics, you beautiful creature. Yeah. So again, you can, you don't have to soften it as much when you're talking with the family. That's how I approach it is this is

Melissa Therrien, RN (22:09)
Yeah.

Liz Lewington, LPN (22:20)
this is what it looks like. I can see that your mom is not eating, she's not drinking, she has multiple hospitalizations. Not eating, not drinking and hospitalizations can easily be fixed by having somebody in the home to ensure that she's getting nutritious meals, she's having you know regular bowel movement, she's getting enough fluids to keep her body functioning. We can reduce her hospitalizations and that progression of her illness will slow because we're not having

these major knockbacks where she's on antibiotics and you know like having conversations that are pragmatic and and pointing out the easy to fix things like

Hydration. Hydration is so important. seniors have a blunted reflex for thirst. they may not feel thirsty, but their body does require the water. And especially if they're on a lot of medications or dehydrating and work on the kidneys. so flushing the kidneys out, obviously not for everybody, but majority of folks adding a lot of fluid to their diet is gonna help improve them. Not just their, not just...

not being dehydrated, but you can see a cognitive improvement. There's improvements across the board that happen just by making sure that person's getting water. So keep it black and white when you're talking to the siblings and then give them all the, like what I do if it's a rip roaring family, because you never know. Families are fun. Yeah. So when you're in with a rip roaring family, I will go in and I'll give them the facts and then they'll have it out.

Melissa Therrien, RN (23:30)
Yes.

Bye!

Liz Lewington, LPN (23:56)
and then I'll give them the facts again and then they'll have it out and then it's off and leave and we'll touch base again later. So those volatile families, we're here for it. Like this is part of what we navigate to. I didn't realize it going into nursing that this is gonna be, you know, a pretty substantial part of my role is making sure the family feels supported, making sure they have access to the information out there. So yeah.

Melissa Therrien, RN (24:01)
Ha ha ha!

Yeah.

Liz Lewington, LPN (24:25)
black and white with family. And that's what we do. yeah, 100%. Yeah, yeah.

Melissa Therrien, RN (24:26)
Yeah, because misinformation, misinformation is huge, right? Yeah, one sibling thought one perspective and is sticking to what they understand, right? Yeah, misinformation. yeah.

Liz Lewington, LPN (24:36)
Yeah, and they're in different provinces, different cities, you know, and then and then there's always one, not always, but there's usually one sibling that is, I'm the most involved, I know what's going on, I'm burnt out, and I don't want anything to do with this anymore. And so that's where the other siblings have come in. And now we're, you know, there's a fire. So let's put it out. Yeah, yeah.

Melissa Therrien, RN (24:52)
That's right.

Yeah, yeah, yeah. Or as you said, they're out of town, they're out of touch with what the reality is for a mom or dad, right? Yeah, yeah. And just don't have a firm understanding of what the needs are and what it's taking to navigate all of those needs for sure. Yeah, yeah.

Liz Lewington, LPN (25:06)
The daily grind was tough, yeah.

Yeah, Christmas is a huge time for it, I'm sure. You see your loved one and you think, wow, their clothes are a bit baggier than I remember. And there's a lot of buttermilk in the fridge. She doesn't even need buttermilk. Why has she got so much buttermilk? That was one of my clients just bought buttermilk every time she went to the store. It was a consistent thing. And then you went into the freezer and it was all buttermilk. So...

Melissa Therrien, RN (25:34)
Delicious.

Hahaha

Liz Lewington, LPN (25:39)
How long has this decline been going on and no one has noticed? Because it was minor. And when you have an intelligent person, they can hide, they can mask that dementia because they're, and like that social IQ is high. You can have somebody carry on a conversation with you. And even as a nurse, you can be fooled for a little while.

Melissa Therrien, RN (25:42)
huh. Yeah.

Mmm.

Liz Lewington, LPN (26:00)
thinking that they know what's going on exactly until you realize, well, no, that person isn't in their life or they haven't gone for a walk in six months. They feel that they did, but they haven't. Yeah, so yeah, there's some crafty folks out there that definitely can mask it. Yeah, they cover for each other like crazy. yeah, you go in and yeah.

Melissa Therrien, RN (26:00)
He's a...

Yep.

Yeah. And spouses, compensating for our spouses. That's a big one. Yeah. Yeah. No, that didn't happen. Absolutely not.

