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HEALTHY AGING: Preventative health behaviours A practical guide to lifelong well-being for First Nations, Inuit, and Métis adults (18-49 years) and older adults (50+ years) in Canada

IN THIS ISSUE: Getting proper sleep Having regular medical check-ups Getting vaccinated Limiting harmful substances

How this resource was developed This resource is one of a series of six healthy aging booklets for First Nations, Inuit, and Métis adults (aged 18 to 49 years) and older adults (aged 50+ years) in Canada. It was developed in response to expressed interest from Indigenous families and community partners for useful, culturally appropriate information to improve and protect the health and well-being of First Nations, Inuit, and Métis people throughout the aging process. The healthy aging booklets in this resource series include: • Healthy aging: Physical activity and exercise • Healthy aging: Food, diet and nutrition • Healthy aging: Preventative health behaviours

• Healthy aging: Mental and emotional health • Healthy aging: Life stages and wellness • Healthy aging: Financial wellness

The resources were developed using information from print and digital publications, webinars, conferences, and online forums. A number of First Nations, Inuit, and Métis people from across Canada helped with the development of the healthy aging booklets by sharing their knowledge, insights, ideas, stories, health tips, and feedback to improve the quality and value of the resources.

We want to thank the following people for assisting with the editing of our healthy aging booklets:

• April Tucker, Cayuga Nation Member of the Haudenosaunee Confederacy, ON

• Jolyne Knockwood, Mi’kmaq, Amlamgog First Nation, NB

• Belinda Vandenbroeck, Ininiw Grandmother, Opaskwayak Cree Nation, MB

• Karyn Davis, Anishinaabe, Ebb and Flow First Nation, MB

• Clayton Sandy, Sioux Knowledge Keeper, Sioux Valley Dakota First Nation, MB • Dawn Cardinal, Cree, Whitefish Lake #128 (Good Fish Lake/Saddle Lake First Nation), AB • Franny Alec, Stati’mc Knowledge Keeper, Xaxli’p First Nation, BC • Gloria Cochrane, Cree Grandmother, Fisher River Cree Nation, MB • Jack Mercredi, Cree Métis, Fond du Lac Denesuline Nation, SK

• Julie Carmichael, Red River Métis, MB

• Kathleen (Kathy) Mallett, Anishinaabe‑Cree Grandmother, Fisher River Cree Nation, MB • Levinia Brown, Inuk Elder, Rankin Inlet, NU • Linda Nobiss Campbell, Red River Métis Grandmother, MB • Myrtle Beaulieu, Métis Cree, AB • Roselyn (Fern) Bear, Dakota Grandmother, Standing Buffalo First Nation, SK

Table of contents Introduction........................................ 4 About this booklet............................................. 4 Acknowledging diversity................................ 6 What is healthy aging?................................... 7

Preventative health behaviours... 9 Getting proper sleep........................................ 9 Practicing good oral health habits............12 Keeping healthy feet.......................................14 Testing for hearing loss...................................19 Preserving eye health....................................22 Having regular medical check-ups..........26 Getting vaccinated.........................................29 Limiting harmful substances........................31 Practicing healthy gaming.......................... 37 Keeping a healthy home environment...39

How you can learn more............... 41 © 2026 National Collaborating Centre for Indigenous Health (NCCIH). This publication was funded by the NCCIH and made possible through a financial contribution from the Public Health Agency of Canada (PHAC). The views expressed herein do not necessarily represent the views of PHAC. ISBN (print): 978-1-77368-770-4

ISBN (online): 978-1-77368-771-1

Introduction About this booklet Traditionally, First Nations, Inuit, and Métis people viewed health as a wholistic balance of physical, mental, emotional, and spiritual well-being. To promote longevity and ward off common ailments, they practiced preventative health behaviours that emphasized harmony with the lands and waters. This involved: • intimate knowledge of local flora and seasonal plant medicines — such as preventive tonics, teas, and salves — to boost immunity, reduce inflammation, and prevent illness • communal ceremonies — like smudging, qulliq-lighting, drumming, singing, sweatlodges, and storytelling — to cleanse the body, reduce stress, maintain spiritual grounding, protect emotional health, and foster community connection, resilience, and strength against challenges

• traditional subsistence lifestyle practices — such as hunting, gathering, and seasonal relocations — to ensure daily physical fitness and prevent chronic conditions • collective responsibility for the health of the lands and waters, local ecosystems, and natural cycles to keep communities safe

Because of the processes of colonization — including the introduction of infectious diseases, environmental damages, and colonial policies like residential schools and ‘Indian’ hospitals — the structures and well-being of First Nations, Inuit, and Métis societies were adversely affected and forever changed. Many Indigenous people today struggle with the lasting effects of ongoing colonialism, systemic racism, unequal access to quality healthcare, and socioeconomic disparities that continue to drive high rates of chronic conditions like diabetes, heart disease, lung disease, cancer, and mental health issues.

This booklet is intended to promote healthy lifestyle habits to improve and protect the health and wellbeing of First Nations, Inuit, and Métis adults (aged 18 to 49 years) and older adults (aged 50+ years) in Canada. Learning how to take care of your mind, body, and spirit through preventative health behaviours can improve your overall health and quality of life. This includes getting proper sleep, practicing good oral health habits, and having regular medical checkups. It also involves understanding the importance of keeping your feet healthy, protecting your eyes and ears, and keeping a healthy home environment. These topics are among several good health habits discussed in this booklet.

