What people working in end-of-life care have learned

Eventually, we are all going to die. It’s a reality that most people are uncomfortable with and do everything they can to avoid thinking about. But for people who work in end-of-life care, such as hospice workers, death is both a fact of the job and a part of their everyday reality. While the work may sound grim, those who do it say that their daily proximity to death doesn't cast a shadow over their lives; rather, it has enabled them to more purposefully celebrate life’s beauty. “People think hospice nursing is depressing, but it's really amazing because people are so vulnerable, which helps you be vulnerable,” Julie McFadden, a hospice nurse known by millions online as Hospice Nurse Julie, tells Yahoo Life. “You just see love in action.” Yahoo Life spoke to hospice professionals to hear the life lessons they’ve learned by working so closely with death. Here’s what they said. Take care of your health and be grateful for it For many, working with patients in their final days inspires a deeper appreciation for health and how to best preserve it. “After watching the horrible deaths my patients with alcoholic cirrhosis went through, I quit drinking,” says hospice nurse Penny Smith, who co-hosts the podcast Death Happens and manages the popular social media account Hospice Nurse Penny. McFadden says that hearing patients express regret for taking their health for granted motivated her to more fully appreciate her own health in the moment. “People don't realize how lucky they are to not wake up in pain,” she says. "[Some patients] will stay stuff like, ‘I wish I would have appreciated being able to get up and walk and do whatever I wanted to do.’” Keep your sense of humor The end of life can be sad, but those who work with people who are close to death testify to the importance of a sense of humor. “The things that have stayed with me are the moments of joy and humor,” says Halley Harris, a social worker and co-host of the Death Happens podcast. “Like one patient’s T-shirt that they showed me that said ‘Cremation is my last chance for a smoking hot body.’” Others in hospice care say dying patients' regrets have inspired them to seek out more humor and fun in their lives. Dr. Christi Bartlett, medical director of inpatient hospice at the University of Kansas Health System, remembers a patient who was diagnosed with a rapidly progressive cancer. “As she was facing death, she looked at me and said, ‘I should have had more fun,’” Bartlett says. “It felt like a lament but also a challenge for those of us in the room to simply have more fun.” Prioritize your relationships “The biggest lesson I’ve learned is that no one gets through life alone,” palliative care physician Matt Tyler tells Yahoo Life. “In those final moments, the things people say are almost always about relationships. ‘He was a wonderful father,’ or ‘She was the best sister.’ What sticks with me is that we are remembered for who we were to others.” Lisa Pahl, a hospice social worker and co-creator of The Death Deck, a party game that helps people confront end-of-life issues, remembers moments when patients regretted the fact that relationships weren’t their top priority. One relatively young hospice patient who lived alone and had few people in her life stands out. “When we began discussing a plan for when she declines and needs more help, she became teary," Pahl tells Yahoo Life. "She shared that she wished she had spent more time nurturing friendships. ‘Then maybe I wouldn’t be alone now, at the end of my life.’” Acknowledge your mortality — and talk about it Those who work in end-of-life care understand that most people don’t want to talk about death. But they agree that doing it anyway is the best way to make the experience peaceful — not just for the dying, but also for their loved ones. “When I walk into a new hospice patient’s home and there have been open conversations about the fact that this person is in the final stage of their lives, and there’s been some preparation such as making burial plans and completing a will or trust, there is a sense of peace and calmness,” says Pahl. “When the person or family are fearful of the topic of death and dying and have not had these meaningful conversations, there tends to be a lot of anxiety and chaos.” Bartlett says that knowing your loved one’s end-of-life wishes can help avoid a great deal of pain for all. “We see people get stuck in the hospital and on machines that can no longer speak for themselves," she says. "It is incredibly difficult for loved ones to make decisions on their behalf if they never had open and honest discussions about their wishes." Bartlett adds that in those instances patients often end up getting aggressive treatments leading to a quality of life they may not have chosen for themselves. “The people who have made a point to talk with their families about their wishes are much better protected from these unfortunate outcomes, and their families typically feel much better equipped and at peace when it comes time to make hard decisions,” she says. The body knows how to die McFadden says that watching people die has helped her ease her own fears about mortality. “Our bodies are built to die," she says. "They have built-in mechanisms like shutting down the hunger and thirst mechanism so you don’t feel hungry and thirsty at the end of life. Then your calcium levels rise usually, so then you feel really sleepy. People always think it's this big, painful, awful event, but for the most part the actual dying process is peaceful and the body knows how to do it.” Live your life Constant exposure to death has made end-of-life workers evermore grateful for their lives. “Life is for living — don’t wait to start until you’re dying!” says Smith. “Tomorrow isn’t promised for anyone.” Bartlett says that her work helps her to feel gratitude in the moment. “I have stopped with the notion of ‘When I finally XYZ, then I will be happy. There is always something else out there we want to accomplish or achieve and it is easy to miss the most amazing things in the present, while we are waiting for that ‘thing’ to happen. It is critically important to look for and embrace the beauty of exactly where I am right this moment.” Dr. Sunita Puri, author of That Good Night: Life and Medicine in the Eleventh Hour, says that her patients have reminded her that living life isn’t always about being joyful; it’s about experiencing it all. “One of my favorite patients wrote me notes because oral cancer devastated his mouth and throat," she tells Yahoo Life. "I still have the note that says, ‘You cannot have joy in this life without the pain. Embrace both. Thank them both for what they can teach you.' It's a philosophy that I have kept with me ever since.” “We all are going to die. To me, that statement is not depressing,” says Pahl. “When we think about the fact that our time on earth is finite, it can help guide us to live our best lives. I think about the regrets that I hear from people in their final days, and try to live my life with intention and joy.” Source: yahoo life, 9/16/24.

