Healthy Living in Community
- Written by Lynne Feldman
Bec Belofsky Shuer and Lee Shuer, from Easthampton, will facilitate a Wellness Recovery Action Plan (WRAP) group to support you as you develop strategies for making the most of every day, even when things are tough! This free workshop will meet at Baystate Franklin Hospital Conference Room B in Greenfield, from 1 to 3 p.m., Mondays and Wednesdays April 29-May 22, 2019.
WRAP is about finding and keeping hope and independence in our lives. Each week, we will discuss practical skills and action plans to deal with life’s ups and downs. We will meet six times, for two hours. You will be provided with a personal WRAP workbook - it’s yours to keep!
Bec and Lee love running these groups and hope you will join them. Their group at the Longmeadow Adult Center was a hit, thoroughly enjoyed by attendees and facilitators alike!
This workshop series is sponsored by LifePath with support from the Massachusetts Council on Aging, under a service incentive grant from Massachusetts Executive Office of Elder Affairs.
- Written by Becca Belofsky
Depression is like gray paint over the canvas of my life. I’ve lived with it since childhood and no amount of wishing or sleep has made it go away, but there are things I can do to ease the burden it lays upon me. By reading this article, you’re opening yourself up to finding a tidbit that will lead you to think or do something that’ll improve your wellbeing, too. If you agree, then you have hope.
Hope is one of the five key concepts of recovery as developed by Dr. Mary Ellen Copeland and her colleagues when they created WRAP, a Wellness Recovery Action Plan. It’s an evidence-based self-help life management system whose premise is that through hope, personal responsibility, education, self-advocacy, and support, we can live the kind of lives we want, even as we encounter difficulties like those associated with depression. If you don’t feel you’ve got much hope, don’t fret. Just a little bit can take you as far as you need to go. Hope is like a personal pilot light. We can’t cook if the light in the stove goes out and people are like that, too. With the flame on, though, all kinds of things can be accomplished, even with depression.
If your hope flame is totally dark, you might have to give yourself permission to take a hopeless leap of faith. It’s funny how that can sometimes get things started. In wrestling with depression, tricks are necessary when we’ve got nothing else to move us. If you have to pretend you’re a person with hope on a day when you know you don’t have it, I’m asking you to try pretending so you can do things that are likely to enrich your wellbeing. If that doesn’t work, believe in hope that others can hold for you. Try using the next four key concepts and you are likely to notice positive effects and hope can re-enter your life as a result.
Personal responsibility means claiming ownership of your recovery. It can feel easier to say, “Oh, the doctors are taking care of it,” or, “There’s nothing I can do,” but that won’t get you to a better place. When we feel in charge, we can act in ways that reflect that and make changes that will be life-enhancing. For example, a doctor might give me a prescription that works for many people, but makes me feel sick. I know it’s not the right one because I’m the expert on myself. Likewise, you are the expert on yourself. With that acknowledgement, the next step is self-advocacy. Before we go on, though, you might need to repeat the words, “I am the expert on myself,” aloud. Say it. I encourage you to do so, to make it feel real, if it doesn’t already.
Speak up with your concerns and needs. Your voice is the one that matters most when it comes to your own wellness. Use it. It might feel rusty if you haven’t tried it in a while, but it will become stronger with use. Sometimes life feels like exhausting work. Fortifications are necessary along the way. Don’t forget to take care of yourself as is right for you. Maybe laughing over a show makes you feel good. Maybe a twenty minute rest and a cup of tea helps you. I like to snuggle with a cat and sing. Feel-good energy is restorative and gives us strength and positivity. By acting to support your recovery, not only are you heading towards your goal, but you’re also experiencing a better today.
There are countless ways to learn nowadays. I can ask friends if they know doctors I might like. I can google reviews of doctors in my area. I can find a support group through local listings. I can attend a talk at the library. I can ask the pharmacist a question about my meds. I can read a book or listen to a lecture online. Education comes in a variety of forms and it is empowering.