Sometimes the system, they never explain things to you. I found many times, a lot of my relatives, they’d ask me to come with them when they come to Winnipeg to an appointment, just to explain things or to clarify things. — First Nations advisor

Healthy aging: Preventative health behaviours

Throughout this booklet, you will find external links to additional knowledge resources that you can check out for more information. You can also refer to the list of national organizations at the end of this booklet for culturally appropriate services, links to local programs, and online knowledge resources to support your best health, wellbeing, and quality of life through healthy aging.

Acknowledging diversity Indigenous people across Canada are not all the same. First Nations, Inuit, and Métis people comprise three completely distinct cultural groups with their own unique histories, languages, cultural heritages, and spiritual beliefs. They have different worldviews, ambitions, and lived realities. There are also differences within each First Nations, Inuit, and Métis cultural group, depending on regional geography, constitutional rights and entitlements, and

whether residing in urban centres, rural or remote areas, on reserve, or in Inuit Nunangat. Many factors shape the aging processes of First Nations, Inuit, and Métis people and their ability to age well. Experiences of colonization and ongoing colonialism, political and economic structures, proximity to healthcare services and specialized care, connections to community and family, connections to the lands and waters, and even sex and gender identities all play a role in the lived realities of healthy aging. For example, First Nations, Inuit, and Métis adults and older adults in rural communities face a very different reality than Indigenous people living in cities, especially if they are trying to manage chronic health conditions, struggle with physical disabilities or accessibility limitations, or have lost their ability to drive. All First Nations, Inuit, and Métis people have different health realities and mental and physical capabilities. The information in this booklet provides a foundation for

healthy aging and well-being in later life. You are encouraged to adapt these guidelines to fit your own needs, physical abilities, and personal circumstances.

What is healthy aging? Aging is a natural part of our life cycle. It begins at conception and continues until death. Still, we usually do not start thinking about the health aspects of aging until we are in our 40s or 50s and changes in our bodies, health, and functional abilities become more apparent.

There’s been ringing in my ears for months now. That’s a sign of hearing loss. … Like right now, when I’m talking, I sound like my voice is inside my head somewhere. It’s like I have to project. I didn’t know that I was losing my hearing. … I had the test done. I can tell you that when he put hearing aids in … I could hear so clear. — First Nations advisor

Healthy aging: Preventative health behaviours

Healthy aging is about aging well, actively and successfully, by living well, staying positive and productive, and keeping good physical, mental, and social functioning. It focuses on what matters for your overall health and well-being in older age, like lowering your risk of chronic diseases and age-related disabilities and building a strong sense of life satisfaction and happiness. Healthy aging is about shifting the narrative, where growing older is not about decline, loss, and insignificance but rather, about dignity, connection, and purpose. It is about gaining wisdom, strengthening your social connections, and finding new and meaningful ways to not only extend your lifespan (to live longer), but also enhance your healthspan (to live longer in good health). Healthy aging is a lifelong process that can start at any age. You are never too old — or too young — to start taking care of your mind, body, and spirit. This booklet is the third in a six-part series of guides to healthy aging.

Preventative health behaviours Getting proper sleep Sleep is crucial for good health. Getting seven to nine hours of sleep each night helps to: • repair and restore the cells in your body • boost your memory • regulate your hormones • strengthen your immune system In addition to getting enough sleep, you need to get high quality sleep, where you fall asleep within 30 minutes, sleep soundly (uninterrupted, not waking) throughout the night, and wake up feeling rested, refreshed, and energized. It is also important to stick to a consistent sleep schedule to regulate your body’s internal clock, support healthy brain function, and nurture your physical, mental, emotional, and spiritual resilience. This means going to bed and waking up around the same time every day, including on weekends.

Sleep deprivation occurs when you consistently fail to get the amount or quality of sleep you need to restore and sustain your physical and mental well-being. The consequences of not getting proper sleep are listed below and on the next page.

Health outcomes of sleep deprivation FATIGUE Drowsiness, lack of energy, muscle pain and weakness DECREASED EYE FUNCTION Watery, burning, or itchy eyes; blurry vision; eyelid twitches WORSENED BRAIN FUNCTION Difficulty focusing and concentrating, forgetfulness, slowed reaction time

Healthy aging: Preventative health behaviours

MOOD AND MENTAL HEALTH DISORDERS Depression, anxiety, emotional outbursts, hallucinations, delusions

BALANCE AND GAIT ISSUES Increased risk of falls, fall‑related accidents and injuries

Stress and anxiety, varying health conditions, lifestyle choices, and environmental factors — such as outside noise, light, temperature, and things going on at home — can make falling asleep and staying asleep challenging. There are several things you can do to try and get a good night’s sleep. For example, you can:

WEAKENED IMMUNE SYSTEM

• avoid large meals, nicotine, caffeine, and alcohol close to bedtime

Difficulty fighting off infections and diseases

• exercise regularly but avoid exercising before going to bed

LONG-TERM PHYSICAL HEALTH CONDITIONS Heart disease, stroke, diabetes, obesity, colorectal and breast cancer, Alzheimer’s disease, dementia

• keep daytime naps short and avoid napping late in the day • get some fresh air outdoors, everyday • take a leisurely walk before bedtime • turn off your TV and electronic devices a half hour before going to bed • meditate regularly to clear your mind, manage stress, and ease anxiety • read in bed for a few minutes before turning off the lights

• fall asleep to comforting sounds or music (e.g., nature sounds, rain sounds, powwow music, throat singing, fiddle tunes)

• sleep in shifts with other trusted adults in the home to keep an eye on what’s happening in and around your home

• take a warm bath or shower before bed

• sleep near a phone and exit so you can quickly leave if trouble at home escalates

• take natural medicines for sleep aid, such as chamomile and organic teas (e.g., Sleepy Time, Nighty Night) • use room-darkening shades, a fan, and comforting smells (e.g., lavender, essential oils, diffusers) to create a restful sleep environment • wear earplugs or noisecancelling headphones to block outside sounds, snoring, yelling, arguing, or sudden noises

• set an alarm clock so you do not have to worry about sleeping in If you often have trouble sleeping, you can also talk with your doctor or local healthcare provider about your sleep concerns. Identifying and treating the underlying causes of your sleeplessness can help you get the proper sleep you need for healthy aging.

