The Lighthouse Supported Living Annual General Meeting is tomorrow, March 29th at 7:00pm in the Lighthouse dining room. 304 2nd Ave S, entrance is on 20th St. We will share about the work done by the Lighthouse including expansion of services and uplifting stories of lives changed in 2015. All are welcome to attend.
Feet are not for everyone, especially caring for feet. But having healthy feet is vital for anyone who wants to get from point A to point B. It’s not something we think about when we’re young, but as we get older, foot care becomes an important part of maintaining mobility. Nicole Masson-Greenhorn is a registered nurse for the Victorian Order of Nurses, and specializes in foot care. She came to The Lighthouse last week for her first drop-in foot clinic.
“It went well,” says Masson-Greenhorn, “I wasn’t sure what to expect for feet, but everybody I saw needed foot care, from super long toe nails to a little bit of teaching about foot care. Although feet are usually a lower priority, everybody who was diabetic seemed to know that feet are important, which I really like to see.”
The Victorian Order of Nurses is a charitable organization which was founded in 1896. It was originally started as a group of travelling nurses who would visit isolated communities in Canada to provide health care. In 1898, a VON cottage hospital was opened in Regina to provide care to pioneers and early settlers on the prairies. Over the next century, the order grew into a leading charitable organization, providing home care, education and health services across the country.
“In Saskatoon our role is foot care, so we go to all the nursing homes, people’s homes and hospitals to do feet. My job is foot care five days a week,” explains Masson-Greenhorn, “we do the flu programs, wellness clinics, we do some drug programs, teaching people to self-administer meds that are injectable, but our major role is foot care.”
As a registered nurse, Masson-Greenhorn always starts off with an assessment of her patient’s feet. She looks at what kind of shoes and socks they normally wear, as well as inspects their circulation and color. The next step is to, “cut and file toe nails, if people have corns or calluses we can file those as well. And then depending on what people have, if they have paralysis on one side or diabetes, we assess how that affects the foot and how can we keep it healthier.”
This kind of health care is vital to Lighthouse clients because many homeless individuals are forced to walk long distances every day to find food, shelter and access services in Saskatoon. Masson-Greenhorn understands that her patients have other health concerns, but wants to emphasize the importance of foot care, “People concentrate on high blood pressure, and they concentrate on insulin and all those things are important, but we want to focus on the feet and make sure that people can walk as well as they can and deal with issues. ”
It’s especially important for people with diabetes to be aware of their feet, due to their changing level of blood sugar that can damage nerves and lead to loss of feeling. This can cause something like a cut to go unnoticed and become infected, sometimes resulting in amputation. Masson-Greenhorn’s goal is to catch this before it even starts.
The Lighthouse hopes to take advantage of funding and have a foot care specialist come in once a month for a drop-in clinic. In the meantime, clients are advised to change into a clean pair of socks every day and wear proper fitting, supportive shoes.
When Jeannie Coe steps into her office at The Lighthouse, she has no idea what the day will bring her. As a nurse practitioner employed through Saskatoon Health Region, she has to be ready for anything. Coe and her colleague Donna McKnight, a registered psychiatric nurse, are on the front lines of primary health care at The Lighthouse.
Coe and McKnight run a drop-in clinic for anyone staying or living at The Lighthouse, helping people on a first come, first served basis, “people can show up or call or leave a note and say I have a medical concern or a health concern or I have a need and I need to see you,” says Coe.
She emphasizes that this is not a doctor’s office, clients don’t need to make an appointment and they don’t need to have a family physician. Both nurses are experienced and knowledgeable, and as a NP Coe can, “diagnose and treat common medical disorders, including ordering diagnostic tests, x-rays, lab work, ultrasounds and prescribe medication.”
Clients are welcome to come see McKnight or Coe for anything from an episodic illness, such as a cold or the flu, to a serious chronic illness. “We do have a lot of people living with Hep C, HIV and chronic diseases like diabetes, obesity, hypertension, high cholesterol, COPD, depression and anxiety,” describes Coe, “but we also have some more complicated people with cystic fibrosis, schizophrenia, bi-polar disease and pre-natal clients who are homeless, living in poverty often with infectious diseases as well.”
For more complicated presentations, Coe helps connect her patients to a specialist or family physician, ensuring they receive the care they need. “We highlight that the Westside Clinic is a great support to us. There are eight family doctors and a nurse practitioner that work out of there and we get a lot of people attached to that clinic.”
Before coming to The Lighthouse, Coe was a nurse practitioner in Northern Saskatchewan, “I worked with an excellent team in La Ronge that gave me invaluable experience about providing holistic care to people.” The Lighthouse has adopted the holistic care practice, meaning both nurses seek to treat not only their patient’s body, but also provide culturally appropriate emotional, mental and spiritual care.
“One thing we try to do here is be very opportunistic,” says Coe, “so it’s not like you come in and we can only deal with one thing, as you hear can happen in other places. So when they’re here and they’re engaged we do as much for them as we can.”
Sometimes the best service Coe can provide is lending an ear, “Lots of times it’s just listening with compassion, that’s what meets their need at the time. We hear often that’s really what they’re after and that’s how they find their way through some of their struggles, if they know that there’s somebody there to listen to them. That’s what makes this such rewarding work.”
Kevin Ohlheiser is a resident of the Affordable Living Suites. He came to The Lighthouse in February and stayed in the Emergency Shelter briefly. When an independent apartment became available, Ohlheiser and a roommate moved in.
