Healthy Living: Taking Care of Yourself
 
5 Class Hours

OJECTIVES: At the end of this class, you will be able to:

1.   Describe a number of human needs, like physical and emotional needs

2.   Detail the components of physical health.

3.   Detail the components of mental or emotional health.

4.   List ways that you can be healthier physically.

5.   List ways that you can be healthier emotionally.

INTRODUCTION

Nursing assistants and other people who are working in health care must take care of their own mind, body and spirit in the same caring way that they care for their patients. It is known that many people who work in health care do not take very good care of themselves. They take better care of their patients than themselves.

HUMAN NEEDS
 
All human beings are bio-psycho-social-spiritual-cultural beings. We have the following needs:
 
·         Physical needs (bio)
·         Emotional needs (psycho)
·         Social needs
·         Spiritual needs
 
According to Maslow, human needs in order of the most important to the least important and from the highest to the lowest priority are:
 
1.   physical needs (airway, breathing, body temperature, food, housing)
2.   safety and security (comfort and freedom from pain)
3.   love and belonging
4.   self esteem and esteem by others
5.   self - actualization
 
Physical and Emotional Needs
 
The first two (physical and safety/security) are physical needs. The last three (love and belonging, esteem and self actualization) are mental, emotional psychological needs. Meeting physical needs is more important than meeting the emotional needs. We must meet the physical needs of our patients and then take care of their emotional needs.
 
Some of our patients may have very basic, life saving needs like air and good heart function when they have lung or heart disease. Nursing assistants and other people take care of these patients and these very basic needs.
 
Nursing assistants do not tend to have these basic, life saving needs but they do have many other physical needs. Some of these other physical needs are food, water, shelter, exercise and diet.
 
Many of our patients have comfort needs (safety and security). They may be in pain because they broke their leg. They may be in pain because they have a disease like cancer. They may not be comfortable because they have muscle pain or because they can not move side to side in bed. Nursing assistants do comfort measures to help the person to be free of pain.
 
Nursing assistants and other healthcare workers usually do not have these safety and security needs except sometimes and for some things. For example, a nursing assistant may have a head or stomach ache. They may have hurt their leg playing baseball or they may have an infected sore that causes them to have pain. The nursing assistant would take Tylenol or an aspirin for this kind of pain unless the person is in great pain. Most nursing assistants who are very seriously ill and in great pain will take time off from work until they feel better.
 
The psychological needs of our patients can also be very great or they can be mild. For example, a patient with a severe mental disorder has great needs that we care for. The patient may also have less severe needs. For example, a patient may be depressed. They may have stress. They may have a need for respect and esteem by others. Nursing assistants help these patients by letting them express their sad thoughts. They may also help the patient by helping them with stress management and showing them respect and caring at all times.
 
Like our patients, we also have emotional needs. We have stress. We may feel sad and depressed at times. We may not feel loved and respected by others. We must have emotional health like our patients, but are we caring for our self like we care for our patients?
 
Nursing assistants need physical and psychological health in order to care for others. This course will teach you about the many things that you can do to stay healthy.
 
Social Needs
 
People, including our patients, also have social needs. Human beings have a need to be close to other people in their homes and in their community. Some of these people are family members and other relatives. Other people are friends, neighbors, and people who go to the same church or community groups.
 
We encourage our patients to have guests when they are in a hospital or nursing home. We set up groups for them so that they will be with other people. Some of these groups are learning classes, BINGO games, movie nights and exercise classes.
 
Nursing assistants, and others who work in healthcare, also have social needs. It cannot, and should not, be all work and no play. We should all be with other people and other groups of people. We, too, are social beings.
 
Spiritual Needs
 
Human beings, including nursing assistants and their patients, also have spiritual needs. Not all spiritual people are religious. Some people are religious as well as spiritual. Spiritual people see a connection between their own being and the environment, the things they see and the whole universe and things that we do not see.
 
WHY DON’T WE TAKE CARE OF OUR SELF LIKE WE TAKE CARE OF OTHER PEOPLE?  
 
There are probably a lot of reasons why we do not take care of our self. Some of these can be:
 
·         “I am young and healthy. I do not have to do anything special to stay healthy.”
·         “I am just too busy. I work, I take care of the house and the children. I just do not have any time left to cook a good meal or to exercise.”
·         “I am too tired to exercise.”
·         “I do not like to cook and the kids like McDonald’s so McDonald’s hamburgers are tonight’s dinner.”
 
It is easy to get so involved in your job and your home life that you forget to take care of yourself. You forget about how important it is. We have to learn how to take the time to take care of our self. We must not expect so much of our self that we cannot take care of our own needs. We must stop pushing our self to the limits. Ask for help when you need it. Listen to your body. Look for signs of fatigue, stress and anger. Learn how to laugh and have fun. How can you think that you can take good care of others when you do not take good care of yourself?
 
Self-care is not selfish. It’s very important because you cannot take care of others when you are tired, burned out, stressed out or ill.
 
TAKING CARE OF YOUR PHYSICAL SELF
 
 

There are many things that you can do to take care of your physical self. These things are:
 
·         Going to the dentist and doctor at least once a year for care and a physical exam
·         Eat a healthy diet
·         Exercise on a regular basis
·         Get enough rest and sleep
·         Make good lifestyle choices
·         Take your medications as the doctor ordered
·         See your doctor as soon as you feel sick or ill
 
Getting Medical Care
 
Every year you must go to the dentist for a checkup and a dental cleaning. You must also go to your primary care doctor for a complete physical exam and other routine things such as a flu shot, lab work and other gender related care. For example, women should get a mammogram and a pap test. Men should have a testicular exam and a prostate test depending on their age.
 