Have you noticed that though I’m responsible for myself, others play a part in my wellness journey? Support evolves over time by need, desire, and opportunity. I add good people to my life whenever I can. The day I moved into my house, I couldn’t open the back door. I would have been outside all day if I didn’t accept help from my neighbor. Besides help for practical matters, support brings us a feeling of connectedness. A community choir, a senior center, or a social worker might be part of your support network. You decide what works for you! Good support supplies peace of mind. We can improve our quality of life by doing more for ourselves, and sometimes that “more” means being vulnerable and asking for help. Best wishes to you as you paint on top of the gray.
The author, Bec Belofsky Shuer, and Lee Shuer, from Easthampton, will facilitate a Wellness Recovery Action Plan (WRAP) group to support you as you develop strategies for making the most of every day, even when things are tough! The group, offered by LifePath, will meet on Mondays and Wednesdays Apr. 29-May 22 from 1—3 p.m in Conference Room B at Baystate Franklin Medical Center. Call LifePath at 413-773-5555 for more information or to register.
- Written by Andi Waisman, Healthy Living Program Manager
As we reach the end of 2018, many people will be thinking about what changes they’d like to make in the new year. Eating healthier and exercising often top the lists of resolutions. Yet, as we all know, the path between setting a goal and reaching it can be fraught with many obstacles. We struggle with survival needs; we struggle with addictions; we struggle with managing all the demands on our time and attention.
Change is hard, but change is also possible. Here in the Healthy Living program at LifePath, we run programs that are proven to help people take control over their chronic health conditions, in part by exploring ways to make more behavior changes happen. People who have participated in our evidence-based programs over the years generally have fewer symptoms, such as depression, shortness of breath, anxiety, pain, mobility limitations, and have better quality of life, exercise more, and usually utilize health care less. Something in the recipe of these self-management workshops works.
The behavior change principle that underlies many of our programs is the concept of self-efficacy, the belief that we can perform the targeted behavior. How do we enhance people's confidence in their ability to manage their chronic conditions and other aspects of their lives?
One of the major tools in our self-management workshop “toolbox” that help to build self-efficacy is the tool of action planning. For about 25 to 35 percent of each weekly session, we each take turns making a specific action plan, sharing it with the group, and brainstorming solutions to the barriers that keep us from accomplishing our plan. It is through action planning that people begin to feel in control of their fate, begin to grow their confidence in their ability to make changes, and see some hope that improvement is possible.
Given a structure and support, all of us usually make good decisions about our health and get motivated to make and complete goals we want to achieve. For this reason, the group leaders and peers never tell people what to do but rather support them in what they choose to do, even when the group or their doctor might have other goals for them. By asking people to make action plans and report on these plans, participants are gently persuaded and supported to try new activities they truly want for themselves.
How does action planning work?
Sometimes it can be overwhelming to think about the changes we want to make or the activities we want to accomplish. They seem too big to work on all at once, which makes it hard to get started. So, action planning asks people to commit to attempting, in front of a group of people, a small, “doable” action step, one that is achievable, specific, and answers the questions of what, how much, when, and how often.
For example, a person who wants to improve fitness might break this goal into several steps over the course of a few weeks:
- Research what type of exercise to do.
- Find a place to exercise.
- Start an exercise program by walking for five minutes, two or three times a week.
- Ask a friend to exercise with them.
Each step should be action-specific. For example, losing weight is not an action or behavior, but replacing processed food snacks with fruit between meals is.
Peer support and accountability are important aspects of this technique. The thought of facing their group and having to admit that they blew off their plan is, for some, the motivator to complete it.
