Section 2: Moving Forward and Taking Control
Learning Objectives
- Learn to take stock of your resources and your support system.
- Initiate making a plan for the future and communicate your plan to others.
- Learn to set goals and create strategies to get back to the job of living.
George's Story
George was only 45 years old when he discovered the diagnosis for the fatigue, aches, and pains he had been dealing with for the last few years. He knew it was getting tougher to take care of his goat herd, and had begun to think he might have to liquidate the herd. The doctor’s diagnosis was Fibromyalgia. George and his wife, Robin, had never heard the word before, but the doctor said it was a type of incurable arthritis. George was told he would have to learn to live with Fibromyalgia for the rest of his life. “Live with it?” George thought, “I’d rather be dead!” Despite Robin’s support, George became more depressed, discouraged, and helpless. Robin was exhausted from working at her town job and then coming home to take care of George, the garden, the house, and the farm books. She was exhausted and beginning to become ill more frequently. Clearly something needed to change.
George and Robin reached out for assistance to re-build the ability and resilience to continue to farm successfully. Agricultural work is a unique experience and has its own set of challenges.
Many studies support the idea that farming and ranching families look at life differently than urban families, especially the idea of work. The care of livestock, land, and resources takes a 24/7 approach to stewardship. Working alone, especially under harsh or trying conditions, becomes central to a farmer and rancher’s identity.
As a result of being tried and tested by work and nature’s extreme conditions, many farmers and ranchers have developed what some researchers call “resilience.” Resilience is the ability to adapt or recover from conditions of adversity, whether from illness, disability, or even drought. Part of recovery is demonstrating resilience through taking control and moving forward with life, despite life’s circumstances.
Farmers and ranchers with disabilities usually reach a point during recovery when they want to return to their work. This often requires taking control of one’s situation as well as learning about resources and support available for returning to agricultural production. It requires being able to make a plan, communicate the plan, set realistic goals, and create strategies. Resilience is not only a “cowboy up” feeling, but the ability and skill to convert that attitude to an effective plan. This section will cover how to make a plan.
Taking Stock
First, start by asking, “What do I have? What are my assets?” For most farmers and ranchers, the assets of agriculture come to mind. The farm or ranch is an asset made up of land, water, animals, crops, and the labor and machinery that goes into production. We will cover the business aspect in depth later, but for now look at the general picture.
But what about you, the farmer or rancher? The farmer or rancher is perhaps the most important asset to the business. They know the seasons, how to analyze conditions, what the land can sustain, and have multiple years of experience in making practical, and sometimes tough, decisions. Without this wisdom, the business is less likely to succeed and may struggle to survive.
Look realistically at the kind of person you are, and think about the qualities it takes to be a successful farmer or rancher. They probably are similar. Most farmers and ranchers value independence, hard work, spirituality, trustworthiness, family, and helpfulness to family, friends, neighbors, and community.
What kind of family steward have you been? Have you taught others to be independent and responsible? Or have you micro-managed every detail and treated others as incapable? Be honest with yourself, how do you measure up?
If you measure up well, then you are probably ready to identify your social support system and make a plan.
If not, then this is your opportunity to take a good hard look at making some changes in your character. It may not be too late to cultivate the qualities of success mentioned above. Someone who is resilient will apologize and ask forgiveness as well as offer forgiveness. Likewise, an individual who is not resilient will most likely give in to self-pity, blame, denial, and contempt for those who do offer help. Which has been your pattern in the past? How are you now? What do you want to be like in the future? It is your choice.
If making character changes is proving too difficult to do by yourself, then consider counsel from a trusted friend, spiritual leader, or psychologist.
Building a Strong Support System
Who can you count on for support? Your spouse and family are potentially one of the greatest support systems you have in your life. Positive support from one’s spouse is usually dependable “for better or for worse; in sickness and in health.” However, it is important for you to consider the health of your spouse and the many ways they already offer support. Many studies confirm that caregiving for an adult with a disability can be physically, emotionally, and mentally taxing.
The farmer or rancher with a disability can assist their spouse with the tasks and activities they are safely capable of performing such as dressing, bathing, and preparing food, versus “learned helplessness.” Learned helplessness occurs when an individual can do things for themself, but habitually allows others to do the task instead. The opposite of this is helpfulness. Along with trying to be helpful, being able to demonstrate genuine appreciation, rather than just expecting something can go a long way toward having a true healthy partnership with one’s spouse.
