~ YOUR BODY WHERE YOU ~Live ~ A Guide to Healthy Living for People with Disabilities -Volume II is A Gu ide to Healthy Living for People with Disabilities Volume II The research and preparation of this guide was accomplished through a collaborative efort of the New Jersey Department of Human Services, Division of Developmental Disabilities, Ofce for the Prevention of Mental Retardation and Developmental Disabilities and the Division of Disability Services, the Disability, Health and Wellness Program. Chris Christie Kim Guadagno Governor Lt. Governor Elizabeth Connolly Acting Commissioner NJ Department of Human Services Joseph M. Amoroso Jonathan Sabin Division Director Director Division of Disability Services Ofce for the Prevention of Developmental Disabilities Jennifer Shore Researcher Harry Pizutelli, Traci Burton, Colleen Roche and Gianna Marchesi Authoring and Editing Team Partner Agencies Division of Developmental Disabilities The Division of Developmental Disabilities (DDD) funds services and supports for eligible indi- viduals with developmental disabilities. These services are ofered in the community by more than 200 agencies and in fve residential developmental centers administered by the division. DDD assures the opportunity for individuals with developmental disabilities to receive quality services and supports, participate meaningfully in their communities and exercise their right to make choices. www.state.nj.us/humanservices/ddd/home/index.html Ofce for the Prevention of Developmental Disabilities The mission of Ofce for the Prevention of Developmental Disabilities (OPDD) is to reduce the frequency of occurrence of severe chronic mental or physical disabilities that originate during pregnancy or early childhood. Preventing developmental disabilities begins long before a woman gets pregnant and continues long after her children are born. OPDD addresses the many facets of prevention by using the life cycle paradigm which includes: preconception health, prenatal health and infant and child health. www.state.nj.us/humanservices/opmrdd/home/index.html Division of Disability Services The Division of Disability Services (DDS) is designated as the “single point of entry” for informa- tion about and access to services for people with disabilities living and working in New Jersey. DDS administers programs that allow people with diferent types of disabilities to live more independently in the community, and in many cases, avoid the need to move into an institu- tion. DDS does not have disability specifc eligibility criteria and thus operates as the cross-dis- ability, human services organization for state government. www.state.nj.us/humanservices/dds/home/index.html Disability, Health & Wellness The New Jersey Disability Health & Wellness (DH&W) Program is a unit within the Division of Disability Services. The DH&W Program consults and collaborates on projects that seek to promote healthy living and prevention of secondary conditions for people with disabilities. The DH&W Program works with policy makers, health educators, public and private agencies, and experts in the feld of health and wellness to facilitate the integration of people with disa- bilities into the general health promotion activities which currently exist throughout the state. www.state.nj.us/humanservices/dds/projects/dhwi/index.html The DH&W Program encourages individuals with disabilities to be proactive in their healthcare. In taking on a healthier lifestyle, you can elevate your overall health and wellness and possibly prevent secondary conditions. In support of these goals, the Your Body Is Where You Live: A Guide to Healthy Living for People with Disabilities, Volume II provides multiple wellness re- sources for individuals with disabilities. For additional healthy living tips and disability specifc resources join us for “Wellness Wednesdays” on the Department of Human Services Facebook page at: www.Facebook.com/NJDHS Preface Health and Wellness for People with Disabilities: Why is it Important? Our frst guide, Eat Well. Live Well. Be Well. A Guide to Healthy Living for People with Disabilities, focused on nutrition and healthy eating. While promoting this guide, we met individuals with disabilities throughout the state and felded many questions about exercise and adaptive sports. It became clear that we needed to dedicate a second guide to the topic of physical activity. As they say, a journey of a thousand miles begins with one step. Creating a healthy lifestyle doesn’t happen overnight. For most of us it is a life-long process that requires lots of adjust- ments along the way. This guide is for people with disabilities who are saying to themselves, “I want to live a healthy life, but it seems so complicated; where should I begin?” In addition to dis- cussing ftness, health and nutrition, this guide will also provide some information on disability specifc exercise techniques that you can do from the comfort of your own home. Why is wellness so important and what does your disability have to do with any of it? The truth is wellness, or making healthy choices in all areas of your life, is really important and disability can play a big role in your ability to stay well. In fact, this topic is so important, there is a pro- gram which sets out to “improve the nation’s health” called, Healthy People 2020 (HP 2020). Healthy People 2020 has four main goals: To live longer, healthier lives To