A good night’s sleep: Adapted step up booklet bit.ly/HA03-camh-goodnight How to feel rested and get a good night’s sleep bit.ly/HA03-heretohelp-sleep

Healthy aging: Preventative health behaviours

Practicing good oral health habits Practicing good oral health habits is important for healthy aging. Whether you have all, none, or only some of your natural teeth, daily oral care (brushing, flossing, rinsing) is essential for removing food debris and bacteria from your teeth, gums, lips, and dentures.

Keeping your mouth clean, diseasefree, and healthy is good for not only your teeth and gums, but also for your overall health and quality of life. Poor oral health often leads to plague and tartar buildup, cavities, and tooth decay, which can cause other longterm health conditions, including: • discoloration, sensitivity, and loss of teeth

Daily denture and mouth care bit.ly/HA03-cdhadenturecare Oral care tips for seniors and their caregivers bit.ly/HA03-cdhaoralcaretips

• persistent bad breath • gum disease and infection • pain, discomfort, and difficulty chewing and swallowing • malnutrition • diabetes and difficulty managing diabetes • poor heart and gut health • stroke, lung diseases, oral cancer, Alzheimer’s disease, and dementia

important for stopping oral health related chronic conditions before they start. Common signs of dental problems include:

A healthy smile is good for your heart bit.ly/HA03-cdhahealthysmile Diabetes and oral health bit.ly/HA03-cdhadiabetesoralhelth Dry mouth bit.ly/HA03-cdhadrymouth

• red or bleeding gums and receding gumline • dry mouth and bad breath • loose, broken, or discoloured teeth • ill-fitting, broken, or chipped dentures • mouth pain or sores that do not heal • difficulty chewing or swallowing

How your oral health directly impacts your heart and gut health bit.ly/HA03-luminaoralandguthealth

• changes in behaviour

Practicing good oral health habits and having regular dental checkups every six months is the most effective way to preserve your oral and overall health. Your dentist or local dental care provider can identify and treat issues like cavities and gum disease before they worsen into severe, painful, or expensive conditions. Early detection is also

Canadian dental care plan for eligible canadian residents bit.ly/HA03-GovCandentalplan Non-Insured health benefits program for First Nations and Inuit: Dental benefits guide bit.ly/HA03-GovCandentalbenefits

Healthy aging: Preventative health behaviours

Keeping healthy feet Having healthy feet is essential for keeping an active, healthy lifestyle and quality of life. Your feet carry you through life; you must take good care of them, especially if you have diabetes, poor circulation, or nerve damage. Regular foot care is key to preventing foot problems, injuries, and infections. Keeping your feet healthy involves

a combination of daily foot care practices, wearing proper footwear, and doing simple foot exercises to relax the muscles in your feet and promote flexibility and circulation. The next section describes proper foot care practices that are crucial for keeping your mobility and overall health.

I have a set of balls and you can heat them or not heat them. Because I get bad cramps, I rub my feet on these balls every night before I go to bed. And you’re moving your knees and ankles. ... They really helped my feet with the circulation because one time, a health aide told me, ‘If there’s anything that you think helps you have a more comfortable life, try and get it. Even if you spend a few dollars on yourself, they really help when you get older.’ — Métis advisor

Daily foot care practices WASH AND DRY Use warm water and mild soap to wash your feet. Thoroughly dry your feet, especially between your toes.

MOISTURIZE Apply moisturizing lotion to the tops and soles of your feet to prevent cracking. Avoid the areas between your toes to prevent infection. INSPECT Look at the tops, bottoms, heels, and sides of your feet and examine your toenails, as well as between your toes. Use a handheld mirror if you cannot see the bottom or sides of your feet. Check for blisters, redness, swelling, cuts, scratches, sores, cracked or peeling skin, and thickened or discoloured toenails. Visit your doctor or local healthcare provider immediately if you have: • thick, brittle, curved, ingrown, or fungal toenails • redness, swelling, warmth, pain, or tenderness • pus, fluid discharge, or foul-smelling areas • cuts or sores that do not heal

NAIL CARE Use a toenail clipper to trim your toenails as needed. Clip your toenails straight across to prevent ingrown toenails. After clipping your toenails, use an emery board to gently smooth the sharp edges of your toenails and prevent snagging and injury. File in one direction across the edge of each toenail, rather than using a back-and-forth “sawing” motion that can tear and weaken your toenails. Apply light pressure when filing to avoid taking off too much toenail or damaging the surrounding skin.