Positive support from family can also depend upon the “health” of relationships. Resilient and healthy family relationships depend on trust, compassion, and the capacity for “pulling together” and “being there” during hard times. Healthy families usually enjoy each other’s company, are open to contributions and participation from in-laws and extended family, and continue to grow and adapt as individuals and family members.
Although no family is perfect, it is harder for an unhealthy family to grow and adapt. Family issues such as divorce, family violence, substance and alcohol abuse, and/or emotional abuse can contribute to multiple generations of family dysfunction and entangled relationships. Many, if not all, of these situations require legal, professional, and psychological intervention. If you are a victim, or even a perpetrator, check the resources section found at the end of this section for suggestions on how to seek help.
In addition, even minor issues like sibling rivalry, adolescent rebellion, and hurtful communication can keep a family off balance. Since this can be true for many families, a section on developing farm or ranch family communication will be covered later.
If you are already fortunate enough to have a positive family support system consider this an asset in taking control and moving forward. Also, consider the support you may be receiving from your spiritual community. Faith-based organizations are typically willing to make home visits to provide spiritual support, prayer, and the opportunity to participate in important spiritual rituals. Your spiritual community may also be willing to provide support for caregiver respite, assisting with home exercise programs, and perhaps minor home alterations like adding bathroom grab bars and ramps where necessary for entering/exiting your home easier.
Even community-based organizations, businesses, and fraternal groups may be willing to assist with minor home alterations to improve access and quality of life for an individual who has a disability. Many Oklahoma farmers and ranchers have received this kind of assistance, and when times are better, they frequently “pay it forward” by helping others.
In addition, various public resources like Aging Services Division/Area Agencies on Aging and Human Services can offer services and information to improve quality of life. Other resources offer assistance, information, and/or expertise to address work concerns and transportation.
As you begin to take control and move forward, you will want to become familiar with several of these resources. You should also determine exactly what services, assistance, and information is available and whether you are eligible to receive them. You may seek support and resources in the government pages section in the phone book.
Other strategies include using the Internet. In fact, using the Internet as a tool to find information is growing quickly in use and popularity. Be sure to determine the reliability and trustworthiness of websites. Just because it is on the Internet, does not make it true. Since no one monitors what information is published on the Internet, users should be skeptical of information unless it comes from a respectable source like a health center, government agency, well-known nonprofit organization, university, or cooperative extension. Usually, reliable web resources have addresses that end in .gov, .org, or .edu. Addresses that end in .com or .net are often commercial websites that may have something to sell to you. Websites that offer cures for diseases, disabilities, or offers that are too good to be true are most likely a scam. People looking to scam you specialize in preying on the vulnerabilities of others.
With these ideas in mind, using the Internet for health-related information and becoming more knowledgeable about resources and support will help you move forward.
The Six Steps to Making a Plan
Step 1: Situation Analysis
Can you list the problems or difficulties you are facing? Can you prioritize some problems over others? What are the strengths and weaknesses observed in the situation?
What opportunities can be seen up ahead? A savvy farmer or rancher may stay current on information about new USDA farming programs that could benefit production and quality of life. What potential threats could jeopardize planning? A sudden flood, tornado, fire, or hail are all definite threats. Identifying threats can assist in preparing for contingencies and add “what if” scenarios. A potential “what if” situation may include planning for more care in the future or making necessary home modifications before physical performance declines.
Step 2: Assumptions
Assumptions are the things we take for granted. While we all make assumptions, many of us do not take the time to ask questions. For example, we may assume that after acquiring a disability we are no longer fit for work. If we test the assumption, we may learn instead that many people with disabilities can and do work, drive themselves, live at home, play sports, travel, and have sexual intimacy.
Step 3: Inputs
It is important to think about what “inputs” are needed for the plan. Inputs can be things like money, technology, equipment, people, and resources. They are the things needed to make the plan work. For example, money will be needed to purchase assistive technology and adaptive devices that enable working. Or perhaps a hired hand will be needed.
Step 4: Set Goals
Goals are a desired result or achievement. Keep in mind, goals should be reasonable and achievable. Your goal may be to continue farming and ranching, despite different circumstances. Or perhaps your goal is to continue living at home. These may be very reasonable and achievable. Frequently, they require actions that lead to obtaining the right mix of funding, support, and resources.
Step 5: Activities
Planned activities that lead to meeting your goals include organizing the activities in logical steps. Include the time in weeks, months, or years that you estimate it may take to reach the goal. Identify the efforts that will be required by you to reach the goal.