Diet
 

 
The United States and other groups have food pyramids. One is pictured above. It tells you what foods you should be eating every day. It also tells you how much of each food you must eat every day in order to have a healthy diet. For example, you should eat 3 to 5 servings of vegetables and you should only have 2 to 3 servings of the milk, yogurt and cheese group.
 
All of these food pyramids tell you to:
 
·         Eat lots of fruit, vegetables and whole grains
·         Cut down on sweets, snacks, fast foods, prepared foods, empty calories and salt
·         Avoid saturated fats and trans fats
·         Cut down on foods that are high in cholesterol
·         Eat a number of foods from each major food group on a daily basis. This gives you a balanced diet.
 
You should avoid sweets, snacks, fast foods, prepared foods, empty calories and salt. Sweets do not give you good nutrition. Instead, they will cause you to gain weight. Keep wholesome snacks and drinks on hand, like fresh and dried fruit, yogurt, nuts, cut-up vegetables, low-fat cheese, fruit and vegetable juices and herbal teas.


Fast foods and prepared foods tend to be high in fat, high in salt and high in calories. They also are not as nutritious as home cooked foods. Things that have no value, but have calories, are called empty calories. For example, candy, tea and coffee are empty calories.
 
Salt will cause you to gain weight and it also will affect your heart and blood pressure. Table salt should not be used. A small amount of salt can be used for cooking only. Other spices should also be used instead of salt. Salt is hidden in many foods. It is found in all canned vegetables, frozen foods and other ready to eat foods like the cold cuts that you use on a sandwich for lunch. Even fresh fruit has salt or sodium so it is very important to avoid salt on the table and when cooking.
 
Many busy people eat too much fast food. Working families find “take out” and “fast foods” easier than cooking a meal after a hard day at work. Here are some suggestions to help you to avoid these foods as you drive home from work:
 
·         These foods cost more than cooking the same or better foods at home. Stop eating these foods and use the extra money for something else like a nice vacation for the whole family.
·         These foods empty calories and a lot of fat and salt. Stop eating these foods and you will lose weight and you will have a healthier heart.
·         Form or join a family food exchange with your friends. Each group member could agree to making one meal per week for all of the other members. If you have 5 members in the group, you will have 4 meals per week that you did not cook. This saves you a lot of time and it also gives you good meals for the family.
·         Get organized. Plan your shopping list for the week and prepare and freeze your meals for the whole week on one day. This gives you the other 6 days of the week to have your meals ready to eat. Use the extra time you have on these 6 days to help the children with their homework, to exercise or to just relax.
 
Exercise
Another way to take care of yourself is to exercise. Regular physical activity helps your health and fitness. It also lowers your risk for many diseases.
Fitting regular exercise into your busy day may seem not to be possible but give it a try. The new Centers for Disease Control and Prevention’s (CDC) guidelines are easier than you think. People of all ages must exercise. Even people with a disease or in a wheelchair must do it. The amount and the type that you should get are based on the age of the person. Exercise yourself and encourage your children and other members of your family to exercise.
Encourage your children to exercise by doing things that they like to do. For example, if the child likes to ride a bicycle, have them do so. lf the child likes to do push ups, have them do push ups. Children and teenagers should do three kinds of exercise. A child should do the following kinds and amounts each day.
·         Aerobic exercise. The child should do at least one hour of this kind of exercise each day. Running and walking are two examples. This type is most of the exercise that the child should get.
·         Muscle strength exercise. Push ups, climbing rocks and other gymnastics are examples.
·         Bone strength exercise. The child should do this type of exercise 3 times a week as part of the 60 minutes or more exercise per day. Running and jumping rope are examples of some that most children enjoy doing.
Adults need the following kinds and amounts of exercise each day:
·         Aerobic exercise. 2 ½ hours of moderate aerobic activity every week. Fast walking is an example.
AND
·         Muscle strength exercise for all muscles at least 2 times per week.
OR
·         Aerobic exercise. 1 ¼  hours of fast aerobic activity every week. Running and jogging are examples.
AND
·         Muscle strength exercise for all muscles at least 2 times per week.
 
All of these can be spread out over the week. You do not have to do it all in one day. Break it up into short times, like 10 minutes, a couple of times a day when you have the time. If you never have the time, you must make the time to do it. Skip an hour of TV watching and use it to exercise. You will feel the benefits. You will sleep better. You will feel more fit. You will be happier. You will tone up your muscles and you will lose some body fat. In the long term, your heart, lungs, muscles and balance will remain healthy and your bones will become stronger.

Give it a try. Go for a 10-minute brisk walk 3 times a day, 5 days a week. Do one walk in the morning, one during your lunch hour at work and one after work. This will give you a total of 150 minutes activity each week.

 
These are some examples of moderate effort things:
 
·         Walking fast
·         Doing water aerobics
·         Riding a bike on level ground or with few hills
·         Playing doubles tennis
·         Pushing a lawn mower
 
These are some examples of heavy effort things:

• Jogging or running
• Swimming laps
• Riding a bike fast or on hills
• Playing singles tennis
• Basketball

These are some examples of things that make your muscles stronger:

• Weight lifting
• Working with resistance bands
• Push ups
• Sit ups
• Heavy gardening (i.e., digging, shoveling)
• Yoga

 Sleep and Rest
 
Your body needs sleep and rest. Sleep is necessary in order to keep your body and mind in healthy condition. Sleep is just as important as food and water.
 