improve the overall health of everyone Create social and physical environments that promote good health for all To promote healthy behaviors throughout a person’s lifetime One of many topic areas within HP 2020 is “Disability and Health,” which specifcally focuses on the health and wellbeing of people with disabilities. According to the most recent U.S Census, about 1 in 5 people in this country have a disability. That’s more than 50 million people! People with disabilities are more integrated into their communities than ever before. Therefore, equal access to all health related services is important. Such services include: medical care, public health activities, intervention/preventative care, dental care vision care and reproductive care. People with disabilities often have more difculty accessing healthcare than their non-disabled peers. As a result, they are more likely: To be overweigh To smoke To have high blood pressure To not exercise To have fewer social supports Having a disability may also put you at risk for developing secondary health conditions, which are conditions that are brought on, in part, due to your disability. Conditions like osteoporosis, or weakening of the bones, bed sores, asthma, cardiovascular or heart disease and arthritis are all fairly common secondary health conditions people with disabilities may develop. While there is no known “magic pill” to prevent the onset of these conditions, making the decision to live a healthier life and get your body moving will help in more ways than one. As you look through this guide, remember changing habits can be difcult. No one expects that you will be a ftness instructor by next week. But, if slowly but surely, you incorporate one tip into your meal planning here and there and a little more movement into your daily routine, you might be surprised at what a diference it makes. As you look through this guide, remember changing habits can be difcult. No one expects that you will be a chef or ftness instructor by next week. But, if slowly but surely, you incorporate one tip into your meal planning here and there and another into your daily routine every once in a while, you might be surprised at what a diference it makes. Disclaimer The information contained in this guide is for educational purposes only and should not replace the care and/or advice of your doctor and healthcare providers. It is important to talk to your doctor before making any big changes to your physical activity levels. This guide ofers health, ftness and nutritional information and is designed to familiarize you with the basics of a healthy lifestyle. It is not medical advice. If you have any concerns or ques- tions about your health, you should always talk with your doctor or healthcare providers. If you think you are having a medical or health emergency, call your doctor, or 911, immediately. Editor’s Note: Having the tools and information to make healthy choices and knowing how to prevent illness are key components of staying well. This guide is intended for people with disabilities who may be considering exercise for the frst time. The majority of the exercise suggestions contained within this guide can be done in the comfort of your own home or neighborhood at little to no cost. Nutrition and Physical Activity Go Hand in Hand Physical activity provides long-term health benefts for everyone, adults and children alike! By being active, you will burn calories. The activity can be walking the dog or some- thing more rigorous such as wheelchair rugby. Staying active may also improve your sleep patterns and prevent serious secondary health conditions like heart disease, osteoporosis (weakening of the bones) or bed sores. Providing opportunities for children to be active early on puts them on a path to better physical and mental health, but don’t worry-it’s never too late to start leading a healthy lifestyle. Here are some facts about disability and physical activity from the President’s Council on Fitness, Sports and Nutrition: • Approximately 56 million people in the US have a disability. • The obesity rate for children with disabilities in the U.S. is 38% higher than for children without disabilities. • The adult obesity rate for adults with disabilities is 57% higher than for adults without disabilities. • Adults with disabilities are physically active on a regular basis about half as often as adults without disabilities (12% vs. 22%). • Signifcant disparities (barriers) exist in access to health care. 29% of people with disabilities have unmet healthcare needs compared to 12% of people without disabilities. Why do these statistics matter? Diet and nutrition are not enough to stay ft. In order to remain healthy, it is critical for all people to adopt both a nutritious diet and an active lifestyle. For more information on ftness visit: www.ftness.gov. LESS THAN 5% of adults participate in 30 minutes of physical activity each day; only one in three adults receive the recommended amount of physical activity each week. Table of Contents Chapter 1: Command Central: Your Body Page 1 Brains… …And Braun No Bones About It Chapter 2: Let’s Get Moving! Page 8 Set Goals: Be Successful “Is That Really Me?” Benefts You Can See Chapter 3: Healthy and Nutritious, Being Active and Eating Delicious Page 20 An Apple a Day: Let’s Talk About Nutrition Be Creative: Designing an Active Lifestyle Don’t Forget! Tracking Your Progress Chapter 4: Mind, Body