Study Links Walking to Decreased Back Pain

Story at-a-glance Walking is an effective, low-cost intervention for preventing and managing low back pain. Studies show it can significantly extend pain-free periods and reduce recurrence risk by up to 43%. Regular walking is as beneficial as other forms of exercise for chronic low back pain, improving pain levels, disability, quality of life, and fear avoidance. Walking offers numerous health benefits beyond pain relief, including improved cardiovascular health, better sleep, increased resilience, and potential reversal of cellular aging mechanisms. Moderate exercise like walking is more beneficial for longevity than vigorous exercise. Aiming for 7,000 to 12,000 steps daily provides optimal health benefits without risk of overexertion. There’s good news for the 619 million people suffering from low back pain worldwide. Walking, a simple, free exercise, may help prevent back pain and keep it away longer. Effective interventions like this can significantly improve quality of life, considering that nearly 7 in 10 people who experience an episode of low back pain will have another within 12 months. Those who engaged in the walking program, however, were pain free for nearly twice as long as those who didn’t walk, adding even more reason to make walking a regular part of your routine. "Walking is a low-cost, widely accessible and simple exercise that almost anyone can engage in, regardless of geographic location, age or socio-economic status," said study author Mark Hancock with Macquarie University in Sydney, Australia. Five Walks a Week Kept Back Pain Away Longer The study, called WalkBack, revealed that a simple walking program, combined with some education, could significantly reduce the chances of back pain coming back. It involved 701 adults who had recently recovered from a bout of low back pain. Half of the participants were given a personalized walking program and six sessions with a physiotherapist over six months, while the other half went about their usual routines. Those in the walking group had a target of five walks per week for about 30 minutes daily — and they were encouraged to continue walking when the program ended. The walking group saw much better results. On average, they went about 208 days before experiencing another episode of back pain that limited their activities. The non-walking group, however, only made it 112 days before their back pain came back. Further, walking reduced the risk of low back pain recurrence that limited daily activity by 28%, while risk of low back pain recurrence that caused participants to seek medical care decreased by 43%. On a societal level, the researchers also looked at the cost-effectiveness of this approach. For every quality year of life gained, it only cost about $5,257 in U.S. dollars. In the world of health care, that's considered quite cost-effective. "The biggest savings came from less work absenteeism and less health service use among the intervention group," the researchers explained. In fact, the walkers also reported that additional general health benefits they experienced along with back pain relief motivated them to keep walking. Writing in The Lancet, the researchers added, "This accessible, scalable, and safe intervention could affect how low back pain is managed." Walking Works as Well as Other Forms of Exercise to Relieve Back Pain Other research also supports the effectiveness of walking as a treatment for chronic low back pain. A comprehensive meta-analysis published in Disability and Rehabilitation examined five randomized controlled trials comparing walking interventions to other forms of physical exercise. Their findings reveal that walking is just as effective as other exercise types in reducing pain, improving disability and quality of life, and decreasing fear-avoidance in individuals with chronic low back pain. This held true whether the effects were measured after short, medium or long-term follow-up periods, suggesting that walking could be a viable and potentially more accessible alternative to other exercise programs. The benefits of walking extend beyond just pain relief. Studies have shown that incorporating a daily walking routine can have a significant impact on overall health and well-being. Research indicates that taking more than 5,000 steps per day can help prevent or improve chronic pain conditions, while a goal of at least 7,000 steps daily is recommended for cardiovascular health. Ideally, however, strive for 10,000 steps a day. These findings underscore the multifaceted benefits of walking as a form of exercise, addressing not only back pain but also contributing to broader health improvements. This suggests that walking could potentially replace more complex or equipment-dependent exercises in pain management programs, offering a simpler and more cost-effective approach. The use of pedometers provides motivation and can help you increase daily step counts, which could further enhance the effectiveness of walking-based interventions. As research continues, exploring different walking intensities and durations may provide even more insights into optimizing this accessible form of exercise for chronic low back pain management. For example, experimenting with backward walking, which tends to shift your body's center of gravity, can reduce the load on your lower back. This altered biomechanics may provide relief for some individuals with chronic low back pain. Backward walking also eliminates the typical heel-strike to the ground, so it can lead to changes in pelvis alignment that may potentially alleviate pressure associated with low back pain. Source: mercola.com, 8/7/24.

