• Type 2 diabetes, Hypertension, osteoarthritis in both knees 

 Areas for improvement 

• Lack of physical activity (uses mobility aid), lack of social activity, fear of falling and increased pain, poor nutrition choices (lack of education?) 

• Prayer: can improve Amara’s outcome by providing her with hope and a sense of control during this stressful time in her life. 

• Deep breathing: can manage and support emotional calmness while improving her ability to cope and heal

• Encourage Mrs. Johnson to identify and reflect on her past achievements 

• Help her shift focus from physical limitations to strengths and capabilities 

Positive Affirmations:

• Introduce the practice of positive affirmations to improve self-perception

• Build a positive self-image by reinforcing self-worth

Body Image Acceptance:

• Encourage a focus on what her body can do, rather than just appearance 

• Shift focus from physical changes to the functionality and health of her body 

Set Realistic Expectations:

• Help set small, achievable goals for health and fitness

• Celebrate each milestone, no matter how small

Promote Social Connection:

• Encourage social activities with friends or family 

• Social interactions help counter feelings of isolation and improve self-worth

• Reinforce the value of relationships and community for emotional well-being 

Blood Pressure Monitoring: 

• Get checked every 3-6 months  

• Aim to keep her BP under control to prevent heart disease and stroke.

Diabetes Management (A1c Test): 

• Get checked every 3-6 months 

• Aim to maintain A1c below 7% to reduce the risk of diabetes complications.

Blood Glucose Monitoring: 

• Ensure she is regularly self-monitoring her blood glucose 

• Aim to manage her cholesterol levels to reduce risk of cardiovascular disease.

Cholesterol Screening: 

• Get an annual screening or get them as advised 

• Aim to manage her cholesterol levels to reduce risk of cardiovascular disease.

Osteoarthritis Management: 

• Get a regular assessment of her joint health 

• Aim to manage her pain and improve her mobility with physical therapy, pain control, and joint protection strategies. 

Exercise and Physical Activity: 

• Low impact exercises 

• Aim to improve mobility, strengthen muscles, and manage pain

• Gradual increase in activity level to build stamina and confidence 

Diet and Nutrition: 

• Emphasize whole foods 

• Limit high-fat and surgery foods to manage diabetes and weight 

• Encourage smaller portions, high-fibre foods, and balanced meals 

Weight Management: 

• Aim for gradual weight loss to reduce stress on joints and improve diabetes control 

• Focus on small, sustainable changes 

Medication Management:

• Adherence to prescribed medications for diabetes, hypertension, and osteoarthritis

• Regular review of medications with healthcare provider 

Self-Care and Stress Management: 

• Encourage relaxation techniques 

• Address stress and its impact on health, particularly blood sugar glucose 

Vaccinations:

• Ensure up-to-date vaccinations 

• Aim to prevent illness, especially respiratory infections 

• Due to her fear of injury and her pain levels, she does not engage in physical activity.

• To manage Amara’s feelings of sadness and loneliness, therapy and counselling could assist her with her emotional wellbeing.

• Physical therapy and cognitive behavioural therapy are two options that engage in physical activity while reducing pain and decrease her fear of falling.

• Addressing her negative thoughts and redirecting them to have a healthy belief and behaviour towards her well being, Amara’s emotional, physical, and psychological will will enhance her quality of life.

• Another alternative can be support groups, Amara is dealing with grief and isolation.

• Having relationships and communication with other individuals who are in similar situations can allow her to process grief, experience validation, shared coping strategies as well as encouragement.

• A support group can provide her with motivation she needs to take the first few steps in physical activity.

  
  

  personal coping strategies

• Amara can establish a daily routine with new hobbies so that she can reach her new goals.

• As Amara enjoys reading, she can engage in volunteering to read to children. This would increase her physical activity and allow her to distract herself while doing something she enjoys. 

• Talk to her about how gentle exercise can help her feel better and reduce her pain 

• Could share some examples and stories of people have been successful

2. Start with gentle activities

• Start with easy, maybe seated exercise

• Example could be water exercise 

3. Manage pain

• Work with her doctor to make sure she has proper pain relief 

• Tell her to use heat, ice, and get some rest 

4. Ensure safety 

• Check her home to make sure there are no fall risks 

• Show her how to use a walker properly 

5. Encourage social activities 

• Suggest group exercise classes 

• Involve her family or friends for support 

6. Track progress

• Do regular check-ins and track her pain 

-constructing an environment conducive to promoting ms.johnsons activity and diet is important

-producing a manageable eating and activity plan

-Being involved in her activities and providing demonstration will encourage her to try harder

-subtly increasing the availability and convenience of healthier foods will make ms.Johnson more likely to eat healthier

• Track her activity and exercises, and see if she can move better 

• Monitor her weight and blood sugar levels 

Assess pain and safety

• Ask her to rate her pain levels whenever she comes in

• Keep track of any falls or close calls

Check her mood 

• Ask her how she is feeling and her progress 

• Ask if she is enjoying the activities 

• Check for any stress or loneliness 

Adjust the plan needed

• Make changes to the pain management strategies, exercise/activity, her support systems, and what she likes or dislikes

Cognitive-behavioural therapy (CBT) | CAMH. (n.d.). CAMH. Retrieved November 20, 2024, from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cognitive-behavioural-therapy#:~:text=CBT%20is%20a%20structured%2C%20time,reactions%20that%20cause%20them%20difficulty.

Diabetes and Dietary Supplements: What You Need To Know | NCCIH. (n.d.). NCCIH. Retrieved November 20, 2024, from https://www.nccih.nih.gov/health/diabetes-and-dietary-supplements-what-you-need-to-know

Diabetes: What It Is, Causes, Symptoms, Treatment & Types. (2023, September 8). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7104-diabetes

Osteoporosis Canada. (2019, April 8). Osteoporosis Canada |. https://osteoporosis.ca/

Scott, E. (2008, February 8). How to Cope With Loneliness: 9 Strategies to Try. Verywell Mind; Verywell Mind. https://www.verywellmind.com/how-to-cope-with-loneliness-3144939

Social Cognitive Theory Model - Rural Health Promotion and Disease Prevention Toolkit. (n.d.). Rural Health Information Hub. Retrieved November 20, 2024, from https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/social-cognitive