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Coronavirus and Type 2 Diabetes

Terrance Hutchinson/23 April 2020/ All MFN blog/

There is plenty of news in the media which says that the COVID-19 is harmless for a healthy individual. They also mention that people with underlying conditions are sensitive to the disease. One such underlying condition that many have is Type 2 Diabetes Mellitus. According to sources, Tom Hanks testing positive for COVID-19 caused panic… that was because this popular actor is also a Type-2 diabetic.

Why are Diabetic People More in Danger?

A healthy person and a diabetic person are at the same risk of catching the infection. The difference is how the patients deal with the virus. A diabetic patient has a higher chance of facing complications. A person with diabetes will face severe symptoms if they get COVID-19. Diabetes fluctuates the level of glucose in your body. Because of this, diabetic people with COVID-19 have severe inflammation and swelling.

Tips to Protect Diabetic Patients from the Coronavirus

Being a diabetic or the caregiver of such a patient will be stressful for you. Social distancing is the only you can avoid getting the disease. In case you are wondering how to practice social distancing here are a few tips:

Avoid going outdoors, and only do so if it is essential.
Avoid visiting a sick person, whether they are Coronavirus patients or those suffering from any illness.
Try working from home. Discuss this with your employer and try gaining their support in this regard.
Avoid gatherings and large crowds. These include cinemas, restaurants, clubs and bars.
Maintain your blood sugar levels in normal range. That is because people with optimum levels of blood glucose have fewer complications.
Regularly wash your hands. Follow guidelines on the internet about properly washing your hands. If you do not have access, try sanitizing your hands as an alternative.
Avoid hospitals and try contacting your doctor through the phone.
Keep yourself aware of the symptoms of the Coronavirus disease. If you observe any such symptoms, immediately call your general practitioner.

Conclusion

The government suggests shielding advice to all diabetic patients. It meant that all people vulnerable to the disease stay at home for almost 12 weeks. During this period, you should avoid all face-to-face contact. You must understand the risks that you are putting yourself into if you do not take precautions.

Terrance Hutchinson is the Owner of Your Best Lifestyles Fitness and Nutrition. He is a Certified Personal trainer specializing in Exercise Therapy, Corrective Exercise, Sports Nutrition, and Corporate Wellness. He an author of 3 books, he has his own podcast, he has contributed articles to major newspapers and magazines, Terrance has spoken at health events, webinars, seminars, hospitals, schools, doctors offices and has been featured nationally syndicated television platforms. Terrance has clients in many states and counties and is looking to help others bridge the gap between the medical and fitness industries. To learn more about Terrance, visit yourbestlifestyles.com

Save the Date: Virtual Global Employee Health and Fitness Month is May 1-31

Diane H. Hart/22 April 2020/ All MFN blog/

Virtual Global Employee Health and Fitness Month (GEHFM) 2021 Initiative is ready to go – all we need is you! us and show your support for an active healthy world! It has never been easier or more important to keep moving, set goals and create sustainable change in your health and well-being. IGNITE and National Association for Health and Fitness amazing step-by-step toolkits provide outstanding guidance, ideas and tangible examples to ensure success for each participant. Be sure to share your #GEHFM activities and experiences on social media and engage with other participants.

Is Fitness for ASD for Me…Let’s See…

Eric Chessen, M.S./21 April 2020/ All MFN blog/

Is that hip tracking properly?

Is he planning on flopping down to the mat after this next hurdle?

Does Adam know what exercise is after these forward hurdle steps?

These are the series of questions that reverberate in my head as Adam completes the set of low hurdle steps as part of his warm-up. They’re the same questions that need to be mentally noted and checked off throughout a session with an individual on the autism spectrum.

Picture courtesy of Eric Chessen.

Fitness for special needs populations, particularly the autism and neurodiverse demographics, is gaining both awareness and more professionals are entering the sphere of practice. Some still overlap the autism spectrum disorder (ASD) population with other neurobiological disorders such as Downs Syndrome. They are different. And they need to be approached accordingly.