Step 6: Evaluate
An activity must be evaluated to see if it is getting you closer to your goal. At the end of this section, you have the opportunity to write goals, including writing out the activity steps of your plan, and how to decide whether you have met your goals.
Keep in Mind:
During planning, it is a good idea to encourage the input of your spouse, family, and other partners in your support system. Once you have made your plan, it is important to communicate your plan to others and ask for their support in carrying out the steps of the plan.
Remember that plans are flexible. If your activities are not helping you meet your goals, change the activities or goal to something more obtainable.
Worksheet # 2: Making a Plan
Answer the following questions:
- What is the situation? What are the threats and opportunities I can foresee?
- What assumptions am I making about the situation? How can I test those assumptions?
- What are the desired results I am after? My goals?
- When will I reach my goals? (Be specific in terms of days to years for time frame)
- What are my own strengths and weaknesses?
- What inputs will I need to make this plan work? (funding, resources, services, technology, people, etc.)
- What activities and steps will be needed to reach the goals? (must be reasonable and achievable vs. “dreaming”)
- Am I reaching the goal? Or do I need to make changes to the plan?
Self Management of Chronic Health Conditions
Answer the following question: “How confident are you that you can self-manage your health conditions?” Perhaps you rate yourself as very confident. Do you know the names, dosages, and conditions that your medications treat? If not, then you may be over-confident. If you rated yourself as having no confidence, does your chronic illness threaten to overwhelm you and keep you from pursuing a good quality of life?
Most of us probably fall in the middle of the pack. We aren’t very confident about managing our own health, but we know basic information about our health conditions, the medicines we take, and our doctor recommendations. Ultimately, who is responsible for your health? Is it your doctor? Your spouse? The home health nurse? The answer is you. You are responsible for managing your own health conditions by following the advice and recommendations of your healthcare team. Self-management of your health takes active, not passive participation.
What is Self-Management?
Self-management of health refers to a person’s ability to manage symptoms, and seek appropriate treatment, according to the University of Victoria, Centre on Aging in Canada. It also means managing the physical and psychological issues that go along with having a chronic illness. Being effective at self-management is thought to be a necessary skill to maintain a satisfactory quality of life.
Unfortunately, most of us don’t know enough about our health. With the right attitude, we can learn how to be better self-managers through education, practice, and lifestyle changes.
What is the right attitude? Some call it “try,” but others call it motivation. What they mean is that a person is willing to take positive action to reach a desired result. Having the right attitude also means giving your disability serious attention. It is also important to recognize a disability may not be going away. There is no cure for conditions such as diabetes, arthritis, congestive heart failure, and emphysema. The best option is to take control.
What Steps Can I Take to Self-Manage My Chronic Health Issues?
Once you decide to be active in managing your illness, you and your doctor can work together to set goals that will lead to better health.
According to familydoctor.org, take these steps:
Pick a problem: Take an honest look at the unhealthy parts of your lifestyle. Identify something you would like to take control of to be healthier. For example, maybe you want to get more exercise, eat more nutritiously, or start taking your medicine as prescribed by the doctor. Of course, use common sense and talk to your doctor before starting any exercise program, altering your diet, or changing medicines. Your doctor is your partner in self-management.
Get specific: Once you’ve identified a problem, state a specific goal. A vague goal like “I will exercise more” may not be as achievable as a goal that identifies what kind of exercise, how often you will do it, how long, and on what days. So a specific goal would sound like, “On Monday, Wednesday, and Friday I will walk at a comfortable pace for 15 minutes at the city park.”
Plan ahead: After you’ve decided on a goal, make sure to plan ahead for interruptions like weather. For example, on a rainy day instead of walking at the park, maybe you can walk indoors at a mall, senior center, or stay at home and walk-in-place.
Check your confidence level: How confident do you feel about your goal? If you aren’t very confident, then maybe you need to make your goal more realistic, like walking for five minutes and gradually building up your endurance to 15 minutes. Being realistic about your goals will help you feel a sense of accomplishment when you meet them, instead of disappointment from not reaching an unrealistic goal.
Follow up: As you work toward your goals, be sure to check in regularly with your doctor to let them know how you are doing. If you are having difficulty reaching your goals, they may be able to help recommend changes that will help you to reach your goals.
