By: Will Oud, B.Sc.

Will Oud is a Research Assistant in Behavioural Neurology for the Brain Health Clinics, Rotman Research Institute, Baycrest (Toronto, ON).

Does Physical Activity
Improve Brain Health?

You know that last 5 km you just ran? That set of push-ups you just completed? That decision to walk to the store instead of jumping in the car? You’re not only exercising your body. As it turns, out you’re doing a load of good for your brain too. In other words, yes, you’re working out your brain. Nike’s “Just do it!” motto suddenly gained an all new epistemological significance.

We generally tend to think of exercise in terms of its benefits to our physical bodies. After all, following any physical activity we typically feel fatigue in our muscles, a shortness of breath and our heart beats faster. We naturally link these physical symptoms to the common knowledge we possess (and that you hear every other day) that regular exercise is among the most important things we can do to prevent disease and positively affect our overall health.

All that knowledge began several decades ago when a fitness revolution was spawned due to research that positively linked changes in lifestyle to the prevention of cardiovascular disease and related conditions such as diabetes, hypertension, obesity, etc.

Do you ever feel more alert or better able to focus after exercising? As an active individual, I certainly do, and experts alike in fields like mental health and neuroscience are becoming very interested in the role physical activity may have toward brain health. Their work could have considerable implications for how we confront the aging process, particularly the prevention and management of dementia. It may change how you look at exercise too.

Studies Linking Exercise & Brain Health

A growing body of research has been developed over the past few decades that is fairly comprehensive in exploring the connection between physical activity and brain health. The findings are being derived from cross-sectional (observation) studies as well as longitudinal (intervention) studies that have been showing a strong positive relationship between cardiovascular fitness and overall brain health in terms of structure and function. This correlation is seen in both older adults free of neurologic disease and clinical populations such as those with dementia, Parkinson’s disease, and depression.

Functional Benefits

The emerging evidence is encouraging, indicating that individuals in both normal aging populations and those with cognitive impairment/dementia perform better than comparable but less physically fit individuals on tests of general cognitive function (such as the mini-mental state exam). The cognitive benefit appears to be greatest for higher order processes (executive functions) like planning, multi-tasking, inhibiting irrelevant information, and working (short-term) memory. These are abilities that have been consistently shown to decline most with the aging process.

Structural Benefits

Results from imaging studies show significantly preserved gray matter volume for high fitness individuals over their less fit counterparts in cross-sectional studies. Longitudinal studies have produced promising findings too, showing that gray matter volume can actually be increased through cardiovascular training. Interestingly, exercise’s protective effect against neuronal death and capacity for growth appears to be greatest in the frontal, parietal and temporal cortices regions of the brain. These regions are thought to support the higher order process (executive functions) that were identified above.

These findings lend considerable support to the notion that physical activity may act as a protective mechanism against the brain aging process’ degrading effects.

How DOES Exercise Affect
Positive Change in the Brain?

Circulation throughout the body is improved during exercise when the heart begins to pump more blood. The increased blood flow is known to produce many positive effects on the body’s physical systems. The benefits seen in the brain may be widespread too and likely comparable in nature to those seen in the body. To discover what changes are occurring that may be affecting this positive trend, we must rely on work done with animals since we cannot efficiently study the brains of fellow humans in this way. The work in this field has shown that the neural mechanisms physical activity affects are widespread. They include:

• Growth Factors – Two major growth factors inside the brain of exercise trained animals are seen to increase significantly with exercise: BDNF (Brain Derived Neurotrophic factor), and IGF1 (Insulin-like growth factor). These are important signalling molecules that support growth and offer many protective effects in the brain’s neural environment.
• Blood Flow – Blood flow to the brain increases when exercise is started, similar to the increased flow to the rest of the body. Like the body’s tissues, the working neurons of the brain need glucose for fuel and optimal function. Increased blood flow to the brain – bringing with it more oxygen and nutrients – consequently improves those working neurons’ glucose metabolism potential. Regular exercise is also shown to lead to angiogenesis (an increase in the density and size of capillaries surrounding the neurons), thereby enhancing blood flow even while at rest.
• Neurogenesis – New neurons are generated in the brains of animals that run regularly. These new neurons develop mostly in the hippocampus (an important structure for memory and well-known to deteriorate with Alzheimer’s disease). The new neurons survive to contribute to the function of the cortex and become associated with learning and memory.
• Synaptic Plasticity – A process called Long Term Potentiation (LTP) – a cellular level mechanism for learning and memory – is a long lasting increase in the strength of communication between two neurons across the synapse (a tiny gap between two neurons where communication occurs via chemical signals called neurotransmitters). Stronger connections and thus communications between neurons is shown to improve brain function. In studies done with animals, running exercises have been shown to enhance the LTP process in the hippocampus.
• Neurotransmitters – Neurotransmitters are important chemicals in communication between neurons at synapses. For instance, deficits in neurotransmitters like Acetylcholine (ACh), serotonin, and dopamine have been implicated in the disease processes of Alzheimer’s disease, depression, and Parkinson’s disease. Levels of all three of these major neurotransmitters have been shown to increase within exercised animals’ Brains.