Why People Stay Broke — and 3 Traits that Make People Rich

Ask anyone who is having financial stress and they will agree, it sucks! Financial stress is a huge silent health killer, marriage killer, self-esteem killer and all-around mood killer. This newsletter will discuss the traits that keep people broke and why others excel. If you see some bad behaviors of your own, why not start correcting them TODAY? Three Traits That Make People Poor or Keep People Poor. 1. Not Understanding Cash Flow. If you make $1M and spend $3M you will go broke. It is not about how much you make but rather how your cash flows. Cash flow and profit are the only two financial variables that will determine if you stay in business and if you will become wealthy. If you do not understand how to read and interpret profit and loss, cash flow statements; and a balance sheet now is the right time to learn. 2. Not Saving Enough. The financial gurus recommend saving 10% of your gross annual salary. I like that as a bare minimum. The more you save the better. In order to save properly you need to create and adhere to a strict budget. The compounding of interest over time is what will make you very rich. Start saving early and encourage your kids to do the same. 3. Living Beyond their Means. This is probably the biggest mistake that I see people make. Here is an easy rule of thumb to prevent you from living beyond your means. If you cannot pay cash for the good/product/service and you HAVE to put it on a credit card that means YOU CANNOT AFFORD IT AND DON'T BUY IT! Three Traits That Make People Rich. 1. Endurance. Go read Colonel Sander's (Kentucky Fried Chicken) biography to see what real endurance is. Unless you were born with a trust fund, every single self-made millionaire probably started off much poorer than they are today. To become rich, you have to endure the short-term pain and soldier through until you reach your goal. 2. High Tolerance for Pain. Every successful person probably failed multiple times before they made it. Thomas Edison, Abraham Lincoln, Richard Nixon all failed miserably. They endured ridicule, financial stress, dings to their self-esteem and huge amounts of pain until they reached their goal. 3. Asking For Help. Not many, if any, can do it all by themselves. It is not a sign of weakness to ask for help; it is a sign of strength. You heard it here first. Now go share this newsletter with someone who can use the information. In Gratitude, Paul Source: 911 profit.com, 6/9/24

How to Sleep When You Can’t Fall Asleep

There may come a time in your life when you can’t fall asleep. Insomnia is, unfortunately, a common condition for many people, and most of us will experience it at one time or another. If counting sheep isn’t your cup of tea and doesn’t result in getting the sleep you need, there are plenty of other methods. Keep It Simple If you’ve been lying in bed for a while, but sleep isn’t coming, focusing on it will only make matters worse. Worrying that you’re not falling asleep is counter-productive, and will cause anxiety which most likely will keep you awake even longer. Sleep is something that needs to come naturally and it can’t be forced. Sometimes just not thinking about trying to sleep is all that you need. Calm Your Breathing Insomnia could cause stress and an increased heart rate. Try some deep breathing exercises the next time you can’t sleep. Breathe in slow and steady, hold it for a moment, and then slowly exhale. Focusing on your breathing will not only slow down your heart, but it’ll also relax your body, making it easier to fall asleep. Daily Exercise Keeping your body active during the day could be the answer to your sleeping woes. A small amount of physical activity daily could help you sleep easier at night. Put Your Phone Down Being unable to sleep may cause you to pick up your phone and start scrolling. The light your phone emits is not conducive to sleep and won’t help you to feel sleepy. Checking your social media or playing games will keep your mind awake and engaged. Restrict your phone time to daylight hours or stop using it at least 30 minutes before you go to bed. So, To Get the Sleep You Desperately Need: Focusing on trying to fall asleep could be your worst enemy. It’s better to calm your mind, try some breathing exercises, and resist the urge to pick up your phone. By keeping things simple, you’ll find it easier to fall asleep. I tell my patients to at 8:30ish to take a warm bath or read a good book and to not watch TV which will only stimulate your brain and find it hard to relax. Plus, the blue screen from the TV or your computer will not relax you either. Source: Dr. Todd Singleton, 4/6/24.