When you do not get enough sleep and rest you will be:
·         tired, 
·         at greater risk for accidents,
·         less useful at work and in your own home,
·         moody and
·         less able to focus on what you are doing.
 
Sleep helps your memory, concentration, decision making, learning and mood. Tired drivers are a major cause of auto accidents in our country. Driving without enough rest causes drivers to drive like they have drank too much beer or alcohol.

Sleep also helps our nervous system, our growth and development as well as our  immune system. Sleep restores our ability to do nervous system activity like thinking and learning. Sleep helps our immune system so we can fight off germs like the common cold. Sleep helps a new baby to grow to a young child and then to grow to become a teenager and adult. Growth hormones are released during sleep. Without sleep, we do not grow.

 
You will become sleep deprived when you do not get enough sleep. It can be a short term problem or it can be a long term problem. For example, you may have a short term problem with sleep when you bring your new baby home or when you stay up all night with an ill child or family member. It can also be a long term problem if you, yourself, are ill with a serious disease or you work long hours and have a lot of other responsibilities at home. These long term sleep problems can lead to diabetes, obesity, high blood pressure and heart disease
 
Some of the signs that you are not getting enough sleep are listed below.

• You have trouble waking up in the morning.
• You are not doing well in your job.
• You are clumsy and you have accidents.
• You have trouble thinking and making a decision.
• You can not focus on what you are doing.
• You fall asleep when you should be awake.
• You are moody and have a short temper.

Some people need more sleep than others. Some may do well with only 6 hours of sleep. Other people may need at least 8 hours of sleep to be well rested and without any of the signs of the lack of sleep.
 
Some people need less sleep because the quality of their sleep is very good. Others need more sleep because of their genetics or the poor quality of their sleep.
 
You know if you are getting enough sleep when you wake up rested and you do not have any of the signs above. Generally speaking, these age groups need this amount of sleep each day.

• Infants- 16 hours
• Toddlers- 10 to 14 hours
• Children from 3 to 6 years of age- 10 to 12 hours
• Children from 6 to 9 years of age- 10 hours
• Children from 9 to 12 years of age- 9 hours
• Teenagers - 9 hours
• Adults- 7 to 8 hours

Sleep is controlled by our internal body clock. This clock knows when it is day or night. Human beings are day time active and night time sleepers. Bats are night time active and day time sleepers. Deer are dawn and dusk active and both day and night time sleepers. Human beings should, normally, fall asleep at night unless of course they work the night shift.
 
Sleep Cycles
 
You go through cycles of sleep when you fall asleep. You move back and forth between deep sleep, which restores your body and mind, and light sleeping, which is when you dream.
 
There are two main types of sleep. They are REM and non REM. REM stands for  Rapid Eye Movement sleep. The person’s eyes actually dart back and forth very quickly during this stage. The person also dreams during this stage. Non REM sleep is deep sleep. The eyes do not move back and forth in this stage.
 
Deep sleep is a little bit more important to human beings than light sleep. REM sleep, or dream sleep, helps our mind and brain. Deep sleep restores our bodies. If you lose deep sleep, your light dream sleep will decrease so the body can catch up on the deep sleep.
You can get better deep sleep when you make your sleeping area as comfortable as possible. You should try to keep it noise free.
 
Some people have trouble falling asleep. Others have a problem with  staying asleep. Some of the things that you can do to get enough sleep are listed below.
 
·         Go to bed and get up at about the same time every day.
·         Keep your bedroom comfortable and noise free.
·         Do not use the bedroom for things like work. Keep it for sleep.
·         Try night time routines like a glass of warm milk or tea without caffeine.
·         Do not exercise around bedtime. Finish your exercise at least one hour before your regular bedtime.
 
Sleep Disorders
 
Some people have a sleep disorder. If you have one, get it treated. Some of the sleep disorders are insomnia, sleep apnea, restless legs syndrome, and narcolepsy.
People with insomnia do not get enough sleep because they can not fall asleep or they can not stay asleep without waking up and staying up. Insomnia is the most common sleep disorder.
Many things, including some things that can be easily fixed right away, can cause it. For example, a person may have it because they drink too much caffeine as found in coffee and soft drinks. This is easy to fix. Simply stop drinking these things and the problem may go away.
 
Other causes can be fixed with a little bit more work including help from the doctor. For example, the cause may be depression or stress. Managing the stress and getting over the depression needs more work than just stopping the coffee. At times, the problem may last a long time. It can be caused by emotional  problems, a physical problem, some medications and other sleep problems like sleep apnea. Depression and anxiety are the most common causes.
 
Some of the things that you can do are listed below.
 
·         Look at the things that you are doing. Change those that must be changed. For example, do not drink coffee and alcohol before sleep.
·         Do NOT take a daytime nap. Taking a nap will make it harder to fall asleep at bed time.
·         Do not smoke before bed time.
·         Go to bed at about the same time every night.
·         Have quiet time rather than surfing the internet or watching TV.
·         Make your bedroom quiet, dark, and comfortable.
·         When you think of bed time, think of sleep and not a fear about being able to go to sleep.
·         Get out of bed if you cannot sleep. Do not toss and turn. Get up and take a warm bath or a warm cup of caffeine free tea until you are sleepy enough to go back to bed.
·         Turn your clocks around so that you cannot see them. Watching the minutes roll by only increases your stress when you cannot sleep.
·         Be positive. Do good self talk. Say things to yourself like, “ I will be able to sleep well with practice. I can get over it by doing some things.”
·         Use relaxation tools like those listed below. For more information about stress management and relaxation, take our Stress Management course.
 