These mechanisms are likely to be interdependent upon one another, acting in combination to provide a more protective, healthy neural environment.

Beginning to Exercise in
Later Life – It’s Never Too Late

Taking up regular physical activity later in life may seem like an intimidating task. You may be reading this article while painfully imaging the participants in these studies exhausting themselves during intense workouts. The good news is, however, that the activities that can produce the benefits reviewed above do not need to be very strenuous. The exercise programs used in the studies mentioned were, for the most part, rather simple walking programs done multiple times a week for half an hour to an hour and designed to cause only a moderate increase in heart rate.

There are many simple things you can do if you wish to increase your physical activity. For older adults and those who haven’t exercised for a long time, you should start by slowly adding a bit more activity to your lifestyle. For instance, take up more chores around the house that get you moving like vacuuming, cutting the grass, or gardening. When you’re ready to partake in more regular activity, get started by asking your spouse, a family member, a friend, or a caregiver to go for a walk with you, take the dog out, or visit a friend’s house. Aim to do this 3 or 4 times a week for maximum benefit. Being active with someone whose company you value, or walking with a fond destination in mind will make it more enjoyable. Overtime, you may gradually increase the distance walked or the speed but be sure to stay within your comfort zone.

An Active Lifestyle for a Healthy Brain

Build activity into a regular part of your lifestyle, stick with it and, in doing so, you are building a solid foundation for lifelong brain health. This is all just another great reason to get active (as if we didn’t have enough already!).

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By: Joanne Smith (her biography)
Certified Nutritional Practitioner, FruitfulElements.com

Spring is here and hibernation season is officially over! It’s time to peel  off the winter woollies and get back to our favourite outdoor activities; walking, hiking, biking, wheeling, gardening, sailing and more. Now, as much as we love these sports and hobbies, for many of us with mobility impairments, these activities can put extra strain on our joints causing swelling and pain.

So while you’re tuning up your bike this spring or getting your gardening tools ready to plant, you might want to also consider tuning up your joints. One of the best ways you can do this is by eating celery. Yes, this crunchy, low-calorie, fibrous vegetable has a number joint-health benefits.

Important Minerals for Your Joints

To start, celery contains a substance called silica, which is one of the most important minerals for our joints because it helps build the cartilage and connective tissue that make these vital body structures. Celery is also 23% sodium, another mineral that is an integral part of our bone health.

This means this bone-shaped veggie helps to strengthen the bones that come together and build our joints. The high water content of celery helps to lubricate our joints, while its anti-inflammatory properties help reduce swelling and pain around the joint. You just can’t go wrong by eating celery!

So give yourself months of pain-free fun and start munching on some celery several times a week. Slice and dip it into hummus, chop some stalks in your salads or blend it into a refreshing glass of juice.

More “Nutrition by Joanne Smith” articles:

• Astragalus: Herbal Armour (Mar. 11, 2010)
• The Almighty Pea! (Nov. 5, 2009)
• High Fibre Diet (Aug. 13, 2009)
• Quinoa (July 16, 2009)

__Contact Information:__
Joanne Smith, Certified Nutritional Practitioner
Ph: 416.992.2927
Email: fruitfulelements@gmail.com
Website: http://www.fruitfulelements.com/

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By: Will Oud, B.Sc.

Will Oud is a Research Assistant in Behavioural Neurology for the Brain Health Clinics, Rotman Research Institute, Baycrest (Toronto, ON).

Forecasting Canada’s
Brain Health & Dementia Risk

A decade into the new millennium and it is well understood that Canada’s demographic landscape is changing – our most elderly population cohort is growing immensely. Advances in science, healthcare technology and medicine, along with better lifestyle choices, have resulted in individuals living longer lives and maintaining better physical health throughout their later years. Along with this will come the inevitable implications of an older population.

An impressive study recently commissioned by the Alzheimer’s Society of Canada – appropriately titled, “Rising Tide” – examines the impending tsunami-like impact of dementia on Canadian society. The study’s results are truly alarming. It estimates that about 500,000 Canadians are living with dementia today, already crowning it as the most significant cause of disability in those aged 65 and over. This number is expected to more than double in the next 30 years, increasing the number of those inflicted to 1,125,200 people by 2038. Such a dramatic increase represents not only a serious health concern but also a crippling economic burden for Canadian society. It is clear that we must begin addressing the issue now.