15 Habits of Happy People

1. You manage your finances well and live within your means. You have enough money to do everything you want to do. 2. You set and reach goals on an ongoing basis. 3. You always make time for trips or vacations with family and friends. 4. You use your strengths to do what you do best every day. 5. You feel safe and secure in your community. 6. You learn something new or interesting every day. 7. You have someone in your life who encourages you to be healthy. 8. You eat healthy every day. 9. You eat five servings of fruits and vegetables at least four days every week. 10. You go to the dentist at least once per year. 11. In the last 12 months, you have received recognition for helping to improve the city or area where you live. 12. You don’t smoke. 13. You are of a normal, healthy weight. 14. You exercise at least 30 minutes at least three days per week. 15. You are active and productive every day. Source: mercola.com, 3/6/24.

Use of Chiropractic Care Increases by Almost 47%

1) Use of any form of Complementary Health Approaches (CHA) increased from 19.2% of the U.S. population in 2002 to well over a third (36.7 %) of the population in 2022 (approximately 122.3 million adults). 2) Use of chiropractic specifically in the previous 12 months increased from 7.5% of adults in 2002 to 11% in 2022 (an increase of almost 47%). That equates to almost 37 million adult patients. 3) Use of chiropractic for pain management also increased, from approximately 78% in 2002 to 85.7% in 2022. A research letter in the Journal of the American Medical Association (JAMA) provides initial findings from the most recent (2022) survey on the use of complementary health approaches (CHA). The findings include data from the National Health Interview Survey (NHIS), which conducts interviews both by phone and in-person. The CHA results have been published in 2002, 2012 and again in 2022. Seven forms of complementary care are included in the latest study: chiropractic, acupuncture, guided imagery, massage therapy, meditation, naturopathy and yoga. Unfortunately, the results from the 2012 survey are not relevant to the use of chiropractic specifically because osteopathy was included in the survey question that year. The survey asks respondents about their use in the previous 12 months. Use of any form of CHA increased from 19.2% of the U.S. population in 2002 to well over a third (36.7 %) of the population in 2022 (approximately 122.3 million adults). Use of chiropractic specifically in the previous 12 months increased from 7.5% of adults in 2002 to 11% in 2022 (an increase of almost 47%). That equates to almost 37 million adult patients. The use of any form of CHA for pain management also increased, from 42.3% in 2002 to just under half the population (49.2%) in 2022. For chiropractic patients, use of chiropractic for pain management increased from 78% in 2002 to 85.7% in 2022. **With the use of any form of CHA almost doubling (91% increase) during the 20-year period and the use of chiropractic care increasing by 47%, it is clear that the public’s health care preferences are shifting to less invasive forms of care that are not drug-dependent. This is especially true for pain relief. Based on these findings, the chiropractic profession will want to expand its effort to educate more consumers about the benefits of consistent chiropractic care. Source: Dynamic Chiropractic, 1/25/24

10 Ideas to Grow Your Business

I have been coaching small business owners just like you for the past twenty-one years. This gives me the unique perspective and vast experience to help you. This newsletter will outline a few universal strategies to growing any business. My sincere wish is that you implement what is presented. 1. Can you be proactive at least three hours per week? Too many business owners do not want to put the time in to grow their business and guess what? Their businesses don’t grow. Three hours per week is that too much to ask? 2. How was your Thanksgiving? Will you get into “Christmas Head” until January? After all, you deserve a break, don’t you? If you decide to check out for the rest of the year so will your business. Now, please don’t get me wrong. You should take a vacation or many vacations. All I ask is that when you are at work be present don’t day dream about your upcoming vacation. Is that fair? 3. Work smarter not harder. Strategy will crush tactics any day. Here is the problem that I have witnessed over and over ad nauseum. 99.9% of small business owners want the tactic and pay very little to strategy. Take this to the bank…STRATEGY CRUSHES TACTICS EVERY SINGLE TIME! 4. Get new business. This is the key to any business. How many current strategic methods are you using right now? If it is fewer than three you must change that. Do you have a market dominating position. 2024 will demand it from you. 5. Understand how to communicate with people. Your success with prospects, staff, family, EVERYONE depends on your communication skills. 6. Effective presenting is key to leading and landing new business. 7. Time management is an important key to success. If you are not getting a full sixty minutes out of every hour then you are wasting time. Time that you can never get back! 8. Systems allow you to take as many vacations as you want. They allow you to work smarter instead of harder. The problem that I have seen is that most small business owners either don’t want to take the time to create systems or they don’t know how. Fix this problem and watch your happiness and peace of mind soar! 9. Training staff is the difference between a happy stress-free day vs. chaos. 10. Goal setting allows you to create the plan for achieving all that you want. I have seen and continue to see way too many small business owners who do not create goals. Those that do, I have also seen, create amazing businesses and lives. Ten easy to implement steps. Do an experiment. Implement the above for the next six months and report back to me what happens. By the way, after twenty-one years of doing this, I already know what will happen. I want you to experience it for yourself if you choose. You heard it here first. Be sure to share this newsletter with someone who can use the information. Life is too short not to have a dream job or business. In Gratitude, Paul Source: Paul Inselman, 911profit.com, 1/6/24