Relaxation tools include: 

• Guided imagery
• Visualization
• Yoga
• Deep breathing
• Progressive muscle relaxation
• Meditation
• Tai chi

Practice these techniques and use them often.
 

 
There are some “over the counter” natural pills that may help you to sleep. You do not need a doctor’s order but you must be aware of the fact that these may interfere with other medicines that you are taking. So, check with your doctor or drug store before you take them.
 
Two natural things that can help you to sleep are melatonin and valerian. Melatonin is a natural hormone that controls the sleep and wake cycles. It helps quite a bit, especially if you are a “night owl”. Valerian is an herb. It helps people to sleep better.
 
Sleeping pills should be avoided. They should only be used for a short period of time. They should not be used for the long term. Long term use can only make the problem worse. Changing habits and doing other things like stress management are much more helpful over the long term.

Another sleep problem is sleep apnea. In Latin, “a” means without and “pnea” means breath. (If you want to learn more medical terminology, take our course titled “Medical Terminology”). So, the term “sleep apnea” means sleep with no breathing. Many people have it and they do not even know it. It can be a serious problem. In addition to breaking up one’s sleep, the person can get health problems as a result of it. It can be caused by a number of things including heart failure, weight gain, and narrow breathing passages when the muscles of the throat and mouth relax during sleep.

A special machine (CPAP) and a mask are used to treat it if the airways are narrow or collapse during sleep. This machine blows room air into the person’s mouth and throat to widen the airways during sleep so the person will continue to breath while they are sound asleep. The person should lose weight if the apnea is a result of a weight gain. Surgery may be needed if the problem is very bad and no other treatment helps.

It is often the person’s bed partner (wife, husband, boyfriend, etc.) that notices the sleep apnea and its signs before the person does. The person will snore and gasp during sleep. The person will also be very tired during the day because they have not gotten a good night’s sleep. The “no breathing” times can be very frequent and for long periods of time. The person’s oxygen levels may drop to very low levels.

Restless leg syndrome also robs people of their sleep. The person will have leg aches, pains, and a “creeping along” sensation that seems to start at the lower part of the leg and then travels upward.
The person may have trouble falling to sleep unless they walk or kick their legs. There are medicines that can help this nervous system problem. The person should see their doctor if this problem is hurting their sleep.

The last of the 4 most common sleep problems isnarcolepsy. The person with this problem is very sleepy during the day even when they had a “good night’s sleep” the night before. The person will also have sudden muscle weakness. The person’s may fall asleep at work, during a very important meeting, and other times. The author of this course knows a person who falls asleep driving a van full of prisoners as a sheriff. Many people with sleep apnea also have this. It probably will go away when the apnea is corrected. Others may have to take planned naps and/or take special medicines.

Lifestyle Choices

Human beings have the ability to make decisions. They have freedom of choice. Some of the choices that we make are good ones. Others are not good. For example, we can choose to use safe sex practices to avoid sexual diseases like AIDS/.HIV and hepatitis. And, we can choose to use illegal drugs even though we know that they can not only be deadly and interfere with your life and job, but they can also put you in jail.

Healthy living habits mean that we have to make good choices. We must make good choices in terms of:
 
·         Diet
·         Exercise
·         Drugs
·         Sexual practices
 
Two of these choices (diet and exercise) have been previously discussed in this course. Drugs and sexual practices will be learned now.
 
Many substances are considered drugs. For example, there are:
 

• prescription drugs, or medicines;
• over the counter drugs like aspirin;
• illegal drugs like cocaine; and
• legal drugs like coffee, alcohol and tobacco.

 
All drugs have an effect on the human body. For example, a blood pressure pill will lower your blood pressure and an aspirin will lower your temperature when you have a fever. Coffee will wake you up in the morning; alcohol will relax you. Cocaine will give you a pleasant feeling.
 
Drugs also have side effects. Some of the side effects can be bad for your health. For example, coffee over time will raise your blood pressure. Aspirin over time may cause bleeding. Sleeping pills may cause you to be so tired in the morning that it makes you an unsafe driver.
 
Drugs also interact with other drugs, natural substances and even foods. For example, alcohol and a sleeping pill can be a deadly combination because each one makes the other one more powerful than it could ever be when it is taken alone. A sleeping pill must never be taken with alcohol for this reason. Some drugs also interact with natural things like vitamins, herbs and “over the counter” medicines. For example, the effects of blood thinner pills will decrease if the person takes vitamin K and foods that have vitamin K; and antacids may interfere with the effects of many doctor ordered pills. Cholesterol and heart medicines often interact with grapefruit and grapefruit juice. You must check to see if any drugs that you are taking, or using, interfere with other things before you mix them.
 
Prescription drugs, or medicines, should be taken only with an MD order. They should also be taken exactly as the MD orders. Do NOT give, lend or sell any of these drugs to other people. Also, do NOT ever take a pill that your doctor did not order for you. Today, many people are addicted to, and sell, MD ordered drugs on the street as a drug dealer.Over the counter drugs should also be used with caution and only when necessary. They can lead to very severe health problems. They are NOT harmless.
 
Illegal drugs like “pot”, cocaine and “meth” should neverbe used. They should not even be used at all! They can lead to addiction, health problems, legal problems, job problems, money problems and even death. Below is a table of some illegal drugs and the signs of their use.
 

 
Tobacco use is dangerous. It can lead to problems like cancer, heart and respiratory problems. It can also cause problems in new born babies when the mother smokes. For example,  the baby can be a low birth weight baby. Alcohol and illegal drugs also cause problems with new babies. For example, the baby may be a cocaine addict when they are born.
 