The most current statistics from the Centers for Disease Control (CDC) show an autism diagnosis occurring at 1 in 59 children. The statistics for teens and adults with autism are more difficult to find, though many individuals have been diagnosed retroactively as the criteria for diagnosis has changed/broadened with the DSM V (Diagnostic and Statistical Manual of Mental Illness Vol 5). Some of the most common, if not readily discussed, areas of deficit for those with ASD are gross motor deficits and low muscle tone (a catch-all phrase).

By way of intrepid professionals and dedicated parents/caregivers, the field of fitness for individuals with autism has grown in the last few years. As is the case across the fitness/wellness arena, programs and practices vary with no official standard or code of practice for those providing exercise programs to individuals with ASD.

Given the number of children, teens, and adults affected by autism and the evident need for professional fitness services, this is a burgeoning specialty area. While sport-specific, even vocation-specific training has existed in the fitness profession for decades, fitness programming for the ASD population is new and requires some important considerations.

Working with the autism population in a fitness capacity requires being a specialist turned generalist turned specialist. Allow me to expand on that. A fitness professional working with the ASD population, ideally, has a conceptual background and practical skill set to assess movement skills and provide appropriate progressions and regressions for various exercises.

The adaptive/behavior challenges inherent to autism require more than a great fitness program “on paper”/in theory. Not only are the previously noted movement and strength deficits significant considerations, but behavior issues (off-task, maladaptive) must be addressed. The “Greatest Program Ever” is no match for a 17-year old who refuses to budge from lying face down on a yoga mat in the corner of the room.

So here we move from specialist to generalist; gaining an awareness and working knowledge of how different challenging behaviors present in the autism population, how to effectively manage those behaviors within scope of practice, and then how those behaviors may present with specific individuals. Some of our athletes (term used universally) with ASD may be off-task, wandering around the room for ninety-four percent of the session, while others are cooperative to a remarkable degree. Understanding motivation and reinforcement both generally and with specific application to each individual is a necessity here.

Cognitive deficits are another hallmark of autism that requires both global and specific understanding and working knowledge. Our athletes with autism tend to be literal thinkers, having a great amount of difficulty with abstract concepts or directions that include analogies. “Run as fast as a Cheetah” won’t have the same connotation for an individual with ASD as it does for the neurotypical population. With respect to cognitive functioning we have one priority; ensure that our athletes are able to follow our directions to the best of current ability.

Fitness and Medical Fitness professionals considering working with the ASD population may find that the instructions, cues, and even the exercises they rely on with most clientele don’t quite work for individuals with autism. While the general best practices approach to strength, stability, and motor planning still apply (strengthen the large muscle groups first, build a healthy movement pattern before adding load), the path towards success may wind a bit.

In our Autism Fitness™ Certification Level I, we have a consistent cornucopia of professionals with backgrounds in fitness, occupational and physical therapy, behavior therapy, pediatrics, recreational therapy, and education (not to mention parents of individuals with ASD). Each attendee brings in their own knowledge and experience with autism from their professional vantage point. The keys to success are taking the best practices from each area of ability (physical, adaptive, and cognitive), and having strategies that have wide-ranging application. Again, specialist-generalist-specialist.

Odds are that if you’re reading this or have been researching fitness programming for autism, a parent or school has approached you about running a 1-to-1 or group program. You may be starting next month, or next week, or in two hours. So I’ll spend the last of this article providing some practical, go-to strategies within each of the physical, adaptive, and cognitive (PAC Profile™) framework.

Physical

Focus on basic, essential movement patterns (pushing, pulling, crawling, squatting, carrying, and locomotion)

Have appropriate progressions and especially regressions for each exercise

Don’t add variety where it is not needed. Keep programming as simple as possible.

Adaptive

Let the athlete know what they’ll be doing and what’s coming after that. Anxiety levels tend to be high among those with ASD. Providing a “what’s happening next” can deescalate.

Provide opportunities for choice; “Do you want to do push throws or overhead throws first?”

This establishes that the athlete will be doing one of those two throws AND they get to choose which one

Use contingencies; “First hurdle steps, then you can take a break for a minute.” This creates a natural timeline and enables the athlete to know the specific beginning and end of the sequence and what the expectation is.

Cognitive

Label the exercise and demonstrate. Avoid extraneous language.