What Brain Health Means to You and I

Many of us will come to accept that living into our 70’s, 80’s, 90’s or beyond will eventually mean sacrificing some of our physical independence due to unpreventable physical frailty. We may need to employ services like homecare for the added assistance required in maintaining a certain level of personal independence. While for most this is an acceptable compromise in exchange for an extended lifespan, amongst our biggest unresolved fears and one most difficult to comprehend is the potential loss of our mental faculties.

Losing the ability to think for ourselves, to decide on the direction of our own lives as a result of the senility caused by a degraded brain, is not a comfortable concept even for the most stout of heart. For anyone who has witnessed the devastating effects of dementia on another – whether in a family member, friend, or as in my case with clients – the experience can become a very potent alarm, signalling the importance of educating ourselves of this health risk.

I welcome you to my Brain Health Series on the Premier Homecare Services Blog. I hope that with this first entry you will become convinced we should all begin paying more attention to this topic of brain health.

Shattering Traditional Modes
of Thinking about the Brain

In the not so distant past, the accepted concept of the adult nervous system was that it was a fixed static entity both in terms of function and structure. Remember hearing the expression, “You can’t teach an old dog new tricks”? Contrary to this ingrained maxim, many years of groundbreaking research – the work of many brilliant minds – has begun to offer a different way of thinking about the brain. We now view the brain as a very dynamic organ constantly changing both in function and in structure.

Evidence of Functional Change (Synaptic Plasticity)

Back in the middle of the 20^th century, neuropsychologist Donald Hebb posited a theory, which has been summarized as, “[brain] cells that fire together, wire together”. This means that if a neuron (the cells which make up our nervous system and act by stimulating each other in a pathway) continually causes a neighboring neuron to fire, a metabolic change will take place that can, over time, strengthen the connection between the two. Neuroscientists like Michael Merzenich have applied this theory and observed significant functional rewiring of the cortex of primate and human brains, experimentally demonstrating that this theorized functional change occurs.

Evidence of Structural Change (Neurogenesis)

We used to think that the growth of new neurons was not possible after our childhood years. If someone were to experience brain injury there wasn’t much that could be done with them other than to help them cope with what functions remained because we believed that brain cells could not regenerate and the damage was permanent. We now know that through a process called neurogenesis, the development of new neurons is very much a possibility. Psychologist Elizabeth Gould has conducted pioneering research in this area of neuroscience. She has shown that the generation of neurons in the adult brains of monkeys does indeed occur. These newly created neurons arise from neural stem cells and migrate not only to the hippocampus – a part of the brain important for memory – but to the associative areas of the cortex that are important for higher cognitive function.

Until recently and most likely because of the traditional model of the static brain, the most focus on brain health has been given to the stages of older age and what happens in advanced brain failure like Alzheimer’s disease. Armed with this fresh knowledge regarding a more dynamic brain, we may begin to adopt a more holistic approach to brain health and focus on the greater process of brain aging. By turning our attention to what we can do in the areas of prevention, early intervention, and rehabilitation, we may be able to strengthen Canada’s brain health and reduce the burden of dementia on future generations.

Strengthening Brain Health – Strategies
for Slowing the Progression of Disease

Many scientists are actively searching for effective methods of promoting positive changes in our brains. The hope is to find solutions for preventing or slowing the loss of brain tissue during aging and disease progression, or for minimizing the impact of such losses. Much of the research that has shown noteworthy promise is in healthy lifestyle choices like physical activity, nutrition, the exercise of mental activity, and choice of environment. According to the Alzheimer’s Society, promoting brain health through lifestyle choices may be the most effective way of reducing the risk of Alzheimer’s disease and for slowing down its progression.

Through this blog series – Brain Health by Will Oud – I will take a critical look at contemporary research involving lifestyle choices and their potential effects on healthy brain aging and the prevention of disease. I’ll begin to sift through what advice is supported by valid research and what claims the literature just doesn’t back up. Follow-up four weeks from now for the next addition to the series.

By: James Watson & Joanne Bunton

When you work within the homecare business you become accustomed to the story of families or individuals facing a crisis – a loved one becoming ill or injuring themselves by a fall – and suddenly they don’t know where to turn for help when they need it most. Everyday our offices across Canada receive calls from families facing this precise situation.

