A heartfelt conversation: Caring for your heart as you age
Everyone knows how vital heart health is to our wellbeing, but did you know that heart disease is the single leading cause of death in Australia and one in 20 Australian adults is affected by cardiovascular disease?
The good news is that there are a lot of things people can do to reduce their risk when it comes to heart disease. Registered Nurse, Fatimah Lesiguez, facilitates the Cardiac Wellness Program, one of integratedliving’s many award-winning Wellness for Independence® programs, and she cannot speak highly enough about the benefits of educating seniors about heart health.
The program teaches participants how the heart works, risk factors for heart disease, common heart conditions and how things like diet, stress and other lifestyle factors can affect your heart health. It also provides guidance on ways to mitigate risk including healthy eating, exercise tips and managing stress.
This podcast focuses on heart health and you’re invited to listen to Fatimah’s great tips on protecting your heart. You can enjoy her wonderful philosophy on life and passion for nursing as an added bonus!
A full transcript of this podcast is now available below. You can subscribe to our YouTube channel and be updated with our latest episodes. You can also subscribe to our podcast channels available on your favourite podcast listening app, including Spotify.
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Transcript
Introduction
In the spirit of reconciliation, integratedliving acknowledges the traditional custodians of country throughout Australia and their connections to land, sea, and community. We pay our respect to their elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander peoples today.
Catherine
Hello and welcome. My name is Catherine Daley, CEO of integratedliving Australia, a community-based health and aged care service provider. I'm thrilled to be welcoming you to our brand new platform, our Live Well podcast. As the media and digital landscape evolves, we want to be able to offer our clients, team members, and listeners more broadly, a new way to hear from us.
Our Live Well podcast is for everyone in our integratedliving Australia community, and for anyone who loves a great story. Each edition will speak directly with integratedliving Australia staff, our support workers, registered nurses, and people from across the country, and hear their stories. Those on the front line who deliver exceptional care to thousands of older Australians in regional, rural, and remote areas.
Jo
Welcome everyone to the Live Well Podcast. Jo Isaac with you for this episode, and I'm very pleased to be joined today by one of integratedliving’s, wonderful, registered nurses, Fatimah. Today we'll be talking about heart disease, which sadly is the single leading cause of death in Australia, killing one Australian every 30 minutes. February marks heart research month, raising money for Heart Research Australia and their work in supporting research into the prevention, diagnosis, and treatment of heart disease. So this is a great time to be highlighting how we can all make simple changes to improve our heart health. Welcome, Fatimah. And thank you so much for joining me today.
Fatimah
Hi, and I'm actually very honoured to be part of this podcast and it's a nice opportunity for me to talk about our wonderful program, Wellness for Independence®.
Jo
That's fantastic. We're looking forward to hearing more about it. All right. So to start, I'd really love our listeners to hear about your wonderful philosophy when it comes to caring for our seniors as a registered nurse. You mentioned to me how much you really love your job. Can you tell us why?
Fatimah
Okay. So, I always believe that every client is special. I could not emphasise enough to all of my clients how important they are. And I always treat my clients as my pops and my nana. And they deserve the right care, respect, and love that we should shower our own family. So I always look at them more than just their medical background or medical history. When I am looking at them, I always tell myself they are someone else's loved one. They are someone else's pops, dad, uncle, brother, son, nana, mum, auntie, sister. The list goes on. And being a registered nurse, it's more than just possessing the clinical knowledge and technical skills. It is having the heart to serve and to care and to be an advocate, especially to those who are vulnerable like the many pops and nanas we have in our community.
Jo
Well, that is so lovely to hear. And can you tell us just a little bit about one of your Wellness for Independence® groups, who call themselves Fatimah's Fabulous Family. Can you tell us a little bit about how that came to be?
Fatimah
Yes, so I started running this group early last year. They're actually from the Central West and Orana Far West. I haven't met them. We only met each other through Zoom. So they enjoy the program that we run and then they just keep on asking me even before the program has ended, "Hey, Fatimah, what are we running next? What are we running next?" So we called ourselves Fatimah's Fabulous Family. And it's actually very humbling. I see how happy they are. At the start of the program, they're just catching up. They're just like old friends like they know each other since probably they were young. And it's actually amazing how I became an instrument for that. And for me, that actually is more than enough to tell myself, "Yep, you're on the right call. You're on the right profession. It's right. You are actually touching and changing lives." It’s more than enough. It's very rewarding.