Remember, only you can change your behavior. No one else can do it for you. A disability can make all of us feel helpless. But when we take steps to self-manage them, we can improve the state of our health and personal control.
Taking a Personal Health Inventory
If you have decided to take an active role in managing your chronic health condition -- Congratulations!
We recognize this is an important step for you. If you feel ready, we encourage you to take an honest look at your current health status by completing the personal health inventory worksheet. Follow the instructions by adding or subtracting the points as indicated.
On the next few pages are two worksheets to help you think about important information about health status and lifestyle choices. It requires close attention to arrive at an accurate look. The results of this health inventory can be used to answer questions in the Worksheet entitled: Now What?
Worksheet #3: Personal Health Inventory
| Lifestyle | + | - |
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Disposition:
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Exercise:
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Home Environment:
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Job Satisfaction:
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Exposure to Air Pollution (including dust, animal dander, silo gas, etc.):
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Smoking Habits:
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Alcohol Habits
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Eating Habits
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Auto Driving:
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Drug Habits:
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| TOTAL PART ONE |
| Physical Health Inventory | + | - |
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Weight:
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Blood Pressure:
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Cholesterol:
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Heart Murmur:
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Pneumonia:
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| Asthma: (+6) | ||
| Rectal Polyps: (+6) | ||
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Diabetes:
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Depression:
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Regular Medical Checkups (healthy adult 1X year):
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| Regular Dental Checkup (2X year): (-3) | ||
| TOTAL PART TWO |
| Family and Social Inventory | + | - |
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Father:
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Mother:
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Marital Status:
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Home Location:
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Women Only:
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| TOTAL PART THREE |
| Scores | + | - |
| Total Part One | ||
| Total Part Two | ||
| Total Part Three | ||
| Total All Charts | ||
| Subtract the minus from the positive (you may end up with a negative number) | ||
| Divide the chart total by 12 and enter + or - | ||
| Current Age | ||
| Add or subtract the above figure from your current age to arrive at your MEDICAL AGE | ||
Worksheet # 4: Now What?
Look at your Medical Age score. Is it higher or lower than your current age? If it is higher, what can you do to “earn” back some time? First let’s review some of the habits and behaviors that are risks to your health:
- What is your overall health outlook according to the inventory?
- Do you have any risks related to driving? (ex. not wearing a seat belt)
- What about nutritional risks? (ex. eating too much fatty food)
- How about exercise? (ex. sedentary or doing farm/ranch work only)
- What kind of stress am I under? (ex. harvest time, drought, debt)
- What health issues am I dealing with? (ex. diabetes, arthritis, high blood pressure)
- What risks could excess weight be creating for me? (ex. heart attacks, wearing out joints)
- What risks can I identify about my personal safety? (ex. using unshielded PTO)
- Have I had all the immunizations for my age group? (ex. pneumonia, flu shot, Hepatitis)
- Other risk factors:
- Based on my risk factors, what changes could I make to reduce them?
- Develop a plan for making these changes:
- Time frame for making changes?
- People who can help me meet my goals?
- Other incentives that could help me meet my goals ?
Protecting Personal Health Information
Information about your personal health issues are protected by federal laws like the Health Insurance Portability and Accountability Act, otherwise known as HIPAA (see insert on right). Such privacy protection is harder to protect in the electronic information age, as more and more information about each of us is kept in electronic formats. People can take steps to enhance the protection of personal health information, which we will discuss further in this section.
Avoiding Medical Identity Theft
It is possible, but rare, that someone may be able to access your personal health information without your knowledge or consent. Those committing Medicare or Medicaid fraud may use the health information to bill for fraudulent treatments, services, or goods that people never received. Sometimes the fraud is not discovered until the person whose identity has been compromised gets stuck with related medical bills or is denied credit. The American Health Information Management Association has information on its website about protecting your health information. In general, they advise you to monitor your health records closely and report errors quickly; only share information with trusted providers (be very cautious of companies promising “free” medical services or treatments); safeguard your health insurance card like it is a credit card; and monitor your credit reports on a regular basis.
Keeping your own record of personal health information is important. Personal health records can be easily developed and securely maintained at home. Personal health records should include information like age, height, weight, blood type, primary health issues, medications, emergency contacts, healthcare providers, etc. The information can be collected in a simple folder with tabs or created and managed in a computerized form. Computerized methods allow for the collection of more complex information like doctor visits, surgeries, family history of illnesses, a log of health issues, tests, labs, hospitalizations, and even your own notes about recollections from health events. By keeping a personal health record over time, a more complete picture of your health can be gained by new healthcare providers you may encounter, and ensuring care is constant over that same time. The collection of information can be powerful in preventing mistakes and fragmentation of care or even forgetting about important health events over one’s life. Once again, it very important to protect this health information by keeping it in a safe place and only sharing it with trusted individuals. Refer to the resources at the end of this section to find free personal health record templates from two reliable sources.