It is not always easy to plan ahead for something you cannot anticipate. Even when you can see the need, planning ahead can be very difficult. Consider the example of deciding on whether to plan for moving into a long-term care home versus a retirement home, or to forget that altogether and plan to remain independent in your own home. Each option one has a unique set of advantages, disadvantages and decisions that must be made. An individual’s situation will change over time and thus their needs and preferences too. One of the purposes of the Premier Homecare Services blog is to provide you with information that can help your family and you anticipate and plan for these unforeseen circumstances.

Planning Ahead for Your Funeral

With the woman I have chosen to interview in this article, it is inevitable that we will all require the services of her line of work at one point in time. A licensed Funeral Director, Joanne Bunton will commonly refer to herself as a “Community Outreach Co-ordinator”. She works with Ward Funeral Homes, advocating in her community that you should look to planning your funeral arrangements now, lest more headaches arise in the future. Below, I asked her to shed some light on the topic:

Q: Why Advance Planning?

A: When you plan your funeral in advance, you spare your family from having to make complex decisions at an especially demanding time. As well, you give yourself the ability to make those important choices at your leisure, giving them the time and consideration they deserve – and your family will not have to “second guess” what you might have wanted. There are several options available to help you personalize the funeral service. We can show you how contemporary funeral services allow you to create an event that is most appropriate for both you and your loved ones.

Q: What details are you certain to cover when you sit down with someone?

A: The extent to which people plan in advance and the amount of detail they ask us to keep on file varies from one person to the next. We provide a wide range of options including service details, a comprehensive selection of caskets, cremation urns, burial vaults, stationery and monuments and markers. We’ll discuss the kind of funeral you think would be most appropriate, discuss your options related to burial, cremation or entombment, and guide you through the choice of merchandise. Once those things are known, we are able to explain the costs involved. We’ll also record the “Vital Statistics” information such as your name, address, date of birth, place of birth, Social Insurance Number, occupation and your parent’s names and places of birth.

Q: Does the advance planning incorporate pre-financing for the funeral?

A: Advance Planning does not necessarily mean you have to pre-finance. If you do choose to prepay your arrangements, you can protect yourself against future price increases and spare your family the possibility of unexpected expenses. In fact, effective July 1^st of this year, the tax on a funeral and related cemetery services will increase from 5% to 13%. As we make people aware of this, we’ve noted a marked increase in the number choosing to pre-finance their arrangements in order to avoid the additional 8% tax. The principal and all interest remain on deposit until the time of need to cover the increase in cost due to inflation. Any excess funds will be refunded to your estate and all money is guaranteed, safe and secure. Should you relocate, the pre-paid funds are transferrable to another funeral service provider. Pre-paying your funeral eases the financial burden that can surround unprepared families and friends at the time of loss.

Q: Beyond simply planning and financing the funeral service, what other related things should someone anticipate?

A: During the advance planning discussions, we are often asked about Powers of Attorney, Wills, Living Wills, Organ Donation, Memorial Donations, Estate Settlement, Canada Pension Plan Benefits and other matters unique to each individual situation. You should definitely anticipate leaving with a more secure and settled state of mind knowing that you have done a good thing not only for yourself, but for those you love and care for.

Ward Funeral Homes – http://www.wardfuneralhome.com/

Related Blog Articles about Planning Ahead:

• My Parents Need Help, Where do I Begin? (Feb. 12, 2009)
• Where do I Begin? – Homecare (Feb. 26, 2009)
• Homecare: Questions You Might Ask (Feb. 26, 2009)
• Where do I Begin? – Retirement Homes (Mar. 12, 2009)
• Where do I Begin? – Moving Solutions (Mar. 26, 2009)

Other Informative Blog Articles:

• Veterans Independence Program (May 7, 2009)
• Q&A with Dr. Michael Gordon (July 2, 2009)
• Anticipating the Flu Season & H1N1 (Sept. 1, 2009)
• Coming Home after Hospitalization: What to Expect (Dec. 3, 2009)
• A Palliative Care Story, by Jane Teasdale (Jan. 28, 2010)
• Regulatory Changes to the Live-in Caregiver Program (Mar. 25, 2010)

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By: Joanne Smith,
Certified Nutritional Practitioner
FruitfulElements.com
(view her biography)

It seems everyone I talk to these days is either sick, or just recovering from a nasty bug. As individuals with special health conditions or disabilities, we need to take extra special care to ensure that our immune systems are working optimally. Decreased mobility and circulation, as well as altered and compromised digestive systems can often make our immune systems less efficient in protecting us from bacterial and viral infections.

Boost Your Immune System

So boost your immune system and help protect yourself from these dreadful invaders with a powerful herb called Astragalus. The medicinal benefits of herbs have been known for thousands of years. Many aromatic plants contain potent ingredients that can help strengthen and heal the body and don’t have any of the negative side effects associated with many over the counter medications.