Jo
That's wonderful. And I'm sure your fabulous Fatimah's family are very lucky to have you running all these programs and just enriching their lives as you do so well. So, thank you on behalf of everyone. Our wonderful nurses have really been so instrumental over the last two years, and of course they always were and always will be, but our nurses have made such a difference to people's lives during the pandemic, and I'm sure I speak for everybody saying thank you to you too.
Fatimah
Wow. That's actually nice. I remember now. My fabulous family said, "Families are like trees. We could have different branches, but we're just one root." That's what we always say. And I was like, "Aww, that's really nice." And doing this job and meeting these people makes me want to become a better nurse, work harder, and be happier. Like I said, it's a very rewarding profession and it's very humbling. And for me, seeing them smile, making a small difference, the effect lasts forever. You think about it and you smile and you bring positivity and happiness to not just them, but for anyone. So, I'm very honoured to be part of this company actually and being able to do this job as well.
Jo
Oh, that's wonderful, Fatimah. Thank you so much. Well, moving on to our heart health, which is so important at every stage of our life, of course, but especially as we're getting older. And as a facilitator of our Wellness for Independence® programs, our Cardiac Wellness program in particular, can you tell me a little bit about heart disease? What are the key heart conditions people may develop?
Fatimah
Okay. So, the heart is actually a very vital organ in our body. One of its main functions is to ensure that blood is actually pumped or delivered to every organ in the body. So, blood actually carries oxygen and nutrients that our organs need for them to function properly. As what you have mentioned earlier in your opening statement, heart disease is the single leading cause of death in Australia. And that one Australian in every 30 minutes dies from it. According to the World Health Foundation 80 percent of the deaths associated with coronary vascular diseases are preventable. So, some of the key heart conditions that people may develop are angina, heart attack, arrhythmias and heart failure.
Jo
Yes. And I mean, it's great to hear that whilst heart disease can be so dangerous that there's so many things we can do to prevent it. So that's a really important note as we go on and talk about it. Can you tell our listeners what they need to know about heart attacks? What are the signs of a heart attack and what should someone do if they or a loved one are displaying any of these signs?
Fatimah
A heart attack is a sudden and complete blockage of a blood vessel. As we know, blood vessels are like... I always tell my patients when I do the classes, blood vessels are like bridges and roads, and that's where the blood would usually pass through. In that way, it would reach all of the other parts of the body. So, during a heart attack, this heart is somehow blocked. So when it's blocked, as you know, blood cannot reach the organs, which we know blood is very vital for all of them to function properly. So when there is a blockage to the heart or some part of it, what happens is it becomes starved of oxygen. And when there's starvation of oxygen, that part of the heart becomes damaged or even dead.
I mean, there's a couple of signs of heart attack. It can varies from people to people. It's more than just the chest, and the clutching in the chest that we normally see in dramas and movies. Actually, it can be manifested in many ways and each patient is always different, but these are some of the, not common, but these are some of the signs that are associated with a heart attack. Of course, as mentioned, the clutching of the chest because it means that there's a chest pain. And it's like someone or something heavy is on it. And it doesn't actually go away with resting.
The other thing too, it actually radiates the pain. Radiates from the chest all the way to the jaw or to the arm. Some people don't have that, but they could have stomachache like indigestion stomachache. Other people would just feel tired like, "Oh, I'm just unusually tired." Or nausea. They're like, "Hmm. I feel like vomiting. What's this? I don't know what's happening."
The other thing as well is they could develop shortness of breathing. They couldn't breathe well. Weakness is also another thing. And sometimes they become sweaty and they also become dizzy.
The best advice I always tell my patient or my client when they experience something like this, I always tell them, "Call triple zero." I know for a fact, some of my very lovely, beautiful nanas and pops in the community would tell me, "But Fatimah, what if it's not a heart attack? What if it's nothing? I'm actually taking away the time from someone else who needed it." And I'm like, "Hey, nan, pops, you are important. In fact, you're the most important person in this room. You are as important as anyone else."