An App for That
Since “smart” devices are so popular, individuals are beginning to want to use the capability of these devices to manage issues in daily life. Farmers and ranchers are using devices to monitor up-to-the-moment weather data, crop forecasts, market information, and even remotely monitor equipment or technology in the field. Imagine being able to remotely turn on/off pivot irrigation devices from miles away or receive status alerts on calving mother cows. Such powerful devices can also be used for the management of health issues by the farmer or rancher. For example, farmers or ranchers with diabetes can chart blood sugar results, A1C reports (measurement of average blood sugar over 90 days) reports, maintain food logs using their devices, and receive reminders to take medicines, go to appointments, or call the pharmacy. Such information can be shared with primary care providers and provide important data on “how you are doing” at being proactive in your care. While such “apps” make it easier to self-manage health issues, some precautions are needed to protect the information stored on the devices. Before downloading health management apps, the American Health Information Management Association recommends considering why you want to use the app, whether your doctor recommended the app, whether it will help you reach a health goal, learn more about the health issue, and whether others similar to yourself have legitimately reviewed the app and found it easy to use or whether they had any concerns.
Once that question is settled, consider whether the app allows you to password protect your information and whether the application’s source is collecting data from your device and sharing it. If the app doesn’t allow you to protect your health information and maintain privacy, you may want to skip on downloading it. Always remember to password protect your smart devices, be able to delete the data in case it is lost or stolen, and backup the information in a secure second
location like a home computer or a secure cloud-based server.
Mobile health applications, electronic health information, and personal health records are important tools in 21st century healthcare, but they also require knowledge to the advantages and disadvantages of having the information so readily available. Readily accessible is great when health decisions must be made quickly, but such advances must be balanced with proactively keeping information private and safe from theft and misuse.
Communicating with Healthcare Professionals
Adapted from “Communicate with your Healthcare Team,” Livestrong Foundation atwww.livestrong.org
Your healthcare team is made up of doctors, nurses, social workers, psychologists, pharmacists, and any other medical professionals who care for your physical and mental health. Each member of your healthcare team is specially trained to treat certain aspects of your chronic illness or disability.
Communicating with your healthcare team means:
- Asking them any questions you have.
- Talking with them about how you feel.
- Telling them about any changes in your body.
- Letting them know if you have any worries or concerns that overwhelm you.
Preparing for your healthcare team visit is an important part of good communication. You will make the most of your time in the visit if you provide clear information and ask questions when you don't understand. If you don't communicate your concerns or ask questions, your healthcare team will not know what your concerns are.
Everyone's communication style is different and what works for one individual might not work for another. However, it is extremely important that you find a way in which you are comfortable communicating with your healthcare team. When you get answers to your questions, you feel confident about the healthcare you are receiving.
You might think that it is disrespectful to question your healthcare team. However, asking reasonable questions is not disrespectful. If you tell your team what you do and don’t understand, they will be able to create the best treatment plan for you. Knowing you can ask questions builds trust with your healthcare team.
Write down your questions and concerns before the visit so that you don’t forget them. If you need an interpreter to communicate, ask for one when making the appointment. It is easier for the doctor to plan for having an interpreter present before the visit than when you arrive. Having a family member or friend at the visit can help make sure that important information is given to the healthcare team and that the best treatment plan is created. Some signs that you may need better communication with your healthcare team include:
- You leave the office feeling like you still have questions, or that the questions you asked were not answered.
- You or your family members think you never have enough time with members of your healthcare team to discuss your questions or concerns.
- Your healthcare team members don't seem open to discussing a question, concern, or problem you have.
If one member of the team cannot answer a question, other members of your team should be able to help. If you continue to have problems, it is OK to change healthcare professionals.
Members of your healthcare team sometimes suggest that you seek a second opinion or direct you to someone else who they feel can better answer your questions. This does not mean that they don't care about you or your question. It usually means they want to make sure you get the best possible answer. Not all healthcare professionals communicate in the same way. That is why it's even more important that you communicate your concerns and ask members of your healthcare team questions when you aren't sure about what they are telling you.