SOCKS, COMPRESSION STOCKINGS, AND SHOES Wear clean, moisture-wicking socks made from Merino wool, polyester, or nylon (not cotton) to keep your feet dry and prevent blisters. Your doctor, podiatrist (foot doctor), physiotherapist, or local healthcare provider may also prescribe compression stockings to: • reduce swelling in your lower legs and feet • relieve aches and fatigue in your legs and feet • prevent blood clots • manage problems with the veins in your legs Choose well-fitting, comfortable footwear that offers: • adequate arch support • cushioning for shock absorption on hard surfaces • a non-slip sole for traction • a firm heel tab to stabilize your ankles and prevent injury 16

EXERCISE Toe spreads: Sit in a chair with your feet on the floor. Spread your toes apart as far as possible. Hold for 5 seconds and release. Repeat 10 times. Toe curls: Sit in a chair with your feet on the floor. Place a small towel on the floor under your feet. Use your toes to scrunch the towel toward you, then use your toes to push the towel back out. Repeat 10 times. Ankle rotations: While seated or lying down, rotate one foot in a slow, clockwise circle, 10 times; then slowly rotate the foot counter-clockwise, 10 times. Repeat these ankle rotations with your other foot. Ankle pumps: While seated or lying down, flex your feet up and down (like pressing a gas pedal) to engage your calf muscles and improve your blood flow. Repeat 10 times. Foot massage: Use your thumbs to apply firm, circular pressure to the sole of one foot, working from the toes toward the heel of your foot to reduce tension. Do the same thing with your other foot.

In my case, I had a really good footcare nurse. … Orthotics saved my life. If I didn’t go to the ankle/foot clinic and get those orthotics, I would have been walking steady with calluses and having open sores on my feet. — First Nations advisor

Healthy aging: Preventative health behaviours

In addition to daily foot care practices, some First Nations, Inuit, and Métis adults and older adults routinely visit professional nail salons for cosmetic footcare treatments such as toenail trimming and filing, cuticle care, callus removal, and foot and calf massages. However, professional nail technicians are not a substitute for medical care. If you have diabetes, poor circulation, or a weakened immune system, you are encouraged to seek extra care and attention for your feet from a podiatrist (foot doctor) or footcare nurse.

Find a footcare nurse bit.ly/HA03-cafcnfootcarenurse 18

Podiatrists typically prioritize medical issues with your feet but will routinely cut and trim toenails and remove calluses from your feet, especially when physical limitations or medical conditions such as diabetes prevent you from safely doing this yourself. Podiatrists and footcare nurses provide medical care for your feet and toenails using sterilized, clinical tools to prevent injury and infection. You can also talk with your doctor, local healthcare provider, Indigenous health navigator, or community wellness worker if you need help safely clipping your toenails or cannot physically reach your feet.

Find a podiatrist bit.ly/HA03-cpmafindapodiatrist

Testing for hearing loss Hearing loss is a chronic health condition that can have major consequences for your overall health and quality of life. Hearing loss can occur naturally, as part of your genetic makeup, or it can be caused by a combination of natural aging, chronic health conditions, and long-term environmental and social factors. The primary causes of hearing loss in First Nations, Inuit, and Métis adults and older adults include: • a history of repeated ear infections as children, resulting in permanent, progressive hearing loss later in life • smoking and prolonged exposure to tobacco smoke • long-term exposure to loud sounds — such as from snow blowers, lawn mowers, powwow drumming, hunting (firearms), snowmobiling, farm machinery, and construction — without wearing earplugs or earmuffs for protection

• underlying and co-existing chronic health conditions — like heart disease, diabetes, and high blood pressure — that negatively affect blood circulation to the inner ears and increase auditory (sense of hearing) nerve damage • lengthy use of prescription medications — such as strong antibiotics, high-dose pain relievers, and some cancer treatments — that can be toxic to the inner ear • persistent household overcrowding — particularly in remote or northern regions — that increases the spread of respiratory diseases and likelihood of recurring ear infections • systemic and social barriers — such as lack of specialized hearing services; long wait times; culturally unsafe and inappropriate services; and racism, discrimination, and stigma — that hinder access to specialized services, early diagnosis, routine cleanings, and hearing aids

Healthy aging: Preventative health behaviours

If you’re a diabetic, that can also contribute to hearing loss because when you have diabetes, your nerves are being destroyed from this disease. I didn’t know this until the guy that was doing my testing told me. … Apparently, the literature on hearing loss is that it also can result in dementia. — First Nations advisor

Healthy aging involves protecting your ears from noise and lifestyle hazards, effectively managing chronic health conditions and your overall health, and regularly testing for hearing loss. Untreated hearing loss is a major risk factor for: • dementia and Alzheimer’s disease • frailty, falls, and fall-related fractures • social isolation and depression

Common signs of hearing loss include: • speaking louder than necessary in conversation • difficulty hearing the TV, radio, and people talking on the phone • constantly asking for words to be repeated • thinking people are always mumbling • misunderstanding conversations, especially in noisy situations • favouring (hearing better in) one ear • ringing or buzzing in one or both ears

I was telling the doctor there’s certain sounds I can’t hear. I went and got checked and I got hearing aids almost right away. ... It’s not natural, but it certainly helps you pick up sounds that you otherwise might miss. — Métis advisor

Current treatments for hearing loss — like hearing aids and assistive devices — are highly effective in keeping your brain engaged and minimizing the risks of cognitive decline. If you notice changes in your hearing or any signs of hearing loss, talk with your doctor, local healthcare provider, audiologist (hearing specialist), Indigenous health navigator, or community wellness worker to learn more about testing for hearing loss and available supports for hearing aids, assistive technology, and counseling. Hearing tests are available free of charge for First Nations, Inuit, and Métis adults and older adults aged 55+ years.

Audiology equipment and supplies benefits list bit.ly/HA03-GovCanaudiologybenefits

NIHB hearing aid funding guide bit.ly/HA03-hearing solutions-fundingguide

Find a hearing specialist bit.ly/HA03-connect hearing-specialist

Organizations providing disability benefits navigation services bit.ly/HA03-GovCanbenefitsnav Healthy aging: Preventative health behaviours

Preserving eye health Keeping your eyes healthy and protected is an important part of healthy aging. Certain health conditions like cataracts, glaucoma, and age-related macular degeneration are common in First Nations, Inuit, and Métis adults and older adults. Underlying health issues — including diabetes, high blood pressure, lupus, rheumatoid arthritis, and multiple sclerosis — and environmental hazards such as pollutants and ultraviolet (UV) radiation also play a major role in eye deterioration and vision loss.