Teach exercises one at a time. Use a lot of repetition.

Fitness is a life skill, one that is tremendously needed by the autism population of all ages and ability levels. For professionals who choose to offer fitness services to those with ASD, it is imperative that best practices, all around, be used. When we know what we are looking at, what outcomes are realistic, and what strategies to employ, we can meet our athletes where they are at and enhance quality of life.

Eric Chessen, M.S., is the Founder of Autism Fitness. An exercise physiologist with an extensive background in Applied Behavior Analysis (ABA), Eric has spent nearly two decades developing and implementing fitness and adapted PE programs for individuals of all ages and ability levels. Eric is the creator and Lead Instructor for the Autism Fitness Certification and has presented at TEDx on the subject of fitness for those with ASD. He is also the Co-Founder of strength equipment company Stronger than U. He is New York native and very new resident to Charlotte, NC.

Exercise for Atrial Fibrillation

Eric Durak/20 April 2020/ All MFN blog/

Here are some things to look for when working with a client with Atrial Fibrillation (A-fib).

FIRST…

What types of medications are they on? Calcium Channel Blockers, blood thinners (Coumadin)? These may have an effect on the intensity and type of exercise performed. You know that people who have A-fib are at increased risk for strokes, and may have hypertension and get dizzy more often. The medications – while they may help with some factors – may preclude a well-designed exercise program just because they may not tolerate some types of exercise.

What are the exercise goals? Are they wanting to tone up? Lose some weight? Get stronger? Train for a tennis match or 5K? This would help in structuring the program. The type / intensity / duration are all dependent on what the client wants. If they are just coming off surgery or a new prescription – this is important to build the foundation (which you know).

SECOND…

Does the doctor have any contraindications for exercise? Usually, it’s not to “overdo”, which means building up a program. I read a good article by Dr. Bill Sekula on a program for A-fib. It’s essentially a “step down, time up” program, where patients go from a few minutes of exercise a few times per day – to building up to an hour of exercise one time per day. However, I am going to recommend more of an ITP (interval training program) that concentrates on moderate strength programs (using the 40-50% rule similar to cancer patients), so they don’t use the Valsalva maneuver while lifting, but still use a progressive resistance approach.

THIRD…

Monitoring with a HR monitor, and having good hydration status are both important. Of course, you probably have them using the smart water bottle. Because of the heart dynamics and possible Coumadin Rx, the hydration is important. I assume you do a HR variability test with your client. This may be a very important test to do, as over time it may be instrumental in reducing A-fib occurrences.

I like the article by Dr. John Mandrola on the amount of exercise. He states that A-fib is completely controllable through specific lifestyle changes. He states that low inflammation exercise (high intensity endurance / triathlon, etc.) training needs to be modified, as do other lifestyle issues. I really like the discussion on inflammation, which may be one of the biggest issues in cardiac care of late. He talks about the “J curve” of exercise and that the more intense actually increases the odds ratio (OR) for sudden cardiac events and other abnormalities related to A-fib.

I think he is on to something, and you should look into some other lifestyle aspects such as meditation and heartbeat regulation through mindful breathing and relaxation. I know that excess stress, lack of sleep and poor diet have effects on the electrical system, including SA node and conductivity. Regular relaxation may do a LOT to improve the normal sinus rhythm and reduce resting HR to a more manageable level.

Dr. Mandrola also recommends regular monitoring of BP, keeping the use of warm exercise clothing due to peripheral circulation issues, and not overheating.

I like the issue of ITP and progression. I also am more of a fan of modified strength training for most clinical conditions. I think it would work for AF because if you think of the strength of contraction during exercise (even moderate) – it will have a strong steady beat during exercise (in most cases).

Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

References

Food, Anxiety & Athletes: A Troublesome Trio

Nancy Clark, RD/15 April 2020/ All MFN blog/

As I write this column, the date is April 10th, 2020, three weeks into the coronavirus shut-down here in Boston. I continue to counsel clients from my virtual office. I am talking with gym rats and athletes alike who are stuck at home, hating what they see when staring at themselves during Zoom meet-ups, and are spending too much time fighting with food (Do I eat? Don’t I eat? Am I hungry—or just bored?). They are feeling anxious and self-critical.