Good communication with your healthcare team can help you:
- Know up-to-date and accurate information about your illness and possible after-effects of treatment.
- Participate in making decisions about your medical care.
- Manage your symptoms and receive good follow-up.
- Make the most of the time you have with your team.
- Reduce stress by making sure your questions are answered.
- Feel confident that you are getting the best healthcare.
You may not be familiar with certain medical terms or know anything about the types of medicines your healthcare team prescribes. Asking a lot of questions may be the only way you are able to understand how to best take care of your health. Having open lines of communication with your healthcare team will help make you aware of any changes in healthcare, treatments, or insurance coverage.
Sometimes you may need to communicate in-between visits. If it's something that can wait, but you want to know before your next scheduled appointment, either schedule an appointment for an earlier date or ask the member of your healthcare team to call to discuss your concerns over the phone. You can also write a list of your questions and fax or mail this list to your healthcare team. They can prepare answers and then call you to discuss them.
Suggestions:
- Keep a health journal and take it with you to your appointments. Be active during the visit.
- Repeat what the healthcare team tells you and agree on a treatment plan.
- Bring a friend or family member with you.
- Find out about the new policies related to HIPAA (the Health Insurance Portability and Accountability Act).
Nutrition
When working against time deadlines and staying in front of the weather, sometimes farmers and ranchers don’t pay enough attention to their nutrition and drinking enough fluids. For example, it is not uncommon for a combine operator to go for hours in the driver’s seat during harvest without stopping to rest. The work has to get done, animals have to be fed, and machinery has to be repaired. Running the farm or ranch is a priority, and taking time to eat and stay hydrated gets squeezed in when it is absolutely necessary. While such strategies may work in the short-term it is ultimately detrimental to one’s health.
Nutrition is an important part of an overall health plan for everyone. Nutrition is defined as a process of providing or obtaining the food necessary for health and growth. No rancher would willingly raise cattle without considering the proper nutrition needed to promote herd health and animal condition. A farmer would not put all the intensive inputs of farming (fuel, machinery maintenance, seed, and time) into raising a crop and then forget to water the plants and amend the nutritional balance of the soil. So likewise, the farmer or rancher should not neglect his or her own body’s need for fuel and hydration.
In addition, farmers and ranchers with disabilities must often follow recommendations specific to their health conditions. For example, someone using blood-thinning medications would need to avoid eating dark leafy vegetables like kale or broccoli. These vegetables are rich in Vitamin K, which is involved in blood clotting, and interferes with the purpose of the medicine. On the other hand, someone might benefit from adding dark leafy greens to the dinner table for general nutrition needs.
Getting enough water can also be a challenge for farmers or ranchers who are outside working, especially during hot and sunny days. Drinking caffeinated beverages, such as soda or beer, are not hydration. In fact, these beverages can contribute to dehydration by acting as a diuretic. Good hydration is essential to everyone’s body. For example, an individual with a spinal cord injury needs adequate fluid intake to help prevent the formation of decubitus ulcers. However, balancing the need for hydration against health conditions warrants limiting excess fluid intake.
This guide cannot provide all the information farmers and ranchers with health conditions may need in order to address nutrition, but a brief review of nutrition is a good starting point for a conversation with your healthcare professionals.
Your doctor would be happy to make a referral for you to talk to a nutritionist for one-on-one planning assistance. Also, refer to a list of evidence based resources at the end of this section for more details.
Exercise
Unfortunately, a day of stacking hay bales or milking 100 dairy cows twice a day is not the same thing as exercise, although it is considered hard work. For one thing, such heavy work requires putting the body in stressful, awkward postures, and “into gravity” deforming forces. It is not uncommon to see dairymen with the beginnings of stooped forward posture despite having incredible muscular strength and power. Sooner or later, without building the “anti-gravity” muscles needed for good posture, they will likely develop neck and back problems.
So if hard work doesn’t count as exercise, what does? Exercise is defined as activity requiring physical effort, carried out especially to sustain or improve health and fitness.
According to the U.S. National Institutes of Health (NIH), physical activities like lifting weights, aerobics, and playing team sports are considered exercise. But it is important to emphasize that a well-rounded exercise program will promote good balance of muscle groups; tendon and ligament length relationships; core strength in the torso of the body; and good heart and lung function. Physical activity can lower risks for heart disease, diabetes, and cancer.