For over 2000 years the Chinese herb Astragalus, also known as huang qi, has been known to help protect the immune system, promote healing, provide energy and fight fatigue.

If any of your co-workers, friends or family start sneezing, shield yourself with this herbal armour.

By: Jane Teasdale

What I would like to share is a caregiver journey that I experienced with my father’s passing in 2008. I was very lucky to be surrounded by friends and colleagues from the health care industry – from the hospital to the community agencies –and lucky too that I understood a good bit about navigating the system and being proactive. I preach this in the many presentations I have given to professionals, seniors and baby boomers, so I felt I was well versed. Both my brother and I work in the homecare industry so between the two of us, my dad had an excellent team. In addition, 15 years ago, I was the caregiver for my mother who died of breast cancer, offering my experience in this kind of situation. I kept her home until towards the end and then moved her to the hospital for the last couple days of her life.

Europe Bound

The journey began when my father and his girlfriend were preparing for their annual trip abroad (they were going away for over a month). Before they left, I was going through the usual, “where are your documents?” routine; power of attorney, travel documents, travel insurance, contact numbers, insurance policies, etc. He kept a file in the house and showed me exactly where everything was kept, including the safety deposit key if I needed it.

Two years prior, my father had discovered small spots on his bladder that turned out to be cancerous. He underwent surgery to have them removed and the doctor said he had gotten everything. He was a man that was healthy and independent. He loved to garden and was an avid golfer. He had a clean bill of health to travel.

Early Morning Call

While they were in Portugal I received a call from his partner very early in the morning saying that my dad wasn’t eating, had stomach pains and was a bit jaundiced. I had a feeling this wasn’t a good sign so I asked for her to take him to see a Portuguese doctor for blood tests, ultrasound, etc. I spoke to my dad briefly too but his voice was so weak. I immediately got on the phone to my brother in Victoria, B.C., and gave him a heads up on the situation. Since my father had appointed me his Power of Attorney for Care, I was able to speak to our family doctor, who was also my dad’s doctor, to advise her on what was happening in Portugal. She wanted the test results – the blood work and ultra sound – sent back to her.

The tests from Portugal were faxed to our family doctor and she read me the results (I was given this privilege because of my Power of Attorney for Care): there were cancerous spots on his liver. My dad and his girlfriend were not told in Portugal. Meanwhile, I was on the phone with them trying to explain that according to the family doctor, they needed to be back in Toronto as soon as possible. The next task was dealing with the medical insurance, airlines, doctor in Portugal. Could he handle the flight in his condition? What would happen if he became ill on the plane? What does the medical insurance cover and were the airlines liable? I kept my brother informed so he could organize his life, work and family before coming to help the family in Toronto.

The Flight Home

My father managed the flight, but barely. Jaundiced and losing weight, he couldn’t keep his eyes open or his hands from shaking. He couldn’t concentrate very well either. I had my dad and his girlfriend make notes of what had happened in Portugal from when the symptoms started, what tests he had been given, the results from the doctor and how he was feeling. Once he arrived in Canada, the first step was to visit the family doctor so she could explain exactly what the tests from the ultrasound in Portugal had shown. She told him her diagnosis. My father was then admitted to the hospital where more tests confirmed that he had developed stomach cancer in addition to the cancerous spots on his liver. His legs were swollen and I could see we were going to lose him shortly.

The oncologist wanted to try chemotherapy and my father agreed, wanting a chance to see if it would work. My dad was very weak, unfortunately, and I don’t think the oncologist understood how rapidly he had declined from a healthy gentleman to a man near death. The only ones who could see the decline were ourselves and our family doctor. As it turned out, it was not very long before my father was moved to the palliative care floor. His condition had continued to deteriorate so rapidly that the chemotherapy had been ruled out as an option because he would not have had the strength to endure treatment.

In Canada, At the Hospital

Our family arranged a schedule while he was in the hospital so that there was always somebody at his bedside during the days, evenings and nights. He needed a lot of care in the night and there was no way that I was going to allow my dad to be alone. Looking back, it would have been useful to hire in a caregiver to be at his bed side but we had organized enough family members to manage without becoming too exhausted.

From conversations our family had with my father in the past, we knew that he wanted to come home to die with dignity. He did not want to spend his remaining days in an institution. He wanted to look out at his English garden, smell the cooking in the kitchen, listen to his favourite music with all his books and pictures around, hear the noises of the house and neighbourhood in which he had raised his family, and to hear the birds singing. He wanted his girlfriend holding his hand, his grandchildren laughing and playing outside, his children giving him hugs, rubbing his feet and legs, and taking orders from him regarding his final wishes.