You should try to quit smoking if you do smoke. Here are some websites that can help you to quit.
 

• Smokefree.gov 
  A Web site dedicated to helping you quit smoking.
• 1-800-QUIT-NOW 
  A free, phone-based service with educational materials and coaches that can help you quit smoking or chewing tobacco.
• Help for Smokers and Other Tobacco Users 
  Booklet that tells you about ways you can quit.
• I QUIT! What to Do When You're Sick of Smoking, Chewing, or Dipping
  A booklet that will help you quit all tobacco products.
• Pathways to Freedom: Winning the Fight Against Tobacco
  Guide that addresses tobacco issues specific to African Americans.

·         Quit Tobacco—Make Everyone Proud 
A Pathways to Freedom
 

• Questions and Answers About Smoking Cessation 
  A fact sheet from the National Cancer Institute.
• Quit Smoking 
  Tools and guides to help you quit smoking.
• Quit Tips
  Five tips to help you quit.
• Tobacco Cessation—You Can Quit Smoking Now! 
  The latest information to help you quit from the Surgeon General's Web site.
• You Can Quit Smoking
  A consumer guide to help you become tobacco free.
• American Cancer Society 
  Guide to quitting smoking.
• American Heart Association 
  1-800-AHA-USA1
• American Legacy Foundation—Quit Plan 
  A 5-day plan to get ready to quit.
• American Lung Association 
  1-800-LUNG-USA

Healthy sex practices are also important to health. The choices that we make, again, can be good or bad. We make good choice when we use safe sex practices to protect our self from disease and an unwanted pregnancy. We make poor choices when we do not use a condom during sexual activity. This places us at risk for diseases such as AIDS/HIV, hepatitis and other STDs.  It also places us at risk for an unwanted pregnancy.
 
Examples of STDs are:
 

• herpes
• syphilis
• gonorrhea
• chlamydia
• trichomoniasis
• papillomavirus
• pelvic inflammatory disease
• vaginitis
• cervicitis
• Bartholinitis
• HIV/AIDS, and
• hepatitis

 
Some of the signs for some of these are below.
 
Syphilis
 

• Primary stage- sores called chancre(s)

• Secondary stage- fever, weight loss, jaundice, rash, patchy loss of hair

• Latent stage- no signs

• Late stage- tumor like mass, paralysis, lack of coordination, confusion, bad judgment, and slurred speech

 
 
Gonorrhea
 

• Men- urine pain and burning, frequency, white, yellow or green penis discharge, and painful, swollen testicles

• Women- yellow or blood vagina discharge, urine pain and burning, feeling of fullness in the stomach and bleeding with intercourse

 
Chlamydia
 
·         No signs at times.
 
·         Female- vagina discharge, burning with urination, irritation, bleeding after sexual intercourse, lower abdomen pain.
 
·         Male- urethritis
 
Trichomoniasis
 
·         Females- foul smelling, yellow or green discharge and itches
 
·         Males- urethral discharge, urgency, burning with urine and during ejaculation.
 
Herpes
 
·         Vague signs like vaginal or urethral pain and others such as a sore on the vagina or external area of males.
 
Human Papillomavirus
 
·         Warts
 
 
Take your medications as the doctor ordered. If you have an illness or a health problem, and the doctor orders medicine or a special diet, make sure that you do what the MD says, You can not be healthy if you are not treating a health problem. On the other hand, you can be healthy if you control your illness. For example, people with diabetes can be healthy if they take their medicine, eat a special diet, and check their blood sugars.
 
See your doctor as soon as you feel sick or ill. If you do not see the MD, whatever you have can get worse and you may also spread some things to other people, including the people that you take care of. Also, do not care for others if you can spread an illness to them.
 
How to Make Better Life Choices
 
You must make a plan in order to make better choices. Do these 3 steps so you can have a simple plan:
 
1.   Find the areas of your life that you would like to change. Know the reasons why this change is important to you.
2.   Firmly pick actions you will take to do the change.
3.   Do these actions every day so you can get to your goal of a healthier and more positive life style.
 

 
Your plan must be SMART:

• Specific to you
• Able to be measured
• Achievable
• Relevant
• Timed

This should help you to have a better and healthier life. Everyone can have a  better lifestyle when they are positive and always working towards this goal.
 
TAKING CARE OF YOUR EMOTIONAL SELF
 
You can take care of your emotional health by:
 
·         Managing your stress
·         Managing other emotional problems like depression and
·         Getting professional help when you need it
 
 
 
You must manage your stress before it manages you.
 
 

 
Stress is a reaction to some change that upsets our balance. Stress is a reaction to physical or mental changes in our life.
 
Some physical things that cause a stress reaction are:
·         a cut, scrape or burn on your finger
·         any illness or disease
 
Things that upset our mental balance and cause stress are:
·         driving in traffic when you are in a hurry to get to work
·         having to finish patient care in time to attend an inservice class
·         a conflict with a family member, your boss or your co-workers
 
Some stress is good for us and some stress harms us. Good stress helps us to cope with changes inside and outside of our body. Human beings would not breathe if they were not stressed. The stress of rising carbon dioxide in our body makes us breathe. Breathing is automatic because of stress. Without good stress, human beings would not be able to breathe, learn or go to work.
 
Stress is a natural way for us to cope with changes so we can keep in balance. It also helps us to avoid danger. When the human race was living in caves, we had to escape dangers like wild lions and tigers.
 