According to the NIH, there are four main types of physical activity: aerobic, muscle-strengthening, bone-strengthening, and stretching.
- Aerobic exercise involves moving large muscles in the arms and legs. Running, swimming, walking, biking, dancing, and hiking are all aerobics. People who use wheelchairs can get this exercise by using arm-bikes, swimming, or wheelchair sports.
- Muscle-strengthening activities (like push-ups, sit-ups, and lifting weights) improve the strength, power, and endurance of muscles. Varying routines of muscle-strengthening exercises can be done for arms, legs, backs, and abdominal muscle groups to ensure all muscles are getting benefit.
- Bone strengthening activities involve exercises where the feet, leg, or arms support the body’s weight and the muscles push against bones. For example, running, walking, jumping rope, and lifting weights.
- Stretching activity improves flexibility and the ability to fully move the joints of the body through their motion.
In general, the NIH states that adults over 65 should remain active just like everyone else. Any physical activity is better than none. Starting out slow and easy is the best way to go, so it’s important to set realistic goals. The goal for a farmer with arthritis may be to walk a couple of miles a day, but dependng on a person’s baseline condition, it may require starting with a shorter distance. Older adults can build up to doing 150 minutes of exercise per week, depending on abilities and health conditions. As always, you should consult the doctor about what activities are safe.
Reviewing the Fuel in Nutrition
There are six main categories of nutrition, found in food, needed to maintain health:
Proteins: Usually obtained from milk, eggs, or meats proteins supply the amino acids needed to build and maintain health body tissues like muscle, skin, bones, joint tissue, and teeth.
Fats: Certain amounts of fat are necessary for normal body and brain function as well as for transportation of the body’s other nutrients. Good sources of fat are canola oil, flaxseed oil, and cold water fish or fish oil. Animal fats, like lard, are not considered healthy sources of fat in the modern human diet.
Carbohydrates: Carbs are the body’s main energy source. Complex carbs like grains, beans, peas, or potatoes are preferred over simple carbs like sugar because they have fewer calories and cause fewer problems with overeating and diabetes.
Fiber: Dietary fiber is found in plant foods like fruits, vegetables, legumes, nuts, and whole grains. Insoluble fiber from bran, fruit pulp, and and vegetable skins helps move food through the digestive system and helps prevent constipation. Soluble fiber from sources like apples, oatmeal, rye flour, and dried beans is essential for lowering blood fat, thus lowering cholesterol.
Vitamins and minerals: These are organic substances necessary in trace amounts for metabolic function of the body. They are best acquired through eating healthy foods, but some people may need to obtain them through a capsule or pill form to get enough into their diet. Excessive intake of vitamins and minerals can cause serious health problems.
Water: Water is needed to regulate body temperature, transport nutrients to cells, and rids the body of waste materials. Although water is a component part of many beverages, plain old H2O is the best source of the substance.
Precautions: Individuals with disabilities should not change their diets without the advice of nutritional experts or health care professionals. Some individuals should seek supervision from a professional.
Tips for Getting Active
- Make physical activity a part of daily routines: Taking short stretch breaks or incorporating brief episodes of walking into daily routines are powerful ways to stay strong and flexible. One farmer found a way to do chin-ups and wall-push-ups in the barn and workshops as part of a farm-friendly work-out routine. Another farmer completes an arm, back, and neck stretching program each time while sitting in the tractor before starting the machine and working the field.
- Personalize the benefits: You need to determine what exercise is beneficial and whether it helps you feel better, sleep better, lose weight, or even look better. A lot of farmers say they need to stay physically fit because of farm work demands and the continued desire to perform farm tasks.
- Be active with friends and family: Making physical activity a focus of socialization is a powerful reinforcement for the activity. Playing a team sport is a great way to be active, and have fun, without it feeling like exercise.
- Make everyday activities more active: Walking to the store instead of driving a car over allows you to turn a normal activity into exercise. Or, you could take a couple of minutes to do short bursts of aerobic activity, such as lifting a weight while seated or standing.
- Reward oneself with time for physical activity: Giving yourself time for physical activity at the end of a long work day can be a great way to relieve stress and refresh the body and mind.
- Keep track of your progress: Keeping a log of your activity is a powerful reinforcement that you are taking care of yourself.
- Stay safe: Walking in rural areas can be difficult since there are few sidewalks and paved roads. Wearing high-visibility clothing, staying on a well-lit route, having water, and considering clothing for weather changes are important for general safety.