We are continually impressed with the action plans our participants commit to and complete. Some of these have been:
- Taking an art and wine class
- Keeping an eating journal
- Walking 20 minutes a day
- Scheduling regular meals for one week
- Take a shorter nap during the day
- Limiting an evening snack to fruits or vegetables
- Joining a gym
- Going to sleep by 10:30 on two nights
- Putting a positive statement on the mirror
- Doing the shoulder exercises in the book
- Standing up at least 25 times during the day
- Drinking a glass of water before eating
- Calling a parent every day
Sometimes we don’t accomplish our plan. We run into barriers: the weather, a spouse who buys food we don't want to eat, our lack of motivation, or our too busy lives. We then work together to brainstorm solutions to those barriers. We pick a solution to try and start again. I believe it is this restart – this human instinct to set goals for ourselves for our immediate future, to see the possibility ahead – that grows our confidence.
Try action planning
Even if you can’t attend a LifePath workshop, you can still try action planning on your own. Find a friend to make a weekly date with. Support each other to think of a small, specific, doable action plan that you each really want to accomplish over the coming week, and then check in to see how it went. Also, try calling your friend in the middle of the week to remind them of what they wanted to accomplish and express that you have faith in them; see how gratifying that feels.
At this turn of the year, when we naturally are drawn to new year’s resolutions to start fresh with hopes and dreams for the year ahead, know that the folks at LifePath are cheering you on and want to hear about your successes and challenges.
In addition to the workshops, the Healthy Living Program offers a monthly alumni group where graduates from any of the workshops support each other in making and accomplishing our action plans. The alumni group meets on the first Thursday of the month, from 2:00-3:45 p.m., at the Greenfield Senior Center.
- Written by Jessica Riel
“Mindfulness.” It’s become a popular term. But what is mindfulness, where did it come from, and how can it benefit people in our community?
“Mindfulness means paying attention to the immediate here and now, moment by moment,” says Marilyn McArthur, a local mindfulness teacher. “Anyone of any age who has voluntary control of their mind can learn to improve their attention with practice. Marvelously, the bit of effort it takes to be mindful actually relaxes tensions, rather than add to them.”
Originating from a Buddhist term, “sati,” the practice of mindfulness in the West entered our culture over the last century. One of the people who helped to popularize mindfulness did it right here in Massachusetts. In 1979, Jon Kabat-Zinn created the Stress Reduction Clinic, and later the Center for Mindfulness in Medicine, Healthcare, and Society, at the University of Massachusetts Medical School. The son of a biomedical scientist and a painter, Kabat Zinn had gone to school for molecular biology, earning a PhD from MIT in 1971, while also studying yoga and Buddhist practices. He took what he learned from Buddhism about meditation and analyzed it with a scientific approach, researching and reframing it as a tool for health and wellbeing.
Marilyn is a teacher of Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR) program, and she says that she values “sharing its benefits with others.” When she first turned to mindfulness, however, it was as a way to help cope with a frightening and stressful time in her own life.
“On my 40th birthday, I was diagnosed with multiple sclerosis (MS),” says Marilyn. “I was stressed and also frightened, because I had three little children at home. A friend brought me a little book called The Miracle of Mindfulness, and I sensed it was the medicine I needed.”
Mindfulness has been shown to have a positive effect on the quality of life of people living with chronic illnesses like MS, helping to increase relaxation and relieve the depression and psychological stress that can accompany a diagnosis. More specifically, MBSR has been tested for anxiety disorders, chronic pain, insomnia, substance abuse disorder, and other health problems.
When Marilyn first began to practice mindfulness, she says, “Mindful breathing helped me unwind and fall asleep. I was so happy to have a tool to overcome insomnia and rebuild my health.” Over time, her mindfulness practice helped to calm her nerves. “Daily practice helps regulate a jumpy nervous system and reduce stress.”
Marilyn brought mindfulness to the Healthy Living Program at LifePath by way of a group for alumni of the program’s workshops. “[Healthy Living Program Manager] Andi Waisman invited me to present at the monthly alumni group, a free support action group for anyone who has completed any of the workshops,” says Marilyn. The alumni meetings take place at the new Greenfield Senior Center on the first Thursday of the month at 2 p.m.