With the medication I’m taking for arthritis, I have to get my eyes checked every six months because there’s the possibility that the side effect could cause vision loss. There’s also glaucoma, cataracts. These are things that are slowly creeping up on me. — Métis advisor

Some eye diseases are beyond your control, but there are practical things you can do to preserve your eye health and reduce your risk of eye diseases and vision loss. For example, you can: • wear sunglasses labelled “100% UV protection” or “UV400” whenever you are outside during daylight hours, especially in highreflection environments like snow, sand, or water • eat foods that are rich in antioxidants, vitamin C, vitamin E, and beta-carotene • use protective eyewear when working with chemicals or tools and in dusty or debris-filled environments

• practice healthy eating habits, exercise regularly, and get regular medical check-ups (see the Healthy aging: Physical activity and exercise booklet and Healthy aging: Food, diet, and nutrition booklet in this resource series for more information about healthy eating habits and exercise)

• follow the 20-20-20 rule when watching TV or using your computer, tablet, or other digital devices to relax your eye muscles and reduce digital eye strain by looking at an object at least 20 feet away for 20 seconds every 20 minutes • avoid smoking and limit the amount of alcohol you drink • get a routine eye exam every two years (or sooner if recommended by your eye doctor)

Healthy aging: Preventative health behaviours

MY STORY OF BELIEVE Cancer is a disease that has affected our families and friends. As for me, I had a cancer called Hodgkin’s Lymphoma in my late 60s. My first thought was I was going to die. The doctor who called me told me (over the phone). He did not even explain what it was; he just said, “You have cancer.” This doctor was an eye specialist and surgeon. He had removed a small mass in one of my eye lids and the biopsy found it to be cancer. After receiving this devastating news and researching what Hodgkin’s lymphoma was, I kept it to myself for a while. I knew I had to tell my two daughters, so I prepared myself to explain the disease as clearly as I could. I would like to share two dreams that I believe helped save my life. In the first dream, I was lying on my back in bed when the ceiling

opened to reveal a bright, blue sky. Then a great eagle appeared, filling my entire view. It lowered one wing and gently brushed my arm as it hung over the side of the bed. I felt a deep love that words cannot fully express. In our spiritual beliefs, the eagle represents love. Then the dream ended. When I woke up in the morning, I did not remember the dream. I went off to work as usual. That morning, I had a meeting with one of the Indigenous organizations’ staff. She invited me for coffee, and she started to tell me about her young son who played hockey with his team called “the Eaglets.” As soon as she said the word “Eaglets,” the dream came flooding back to me. I got so excited, I shared my dream with her.

Days later I had another dream. My parents passed away in the 1980s and would often appear in my dreams. Once again, I was lying in bed. I turned to the left, and in the darkness of the room, I felt their presence. In my head, I heard voices say, “We’ll take care of you.” When I woke up the next morning, I remembered this beautiful dream. Both dreams carried messages telling me not to fear the disease and that I would survive. Growing up with my parents and siblings taught me that family is most important. My mother also had the ability to interpret dreams, and she passed that ability on to me. — First Nations advisor

Healthy aging: Preventative health behaviours

Having regular medical check-ups Having regular medical checkups and routine health screenings are an important part of healthy aging, especially for detecting and treating potential health concerns early, minimizing long-term illnesses, and managing chronic conditions. Preventive health checks generally include: • testing your blood pressure, cholesterol, and bone density • screening for diabetes • checking for breast, prostate, cervical, or colon cancers • examining your skin for unusual moles and skin changes

• testing your balance, gait (the way you walk or move on foot), and strength for physical functioning and mobility • screening for dementia and other cognitive issues Visit your doctor or local healthcare provider if you are due for a medical check-up or want to learn more about any of these preventive health checks. The specific screenings and exams you need depend on your age, family history, and personal risk factors.

I wasn’t quite sure of what was going to be happening. I started to go to the cancer doctor. … I had started chemo, which I never knew anything about. Does anybody? You know, until you go through it yourself. They don’t explain anything to you. … I found that I couldn’t ask the right questions to the doctor because I’m just thinking about this cancer, which I didn’t know anything about what was happening to my body or what. So, my daughter was there. She was able to explain. I would say to her, ‘Ok listen. Could you ask the doctor about this?’ She was like my translator. She was my go-between because I couldn’t go there alone. Like, I just didn’t want to be alone. I wanted to have somebody there to support me. I mean, I wasn’t married. I don’t have a husband. So, I really counted on my older daughter to be that support system for me. — First Nations advisor

Healthy aging: Preventative health behaviours

You are encouraged to bring someone you trust with you to your medical appointments and pharmacy visits. Many First Nations, Inuit, and Métis adults and older adults find comfort in having an adult child, spouse, sibling, or other relative with them when they meet with their doctor or pick up prescribed medications. Besides being a source of emotional and psychological support, family escorts can help with: • interpreting complex medical jargon • asking clarifying questions • ensuring health instructions are fully understood • asking about prescribed medications, what they do, and potential side effects • translating and bridging communication barriers • upholding cultural values • discussing treatment options and building a shared plan of care • getting to and from appointments (i.e., transportation)