When life feels out of control, athletes commonly end up trying to control other things, such as food, exercise, and weight. Some may be striving to chisel themselves into a perfect body (no excess body fat) and eat a perfect diet (no fun foods). Unfortunately, the same dedication and discipline that help them be top athletes are the same traits that foster eating disorders. For example, perfectionism is common to both athletes and people with anorexia. How else could figure skaters or gymnasts rise to the elite level without demanding perfection from themselves?

Yes, discipline, dedication, and perfectionism are driving forces that help good athletes become great. But genetics is fundamental, as is adequate—but not necessarily perfect—fueling. That is, eating a cookie will not contaminate an athlete’s health nor ruin one’s ability to perform well.

If you are relentlessly pushing yourself hard right now out of fear of getting fat and losing fitness, please consider being gentler on yourself. This is a difficult time for many folks. Little is wrong with a bit of comfort food in the midst of chaos and crisis. Perhaps you can allow yourself to be “bad” and do something out of character, like bake cookies and enjoy some for an afternoon snack. Giving yourself permission to enjoy some comfort food is normal, assuming you also have other coping skills, such as writing in a journal and relaxing yourself with yoga.

When food has power over you

If you are spending too much time trying not to eat (Fill in the blank) ____ (cookies, cheese, ice cream, chips?) because you can’t eat just one serving, think again. Depriving yourself of your favorite foods makes them even more enticing. They can needlessly become too powerful. To take the power away from a “binge food,” you need to eat it more often. (Trust me!) Here’s the analogy:

Pretend you are caring for a four-year-old boy. You take him into a room filled with toys and tell him he can play with all of the toys except for the green truck. You leave the room and then look through the two-way mirror. What is he playing with? The green truck, of course! The same analogy holds true with food.

If you give yourself permission to eat, let’s say, some Oreos every day, after a few days, you’ll either have little interest in yet-another Oreo (because other foods actually make you feel better) or you will be able to eat just one Oreo; it will no longer have power over you. Yes, to gain control over foods that have power over you, you have to allow the food back into your life and eat it more often. Be curious; give it a try.

When the mirror makes you feel sad

Are you spending too much time these days critically evaluating your body in the mirror? Or hating what you see in the Zoom meet-up? Please, just, stop the body-hatred talk. Few humans have a perfect body. The imperfections you see are perfectly beautiful and acceptable.

Instead of being self-critical, be grateful that you are healthy. Grateful that you have two strong legs that help you be a good runner. Grateful that you have two hands that help you row crew. Grateful that you have a body that produced healthy babies that are now your beloved children. You could even apologize to your body for having tortured it with skimpy diets and excessive exercise in your efforts to control how it looks.

Rather than focus on how your body looks, turn your attention to how your body feels throughout the day, particularly before, during and after you exercise. Does your body feel hungry? Tired? Sore? Respond appropriately to that feeling by nourishing it with food, rest, a warm bath. Daily killer workouts that feel like punishment for having excess body fat inevitably end up with the athlete being injured and depressed.

Now is a good time to practice looking in the mirror (or the Zoom screen) and saying nice things about your body, such as, “I have pretty blue eyes.” “I like my silky hair.” “I have strong legs.” You can intentionally pay less attention to the crooked teeth, frizzy hair, and “too big” tummy. Do you really think others care about that stuff?

Note: For more information on making peace with your body, visit RealFoodWholeLife.com, JessieHaggerty.com, and Julie Duffy Dilllon’s podcast Love, Food.

When mindless eating gets out of control

If you find yourself grazing on snacks incessantly throughout the day and have fears about getting fat, try scheduling regular meals and snacks. Also give yourself permission to eat enough breakfast and lunch, so that you are fully satiated. Don’t stop eating those meals just because you think you should but rather because you actually have had enough to eat. Athletes who graze all day rarely feel fully fed.

Hunger is a physiological request for fuel. Hunger does not mean “Oh no, I’m going to eat and get fat. Rather, hunger is your body’s way of saying it has burned off what you fed it and now needs more fuel. Yes, food is fuel, not the fattening enemy. Honor hunger.