Marilyn enjoyed her experience and decided to become trained as a volunteer Healthy Living workshop co-leader. “I retired this year from my work as a museum education consultant, and now it was time to go in this direction,” says Marilyn. “I especially like working on a team and co-teaching.”
She decided to train to co-lead two different workshops: Matter of Balance and Chronic Disease Self-Management (CDSM). “Matter of Balance is good for me, as it addresses my own challenges to stay on my feet and walk as well as I can. Now I can share all its good recommendations. CDSM investigates the whole range of challenges of living with a chronic condition. It’s good to have the support of a group when you are trying to make lifestyle changes.”
Like mindfulness, these workshops are backed up by scientific research, and mindfulness practices may be taught along with a host of other strategies. “Using Your Mind to Manage Symptoms” is one of the tools in the CDSM workbook, encompassing techniques such as distraction, spirituality, writing, and relaxation body scan, a form of mindfulness meditation.
Distraction is common in our modern society. You can distract yourself in many ways: with technology, such as watching television, browsing the internet, or using social media; by socializing, reading, listening to music. While you could call mindfulness “a distraction from the anxiety and worry associated with chronic illness, and modern life in general,” says Marilyn, “practicing mindfulness, for example with the body scan, is an exercise in not being distracted from the here and now. To the contrary, mindfulness is very curious about what is happening right here, right now.”
As Marilyn said, although mindfulness is about paying attention to what is happening in the moment, it is not about focusing on the pain you are feeling or what has you worried. Instead, you leave your inner thoughts behind to focus intentionally on what you are doing, even if all that you are focusing on is your own breath. If your attention slips away, you observe where it went without judgement, and invite your thoughts back to where you’ve intended to focus them.
“It begins by making friends with the breath,” says Marilyn. “Simply to pause and pay attention to the sensations of breathing, in a non-judgmental and curious way, serves to shift body and mind into a very welcome relaxation mode. This reduces unnecessary stress and its harmful effects. We are mindful when we pay attention to the present moment, whatever we are doing: mindful eating savors each morsel, instead of wolfing down food; mindful walking slows us down and puts our brains in the bottom of our shoes, so to speak, instead of careening headlong through the day.”
If you are interested in learning more about mindfulness, you can read about it online, find free resources from your local library, or take a class. “Mindfulness-based stress reduction is typically taught in an eight-week course that not everyone can afford,” says Marilyn. “Alternatively, the idea of community mindfulness is to offer regularly scheduled sessions of guided instruction free of charge or by donation, so people can acquire these skills at their own pace. I am beginning to do this at the Amherst Senior Center and the Greenfield Senior Center.”
- Written by Jessica Riel
Dino is “on the path of living a life WITH chronic pain and not letting it RUN my life”
When Dino Schnelle retired two years ago, his retirement did not seem to hold the promise of “golden years.” Having suffered hip dysplasia for his entire adult life and then a heart attack in 2011, Dino also left his working life with diabetes and chronic nerve and muscle pain.
“With all these problems and conditions, I felt like my life had been taken away from me,” says Dino.
Dino, now 66, had always led an active life. In the 1980s, he moved to a remodeled one-room schoolhouse in Heath. “I started here as an organic farmer,” says Dino, “growing fresh culinary and medicinal herbs, heirloom vegetables and organizing one of the first Community Supported Agriculture projects in western Franklin County.”
In 1997, Dino took a job with Community Action before becoming the Food Pantry Program coordinator for the Center for Self-Reliance, a position he held for 16 years until his retirement.
His health conditions are what brought on his decision to retire. “Not being able to sit, stand or walk for extended periods of time, not being able to lift or carry large boxes of food, not being able to ‘play’ in my garden or go hiking were all things that restricted my ability to do my job, relax and enjoy the things that were important for me.”