So if you feel unwell or not sure if it's a heart attack, just call. Call triple zero, call the ambulance. And remember the quicker that we're able to access the treatment, the better our chances of preventing the damage to the heart muscles and the heart itself.
Jo
That is such important advice because, yes, it's a very Australian thing not to want to cause a bother to anybody isn’t it but it can be the difference between life and death to make that call. So, yeah. Great advice. Thank you, Fatimah. Can you tell us what are some of the risk factors that increase people's chances of developing heart conditions?
Fatimah
In our Cardiac Wellness for Independence® class, we always talk about two types of factors. We have what we call the non-modifiable ones. And we also have what we call the modifiable ones. Non-modifiable ones, these are the ones that can't do anything about. An example for that one is gender. Apparently men have a higher chance of having a heart attack and heart diseases. Women actually also have that chance after they have their menopause.
Another thing, family history. If you have family history of heart diseases in your family or in your genes or your ancestors and things like that, if both of the history is from both mum and dad, you're 50 percent higher of developing heart diseases. Diabetes, same thing. Diabetes is also another thing. If you have family history of diabetes, high cholesterol, high blood pressure, you're also at risk of developing heart diseases.
Age actually is also another thing. As we grow older, there's always physiological changes in our body that also includes our heart. So as we grow younger, I always wink-wink on that on my patients and they laugh about that. I'm like, "Oh, no. As we grow younger, wink-wink, our body develops changes”. That also makes us at risk for developing heart diseases. That's for the non-modifiable one. So this thing, we cannot change.
Oh, and there's also one more thing. Some nationality like our Aboriginal and Torres Strait Islander peoples, they're actually 20 percent more likely to have heart diseases and some ethnicity like middle Eastern people, Asian people they also are higher risk of developing heart diseases.
So modifiable risk like we mentioned. These are the one that you can actually do something. We can do something on this one. So smoking. People who smoke, they have 20 times likely to have a heart attack. So as much as possible, yes, they try to reduce if not quit. There's a lot of programs available that our government is actually encouraging us. Speak to your GPs, speak to your RNs. Ask what you can do to start the process. The very best advice I always say is just try to start. Once you try to start, at least you try. That means that you want it to change.
Alcohol as well. That's also another thing. Obesity is another thing. So when you are obese, you have excess weight. And then when you have excess weight, that actually increases as well, your chance of developing heart diseases. Poor diet - fats, salt, sugar, cholesterol can also increase your chances of developing heart disease. Also physical inactivity. So when you're not active, you gain weight. And as mentioned a while ago, when you gain weight, it also increases your chance of developing diabetes and all the other conditions. Stress is another thing. And unrelieved stress actually may damage your arteries and worsen the risk factors as well.
Jo
So there's so many things that are really important to do, obviously, but it's more of a... The better you are holistically, the way you treat yourself holistically, including your mental health, is really important in reducing your risk factors. So this points to the need to learn mindfulness and trying to reduce stress in your life, which is so important.
Can you also tell me, Fatimah, what are some of the... Well, you've talked about risk factors. What are some simple things people, particularly, those over the age of 65 can do to prevent heart conditions from developing or improve their existing heart conditions?
Fatimah
We can do exercise. We try to encourage exercise. In fact, they say moderate type of exercise, 30 minutes for five times a week, can actually reduce your risk of heart diseases. Proper diet. No more Maccas, no more KFC. No more salami, no more deli things in the supermarket. Try to avoid that one. Also, quit smoking. If not quit, lessen, because it's not easy to quit. It's actually a hard thing. And I would understand. That's why try to make the first step. Acknowledge that you wanted to quit and that would actually make a big difference.
Also, lessen alcohol intake. That's another thing we can do. Reduce stress. Join activities like... We have lots of wonderful programs in our company. The mind and wellness program or join a social group. Do Tai chi, do chair yoga, which we are actually doing at our wellness gyms, very nice, very popular among our clients actually.