Gathering Resources & Planning for Home

The next task then was to move him home from the hospital setting with the proper supports in place. I asked the hospital staff for information about the Freeman Centre and the Temmy Latner Centre. The Freeman Centre is located at the North York General Hospital. They provide palliative care in the hospital, support for the palliative care team in the client’s home regarding medical and pain management, and can offer valuable advice regarding community resources. The Temmy Latner Centre operates out of Mount Sinai Hospital. They provide end-of-life support services to family members and can provide a doctor to visit in the home to direct pain relief management. I also thought it was beneficial to connect with a local hospice in the area so I asked the hospital staff more about Alliance Hospice. Hospice organizations offer many services that revolve around palliative care, including counselling services for adult and children, or caregiver support provided by trained volunteers for short periods of time.

I spoke to the local Community Care Access Centre (CCAC; publically-funded homecare services in Ontario) about procuring help for my father. They suggested putting him into Baycrest Palliative but I knew this was not a very good option. My dad had less than a couple of weeks to live and I knew that this short outlook qualified him for the 56 hours of care provided by the CCAC.

Bringing Him Home

Upon discharge from the hospital I wouldn’t allow my father to leave the hospital until I knew CCAC would be in that evening, that the hospital bed, special air mattress, medical supplies, pain medication, diapers and hospital table oxygen had all arrived before the ambulance was called.

Once he arrived home we arranged all of the services he was receiving to suit our unique situation. We decided to have the caregiver provided by CCAC to come in during the evening until morning so that we could all sleep (or pretend too, at the very least). During the daytimes, we had St. Elizabeth Health Care provide nursing staff and we employed a personal support worker (PSW) from Premier Homecare Services who was experienced in end-of-life circumstances.

One thing that Premier Homecare Services did was to make sure that we would receive the same caregiver everyday to look after our father. This allowed things to run smoother since we only once had to explain how my dad wanted his food, how he wanted his cushions placed, when he wanted his bath, or how he liked his water with a lemon in it. The caregiver built up a relationship with my father and my father trusted her. We trusted her too.

The Whole Family Experience

Our family came to trust and rely upon the many people and organizations that had been helping us during this emotional roller coaster. Circle of Care provided the social work aspect since we had small children, family members and my father too who benefited from some in-home professional counselling. Palliative care nurses and PSWs, family doctors doing home visits, older grandchildren, my dad’s girlfriend, my brother and I – we all took shifts so we would not get burnt out. And what a time we had!

It was a highlight and celebration when father was comfortable in his own room to watch his soccer on television – his home team Middlesbrough United playing an epic match. After that celebration he quickly declined each day and it took almost one and half weeks before his passing. I can honestly say that my brother, myself, my dad’s girlfriend and all our family fulfilled my dad’s wishes to prepare him for the journey to the next life.

Community Resources

The following are important points that families should do or discuss with your family members before the inevitable happens:

• Contact hospice in your area and educate yourself on palliative care. Alliance Hospice 416-385-8885, Dorothy Ley Hospice Etobicoke 416-626-0116
  • Circle of Care provides bereavement programs and workshops, individual counselling contact 416-373-4093
  • Temmy Latner Centre 416-586-4800 Ext. 7884
  • The Freeman Centre – North York General Hospital 416-756-6000 palliative care floor.
• Attend local health fairs so you are up-to-date with agencies in your community.
• Contact your local Community Care Access Centre (CCAC) for a list of community agencies (there are different governmental agencies in each province).
• Keep a file of resources for yourself to share with your children/family members/power of attorney.
• Ask to speak to a social worker to guide you through the process. Your experience can depend on the social worker and the knowledge and experience they have off community services and providers so arm yourself with your own knowledge and ask, ask, ASK!
• Research retirement homes, homecare agencies, community agencies, long-term care facilities, etc., with your family so you have some sort of a plan of action when the time comes. Keep a file of the community resources and store it near your power of attorney and other legal documents so you can find it whenever there is an emergency
• Use other community agencies such as Parkinson’s Society, Alzheimer’s Society, hospices, senior centres, your local hospital (some hospitals have brochures and information on the floors for the families) and Meals on Wheels.
• Who has the power of attorney? Where are the documents kept? What are your loved one’s wishes? Discuss with your family what your wishes are about anything – homecare, retirement homes, what your wishes are towards end of life care, funeral arrangements, etc. – so they know and understand what you want done.