Many people with chronic health conditions feel that, after a diagnosis, they are largely on their own with managing their health, as our modern healthcare system is not built to support the daily management of a long-term condition in the 15 minutes most of us have during a doctor’s visit. Dino was given prescriptions for pain medications and a recommendation to join the YMCA. “Managing my health was now my full-time job,” says Dino.
Last summer, Dino was at the YMCA in Greenfield for a gentle yoga class when he saw a flyer for a free workshop through the Healthy Living Program at LifePath. “Since I did not know anyone who had participated in the workshops, I really was not sure what to expect,” says Dino, but he decided to try it out. “I signed up for the Chronic Pain Self-Management workshop at the Greenfield YMCA in the fall – from late September through November, 2017. I was just hoping to meet others who were struggling with the same problems and looking for practical solutions.”
At the start of the first workshop session, says Dino, his feelings were mixed. “I felt that the reputation of LifePath and my experience working with the organization in the past was one of consistent professionalism, dedication and genuine concern for the people they were working with. I was concerned about the length of the sessions (2 ½ hours each) and was a little intimidated when I saw the ‘workbook’ that was distributed the first session.”
His concerns were understandable. People with chronic pain, as Dino shared, may have difficulty sitting for extended periods of time. Healthy Living workshop peer-leaders, who are also living with chronic health conditions, encourage participants to get up and move around, even to leave the room for a moment as-needed during the sessions to better ensure their comfort.
Fortunately, the heavy workbook turned out to be an invaluable tool. “The workbook laid out in easy detail a wide range of tools and techniques to deal with the ‘limits’ my pain had imposed on me.” Because people who attend the workshop are given the book to keep free of charge, it can also serve as a continued learning resource at home after the sessions have ended.
But on that first workshop day, Dino felt a sense of relief. “It was just a real change to walk into a room of full of people I did not know and NOT have to explain why I was not ‘having a good day’ because of my health problems.”
Surrounded by people from his community who were also trying to manage a life with chronic pain, Dino’s perspective began to shift. “The thing that surprised me about the workshop was the inspiration I got from the other participants, some who were older, some who had struggled with more challenging pain conditions, some who suffered from very different sources and forms of pain. But all of them were demonstrating in their own ways how engaging and facing your pain can empower you.”
Now several months after the six-week workshop ended, thanks to the tools he learned from Healthy Living, Dino says he is “on the path of living a life WITH chronic pain and not letting it RUN my life.”
Healthy Living workshops all have the common practice of teaching people to break their goals down into what Dino calls “simple, easy steps.” Dino reports that “the goal-setting and expectations-management tools have been one of the most important things that I learned, and the exercise and diet tools continue to help me reclaim my life.”
In practice, this means that Dino plans out each day to “maximize my participation in life,” he says, balancing activity with rest so he does not tire himself out to the point of exhaustion. “By planning out my week, I can focus on the priorities in my life of classes and appointments and organizing what I do with whom and when so that I do not suffer the severe ups and downs of over-doing my schedule for a few days and then requiring several more to get my energy back and get my pain back under control. I am now able to attend my gentle yoga and TaiChi classes twice a week, participate in a pain pals support group and am busy in the garden. I maintain my network of friends and, in general, have fewer of those ‘down days’ that are spent on the couch or not being motivated to do all the things I enjoy.”
The workshops include sections on communicating with healthcare providers to make the most of those often short appointments. “Because of the workshop I worked with my health care providers to sensibly reduce some of my pain and blood pressure medications which I felt was only contributing to the ‘woolly-head’ feeling I had from time to time and was one of the things that was reducing my engagement in and enjoyment of my life.”
Dino has even been able to share what he has learned to help someone else: his 87-year-old mother. Immediately following the workshop’s end Dino spent three weeks with his mother after she was released for a 12-day hospital stay for blood clots in her legs. “Upon reviewing the workbook with her, we were able to find exercises that we both could do that would help her build up the strength she had lost in her arms and legs,” says Dino. “She has had a full recovery, and we continue to inspire, support and challenge each other as we get ready to celebrate her 88th birthday!”