and Spirit: It’s All Connected Page 28 Living in the Moment Stress Is a Mess: How Are You Feeling? Catch Some Zzzzs: Are You Getting Enough Sleep? The Power of Love Chapter 5: The World Is Your Oyster! Page 32 Couch to Community: Being Active Within Society People Need People Learning from Each Other: Sharing Your Talents Chapter 6: Tools of the Trade: Items That May Help Further Your Success Page 34 What to Use: Adaptive Activity Equipment Sports Chairs and Hand Cycling And Now a Bit on Prevention Saying Farewell… To the Old You Glossary Page 38 Appendices Page 40 Chapter I Command Central: Your Body Your body is where you live. Think about it, not only is your body a physical support structure, it also contains your mind and soul. To be healthier, it is important to exercise both your mind and body. Your body is made up of many parts including bones, muscles, and organs to name just a few. Just as a house isn’t a home until you fll it with things that are important to you; what you do and fll your body with efects how you look and feel. Filling your body with junk food, preservatives, and artifcial ingredients changes you on the inside in ways you might not be able to see. Your organs struggle to process things that are foreign to them and health conditions like diabetes, high blood pressure, heart problems and high cholesterol can silently creep into your life. On the outside, an unhealthy lifestyle can lead to weight gain and skin problems. Did you know that skin is your largest and fastest growing organ? Not only is it your body’s “coat”, but healthy skin is also our frst line of defense against illness and infection! Therefore, you need to be sure to eat cleanly and add a little bit of physical activity into your daily routine in order maintain a healthy appearance from the inside out. Like the skin, your digestive system also plays an important role in keeping you healthy. If your gut does not recognize what you are feeding your body, and you do not provide it with enough water or nutrients, your whole entire body will feel the efects. No one can change their diet overnight, but there are a few quick and easy changes you can make today to start the process. First, make sure your body is getting enough water. Try replacing sports drinks and soda with water this week. Second, try to switch out a few packaged snacks with fruits and vegetables like ap- ples or celery. You will see the phrase “eat the rainbow” mentioned several times throughout this guide; what on earth does that mean? Exactly what it sounds like. The more color fruits and vegetables you bring to your meals and snacks, the better they will be for you. Sugary, salty and highly processed foods are often white! So, try to avoid candies, snacks and drinks that have artifcial colors. By eating healthier foods, the body will absorb necessary nutrients and have more energy. If the body has more energy, physical activity may become easier. Eating healthy and physical activity do go hand-in-hand, and by putting a little of each into your daily routine, you will become a healthier you. Being “healthy” is not just about your physical body, and how it does, or does not function. Health is state of complete physical, mental, and social well-being – not just the lack of being sick. Paying attention to your mental and spiritual health is often the frst step in creating a healthier lifestyle. As an added bonus, doing so does not require you to move a single inch. 1 If you have a computer, car, bike, or even a wheelchair, you try to take care of it so that it will work properly, right? Do you take the time to take care of YOU too? If not, just like an old car you don’t keep up with, your body it will start to stall, break down, fuses may blow and it just won’t “go” like it used to. Why mention this at the beginning of the book? I’ve missed more than Anyone, regardless of their abilities, can take steps to live healthier! 9,000 shots in my career. Yes, even you. You can do this! If you commit to listening to your body I’ve lost almost 300 games. and making small and steady positive lifestyle choices today, the difer- 26 times, I’ve been trusted to ence you see in yourself one month, or even a year from now might sur- prise you. What do you have to lose? Give it a try. “Been there, done that, take the game winning shot doesn’t work”, you say? The most successful people in life fail many, many and missed. I’ve failed over times before they succeed. Focusing on things that make you feel alive and over and over again in my and content can help you to “zero in” on the positives in your life. Over life. And that is why I succeed. time, you can begin to use these positives to slowly “crowd out” some of -Michael Jordan the negatives which might be weighing you down today. Remember, as John Donne wrote, “No man is an island.” No one lives alone in a vacuum. We all depend on each other in one way or another. You have something to ofer the world that no one else does! Don’t hide it. Brains... The brain is your body’s command center. It controls your thoughts, feelings, actions and move- ments. The frst step in creating a healthier you, is to harness the power of your mind. Did you know that your brain releases chemicals into your body that afect your emotions and how you feel? Believe it or not, your diet, exercise and the people you surround yourself with can have a big impact on your overall wellbeing. It is unrealistic to