“Jeannie has been very helpful, it’s nice to have that support, medical and counselling all here in The Lighthouse,” says Ohlheiser, “I feel comfortable coming down here, as I told Leanne [the addictions counsellor], I feel like I have four or five counsellors, Jeannie being one of them. Things, they get busy here, and you know sometimes Leanne and I try to get together and we can’t, and I’ll go down and talk to Jeannie or Donna. And she’s taking care of all my medical now.”
Coe says the biggest barrier to caring for clients at The Lighthouse is treating concurrent addictions, “people struggling to manage their addictions impacts their health and impacts their ability to engage in a plan for their care.”
She sees many relapses in addictions with her patients, due to the nature of having clients at different points in their recovery under one roof, “we’ve got people active in their addiction right next to the people that are just on their first steps out of it,” Coe says the solution is “to find adequate housing in the community. If we relocate them, they can start their journey.”
For Kevin Ohlheiser, living at The Lighthouse is the best thing for him right now, “My goal is recovery, and being able to talk to these people like Jeannie is very helpful and reassuring, knowing that there’s somebody here.” He says his full time job now is getting a grasp on recovery, “It’s been helpful, I feel like I’m in the right place at the right time to really start this process. I’ll take a serious run at it. I’m learning with the help of Jeannie and Leanne.”
Physiotherapy is an important sector of the healthcare field, especially as an aid to recovering from an injury or treating physical limitations. Unfortunately, it is difficult to secure funding in this area for underprivileged members of our community. After recognizing a need for physiotherapy at The Lighthouse, Nurse Practitioner Jeannie Coe set out to create a volunteer based program. She contacted the Saskatchewan Physiotherapy Association who put out an email and several members responded. One of them was CBI Health Group who offered to donate their services free of charge.
The program launched in April, and has been seeing positive results over the past two months. A group of five young physiotherapists have been taking turns coming to The Lighthouse every Friday afternoon to meet with clients and assess their health concerns.
Ryan Fehr and Lindsey Tasker are two physios who jumped at the opportunity to work at The Lighthouse. “I was really excited to see different presentations of various conditions that I had never seen before,” says Tasker, “so it’s been exciting for me just as a therapist to gain more experience.”
Fehr says they’ve been seeing “a variety of clients presenting with different neurological and musculoskeletal conditions and injuries, both acute and chronic.” Tasker nods in agreement and adds, “I’ve seen long standing injuries that never got attention, which should have probably seen therapy at some point after the injury. So we’re seeing them months, years later. It’s unfortunate, but at least we can provide care now and get people on the right path.”
When the therapists meet a client, they assess their injury, answer questions and decide on the best method of treatment. Sometimes they give clients stretches or exercises to do every day, and they print out pictures to help them remember. “But there’s also the education component,” Fehr explains, “because a lot of these people have chronic pain or arthritic pain that they don’t understand. One thing as physios that we really try to promote is independence in your own care. We assist where needed, and then give them control to take care of themselves.”
Although they encourage clients to come back for follow up sessions, Tasker says the most challenging part is not knowing if they will see their patients again, “I find I’m definitely spending a lot more time educating them on a bunch of different things, where normally I would spread that out over several visits at the clinic.”
Fehr and Tasker also have the opportunity to train students through this program. Second year physiotherapy students from the U of S have been sitting in on assessments for the past few weeks and say they’ve been learning a lot. “It’s a different population than what we normally get exposed to, which I think is the most valuable part,” says Shelby Schemenauer.
After seeing the physiotherapist, clients have been speaking with Garnette Weber, who is the Physio Project Manager. She has just started conducting a survey to gather information about the results of the program. Weber plans on using her research to apply for long term funding towards a permanent physiotherapy position at The Lighthouse.
Everyone involved with the program says that a full time physiotherapist is a much needed service at The Lighthouse. “It would be very challenging for a lot of the residents to be able to access physio outside of here,” says Weber, “They’ve really appreciated that it was available here and they can just go in when it fit with them in a place where they’re comfortable.”
With the Education and Wellness Center set to be completed by the end of September, a more frequent physiotherapy program would be welcomed. The center’s gym and exercise area offers the perfect environment for a therapist to conduct fitness classes designed to work on muscle strength, balance and body awareness.
Although the future of the program is up in the air, Fehr and Tasker have learned a lot from this valuable experience. Both therapists agree that the clients are the best part, “The people we’ve met are incredible and they’re very friendly and very appreciative of our care,” says Fehr, “To hear their stories and to give them a chance to tell their stories, it’s been a really good opportunity. And then we can share our experiences and try to change that stigma and the way others think about homeless people in Saskatoon.”
In response to concerns raised about people being left outside when they can’t or won’t obtain funding to stay at a shelter, are banned from a shelter, or prefer to live off the grid, The Lighthouse has opened it’s Out of the Cold Shelter.
The Out of the Cold Shelter is open to
- youth (16 and older – for those younger there is a separate system that is equipped to help them)
- pets (kennels provided)
The OTCS will have its own space for unique situations but most people will be housed in a variety of other shelter spaces at The Lighthouse.
At present The Lighthouse houses in emergency shelters both men and women.
Support is provided by well trained staff during the night which are there to provide emergency services, housing supports, and make sure the resident has the essentials like hygiene products, warm clothing, and nutritious food.
The next morning support staff work with the resident to figure out their housing options so that no one will have to spent another night in the cold.
An important part of what we do is provide safe transportation from where they are at to where they need to be. People reach out to us from all the city and as the city grows and the weather drops, those distances are further and further away. In extreme temperatures the danger is that people won’t come in because of the distance needed to travel. To overcome this The Lighthouse is working with churches, agencies, and others to pick up people when needed and transport themselves, their belongings and any others that are with them to safety.