All of those doctor appointments, I was there walking with my Mom so I could understand what they were telling her and be able to translate it so it would be easier for her. … She needed somebody there to understand and ask the questions that she wanted answers for. … Elderly people need that. When you don’t understand what’s happening, to be able to have somebody with you, I think that’s important. … It’s better to have somebody with you to translate. — First Nations advisor

Getting vaccinated Getting vaccinated is an effective way to stay healthy and protected from serious and life-threatening diseases, especially as you get older. Aging naturally weakens your immune system, making it harder for your body to fight infections and overcome related complications. This is why certain diseases are more common and severe in older adults, even if they are generally healthy. Vaccines protect you from serious illnesses — such as flu, pneumonia, and shingles — and reduce the risk of related complications and hospitalizations. They also prevent you from spreading infectious diseases to other people. Following is a list of key vaccines that are crucial for preventing and stopping the spread of severe infections in First Nations, Inuit, and Métis adults and older adults.

Key vaccines for adults and older adults FLU (SEASONAL INFLUENZA) Every fall, between October and December

Available at no cost

COVID-19 As updated and scheduled

Only free for specific high‑risk groups; eligibility varies by region

PNEUMONIA (PNEUMOCOCCAL DISEASE) 65+ years

Only free for specific high‑risk groups; eligibility varies by region

RSV (RESPIRATORY SYNCYTIAL VIRUS) 65+ years or as recommended

Only free for specific high‑risk groups; eligibility varies by region

Healthy aging: Preventative health behaviours

SHINGLES (HERPES ZOSTER) 50+ years

Not universally free; coverage and out-of-pocket costs vary by region • Full NIHB coverage for 60+ years • Available at no cost in Ontario for 65-70 years and Quebec for 71+ years

TD (TETANUS, DIPHTHERIA) Every 10 years

Available at no cost

TDAP (PERTUSSIS) Once in adulthood

Available at no cost

Talk with your doctor or local healthcare provider to find out if you are up to date with your recommended vaccinations and to learn more about your risk of developing vaccine-preventable diseases, based on your health profile, current conditions, and lifestyle.

I’ve got shingles. It’s very, very painful. … Even a car ride, like every bump, even to sit long. I can’t sit. I had two Zoom calls this past week. I had to lie down in one of them. … I cook and clean up and stuff like that but the pain is unbelievable. I could birth 20 kids in 20 days and it wouldn’t be enough compared to this. — First Nations advisor

An adult’s guide to vaccination bit.ly/HA03-GovCan-adultvaccination A guide to vaccines for older Canadians: Supporting ageing with confidence, independence and good health bit.ly/HA03-oacao-vaccineguide The overlooked issue of shingles infections in older Canadians, and how to address it bit.ly/HA03-niageing-shingles

Limiting harmful substances One of the best things you can do to improve your health and quality of life is to avoid smoking and vaping. Cigarette smoking causes damage to nearly every organ in your body. It is the leading, preventable cause of chronic disease, disability, and death. Vaping aerosol also poses considerable health risks, especially for your heart and lungs.

Vaping brings harmful substances — like diacetyl, nicotine, benzene, and heavy metals (nickel, tin, lead) — into your airways, causing breathing problems, respiratory infections, and permanent lung damage. By not smoking or vaping, you greatly reduce your risk of cancer, heart and lung diseases, stroke, Alzheimer’s disease, and dementia.

Healthy aging: Preventative health behaviours

Immediate and long-term benefits of quitting smoking 20 mins

• Heart rate drops and blood pressure starts to return to normal levels

8-12 hours

• Excess carbon monoxide is cleansed from the body, increasing oxygen levels in the blood and lungs

1 day

• Nicotine levels in the blood drop to negligible amounts and risk of heart attack and stroke starts to decrease

2 days

• Nerve endings begin to heal, improving senses of smell and taste

3 days

• Energy levels improve and breathing becomes easier as bronchial tubes start to relax and lung capacity increases

2 weeks

• Blood pumps through the heart and muscles more easily, improving circulation and lung function

1 month

• Coughing and shortness of breath decreases as hair-like structures in the lungs (cilia) regain typical function of clearing mucus from the lungs and reducing risk of infection

1 year

• Risk of heart disease becomes half that of a continuing smoker

5 years

• Risk of cervical cancer and stroke returns to that of a non-smoker and risk of mouth, throat, esophageal, and bladder cancers decreases by half

10 years

• Risk of lung cancer decreases to half that of a continuing smoker and risk of larynx and pancreatic cancers also decrease

15 years

• Risk of heart disease is the same as that of a person who never smoked

Smokers’ helpline | Toll free: 1-877-513-5333 Chat online or explore services and resources: bit.ly/HA03-smokershelpline Quit with confidence: Guide to a smoke-free life bit.ly/HA03-GovCanhelpquit

Like cigarette smoking and vaping, alcohol is a highly toxic substance that affects all parts of your mind and body. Drinking alcohol — especially in excessive amounts — carries serious risks of developing many life-threatening health conditions, including:

Quitting smoking: Provincial and territorial services bit.ly/HA03-GovCanquitsmoking

• disrupted quality and quantity of sleep • mental health problems such as anxiety and depression No level of alcohol consumption is completely safe. What you drink, how often you drink, how much you drink, and what you eat when you drink matter. By reducing or abstaining from alcohol, you greatly lower your risk of injury, violence, and many health problems that can shorten your lifespan.

• high blood pressure, heart disease, and stroke • diabetes, obesity, and digestive issues • liver disease and cancer • Alzheimer’s disease and dementia • memory loss and impaired attention, concentration, and judgement

Healthy aging: Preventative health behaviours

Risks associated with weekly alcohol use 0 DRINKS: NO RISK Health benefits include better health and better sleep.