By: Joanne Smith, Certified Nutritional Practitioner
(more about her)

This week I want to tell you about a highly nutritious food that I believe is too often neglected in discussions about healthy eating. This inexpensive, tiny, gastronomic gem has many health benefits and I don’t think we see enough of them on menus or in recipes. What I’m referring to is the powerful pea!

Before I describe all the positive effects that peas have on our well-being, I think it’s important that I first clear up some confusion surrounding its identity. Most people mistake the pea for a vegetable, when in fact it’s a legume.

Little Legume, Big History

Many of you may also be unaware that this legume has a rich and significant role in our culture and history. Once upon a time, about 5000 years ago, our Egyptian ancestors worshipped and buried the pea with their Pharaohs to take into the after life with them. This valuable food source was not lost on the Romans either. They honoured the delicious pea by including it in nine elaborate recipes in Rome’s first cookbook. The pea also holds the distinction of helping develop agricultural societies 1000 years ago, as it was one of the first cultivated food crops. Furthermore, it was the pea that sustained the masses during England’s 16th century famine, hence the well-known English children’s rhyme:

Peas porridge hot
Peas porridge cold
Peas porridge in the pot 9 days old

And lastly, for almost 200 years a single pea has been the focus of one of the most famous children’s stories of all time – Hans Christian Andersen’s fairy tale, The Princess and the Pea.

Nutritional Benefits of Peas

So what makes the pea so very special, you ask? From a nutritional perspective, they are one of the few inexpensive, delicious and easily edible seeds that pack a tonne of health benefits. Here’s a sample of what they offer – they are:

• a great source of protein & complex carbohydrates,
• low in fat & calories,
• high in fibre (helping to reduce cholesterol and improve bowel function),
• have the highest vitamin C content compared to other legumes (the ability to boost our immune system), and
• a great source of vitamin A, B, E, iron, potassium, calcium & magnesium.

The culinary possibilities for peas are also limitless:

• Liven up any stew, soup, casserole, salad or curry.
• Enjoy a hot bowl of peas with mint sauce.
• Make refreshing dips & sauces.

And if all this were not enough, this nutrient dense food employs thousands of people in the agricultural industry around the world. They are also environmentally friendly because they have special characteristics that enable them to take nitrogen from the air and fixate it into the soil through their roots (see: nitrogen fixation). Thus, peas actually enrich the soil they grow in.

All I’m saying is, “give peas a chance!” So if you have any delicious pea recipes you’d like to share, please write in.

___________________
Joanne Smith, Certified Nutritional Practitioner
Ph:  416.992.2927
Email:  fruitfulelements@gmail.com
Website:  http://www.fruitfulelements.com/

By: Joanne Smith, Certified Nutritional Practitioner
(view her biography)

Good health starts with a healthy digestive system. Eating a diet high in fibre helps increase your digestive function, thus boosting your overall health!

Good Health with High Fibre

Fibre is one of those things that we all know is important but actually remains a bit of mystery. So what exactly is it? What are the health benefits? And what are the best sources?

Well to start, fibre is a complex carbohydrate that cannot be digested. It’s the part of plants that actually give them structure and holds them up. When we eat it, instead of being used for energy, it acts as a bulking agent that helps our elimination process.

There are two types of fibre – soluble and insoluble.

1. Soluble Fibre

Soluble fibre mixes with water and forms a gel-like substance. Examples include:

• Oats
• Fruits
• Vegetables
• Beans

The health benefits of this type of fibre are:

• Helps to lower cholesterol (because it helps absorb cholesterol in our intestines, therefore helps it to be excreted it in our stool)
• Helps regulate blood sugar levels (because it causes food to be digested and absorbed at a slower rate, resulting in more consistent blood sugar levels)

2. Insoluble Fibre

Insoluble fibre is not soluble in water and makes our stool bulkier, thus increasing bowel transit time. Examples include:

• Fruit skins
• Whole grains
• Vegetables
• Beans

The health benefits of this type of fibre are:

• Decreases risk of constipation & hemorrhoids
• Helps prevent colon cancer & diverticulosis

Maintaining Digestive Health

To maintain our digestive health we need both types of fibre and a great source is apples. This inexpensive, widely available, low calorie fruit is extremely high in pectin, a water-soluble fibre. It’s crisp, delicious skin contains even higher amounts of insoluble fibre. They are also a great source of A, B & C vitamins. (Tip: if you don’t buy organic apples—make sure you wash them thoroughly as the average apple is sprayed with pesticides 17 times by the time it reaches our hands!)

It is recommended that you eat 35 – 50 grams of fibre a day. Apples contain 4 grams of fibre, so they’re a sweet start to your fibre intake. Enjoy them as a snack, slice them into your salads or whip them up in a smoothie with a fresh pear.

