Take Back Your Kitchen
In 2010, I started working as an Occupational Therapist with the elderly population in a skilled nursing facility. Most of my patients were between the ages of 75 to 95 and either lived in the nursing home or were there for short-term rehab with the goal of returning home. My goals for these patients were usually straight forward and involved getting stronger to increase independence or to return home.
I continue to work in a skilled nursing facility however the population of people I work with are much younger and in much worse physical health. I would estimate the average age of the population in my current facility is 65. This is likely the average age, plenty of people are younger than this as well. Think about that for a minute. 65 years old in my opinion is not old. Certainly not old enough to live in a nursing home, requiring 24 hour care.
A large percentage of the people I work with are diagnosed with obesity or morbid obesity which are defined as preventable diseases. According to the National Institute of Health a diagnosis of obesity can greatly increase the risk for a host of other health issues including heart attack, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, certain cancers, sleep apnea, obesity hypoventilation syndrome, reproductive problems and gallstones. Whew – that was a lot of related health issues! When I read the medical records of my patients I typically see these other related diseases as well; especially diabetes.
Prior to their hospital stay some of my patients were living in the community and working. Most were living on the edge and didn’t even know it. Maybe they fell down and broke a leg. Or woke up one morning to discover their leg was red and hot and were diagnosed with cellulitis. Maybe the doctor has been treating a wound on their foot that just won’t heal. A diagnosis of morbid obesity can significantly complicate a hospital stay that would be considered routine for someone who is not overweight.
A short hospital stay can cause a rapid decline in one’s ability to function or simply bring to light that home life was not all that safe to start with. For some people, when they get admitted to the hospital, have the acute issue resolved they are unable to go home because they can’t get out of bed, can’t walk or use the toilet without assistance. They often see the change in their ability to complete their daily tasks from before the hospital stay to now as dramatic.
Once in the nursing home, the length of stay for patients with morbid obesity is complicated by the fact that it takes 2 and sometimes 3 staff to help them roll over in bed, use the bedpan and transfer to a wheelchair. Sometimes a mechanical lift is needed to help them transfer from bed to a wheelchair. To complicate this situation further, morbid obesity is often coupled with diabetes which can result in amputation of toes, feet and legs. Have you ever tried to help a 350 pound person with one leg get on and off a bedside commode? It is not just the obesity and amputation that come into play but the fear and depression and loss of identity that must be addressed.
The people I work with are not just undergoing a rehab stay. They are often sick, unhealthy, depressed and beat up by life circumstances. I have worked with 60 year olds that think they are old. Young people weighing 500 and 600 pounds, 40 year olds that will never walk again.
I often struggle in my role as an occupational therapist. I am supposed to be supporting people to gain independence in their ability to bathe, dress, and care for themselves. The people I work with need so much more than this. Being able to complete these basic tasks might get them back into their own home or into an assisted living facility. But what happens when they get there? Will they thrive? Will they make life choices that support the advancement of health, wealth and happiness?
I should be able to do more than ensure someone can put their pants on and use the bathroom independently. I am hampered by insurance reimbursement. I am hampered by not wanting to step on the toes of other professionals. I am hampered by my own lack of knowledge and fear of treading into unchartered waters with someone I have just met. Think about talking to someone you barely know and wanting to discuss their weight, their food choices, their lifestyle. The problem is these are taboo subjects. They are personal, they are not discussed with friends and family much less strangers.
A common theme for me is we know the right thing to do. Yet when it comes to eating healthy, nutritious meals it is easy to get confused. Labels such as low-fat, lean, natural, reduced fat are misleading. They make it sound like choosing these options would be healthier than whatever they replaced. But think about it? If the fat was removed what replaced it?
SUGAR (EMPTY CALORIES)
I am not an expert on anything. I don’t have all of the answers. But I do know a few things. I know not to trust the food industry. I know not to believe that these “healthy” sounding labels make the product good for me. I see my patients, thinking they are making good food choices by eating a low-fat granola bar as a snack or diet soda instead of a regular one. Strategies such as this will not help them improve their health in the least.
Food can and should be healthy, nutritious and life affirming. Yet food can also be unhealthy, toxic and life defeating.
If I had to recommend one change to people it would be to stop eating processed food and fast food. To me this essentially means food that comes prepared in a can, bag or box. I know, I know; no one asked me for my recommendations. But I can’t help myself. It is time we all take back our kitchens and food preparation from the food industry. Their job is to make money, they do it by providing low cost food options and they do it well. Their job is not to ensure our health or nutrition. Our jobs is to create healthy meals for ourselves, for our families and for our children.
So my best suggestion is to ditch the processed s*h*i*t. Don’t fall for marketing that makes it look like fruit can come out of a wrapper! Go make a healthy smoothie from real fruits and vegetables. Make cooking and eating healthy part of your daily routine.
What is your best suggestion?
In some ways this blog is written with my patients in mind. Most of them don’t choose health, wealth or happiness. Most of them don’t even realize they are making choices every day that keeps them stuck in a rut in terms of eating food that has no nutritional value such as fries, soda, donuts and white bread. It is oh so easy to consume excess calories from our diets that lack the vitamins and minerals that we need to live a healthy life. Poor food choices lead to unhealthy lifestyles that cause debilitating disease.
So please join me in my little blue kayak by taking back your kitchen.