Also, have a regular GP review. That's what I always emphasise. And I could not emphasise this enough. I always tell my patients, "Always make sure that you get checked." You see? And they were like, "Oh no. It's okay." I'm like, "No, you are important, remember? And because you're important, we have to make sure that you get checked, and make sure that your medication is still also up to date." I also tell them it is important that if they're on a medication, they need to take them. And if they have questions, ask the GP. There's no one that could explain it better to them, than their own GP. So, I know for a fact, some of our clients would be like a bit shy to ask. And I always tell them, "Remember, you're special. You need to ask."
Jo
Absolutely. And when you say regular check-ins with the GP, how often would you recommend that?
Fatimah
For people who don’t have conditions, six months. Have a heart check and blood test. Do check your cholesterol, your levels and everything.
But for people who have existing heart conditions or are actually inclined because of, let's say, some factors that we mentioned a while ago, I would encourage if not monthly, every third month. At least, you can do a bit of a whole blood test, a whole profile on what's going on.
With our elderly clients, they can actually change in a snap. That's the thing. That's why we have to be very careful when we're looking after them because they're very vulnerable. And it comes with all the other things also occurring in their body. As we grow younger, wink-wink, there are physiological changes. So we can't change it. So that's the thing. We have to be very keen and very religious in monitoring them. And that way we can actually catch if they have anything that's starting to develop and prevent further damage or further after-effects that I know could really be debilitating to them.
And so, we want to support them to stay longer in their homes. That's where they're happy.
Jo
Exactly. Can you tell us how integratedliving’s registered nurses can help our clients? How can accessing the services of in-home registered nurses and in-home telehealth, how can that help you as you grow older to ensure that you’re getting checked when you need to? Not everyone's going to go to their doctor every... Often people go when they're not feeling well rather than as a preventative measure. So, how can our nurses and telehealth programs help keep that in check?
Fatimah
Yeah, actually, that's what I was saying. integratedliving has lots of programs available, that our elderly clients can actually access. As you mentioned, we have registered nurses like myself who usually come and visit them every month or every three months or every two weeks or how often they need it. Registered nurses would monitor their blood pressure, would monitor their weight. Would do clinical assessments. And if there's anything outside of range, we would actually talk to their doctors about this and express the concern and be an advocate on behalf of our clients.
Telehealth monitoring is also nice. I actually was a telehealth nurse as well in the company. I still do a little bit from time to time. But how it works is that this is really great for people who are living remotely and they need it, let's say, monthly, not monthly, weekly or daily blood pressure monitoring or sugar level monitoring or weight monitoring, especially for people who have a heart condition that they are at risk of developing fluid overload.
So the best way to actually know if this client is retaining fluid, mind you, is weighing them. It's more than just watching for fluid like edema in the... The best way that we can actually say, "Hey, she is retaining or he's retaining," is actually to do their weight. So, telehealth monitoring can do that. Saturation, temperature, weight as mentioned a while ago, blood pressure, sugar level, and you don't have to actually leave your house. You're just in the comfort of your home. Once you've taken your vitals, it will be actually sent to a registered nurse like myself. We have a very great telehealth team, by the way. I want to say shout out to Sam Barford and her team.
Jo
That's awesome.
Fatimah
And if there's anything that is outside the parameters that we have set up with the GP initially before they started this telehealth program, we would call our clients. We would alert their GP that "Hey, this has been happening. This is the trend." And the GP can actually say, "Oh, all right." So the report is there. Numbers are there. Concrete evidence and data. They would actually tell the GP, "All right. I need to review you. I need to check your meds. It's not working anymore. Maybe adjust the dose."
Jo
That's fantastic. A lot of people don't know about that, the service you can get through in-home care... It gives you that peace of mind as you age that you're having someone regularly proactively help you keep on top of anything that might be happening. And it must be a great relief for people to have that support, which is wonderful. All right. So, let's talk about integratedliving’s Wellness for Independence® programs. Obviously, we've talked about the Cardiac Wellness Program, but there are a whole range of programs that we do. How can people benefit from these and what will someone learn if they take part in the Cardiac Wellness Program, in particular?