Liz Lewington, LPN (26:29)
And then dad will be sitting there and he'll look at mom and mom will look back at dad and she'll answer for him. So knowing those, and as a nurse, like those subtle cues, you know that they're looking for an answer. And then you can see the kids look at you and you know that they are looking to go, do you see what's happening? Yeah. You saw that glance. Yeah. So really.

Melissa Therrien, RN (26:34)
Yeah.

Yes

Totally.

and be like, see? Yeah. Yeah.

Liz Lewington, LPN (26:55)
making sure that if you're the loved one and you're approaching a care company, that you let them know the reality of the situation. And they can come in and it can be a pleasant conversation. But if we get the inside track, we know how to steer the conversation. So we're just keeping us in the loop and then giving the information to your siblings black and white. And if they need to talk to us, give them our phone number. I'll talk to you. Yeah, yeah.

Melissa Therrien, RN (27:22)
Yeah.

I'm not afraid of you. Yeah. What about chatting with people about sustainability? What does it look like to chat about sustainability? And when you are offering home care, is that part of the conversation?

Liz Lewington, LPN (27:26)
No, you're not my family. Yeah, yeah.

It can be. I mean, everyone is concerned with their own finances all the time. Like it's the world that we live in, unfortunately. But yeah, the sustainability conversation is, it's often that, you know, the family is the one involved in the financial decision-making, but letting them know that...

We can start here and there's other financial options that once we get started that we can investigate. And then also letting them know the next steps if we're talking assisted living, this would be the cost of it. If we're talking long-term care, this would be the cost of it. And then I always encourage people like go see the places, put your name on the list.

If possible, if it's somewhere that you want to be and you can afford, put yourself on that list so that you have the option to take it or you can say no. You're never, just because you have put yourself on that waiting list doesn't mean that you have to take the bed when it comes. You can say no and put your name back on the list at a later date. yeah, sustainability is always an important.

conversation and it's difficult because we're talking about mortality and that's never an easy conversation. know, how long do you have? What does it look like? Where do you want to be? What are your other? What is plan A? What is plan B? What is plan C? Yeah.

Melissa Therrien, RN (29:04)
Yeah, and I think people think I want I want to leave everything to my kids, right? you know, I I don't want to spend the money now because You know, want to leave as much as I can to my family and then the the family is saying no like spend your money It's your money spend it to do what you want live a quality life often those butt heads like nobody's business, right and with

Liz Lewington, LPN (29:11)
yeah.

No, I know.

Melissa Therrien, RN (29:33)
Seniors these days, you they're accustomed to a lifestyle where they're Scrimping and saving and you know, they they work hard and they keep their money and be very responsible and those of us of this generation are like Let's blow our money everywhere, right? So I when we get old, it'll be a very different conversation but yeah, I mean, I think the sustainability piece is a big thing financially, but also like

Liz Lewington, LPN (29:47)
Yeah.

No sir.

Melissa Therrien, RN (30:00)
Realistically, like what does the house look like? Has an environmental assessment been completed? Are we pooling those resources like OT, PT, occupational therapy, physiotherapy, technology, right? How are we implementing technology into the house to make that a reasonable and sustainable option? So again, education. Yeah. yeah.

Liz Lewington, LPN (30:18)
Yeah, technology is a big part and it's growing. Every time I go into the house, I'm like, give me a look at that. There's something new. And then, so there's a lot of new safety technology that can help people stay in their home. But yeah, just having the conversation. Please, dear God, have the conversation. Start it now. It may be painful, but it's gonna be less painful now to have the conversation than it would be when the house is on fire, essentially.

Melissa Therrien, RN (30:37)
Yeah. Yeah.

Yeah.

Liz Lewington, LPN (30:48)
Yeah, yeah, yeah. And like you said, altering the house actually to go back. Getting a shower that you can get into, super important. Widening doorways for wheelchairs if that's what's needed, super important. Being able to access the house, also important. And that can be financially a massive cost to the care that you need to alter the house, but there's options. So you can have a reverse mortgage, there's

what is it called? Tax rebates for home alterations. yeah, just yeah, talk to us. How about that? Just call me, call Melissa. We'll sort you out. Yeah. Yeah.

Melissa Therrien, RN (31:28)
You can be on our podcast next week and we can work through it. Absolutely. No problem. We'll set it up like Jerry Springer style and you can be here with your family too.