Another way to bring control to your eating is to eat only when 1) you are sitting in a specific place (kitchen table?), 2) the food is on a plate, and 3) you are tasting it mindfully. (i.e. you are not standing in front of the open cupboard, wolfing down handfuls of chocolate chips.)

My hope is the above tips will help you find peace with food and your body. Enjoy food for nourishment and survive the coronavirus shut-down with sanity.

Boston-area sports nutritionist Nancy Clark, MS, RD CSSD counsels both casual and competitive athletes, helping them eat to win. The new 6th edition of her Sports Nutrition Guidebook is a best-selling resource. For more information, visit NancyClarkRD.com.

Paving the Road to Hell with Good Intentions

Shira Litwack/14 April 2020/ All MFN blog/

Going bigger is not necessarily better.

Many of us have the very best intentions with our health. We try to eat right, exercise, take supplements, make choices we deem to be healthy. However, we frequently think more is better: more restrictive with our food choices, more intense workouts, more supplements.

Let’s examine our choices from the perspective of inflammation.

What is Oxidative Stress?

Oxidative stress (OS) is an imbalance of free radicals and antioxidants in the body. Simply summarized, oxidative stress is electron thievery. Electrons are stable when coupled. Single electrons, called free radicals, scavenge the body to seek out other electrons to couple. It really is a wicked dating scene inside our cells!

Long-term oxidative stress damages the body’s cells, proteins, and DNA. OS strongly contributes to aging and is accepted to be the root of chronic conditions including diabetes, cancers, heart and vascular disease, depression, neurodegenerative disease, arthritis, Alzheimer’s, insulin resistance, IBD… more and more of our chronic issues are being linked to oxidative stress, as it can lead to chronic inflammation, to chronic illness.

Sources of Oxidative Stress

OS has both endogenous (from within) and exogenous (from our world) sources.

Endogenous: Cellular metabolism. Energy production happens in the mitochondria of our cells. Our currency or energy is ATP (adenosine triphosphate). OS is a natural by-product of ATP. When do we produce more ATP?

The body’s natural immune response can also trigger OS temporarily.

Fat cells create OS.

Exogenous: Exposures in our environment and lifestyle choices: alcohol, smoking, cell phone, EMF, environmental pollutants, many chemicals in our food and on our clothing, processed foods, sugar.

Chronic Diseases Continues to be on the Rise

Our inner antioxidant system was not designed to manage our current barrage of OS from our environment and lifestyle choices. According to the WHO, chronic disease is on the rise worldwide. Our levels of OS and chronic inflammation are also dramatically on the rise. An aging population and changes in our environment and our lifestyle choices are contributing to this steady increase. By lowering OS, we have a better chance of staving off illness.

Healthy Lifestyle?

From a perspective of inflammation, what is a healthy lifestyle?

Exercise

Bottom line: Too much exercise in terms of intensity and duration is proven to increase oxidative stress. Yes, exercise and physical activity are a necessity for every aspect of health. Exercise has been proven to lower oxidative stress, cardiovascular risk, but the mechanisms of this are still being studied.

It has been proven that starting “on an exercise program”, then quitting abruptly, increases OS.
Nutrition plus exercise is far more effective in lowering OS, than exercise alone.
Exercise has better control on lowering oxidative stress in people who have higher levels of CRP (inflammatory marker).
Exhaustive and prolonged exercise promotes the generation of ROS, depletion of antioxidants and vitamins, induces oxidative stress, renal impairment and inflammation.
Prolonged aerobic exercise is linked to dramatic increases in oxidative stress.
Less studied thus far, intense hypertrophy training (heavy weight lifting) has been shown to increase oxidative stress. Muscle mass is imperative for healthy aging; balanced training is key.

More exercise in terms of duration and intensity could lose the beneficial effects of exercise. It is very important for those engaging in stressful exercise to support their antioxidant system. Passive exercise is a liberating and invigorating addition to our lives. We can benefit from adding some range of motion and stretching, emphasize our cool-downs, Qi Gong, meditation, and passive exercise.

Nutrient Restricting Diets

Our body needs a variety of amino acids to function efficiently. Bioavailability of these amino acids varies amongst food sources. We need to eat antioxidants to counteract oxidative stress.