Fatimah
So, like you mentioned, there's plenty. I've run a couple of them. Nutrition program that actually always encourages them to be a bit more mindful in what they're going to eat. Learn more about how to read labels, how to cook healthy, even proper storage of food, proper cooking of food. That's actually something they can learn and it's amazing. We have the falls program. We also have the low vision. We also have the diabetes program. We have the memory program. I love that as well. We have, actually, mind and body program coming soon which is very nice. I'm excited to run that. We have the respiratory program, which is actually very timely knowing that it's COVID and COVID will be here at the moment, and we just have to actually learn how to make sure that we prevent this from happening to us so that we have a respiratory program for that.
And then we have the Cardiac Wellness program. So, what are the benefits that our clients can get from joining the Wellness for Independence® program? Aside from getting an iPad with free internet, that's actually amazing. And also a watch that would count your steps and your sleep, you also get to learn lots of things. Let's say you're doing the cardiac program, you get to learn about the heart, about the importance of regular checks. What are the things we need to watch out for? What are cardiac diseases? What is the function of the heart? Better understanding. In that way, you'll be able to make good decisions and be a bit more active and living healthy. And when you're living healthy, we are actually encouraging them to stay longer at home, which, like I said, they love that more than anything in the world.
These programs are actually encouraging our clients to be a bit more wise with how they want to live their life, how to improve their health, how to prevent things that can be prevented.
And knowledge. They gain knowledge too, and they get to meet new people. And socialisation during COVID they need that. And especially during those times when we have the lockdown, my clients always look forward to their classes and they would come early, talk about their gardens, about their new pets or about their flowers or about anything. And that's actually very nice for their wellbeing. Even if they are far from each other, they're not lonely, they're not isolated because we have programs such as this one that brings people together, not physically, but virtually, but it's the same thing. Feel good emotion. It's the same. That's why this program is really, really good. And I would encourage everyone to actually be a part of this.
Jo
They are fantastic programs. You often send photos of your Zoom, of everyone smiling and looking so happy. And it's very heartwarming to see our seniors come together in this new way. And even learning how to use an iPad and how to... Which then brings them connection not just to the programs, but to their families and their friends. And it's such a... So many seniors have really upskilled in terms of technology over the past two years just because they've had to, but also that's opened many new doors for them, which is fantastic, isn't it? So with the iPad and the connection, is that theirs to keep or is it like a... Do they borrow it for the duration of the program?
Fatimah
So the iPads and the internet is actually... They're loaned to them during the time that they're joining the program. By the way, I forgot to mention, we do have what we call the digital program as well where we actually teach our clients about how to use the iPad, the ins and outs of the iPads, the apps that they can actually use. One of the favorite apps that I actually teach them is Libby. It's like an audiobook app. It can be connected to your library and you can borrow audio books and it doesn't cost you anything. And for my client who loves to read, she said to me, "Thank you." Because her eyes are failing and it's hard for her to read a hardbound copy book.
So I said to her, "What about you try Libby? You could just listen to it and it doesn't cost you anything. And you can borrow it from your local library. You can borrow the books available in your local library." And, as you know, it's endless choices for them. So, she was happy with that. So, very amazing program like I said. I can speak probably and talk about this...
Jo
Endlessly.
Fatimah
I love this program, actually, and it's true. I do.
Jo
That's wonderful. On that note, can you tell us about some of the positive health and wellbeing outcomes for your participants? People who've done the programs. Any favourite stories to share? I guess you've just shared the one about your client who loves to read, and this gives her that way in. Any others that you'd like to share?
Fatimah
Yes. I have a lady. She was not too techy. So at the beginning of the program, she didn't have an iPhone. She didn't have anything like a smartphone. She'll have the telephone, the normal line. So, one day, I was surprised before I started the program. She was like, "Fatimah, thank you." I'm like, "Yes, my love. What's wrong?" She said, "I bought myself a new iPhone and now I can scan the QR code. I don't have to write my name when I enter the facilities." I'm like, "Aww, good on you." And she said, "Well, I realise, it's the same as your iPad. So I bought myself a new iPhone." I'm like, "Oh, wow. Good on you." So that's one of the things. So, she was able to... Now she knows how to Zoom. She Zooms her daughter, by the way. The daughter is, I think, in Canberra, another state. So she Zooms her every day or every week. And it's actually amazing.