Stress helped us to escape when we were faced with these dangers. It made our:
·         eyes more able to see the lions and tigers
·         muscles tense and strong so we could run from the lions and tigers
·         heart pump more oxygen so we could be stronger and able to run
·         mind much more alert so we could plan a way to get back into our cave and not be killed by the lion or tiger
 
Our body does the same thing today when it is stressed. There are no longer lions and tigers running in our streets, but when we get stressed while we are stuck in traffic we react the same way. We react as if tigers and lions were running after us, even when they are not. This reaction is not good. Our minds and bodies will suffer if we are under a lot of stress for a long period of time.
 
We must manage stress. We have to learn how to change our lion and tiger reaction to one that is more healthy. Stress will never go away but we can change how we RESPOND to it. We must learn how to manage it before it manages us and makes us sick and unhappy.
 

 
The key to coping with stress is to identify the causes of stress in your life and then learn healthy ways to deal with them. It's important to remember that stress comes from OUR responses to stressful events. Therefore, you have some control over stress and how it affects you.
Stress Is a Killer

Many people believe that stress causes more than half of all diseases. Stress leads to physical damage and illness. It also hurts our quality of life. It causes mental and social problems.
 
Stress causes these physical problems:
·         high blood pressure
·         heart attacks
·         ulcers
·         headaches, neck pain and back aches
·         colds
·         allergies
·         asthma
·         weight gains or losses
·         fatigue
 
Some of the mental problems caused by stress are:
·         loss of sleep or sleeping too much
·         anger
·         low self esteem
·         no energy
·         sadness and depression
·         moodiness
·         lack of an ability to focus, or concentrate, on things
 
Stress also causes these social and work related problems:
·         conflicts with others
·         over-reactions to normal, everyday things
·         lack of interest in one’s usual activities
·         loss of family and friends
·         losing a job
Why Do Nursing Assistants and Health Care Workers Have So Much Stress?

 
Nursing assistants, nurses and most other people have a lot of stress in their life. Today, we live in a very fast paced and complicated world. We have to do many things every day. We get stress from our home life, our work life and our private life.
 
We have to work, be a mother or father, be the child of a parent that may need our help, be a wife or husband, be an active member of our community within our schools, church or another group. We wear many hats. We have many roles that we have to do. We juggle all of these roles every day but we only have a certain amount of limited time to do it. Life is not easy.
 
Nursing assistants are NOT the only ones with all of this stress. Many other jobs have the same amount of stress. The secret to success in managing stress is to MANAGE IT BEFORE IT TAKES CONTROL OF YOU.
 
How Can I Manage Stress?
 
Stress will never go away. We have to get rid of it completely or change how we react to it. The first steps in managing stress are:
Identify the source of the stress. Where is the stress coming from?
Decide if you can get rid of the source of stress. For example, if you are stressed because you are cooking all the meals for the family in addition to working a full time job, you should decide if you can get rid of the cooking and/or get rid of the job.
 
Get rid of all the stress you can. Get other members of the family to help cook meals. Cut up the food and get it ready before you go to work so that another member of your family can simply cook it for you.
 
Do NOT take on more stress by saying yes. Learn how to say no. Do NOT take on more than you can handle. Say no whenever you can. Say no when someone asks you to do something you do not want to do. Say no to things you cannot do because you have too much to do already. Free yourself from stress by saying no.


 
Change how you think about something that stresses you. Which stress is worse, not having hot water to get a bath or hearing that you have a fatal disease? Yes, the terminal disease is far worse than not having enough hot water. Why then do we react to the lack of hot water as a big thing? We react because we allow our mind to make small things into big things. We must step back and look at things in a realistic way. Not having hot water is a little thing that will last only for a short time. Do NOT make an ant hill into a mountain with your mind. If you let your mind make everything a mountain, your body and mind will react as if real danger is present, like the attacking tiger or lion. This reaction will cause unnecessary, physical, mental and social damage.
 
Be good to yourself. Use stress management skills every day to deal with the stress that you cannot get rid of. Use stress management skills when your mind is not able to make the stress small! Some great stress management skills are discussed below.
 

 
Stress Management Skills
 
·         Express your feelings. Talk to someone or yourself about how you feel. Do not hold feelings inside. Talk to a family member, friend, counselor or co-worker. If you do not want to talk to someone else, write your feelings and thoughts in a journal or draw a picture of how you feel.
 
·         Focus on one thing at a time. Take a big project and break it up into small pieces or steps. Do NOT let yourself get overwhelmed.

·         Take a vacation in your own home. Plan a vacation at home. Buy fresh flowers with a beautiful scent. Spray your pillow and sheets with a nice fragrant cologne. Light scented candles. Do a hobby. Paint, do arts and crafts. Treat yourself to something nice that you will enjoy. Buy yourself a present. You deserve it!

·         Use time management skills. Set goals and deadlines that you can meet. Do not set unrealistic goals. Decide on what the priorities are. Focus on the priorities and budget your time.
·         Relax. Do the 2 Minute Relaxation during your lunch break, at home in your bed or in a quiet park. Close your eyes. Think only about yourself and your breathing. Take a few deep breaths and exhale slowly. Loosen up tense and tight areas of your body. Let go of all your tension. Rotate your head in a smooth, circular motion. Let all of your muscles completely relax. Relax and think pleasant happy thoughts while you are taking deep breaths. You should feel very relaxed and limp when you do this. Do the 2 Minute Relaxation several times a day! It works!
·         Do guided imagery & meditation. Close your eyes. Relax. Think about a peaceful image like the beach with softly breaking waves on the seashore. Hear the sounds of the sea gulls. Guided imagery and meditation releases tension, anxiety, and stress. Try soft and pleasant music to help get you into the mood for meditation and guided imagery.
·         Eat a healthy diet. You can increase your resistance to stress and remain healthy when you eat a diet that is complete with all the food groups. Eat a variety of whole grains, vegetables, and fruits. Do NOT consume a lot of caffeine. Avoid alcohol and tobacco.
·         Exercise. Physical exercise is a great stress buster. Join a gym. Walk, swim, ride a bicycle, run or do yoga or Tai Chi. A walk is free. It costs you no money. Almost everyone can walk. Exercise makes you feel great. It improves your mood, lowers your blood pressure and your blood sugar. Exercise every day.