Let’s look at some research on a few popular diets, with respect to oxidative stress

Keto diet: Ketogenic diets have shown to increase inflammatory markers.
Paleo diet: can be good in some respects by eliminating sugar, alcohol. If not done carefully Paleo-ers have been shown to be deficient in fiber and certain minerals and vitamins, which is hurtful to gut health, and yes pro-inflammatory.
Vegan diets: Again, proceed with intense caution. Vegan diets tend to be very carb-heavy. Our grains are not what they used to be. Genetic modification and toxins abound, and our soil is not what it used to be as a source of minerals. Meat and dairy are rich in bioavailable amino acids, and of course, moderation is key.
A 2018 study showed that long term diets excessively low, or high in carbohydrates are both linked with a shorter lifespan.

There is NO utopian diet. Examine lifestyle decisions from the perspective of inflammation. The scale is not the omnipotent indicator of health. We need to examine what we are identifying as our markers of health. Maybe our good intentions weaken our inner defenses. Be healthy and balanced. Balance is strength!

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public.

She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation.

Understanding Dementia: How to Help and Support People with this Disorder

Sarah Kaminski/10 April 2020/ All MFN blog/

If you’ve dealt with a person who has dementia, you are perfectly aware of the hardships that come with the territory. It’s impossible to offer help and support unless you understand the condition. The most important thing to note is that it is an umbrella term pointing to the symptoms of an ailment, rather than an ailment itself.

In other words, the memory loss dementia denotes is usually one of many symptoms that accompany diseases such as Alzheimer’s, vascular cognitive impairment, Lewy-bodies syndrome, and others. To retain a satisfying quality of life, the affected individuals require all the knowledgeable assistance they can get.

This is where you come in as a family member or a caregiver. Here’s what you can do to help.

Set the stage with positivity

The most important thing to remember is that people living with dementia know how to read body language even if they don’t recognize you. As long as you reflect a modicum of modest positivity and ‘normalcy’ in your behavior, you’ll be providing a better environment for them to relax, find their ground, and feel valued as a real person.

A positive attitude is alpha and omega of your support. It requires little effort and it makes all the difference.

Certain ground rules you need to establish

As a caregiver supporting someone with dementia, you need to have some ground rules set in stone. Make a list of pointers on a large sheet of paper which you can refer to now and then, especially if you feel that relationships in the household have been going sideways.

Now, here’s a twist: these rules are mostly there for you. And they go as follows:

Keep your sentences short and your questions answerable. On some days, this will be more important than on others, but you’ll also be amazed at the opportunities to have meaningful and genuine conversations with them.
Let them make manageable decisions – like their choice of dinner, means of transportation (car or on foot), a set of clothes, etc. This will instill in them a sense of agency and confidence.
And while we’re on the topic of confidence, keep your intonation and enunciation distinct and reassuring. This will also improve the overall household atmosphere.
And finally, always maintain your sense of humor. Encourage them to crack jokes, let go, and get silly – humor heals!

Aim for small habits

When it comes to encouragement, there’s another factor that contributes to the perception of agency and confidence in a person with dementia, and that is habit. Your job is to support behaviors that lead to their better cognitive performance and improved quality of life.

Even the smallest habits can mean a world of difference, such as going through a family photo album several times a week or writing a journal daily. Also, creative activities such as painting can do wonders for people with dementia, especially when it comes to memory retention.

Make sure to keep track

As dementia develops, there’s a greater risk of the person in question wandering off. The nature of the condition is such that they may end up confused, disoriented, and unable to recall why they’ve left home or where they are.

Fortunately, it’s possible to minimize the danger and better keep track of your loved one. At the very least, ask them to always carry their phone with them or, even better, get them to take a GPS tracker along.

Better yet, provide them with a portable medical alert tracker to ensure that they never leave home unsecured. In fact, getting more than one can be useful. You can place them in their coat pockets, jackets, jeans, or put them on a necklace that they’ll be wearing whenever they leave the house.

Give them as much freedom as humanly possible, but make this a fundamental condition.