2 DRINKS: LOW RISK You will likely avoid alcohol-related consequences for yourself and others.

3-6 DRINKS: MODERATE RISK Your risk of cancer increases.

7 DRINKS: INCREASINGLY HIGH RISK Your risk of heart disease or stroke increases.

• Each additional drink profoundly increases your risk of alcoholrelated consequences. • More than 2 drinks per occasion increases your risk of harms to yourself and others, including injuries and violence.

Addictions treatment helplines in Canada bit.ly/HA03-ccsaaddictionshelpline Canada’s guidance on alcohol and health bit.ly/HA03-ccsaalcoholguide Drinking less is better bit.ly/HA03-ccsadrinkless

Finding quality addiction care in Canada: Drug and alcohol treatment guide bit.ly/HA03-ccsatreatmentguide Get help with substance use bit.ly/HA03-GovCansubstancehelp Knowing your limits with alcohol: A practical guide to assessing your drinking bit.ly/HA03-ccsaknowlimits

I was on doctor prescribed morphine for 14 years and with the whole not knowing, and trusting a doctor, and the amount of medication I was on, like the combinations and stuff. Maybe if I would have had someone telling me you’re not supposed to take that drug with that drug and that drug. Like, I had no one explain the combinations of what they do. — Métis advisor

Healthy aging: Preventative health behaviours

Other harmful substances that can be life-threatening, particularly when misused, include prescription medications like opioids, sedatives, stimulants, and illicit drugs such as cocaine, heroin, and methamphetamines. Understanding the side effects of prescribed medications and the harms of mixing your medications — especially with alcohol, illicit drugs, and non-prescription medications — is important for healthy aging. Talk with your doctor, local healthcare provider, Indigenous health navigator, or community wellness worker if you have any questions or concerns about your prescribed medications or use of alcohol and other substances.

Practicing healthy gaming Many First Nations, Inuit, and Métis adults and older adults use technology and gaming apps to stimulate brain activity and improve their memory and processing speed. Digital gaming is an effective way to boost cognitive function and lower the risk of cognitive decline and dementia. However, too much gameplay can have negative effects on your mental and physical health, including digital eye strain, disrupted sleep patterns, inactive lifestyle behaviours, and social isolation. Practicing healthy gaming can help maximize the mental benefits of gaming apps while minimizing related health risks. This includes: • setting time limits and restricting gameplay to 20–30 minutes per day • following the 20-20-20 rule for preventing digital eye strain by looking at an object at least 20 feet away for 20 seconds every 20 minutes 37

• putting away your gaming devices at least 30 minutes before going to sleep • watching for physical signs — headache, stiff neck, dry eyes — that it is time to stop gaming When playing digital games on your cellphone, tablet, or computer, try different games to challenge your mind, instead of sticking to the same game that you’ve already mastered. See the Healthy aging: Physical activity and exercise booklet in this resource series for more information about strengthening your brain activity. Playing bingo helps to keep your memory, concentration, and processing speed sharp. Bingo also offers social benefits that help combat loneliness and reduce the risk of depression. At the same time, however, playing bingo requires consistent, proactive management, particularly when it costs money to play. You can keep your bingo

experience fun rather than stressful by practicing healthy bingo gaming. For example, you can: • choose free or lower-cost bingo events offered at local community centres or senior centres rather than at commercial bingo halls • set a practical spending limit and stick to your budget • use cash or a fixed account amount to prevent impulsive, onthe-spot spending • choose fewer cards for better focus and lower cost • play strictly for entertainment and avoid “chasing losses” • stop playing when you reach your budget limit, even if a win has occurred • take your winnings home instead of using it to buy more cards • take regular breaks from playing bingo to avoid financial stress and burnout

Keeping a healthy home environment Keeping a clean, safe, and healthy home environment helps to prevent accidents and injuries. It also reduces exposure to harmful substances that cause respiratory issues, digestive problems, and cancer. You can create a safer, healthier home environment by: • handwashing with soap before meals, after using the toilet, and after being outdoors • practicing safe food handling, including washing fruits and vegetables before eating them and safely storing leftovers in the refrigerator — in airtight containers — within two hours of cooking to prevent bacterial growth and foodborne illnesses • regularly sanitizing kitchen countertops, kitchen/dining tables, and other frequently touched surfaces such as door handles, light switches, and remote controls to prevent the spread of bacteria and viruses • cleaning dust-prone areas such as bedrooms frequently

• avoiding excessive use of chemical-heavy cleaning products to reduce indoor pollutants • opening windows regularly to improve ventilation • keeping floors free of clutter, securing rugs, installing grab bars in the bathroom, and adding handrails to stairways to prevent trips and falls • removing pets and their toys from high traffic areas and dealing with pets that jump or run underfoot to prevent petrelated trip hazards • ensuring medication, cleaning products, and sharp objects are stored safely and securely Being proactive in keeping your home clean, organized, and uncluttered is essential for preventing falls, medication errors, and illness. It also ensures better mental health and emotional wellbeing by reducing daily stressors that cause anxiety, fatigue, and a weakened immune system.

Healthy aging: Preventative health behaviours

Chemicals and pollutants in the home: Tips for renters bit.ly/HA03-GovCanrentertips Healthy home guide bit.ly/HA03-GovCanhealthyhome Is your home healthy? Easy steps to maintaining a healthy home: Environmental health guide for seniors at home bit.ly/HA03-GovCanseniorsathome The safe living guide: A guide to home safety for seniors bit.ly/HA03-phacsafeliving

How you can learn more Several national organizations in Canada offer culturally appropriate services, links to local programs, and online knowledge resources to help you maintain your best health, well-being, and quality of life. Some of these organizations are listed below. 211 at United Way Centraide Canada is a primary source for provincial/territorial government and community-based health and social services. Resources for older adults include programs and services related to housing, food, housekeeping, mental health supports, and much more.