- Talk with your Doctor: You should discuss with your doctor about how to start a safe level of physical activity.
Risks of Physical Activity/Exercise
In general, the benefits of physical activity outweigh the risks, but certain individuals are at greater risk for heart problems caused by physical activity. For example, middle-aged and older adults are at greater risk for heart problems due to physical activity, and people who have existing heart problems have an elevated risk. The risk of heart problems is related to one’s existing fitness level and the intensity of the activity the person is engaging in. The more vigorous and taxing the activity, the more the risk. Everyone should exercise and be as physically active as they are capable of being. Health care professionals can provide you with specific information on how your health conditions need to be accommodated for an exercise program.
Stress Management
Ongoing stress can be detrimental to one’s health. Unfortunately, farmers and ranchers work in an industry that can be very stressful. Stress in the agricultural industry ranges from catastrophic weather events, to animal diseases, and family discord. Stress is a physical and psychological response to a triggering event or series of events. Stress can occur suddenly, or build up slowly day after day.
Physical symptoms of stress include headaches, stomach problems, rising blood pressure, and rapid heartbeat. Stress-related illnesses include heart disease, cancer, diabetes, and stroke. Other signs of stress can include depression, anger, or difficulty controlling emotions. Stress can interfere with one’s behavior and relationships. Some individuals might find themselves drinking, smoking, or eating out more often to cope with the stress. Others might get into more arguments or disagreements with family members. Having an uncontrollable illness, disability, or aging issue may also contribute to perceptions of stress.
Extension specialists from Ohio State University say that farmers and ranchers can control some aspects of stress. Planning ahead is a big part. For instance, replacing worn machinery parts during the off-season can prevent the stress that follows having to repair a machine and wait for parts during the middle of harvest. Planning the use of time can be a huge stress reliever, such as before stressful seasons, planning who will do what during planting or harvest.
Learning to say “no” to extra commitments can be stress relieving. The specialists also say farmers and ranchers can control the attitudes that lead to additional stress. Doing things like setting realistic goals and daily expectations, emphasizing what got done instead of what didn’t, looking at the big picture, and shifting from worrying and blaming strategies to problem-solving can help.
Finally, the specialists recommend eating a balanced diet, getting exercise, a good night’s sleep, and spending relaxing time with family and friends. These are all important parts of reducing life and work stress.
A farmer who uses a wheelchair for mobility was telling a group of other farmers how he has gotten better about handling stress. One time he got his wheelchair stuck in a shed several miles from the house, and there was no mobile phone service available. He said, in his earlier years as a wheelchair user, he would’ve gotten mad, tried to force his way out of the situation, and possibly gotten stressed or even physically hurt. But now, he just relaxes and knows “someone will be around soon” looking for him. Of course, part of being able to take this attitude is knowing he planned ahead by letting someone know exactly where he was going to be and when to expect him home.
Resources
Templates for Creating a Personal Health Record
- Montana State University, My Health Companion©: www.msucommunityresources.org/MHC/default.cfm
- American Health Information Management Association, MyPHR: www.myphr.com/resources/choose.aspx
General Nutrition Resources
- United States Department of Agriculture, Choose My Plate: www.choosemyplate.gov
Nutrition for Spinal Cord Injury
- National Institute on Disability and Rehabilitation Research, Rehabilitation Research and Training Centers: http://sci-health.org/RRTC/publications/PDF/SCI-Nutrition.pdf
Nutrition for Diabetes
- American Diabetes Foundation: www.diabetes.org/food-and-fitness/food/
Nutrition and Disability
- United States Department of Agriculture-SNAP-Ed Connection: http://snap.nal.usda.gov/professional-development-tools/hot-topics-z/nutrition-and-disability
Nutrition Tips for Stroke Surviviors
- American Heart/American Stroke Foundation: http://strokeassociation.org/STROKEORG/
Exercise Resources
- U.S. Department of Health and Human Services-National Institutes of Health: www.nhlbi.nih.gov/health/health-topics/topics/phys/
Stress Management Information
- University of Wisconsin, Farming through Difficult Times: http://fyi.uwex.edu/farmfinances/category/topics/stress-management/
- Colorado State University, Managing Stress in Difficult Times: www.ext.colostate.edu/pubs/consumer/10255.pdf
- University of California-Davis, Stress Management for Women Farmers and Ranchers: http://sfp.ucdavis.edu/files/143919.pdf
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