Label everything you can

Label dispensers and stickers will become the most useful items in your ‘toolbox’ for the following period. Sticking labels on doors, drawers, cupboards, and cabinets to denote what they hold makes everyone’s life significantly easier. But why stop with the name game?

You can take it a step further by compiling a list of all the crucial phone numbers and printing out several copies. Of course, it would be impractical to just leave them lying around. If you have a chance, laminate the lists and hang them on the most frequented doors in the household.

Keep their living space limited and orderly

Naturally, to avoid confusion, you’ll have to make an extra effort to return all objects to their designated spots.

Now, if your loved one is living in a large home, you also might want to rethink their living space. Not that they are physically unfit to navigate spaces, but you’ll need to work with them to help ensure they’re comfortably nested in a space that supports their well-being as well as maximum functioning. You might need to move some furniture around and get rid of clutter to create a layout that eliminates confusion and feels right to them.

Physical activity affects longevity

Simplifying their living space doesn’t mean that they should stay confined to it. On the contrary, people living with dementia need as much physical activity as possible to stay fit and improve cardiovascular health and blood flow through the brain.

Dementia is far from a death sentence – this cannot be overstated – and physical activity correlates directly with longevity and cognitive health.

Now, when it comes to older individuals living with dementia, simple daily tasks that involve physical exertion are perfectly valid. Don’t treat them as victims; instead, keep their hands busy and give them simple tasks they can occupy themselves with.

Important note: elaborate activities might be too much to ask. On the other hand, dish-washing, vacuuming, and other household chores could be a great choice, especially because they’ll be pleased to see the fruits of their labor. Also, if you plan to keep this going, you can print out a schedule spreadsheet and keep track of all activities they’ve already finished, in case they forget.

Apart from that, you might want to look into yoga and see what benefits it manifests for people living with dementia. Yoga strikes the perfect balance between a demanding physical activity and a relaxing stretching exercise with meditative qualities that greatly benefit anyone.

Conclusion

At the end of the day, never forget: the person comes first, not the condition.

You need to prioritize bracing yourself for the forthcoming changes in their behavior, because it’s not merely about being patient in tight spots. To reflect a positive attitude and flexibility, you’ll need to work out the best possible and the worst possible scenarios, and be grateful when the latter don’t transpire, thanks to your efforts.

The naturally positive attitude that follows this frame of mind will have an encouraging and enriching effect on your loved one. And when you provide that kind of supportive environment for them, you might just be surprised what you can learn from them – and the entire experience.

Sarah Kaminski earned her bachelor’s degree in Health Sciences. Due to her parent’s declining health, she decided to become their full-time caregiver. Now, she takes care of her loved ones and writes about the things she learned along the way.

Sarah is a life enjoyer, positivity seeker, and a curiosity enthusiast. She is passionate about an eco-friendly lifestyle and adores her cats. She is an avid reader who loves to travel when time allows.

References

“20 Reasons Why We Need to Know the Early Life History of ….” 16 Apr. 2019, https://changingaging.org/dementia/20-reasons-why-we-need-to-know-the-early-life-history-of-people-living-with-dementia/. Accessed 24 Mar. 2020.
“What Is Dementia? Symptoms, Types, and Diagnosis.” 19 Mar. 2020, https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis. Accessed 24 Mar. 2020.
“Caregiver’s Guide to Understanding Dementia Behaviors ….” https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors. Accessed 24 Mar. 2020.
“Answers To The Most Important Questions About Alzheimer’s.” 31 Mar. 2018, https://www.medicalalertbuyersguide.org/articles/answers-to-the-most-important-questions-about-alzheimers/. Accessed 24 Mar. 2020.
“Dementia – activities and exercise – Better ….” 31 May. 2014, https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/dementia-activities-and-exercise. Accessed 24 Mar. 2020.
“Yoga for Everyone: A Beginner’s Guide – Well Guides – The ….” https://www.nytimes.com/guides/well/beginner-yoga. Accessed 24 Mar. 2020.