Canadian Dental Association offers information about caring for your teeth, dental examinations and treatments, how oral health needs change with age, proper denture care, tips for caregivers, and tips to support good oral and overall health.

Phone: 211 211.ca/#find

Phone: 613-523-1770 cda-adc.ca

Alzheimer Society of Canada provides links to local Alzheimer Society programs, knowledge resources, and referral services to support people with Alzheimer’s disease and dementia, their families, caregivers, and healthcare providers.

Canadian Disability Resources Society helps remove barriers by connecting people with disabilities, families, caregivers, providers, and communities to local trusted supports, accessible services, equipment, benefits, and inclusive resources.

Phone: 416-488-8772 admin.alzheimer.ca/en

Toll free: 888-909-8974 disabilityresources.ca

Canadian Centre on Substance Use and Addiction provides guidance, tools, and knowledge resources to help people learn about substance use and make informed decisions about addictionsrelated harms.

Canadian Frailty Network offers online resources to support people with frailty, their families, and caregivers, including Indigenous resources, impact stories, webinars, journal articles, and tips for navigating the healthcare system.

Phone: 613-235-4048 Toll free: 833-235-4048 ccsa.ca/en

Phone: 613-483-9399 cfn-nce.ca

Healthy aging: Preventative health behaviours

Canadian Hard of Hearing Association offers advocacy, mentorship, support networks, and educational programs for people with hearing loss in Canada. Phone: 613-526-1584 Toll-Free: 800-263-8068 chha.ca Canadian Sleep Society provides educational brochures, podcasts, and other evidencebased knowledge resources about sleep and sleep disorders like insomnia, sleep apnea, and restless leg syndrome. css-scs.ca Diabetes Canada offers a collection of tools and resources, as well as virtual learning opportunities, to help people with diabetes live healthy lives. Toll free: 1-800-226-8464 diabetes.ca First Nations Health Authority offers a variety of tips, guides, and knowledge resources to support healthy aging, quality of life, Elder wellness, and end-of-life care for First Nations people. Phone: 604-693-6500 Toll free: 866-913-0033 fnha.ca

Heart and Stroke Foundation of Canada offers a wide collection of heart-healthy recipes and the latest articles, health tips, podcasts, and digital stories to inform, educate, and raise awareness about heart disease and stroke prevention. Online resources include healthy recipes, lifestyle tips, and whole approaches to Indigenous health. Toll free: 888-473-4636 heartandstroke.ca Indigenous Dental Association of Canada offers culturally safe oral health service delivery, research, and community-based oral care resources. Phone: 306-206-2370 idac.agency Indigenous Services Canada offers information about many health and socio-economic programs and services to support Indigenous people and communities. Toll free: 800-567-9604 canada.ca/en/indigenous-servicescanada.html

Just for You – People with Disabilities, by Health Canada, offers links to a wide range of online resources for people with disabilities, including supports for accessibility/autonomy, violence and abuse, work-life balance, seniorspecific services. Toll free: 866-225-0709 canada.ca/en/health-canada/ services/healthy-living/just-for-you/ people-disabilities.html National Collaborating Centre for Indigenous Health is a source for many reliable, current, and culturally appropriate health-related knowledge resources to support the best health and well-being of First Nations people, Inuit, and Métis people.

National Indigenous Diabetes Association provides programs, projects, regional services, and a wide range of online resources aimed at addressing the diabetes epidemic in Indigenous communities. Phone: 204-927-1221 nada.ca Public Health Agency of Canada offers a range of programs, services, and knowledge resources to promote and support the health and socio-economic well-being of Indigenous Peoples and communities. Toll free: 844-280-5020 canada.ca/en/services/indigenouspeoples.html

Phone: 250-960-5250 nccih.ca

© Credit: (Front cover) iStockPhoto.com, ID 1838440771; (p. 4) USAY, 2025; (p. 7) iStockPhoto.com, ID 2163820465; (p. 8) iStockPhoto.com, ID 2279753491; (p. 12) iStockPhoto.com, ID 2267944879; (p. 18) iStockPhoto.com, ID 2206022852; (p. 21) iStockPhoto.com, ID 1404806101; (p. 22) iStockPhoto.com, ID 1172748298; (p. 23) iStockPhoto.com, ID 2200453868; (p. 24-25) iStockPhoto.com, ID 2200719518; (p. 26-27) iStockPhoto.com, ID 1473148507; (p. 30) iStockPhoto.com, ID 2252110731; (p. 32) iStockPhoto.com, ID 480140313; (p. 34) iStockPhoto.com, ID 2180031743; (p. 36-37) iStockPhoto.com, ID 2218801144; (p. 40) iStockPhoto.com, ID 2220690814.

Healthy aging: Preventative health behaviours

The booklets in this series include:

Healthy aging: Physical activity and exercise

Healthy aging: Food, diet and nutrition

Healthy aging: Preventative health behaviours

Healthy aging: Mental and emotional health

Healthy aging: Life stages and wellness

Healthy aging: Financial wellness

You can view all of the English booklets online at nccih.ca. Aussi disponibles en français: ccnsa.ca. For more information: 3333 University Way Prince George, BC, V2N 4Z9 250-960-5250 nccih@unbc.ca nccih.ca

nccih.ca/485/Launchhealthy-aging.nccih?id=624