Liz Lewington, LPN (31:32)
Yeah, yeah, we'll blur your face. It'll be fine, yeah.

I was thinking to Maury, I was thinking to Maury, I'm like, you are not the caregiver. Yeah.

Melissa Therrien, RN (31:45)
I'm

Okay, so let's just recap everything. Let's break it down step by step. What do families need to think about when they're preparing to have this conversation with their loved ones?

Liz Lewington, LPN (32:03)
what does the loved one value the most and approach it from that way. So approach it with complete empathy and love and openness, no pointing fingers and just have the conversation early. Like if I can, if I can, anybody have the conversation early.

Melissa Therrien, RN (32:06)
Yeah.

Yeah.

And love can be tough love, right? It can be like, this is how it has to be. And I'm sorry that you're not gonna like it today. Tomorrow you might be thankful. It may be a month from now. But ultimately, you know, this is because as you said, I come from a place of love. Yeah.

Liz Lewington, LPN (32:26)
100.

Yeah, yeah. And like you say, in a month's time, there's not been anybody that has

in my career that had started care and then said, you know what, I don't like being helped. I don't want to have good meals. I hate being hydrated. The medication, I hate all of this. Once they accept and embrace it, it's a different story and you can actually physically see that person improve. So you will come in and your loved one will actually feel and look better. It's palpable.

in the room when you have proper care in place. Yeah. So.

Melissa Therrien, RN (33:22)
Yeah, I think that must be a BC thing because I've definitely had people go like, yeah, no, I don't need this.

Liz Lewington, LPN (33:29)
All right, well, this side of the Rockies were doing just fine.

Melissa Therrien, RN (33:32)
Yeah, everyone is very lovey-dovey and this was a great decision. No, but yeah, act. mean, it's true though. I have had people that are like, yeah, no, this is premature or I needed the help in that moment and I no longer need it. And we go back and we start again, right? And I think that's okay too. You know, we can start and stop and come and go and.

Liz Lewington, LPN (33:37)
No. Yeah, Kumbaya, yeah.

Melissa Therrien, RN (34:01)
you know, do what suits you. And that's an important thing to know for everybody, right? There's no commitment. Yeah.

Liz Lewington, LPN (34:05)
Yeah, yeah, yeah. And then giving the family member back their role in the family that they've had their whole life, to be the daughter, to be the son, to not be that only caregiver that is able to help. So yeah, it's a huge, yeah. And then the anxiety and fear that families have, what if I leave and he falls or they don't take their meds or they do take all their meds?

Melissa Therrien, RN (34:15)
Yeah.

Yeah, big job. Big job. Yeah.

Ugh.

Liz Lewington, LPN (34:35)
Like all of their meds. Yeah, there's no break. Even when you're away, there's no break unless there's somebody else there. So, yeah.

Melissa Therrien, RN (34:35)
There's no break. Yeah, there's no break.

Yeah, and that goes back to last week, right? Building that trust. How do you build that trust with your caregivers team? And it may take a team, right?

Liz Lewington, LPN (34:50)
Yeah. Yeah. And if you're a senior listening, know, having this conversation dropped in your lap, knowing again, let's just circle back. If you're the senior and you're having someone talk to you, it's all coming from love. This is not, this is not something that is being done to you. It's being done hopefully with your blessing, but to keep you safe, to keep you safe.

Melissa Therrien, RN (35:17)
Yeah, and to appreciate your wishes, you know, be vocal about those wishes. As we said in the very beginning, you know, let's not just talk about what our wishes are around death. Let's talk about leading up to that and how you want to spend those quality years of your life.

Liz Lewington, LPN (35:22)
absolutely.

Yeah, yeah, you've worked long enough and hard enough to be able to make that decision to enjoy yourself. Yeah. Yeah. Yeah.

Melissa Therrien, RN (35:38)
Yeah, very good. Thanks so much, Liz. This was great. I was really excited about it and this conversation because this like the meat and potatoes of what we do. I think this was good. I really enjoyed chatting with you about it. And I hope this was informative to people. So thanks for joining us again. And we look forward to next week, having you join us and chat more about home care, seniors care, health care, you name it. We'd love to chat about it.

Liz Lewington, LPN (36:06)
Yeah, thank you so much.