Movement and Cognition

Dr. Michael S. Trayford/9 April 2020/ All MFN blog/

How our ability to maintain balance, walk, and move is directly reflective of our higher human functions (A brief overview and case study)

Balance and cognition are inextricably linked. Quantification of improvement in key performance indicators of cognition is directly related to precisely measured improvements in balance and postural stability. A thorough understanding of this relationship is paramount to the understanding of conditions related to cognitive impairment, leaning and behavioral struggles, brain injury, and so much more.

At the time of presentation to APEX Brain Centers, Roger was a 70-year-old male struggling with severe balance problems, clumsiness, fatigue, and a general disinterest in life. He used to enjoy life as a family man, successful entrepreneur and golfer. Just over 10 years prior he had undergone radiation therapy for cancer that damaged his 8^th cranial nerve (the balance and hearing nerve). He had also undergone prism therapies and surgery for eye position abnormalities, which have caused further insult to his ability to maintain good balance and to learn effectively. Although not listed as a primary complaint, he also suffered from significant cognitive decline in several areas as evidenced by very low to low average scores on standardized cognitive testing.

Roger sought care at APEX Brain Centers in Asheville, NC in May of 2015 and underwent an intensive course of brain/body rehabilitation. He was admitted into an individualized program directed by extensive diagnostic testing and led by clinicians highly experienced in functional neurology. What follows is a sampling of some of the leading-edge clinical interventions and significant functional gains Roger experienced during his program.

Intervention for balance and cognitive decline

Roger underwent comprehensive brain/body rehabilitation at a frequency of 3 times per day over the course of 15 days (with 2 days off between each for much needed rest and recovery). His brain function was carefully monitored throughout the training process with measurement of EEG, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount therapy to be effective, but not too much so as to be counter-productive. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic and nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, breathing exercises, and home care recommendations.

Outcomes after Brain Training

Subsequent to his rehabilitative program, Roger reported subjective improvements in the vast majority of his pre-intensive complaints. More profound than that, his wife was quoted as saying, “it’s like I have my old husband back.” She noted that he used to be the life of the party and had been slowly deteriorating over time to the point of sitting in his chair all day and sleeping more and more often. He was finally plugging back into life, putting an end to his isolation and apathy. As is demonstrated by his balance testing, he is also experiencing a renewed ability to maintain balance, allowing him to be safer and more efficient in navigating his physical environment and getting back on the golf course.

Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:

Cognitive Testing: Increase in his Neurocognition Index of 48%. This is a standardized overall score of cognitive performance. Increases in various aspects of memory, attention, processing speed and more as great as 21%.

Interactive Metronome: 56% improvement in task average with motor timing, and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. responding prematurely to a pre-set reference tone).

Computerized Assessment of Postural Stability (CAPS): 20.5% improvement in balance on an unstable surface with eyes closed – bringing him from severe to mild reduction in balance compared to his peers. Elimination of a posterior center of pressure (CoP); significantly reducing his risk of falling backwards.

Video Oculography (VOG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.

Better Movement Equals Better Cognition

With an alarming increase in the number of baby boomers and seniors experiencing balance issues and cognitive decline (that are in fact related and measurable), it is important to recognize the symptoms of these potentially debilitating disorders and, more importantly, that something can be done about them. Early intervention is key, as the longer one waits and the more function is lost, the more difficult it is to recover and have full engagement with life. These same concepts apply to all areas of cognitive and mental health.

Learn more on this topic… join Dr. Trayford for his MedFit webinar, Movement and Cognition.

Dr. Michael S. Trayford is a Board Certified in Chiropractic Neurology and Neurofeedback; and is the Founder and Director of Clinical Operations at APEX Brain Centers in Asheville, NC. His primary areas of focus in clinical practice, associated research, and teaching are learning and behavioral disorders of adulthood (with a focus on addictive and compulsive behaviors), brain injury, and cognitive impairment.

Interesting Times for Interested People

Dr. Mark Kelly/6 April 2020/ All MFN blog/

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas	New Wellness Areas
S-ocial	Social – all interactions with people outside of ourselves
P-hysical	Physical – our physiological status
I-ntellectual	Intellectual – includes cognitive and emotional health
C-ognitive	Career – includes educational and skill acquisition and financial health
E-motional	Environmental (could include emotional) – clean, organized?
S-piritual	Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.

Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.