think every day is going to be a great one. In fact, some days are going to be tough, but it is important to remember that if you make it to the next minute, hour or day you are still here and have gotten from where you were, to where you are right now. That is progress! Every day is an opportunity to try something new. Don’t underestimate the power of your mind to get the ball rolling. Many agree with Gandhi, who said, “Your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, and your values become your destiny.” A healthier lifestyle does not have to even involve the gym, though if you can aford a member- ship, gyms can be great places to workout. A healthier lifestyle can often start by taking time out of your busy rushed life to be still and quiet. Although we will discuss all of these points in more detail later on in the guide, here are just a few things you might want to consider as you begin to think about what a “healthy lifestyle” looks like to you: Nourish Your Mind Know what makes you happy - What do you really love and enjoy doing? What are you good at? What relaxes you? What makes you want to get out of bed? When you develop a sense of purpose, you often can look forward to the things to come in life. Take time out of each day, even if only a few minutes, to do whatever it is that gives you a sense of purpose. Stay active - You can gain so much from constantly moving around doing many little things here and there. Most of our older relatives and elders were always moving. A ton of daily “screen time” has replaced movement for most of us if we are being honest. No one expects you to go from watching television for hours at a time to a marathon runner, but you can make small changes over time to increase your physical activity levels every day. Why not try to stretch during commercial breaks, or contracting all of the muscles in your body at 5 counts each until the show comes back on? If physically moving is difcult, or painful, what can you do to keep your brain sharp? Word puzzles, reading, singing, drawing and writing are just a few things that can keep your mind active. What activities can you think of that will help you to stay active? 22 Clear your mind of can’t. -Samuel Johnson Form healthy relationships - When it comes to relationships with others, previous generations did not have the beneft of technology to Strive forge new bonds with others that we often do. If you wanted to get to know for someone, in most cases, you had to interact with them live and in person. We rarely see these types of interactions in our busy lives today. Even though it progress, may be difcult and awkward to do sometimes, studies show that the more not natural support systems and healthy relationships people have, the healthier perfection. they tend to be. It is important for all of us to know that we are not alone on -Unknown our paths of life. Have an Attitude of Gratitude - Try to form the habit of giving thanks for something each day, perhaps once when you wake up and once before going to sleep; if coming up with something every day is too difcult, how about trying once per week? Some people fnd it helpful to write down the things they are thankful for…they start to add up. And, if you are having a bad day, you can look over your list and remind yourself of the positives in your life. It may make you feel better! Write and Journal Your Thoughts - If something is upsetting you, record one thing you are going to do today to address the issue. If you are unable to write or type, there are computer software devices that can help you write from voice to text, or you can record your thoughts on an audio recorder. The day after you write/record a thought, go back and ask your- self, did I address yesterday’s issue? If not, try again today. Write a book, poem, song or make up a story. Again, if you do not have the ability to write or type with your hands, use software like voice to text or an audio recorder. Listen to Music - Music can sometimes be a great stress reliever because it often reminds us of people, places and things. We hear a song and think back to what we were doing while it was play- ing, and begin to relive conversations and experiences we’ve had with family and friends… Not all memories will be good ones, but many of them will be. Nourish Your Body Socializing at Mealtime - Some of the healthiest peo- ple in the world treat mealtime as a social event that can last for hours. In the US, most of us don’t make mealtime a priority. In- stead, breakfast is often skipped in favor of a few more precious minutes of sleep, lunch might be a quick sandwich, burger or snack from the vending machine on the go and dinner a frozen pre-packaged meal you pop in the microwave. There is nothing wrong with quick and easy meals, but sharing a meal together with someone actually has great health benefts. By eating more slowly, you have time to enjoy your food and your body has time to process it. Have you ever noticed that you feel “full” more quickly when you are not in a rush to eat? For some, mealtime is also a great way to catch up with friends and family. For others, the process of planning and preparing a meal is not only fun, but also a great way to get to know someone better than you already do. Having Drinks and Appetizers - About twenty minutes before you eat dinner, take some time to relax, have something to drink and sit down with friends or family. Before the main 3