 
·         Keep a positive attitude. Believe in yourself. Accept the things you cannot change.
·         Talk to yourself. Tell yourself that you are great. Tell yourself, "I am relaxed at work"; "I am doing a good job"; "Peace fills my life"; "My life is so full of so many good things"; "I am successful". The more you tell yourself these positive things, the better you will feel. It works, try it!
·         Get enough rest and sleep. Your body needs rest and sleep to combat stress.
·         Treat yourself to comfort food. Cook a meal that your mother used to make for you. Enjoy it.

·         Use humor. Laugh, tell jokes and let yourself be silly once in a while. Watch a funny video, with popcorn of course. Keep a sense of humor even when things are very stressful. Humor is great medicine for the mind.
·         Have FUN. Yes, have fun! Play with the dog, play the piano, do a favorite hobby.
·         Set realistic goals. Do NOT take on more than you can handle. You're not a 'superman' or a 'wonder woman'.
Use these stress busters at work. Have a network of friends at work. Set priorities. Ask for help when you need it. Use humor when it is appropriate. Focus on the patients' good outcomes. Go to your employee assistance program director when you need this kind of help.

Stress is natural part of everyday life. The life of a nursing assistant is a very busy one with little time left to take care of you. Take the time to take care of yourself. Use the stress management skills that you learned in this class. Use them EVERY day!
 
The second thing that you must do in order to stay mentally healthy is to get professional help when you need it. Many work places have employee assistance programs that can help you. If not, go to a person in your own community.
 
Some of the most common emotional problems that otherwise healthy people get are:
 
·         Depression
·         Grief
·         Bi-polar disorder
·         Panic and anxiety attacks and
·         Uncontrolled anger
 
These problems are like any other health problem. There are many causes and they can all be treated so that the person can live a near normal life. Many can be helped with medicine, therapy and other treatments.
 
There are many things that you may have heard about these problems that are not true. Some of these are listed below.
 
·         The person has a mental problem. We should not be mean and call them things like “crazy”
·         It is not caused by a weakness.
·         The person cannot just “pull themselves” out of it. They need help.
·         People will not always be ill. They can be treated just the same way that people with a heart disease can be treated. Many can live a full life when they are treated.
·         These people are not always violent.
·         Children, as well as adults, can have a mental illness.
 
You should know about some of the warning signs of a mental illness. These are:
 
·         Thinking that is not clear
·         Abuse of alcohol or other drugs
·         Seeing things that are not there
·         A lack of ability to cope
·         Changes in your daily routines
·         Mood swings
·         Fears and worries
·         Lasting depression
·         Thoughts of killing yourself
·         Withdrawal from family and friends
 
Depression is probably the most common one. Some people get depressed for a short period of time because of some known event. For example, the person may have just lost their wife or husband.  This can usually be resolved by the person without any medicine or an MD’s help. However, some people may get depressed for a long period of time. You must get an MDs or mental health professional’s help when you are depressed and it continues over a long time. This mental health disorder can be treated with therapy and medicines if it is needed.
 
Grief is a little different from depression. Grief is a normal response to a loss or a change in your life that is not good. For example, a child may have grief when the family pet dies and a nursing assistant may grieve when a parent dies or they get a divorce. We must be able to face the loss and deal with the feelings when this happens.
 
Some of the feelings that you may feel are anger, fear, guilt, shock, denial, loneliness and helplessness. Some of the things that you must do are:
 
·         Express your feelings. Do not hold your feelings in. Talk to someone about your feelings. Write them down in book.
·         Accept the help of others like your family and friends. You may even want to speak to people in your church and a member of the clergy.
·         Get professional help when you need it.
·         Be good to yourself and take care of your body.
 
You may also want to go to a support group near your home. For example, you may want to go to Parents Without Partners when you have gotten a divorce. And, you may want to go to Mothers Against Drunk Driving when you have lost a child in a bad auto accident that was caused by a person that was drunk.
 
People with a bi-polar disorder will have it for life, however, they can be treated and live a normal and healthy life. The person will have periods of depression mixed with periods of mania or hyper-activity. This disorder will not interfere with the person’s life as long as the person continues to be treated by their MD.
 
Panic and anxiety attacks, like depression, may be short lived or long term. At times, people have to seek the help of the MD. Therapy and medicines may be needed. These people may have a lot of fears. They may also be nervous about a lot of things.
 
Uncontrolled anger is also a big mental health problem. Anger is an emotion that can be very mild or very strong at times. It can be a mild feeling of not liking something, or it can be a strong feeling of rage and great anger. It is more than just not being happy about something. It goes beyond that state to a state of being annoyed. It is one of the most poorly managed of all of our feelings.
 
Everyday, we read about and hear about crimes of anger. Everyday, we hear the news on the TV about anger, hatred and acts of violence. We hear about violence in the home, “hate crimes”, shootings in schools and things like "road rage". We live in a time where it seems that things are out of control. People of all ages go to jail for crimes of anger.
 