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Joanne Smith, Certified Nutritional Practitioner
Ph: 416.992.2927
Email: fruitfulelements@gmail.com
Website: http://www.fruitfulelements.com/

By: Joanne Smith, Certified Nutritional Practitioner

Welcome to my new nutrition blog! The foods I feature here will provide helpful, healthful nutritional information and tips to help you achieve optimal health and well-being. As someone who has lived with a spinal cord injury for 20 years, I fully understand the unique challenges of trying to stay healthy and living a full and active life with a chronic health condition. One of the keys to this delicate balance is proper nutrition.

Living with a disability or other health challenge can alter your metabolism significantly and this can contribute to the development of a host of other secondary health complications, which can negatively impact your independence. Incorporating whole foods into your diet is an important way to help maintain your health, improve daily functioning, reduce the secondary complications that come with living with a disability, minimize illness and maximize your potential.

Importance of Whole Foods

So what exactly are whole foods? They are foods that are as close to their original form as possible. These foods are free from processing, meaning they contain no additives, preservatives, antibiotics, hormones and other potentially toxic chemicals.

The first fantastic whole food I want you tell you about is Quinoa. Many of you have probably heard a lot about this an ancient grain lately and are wondering what the fuss is all about, right? To begin, Quinoa is a gluten-free, easily digestible grain, so it’s an ideal food for individuals with compromised digestive systems. It is also so nutrient dense that many of our earliest civilizations used it as their main food staple.

Battle Disease with Nutrient Dense Quinoa

Quinoa’s complete protein content can help tissue grow and repair itself, which in turn can prevent and/or heal serious wounds such as pressure sores. Its multitude of minerals such as, magnesium, iron and calcium help reduce the risk of health issues such as type 2 diabetes, anaemia and osteoporosis respectively.

Quinoa can help control cholesterol levels since it doesn’t contain any of this potential artery-clogging substance and has very little saturated fat. Its high fibre content can help eliminate toxins and improve bowel function, which in turn can help reduce the risk of cardio-vascular disease and some forms of cancer. And for those of you who may not be feeling a wee bit lethargic, quinoa’s rich source of Vitamin B’s can help boost your energy levels!

Easy to Prepare and Flexible

This light, fluffy grain with a somewhat nutty flavour needs only 15 minutes to cook. So not only is it faster to prepare than other grains like rice, but it’s also much more versatile. Enjoy it as a main or side dish by tossing in nuts, seeds, beans, fruits or vegetables or add it to soups and salads. The possibilities and health benefits of Quinoa are virtually endless!

If you have any nutritional questions, comments, tips or recipes to share, I’d love to hear from you! Just fill out the comment form below.

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Joanne Smith, Certified Nutritional Practitioner
Ph: 416.992.2927
Email: fruitfulelements@gmail.com
Website: http://www.fruitfulelements.com/

Joanne Smith B.A., BRT Dip., CNP

Joanne is a graduate of the Institute of Holistic Nutrition in Toronto. She also holds a degree in psychology from York University, and a diploma in radio & television broadcasting from Seneca College.

Joanne has dedicated her career to raising awareness of the issues concerning people with special health needs. As a Certified Nutritional Practitioner, she specializes in providing optimal nutritional health for people with chronic health conditions and disabilities.

Her expertise in the disability community comes from her personal experience of living with a spinal cord injury for over twenty years, as well as her role as a disability consultant for both the Toronto Board of Education and Air Canada, and her years as a Gemini award winning broadcaster who focused on telling in-depth stories about Canadians with disabilities.

Joanne’s passion for assisting others with special health needs has also been demonstrated through her years as a dedicated mentor and volunteer for the Canadian Paraplegic Association, Lyndhurst Rehabilitation Centre, Canadian Spinal Research Organization, Easter Seals and numerous other disability organizations across the country. Her commitment to raising awareness and improving the lives of Canadians with disabilities led to her receipt of the King Clancy Award in 2006, induction into Terry Fox Hall of Fame in 2007 and acceptance of the Gabriel Humanitarian Award in 2008.

Joanne fully understands the unique needs of people with disabilities and her nutritional consulting helps others live to their maximum potential. She currently operates her own nutritional consulting company in Toronto called Fruitful Elements, works as a Nutritionist for two neuro-physiotherapy clinics, teaches nutrition at The Canadian Helen Keller Centre and is a regular columnist for The Canadian Paraplegic Association’s Outspoken Magazine.

__Contact Information:__
Joanne Smith, Certified Nutritional Practitioner
Ph: 416.992.2927
Email: fruitfulelements@gmail.com
Website: http://www.fruitfulelements.com/