You see, our program, it actually bridges the gap. Our older generation, they're not born techy, but this program is encouraging them and letting them see that, "Hey, it's okay. Even if you're a bit young, wink-wink, you can still learn new things." I always tell my clients, "You should give yourself a pat because look at you guys. How amazing you guys have been. You now know how to download apps, use Zoom, watch Netflix, open YouTube. Really? Use Spotify that’s so nice.” And I'm so proud of them. I'm like a mother hen. So proud of my chicks.
Jo
Well, obviously, they must just adore you. So, it's wonderful to hear these stories. Finally, Fatimah, how can people take part in the Wellness for Independence® programs? How is it funded? How do they get in touch? All of those things.
Fatimah
It's actually in our website. We have the Wellness for Independence® program. Different types of programs are in there. We have actually reached out to GP practices. We've left some of our flyers. So sometimes they could probably hear it from, let's say... We run like Chris, my wellness lead. She runs information about the Wellness for Independence® program. She liaises with local GPs, hospitals. We also go to places like Men's Shed. I remember going to Men's Shed. Going to bowling clubs and looking for 65 years old and above or, let's say, crafts group. We have nurses like myself, we usually go and disseminate information to them. So if they are interested, they can call, the integratedliving number, and then they would be directed to a registered nurse like myself or anyone around the area.
So, how they can get funded. We actually do a three-way phone call with My Aged Care. And we request for a nursing CHSP referral or an SSS other code, whichever is available in their area, because some areas don't have nursing code. Instead they're using an SSS other code. Once they've been referred and they've been approved for a nursing CHSP or an SSS other funding, then they can join the program. And actually it doesn't have an expiration to some of them. As long as it's active, some of them the referral don't have any expiration. So that's amazing. They can join as many programs as they want. And that's, I think, what my groups are doing now. I have five groups and they're all rolling over and I love them. They're not getting... What do you call the one? Lesser. They're getting more. I am actually going to be running more groups, six, seven groups soon. Wow. I'm very lucky.
Jo
That's amazing. So the people come, they meet each other, they get to know each other, and then they do each of the Wellness for Independence® programs one after the other. That's amazing.
Fatimah
Exactly.
Jo
So really, as long as someone has CHSP or Home Care Package funding, they can do the program?
Fatimah
For the Home Care Package funding, if they're on a level one and two, we normally ask and liaise with the CM, the case manager, to do an SPR, to request for an additional top-up. To do an additional CHSP nursing top-up. And that way, it’s the same, they can still access CHSP nursing and it will not be taken out of their package.
Because level ones and level two have only certain amount of funding in their packages.
So, they can access that. So, CM will arrange that. If they're on a higher package like say level three and level four, we can also have to liaise with the CM because the CM, the case managers, they're the ones who know the budget. So if there’s plenty in the budget, they can join the program.
Jo
Yes. So the best thing would be for someone to ring integratedliving on 1300 782 896, and the lovely, friendly customer service officer who answers the phone can help them figure all that out and point them in the right direction, help them get what they need in order to join the programs, which is, is great. And our website is www.integratedliving.org.au for those who want to look there and have a look and see all the Wellness for Independence® programs that are available at the moment. With more coming soon, I believe.
Fatimah
Yes.
Jo
That's fantastic. All right, Fatimah, thank you so much for joining us on our Live Well podcast today. It's just wonderful to hear the passion you have for nursing and the difference you make to people's lives every day. Our listeners will no doubt appreciate the great information you've shared on how we can keep our precious hearts as healthy as possible. Of course, if any of you listening have any concerns about your heart, you should speak to your general practitioner or medical specialist and tune in to the Live Well podcast for more inspiring stories of older Australians living in regional, rural and remote communities. And of course the wonderful people like Fatimah who support them.
You can also follow integratedliving on Facebook and Instagram and enjoy our Live Well blog by visiting our website, integratedliving.org.au. Until next time, bye for now. Thanks for listening.