Anger can touch the lives of all people at all ages. Young children bully and threaten others in their schools and in their own back yards. Some children that have been bullied suffer greatly and they may, at times, “get even” with the bully by going into their school and killing the bully, teachers, and other people that they do not like. This kind of thing must stop.
 
Young adults and teens go into gangs and other groups that say that it is OK to act out on anger. Some of these young people even kill others for bad things that were said to them or to “even a score”. Teens have also been known to kill their own parents. For example, a teen age girl may kill her parents because they do not want her to date the boy that she loves or because they do not let her stay out late.
 
Adults may act out their anger on their wife or husband. This is called domestic violence. Old people may act out on their anger because they are confused or because they just do not like the person that lives in the same nursing home.
 

 
 
Anger results when there is a gap between what you expect and what you get.
 
Some go into relationships with a big list of things that they want. But, as we all know, many of these things can not be done. Problems happen when we want a lot of things and we do not get them. Some of the things that we often want may not even be possible. For example, we may want our child to get an “A” in math, but it may not be possible because the child may not have the mental ability to get an “A”. You will, then, have to be happy when the child tries their best and gets a “C”.
 
Anger will go away when we expect little or nothing from others.
 

Anger Can Help Us or It Can Hurt Us

 

Anger is both good and bad. It is not the feeling that causes harm, it is how you act on it that causes the harm. Some of these things can be a crime like murder.
Anger helps us to live and adapt in a changing world. It helps us to learn. It helps us to solve problems. It helps us to move toward our goals and to solve out problems. But, it also hurts us.
It hurts us, and others, when it is not in control. Some people get more angry than others. Some may get out of control more than others do. Even when 2 people have the same thing happen to them, they may have different amounts of anger about it. For example, one nursing assistant may not be angry at all when a patient tells them to “go to hell”. But, another nursing assistant may hit the patient and tell them to “go to hell”.
People that get very angry tend to be less able to deal with problems than those that deal with anger in a better way. Things just bother them more than they do with other people. These angry people will become “grouchy” people over time and they will also start to stay alone and away from other people, and/or, other people will stay away from them. They will then be very lonely.  

Anger Can Be Good

 

 
Anger is good when it helps us to:
 
·         learn,
·         solve problems
·         adapt to the world,
·         NOT feel helpless, and
·         change things, including the world.
The world would not be the same with out anger. For example, the right for women to vote, equal rights for all people and ending slavery would not have happened unless people got angry and decided to change things.

 Anger Can Also Be Harmful and Bad

Anger can lead to heart disease and other physical problems. Anger also leads to:
 
·         negative words to others like yelling and cursing;
·         physically aggressive behaviors like breaking dishes and
·         hitting others;
·         drug use; and
·         damage to our relationships with others.
 
You must learn how to deal with your anger. "When angry count to ten. When very angry, count to 100." (Thomas Jefferson)
 
When you feel angry, ask yourself these 4 questions:
 
1.       Is it important enough to be angry about it?
2.       Is the anger appropriate to the situation? 
3.       Is there any way that you can change the 
          situation?
4.       Is the situation worth the anger?
 
If you answer "yes" to all 4 of these questions, then you should deal with the anger and the situation. If you answer “no” to any of them, then the best thing to do is change how you feel.

The best and most healthy way to deal with anger is to express it in a good way that does not hurt others in any way. We must be able to think clearly when we express our anger in an assertive way that is NOT aggressive. We must be able to talk to other people about our own needs and opinions. You can not demand and you can not be pushy. Speak about your own feelings. Do not speak about what others did to you.
 
You must do this in a way that does NOT hurt others. For example, do not say, “You did not clean the kitchen at all today. You are a real slob.” Instead, say, “I get upset when I am at work all day and the kitchen is not clean.”
 

 
One of the best ways to manage stress, depression and other mental problems is to have a positive attitude. You can say that “today is going to be a great day” and that will help you do feel good and do well. Or, you can choose to say, “today is going to be a very bad day.” This will lead to a bad day for sure.
 
Having a good attitude will make you look good, do well, feel better and help you to be much more successful than a bad, negative attitude. A positive attitude can lead to good health and a longer, happier life.
 
SUMMARY
 
Nursing assistants and all other human beings must take care of them self. This self care is even more important for nursing assistants, and others in health care, because they have to care for others. Mental and physical health are very important. It takes effort and daily work to maintain the state of healthy living. 
 
Copyright © 2010 Alene Burke
 
REFERENCES
 
Brody, Jane. (2008). “Caring for Family, Caring for Yourself.” New York Times. http://www.nytimes.com/2008/11/18/health/18brod.html?_r=2
 
Centers of Disease Control and Prevention (CDC).(2010). “Nutrition”. http://www.cdc.gov/nutrition/
 
Centers of Disease Control and Prevention (CDC).(2010). “Physical activity for everyone.” http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html
 
Centers of Disease Control and Prevention (CDC). (2010). “Sexual Health”. http://www.cdc.gov/sexualhealth/
 
Centers of Disease Control and Prevention (CDC). (2010). “Sleep and Sleep Disorders: A Public Health Challenge.” http://www.cdc.gov/sleep/
 
Centers of Disease Control and Prevention (CDC). (2010). “Smoking and Tobacco Use.” http://www.cdc.gov/tobacco/
 
Fitzwater, Evelyn L.  (2010). “Tips on Caring for Yourself as You Care for Others”.http://www.netwellness.org/healthtopics/aging/faq11.cfm
 
Mayo Clinic. (2010). “Food pyramid: An option for better eating.”
http://www.mayoclinic.com/health/healthy-diet/NU00190