PCPID RELEASES 2017 REPORT

The President's Committee for People with Intellectual Disabilities (PCPID) recently released its 2017 Report, "America's Direct Support Workforce Crisis: Effects on People with Intellectual Disabilities, Families, Communities and the U.S. Economy."

The NADSP (The National Alliance for Direct Support Professionals) is proud to have assisted the University of Minnesota's Research and Training Center on Community Living in preparing this report and especially proud to highlight the work from some of our certified direct support professionals and stories from families and individuals who receive direct support services with whom we are honored to collaborate. The Report also shares our National Competency Areas and Code of Ethics, among other NADSP contributions to the I/D field.

According to PCPID, "the intended outcome of this Report is to ensure that the Administration is fully aware of and understand the effects of the direct support workforce crisis and the opportunities to address it in ways that strengthen the ability of people with intellectual disability to both participate in and contribute to their communities and the American economy. Not only does the crisis facing this workforce threaten people with intellectual disability and their families; it also undermines the stability, efficiency and ability to grow much needed long-term services and supports and, therefore, undermines the overall U.S. economy".

The Report specifically examines the following areas to determine how the direct support workforce can be sustained so people with intellectual disability are included and engaged in all aspects of society:

• Overview of the direct support workforce

• Critical challenges faced by the long-term services and supports industry

• Effects of the workforce crisis

• Economic and other factors that have influenced the crisis

• Promising practices to address the direct support workforce crisis.

For more information, visit: nadsp.org •

FIGHT YOUR DIABETES AND GET FIT IN 2018

Now that 2018 is here, you've decided that this is the year you're finally going to better manage your diabetes, starting with that dreaded word: exercise. According to Sheri R. Colberg, PhD, FACSM, if you suffer from diabetes or are at risk for developing the disease, deciding to commit to fitness could be a real lifesaver. That's why it's more important than ever that you make sure this resolution sticks.

"Considering that more than 29 million people have diabetes and 84.1 million American adults have prediabetes, it's crucial that a large number of people make lifestyle changes for the sake of their health," says Dr. Colberg, who partnered with the American Diabetes Association to write the new book Diabetes & Keeping Fit For Dummies.

"If you have diabetes or are at risk of developing it, exercising regularly is the single most important thing you can do to keep your blood glucose levels in check, reduce your risk of developing complications, and slow down the aging process" she adds. "And the new year is the perfect time to commit to doing more physical activity."

Although having diabetes increases your risk of getting health problems that can greatly reduce your quality of life, Dr. Colberg says you can fight back by keeping fit. Exercise enhances your body's sensitivity to insulin. Many chronic diseases in addition to type 2 diabetes are associated with reductions in your insulin action, like hypertension and heart disease. Exercise may also enhance your body's ability to produce more insulin. Plus, it lowers your risk of premature death, heart disease, certain cancers, osteoporosis, and severe arthritic symptoms.

"Beyond just the physical benefits, exercise can have a positive impact on your mental and emotional health as well by lessening feelings of stress, anxiety, and depression," she adds. "Being active can also positively affect your self-confidence, body image, and self-esteem."

Knowing all those benefits may not be enough to get you motivated to start exercising more. So many find that the hardest part can be trying to find the motivation to begin. Read on for Dr. Colberg's tips to get you moving in the new year and beyond.

MOVE IT: MOTIVATIONAL TIPS FOR GETTING STARTED

Choose activities you enjoy.

It's human nature to avoid doing the things you really don't like to do. If you absolutely hate running, it's probably not the best activity to choose to get started with. Most people need exercise to be fun, or they lose their motivation to do it over time. By actually having fun with your activities, you will more easily make them a permanent and integral part of your routine. Try picking activities you truly enjoy, such as salsa dancing or golfing (as long as you walk and carry your own clubs).

"Maybe you haven't found any activities that you enjoy much. If that's the case, choose some new ones to take out for a test run (so to speak). Also, be sure to choose an exercise that suits your physical condition and overcomes or works around your limitations."

Start off with easier activities.

Exercising too hard right out of the gate will likely leave you discouraged or injured – especially if you haven't exercised in a while. Instead, start slowly with easier activities and progress cautiously toward working out harder.

"If you often find yourself saying that you are too tired to exercise, your lack of physical activity is likely what's making you feel sluggish," says Dr. Colberg. "But after you begin doing even light or moderate activities, your energy levels rise along with your fitness, and your physical (and mental) health improves."

Check your blood glucose for added motivation.

When starting a new exercise, use your blood glucose meter or continuous glucose monitor to check your blood glucose before, during (if you're active for more than an hour), and after your workout. Why? A reading that changes – especially in the direction that you want it to – can be very rewarding and motivating. You will be able to see evidence of real results. If you don't check, you may never realize what a positive impact you can have on your diabetes simply by being active. "Let's say your blood glucose is a little high after you eat a meal, and you want it to go lower without taking (or releasing) any more insulin. You can exercise after your meal and bring your blood glucose down within two hours after eating and taking insulin, or you can avoid or lower post-meal spikes in your blood glucose. You wouldn't know the extent of the effect you can have without using your blood glucose meter to check."

Spice up your routine.

One of the chief complaints about exercise is that it is boring. Feelings of boredom with your program can be the result of repeating the same exercises each day. To keep it fresh, try different physical activities for varying durations and at different intensities. Just knowing that you don't have to do the same workout day after day is motivating by itself.

"You may want to do a variety of activities on a weekly basis, an approach known as cross-training," says Dr. Colberg. "For example, you can walk on Monday, Wednesday, and Friday but swim on Tuesday and take dance classes on Saturday. In addition to staving off boredom, adding variety to your workouts has many other advantages as well, such as using different muscles so more muscles get the benefit of exercise training."

Find an exercise buddy (or several).

You don't have to go it alone when being active. Having a regular exercise buddy keeps you accountable, increases your likelihood of participating, and also makes your activities more social and fun. Get your spouse, family members, friends, and co-workers to join in your physical activities. Having a good social network to support your new or renewed exercise habit helps you adhere to it over the long run. "Your community may be a good place to look for other exercise options. Take the time to find out what's available in your area. You can often find groups of health-conscious people walking together during lunch breaks, or you may be able to join a low-impact aerobics or other exercise class offered at your workplace, community center, or recreation center. The more you can get involved in making your lifestyle changes a part of a larger community, the more likely you are to be successful in making them a lifelong habit."

Set goals. 

Setting goals can help keep your interest up and be a great motivator. For instance, if you walk for exercise, you may want to get a pedometer and set a goal of adding in 2,000 more steps each day. But when laying out your fitness goals, be realistic and avoid setting unreachable goals that will sabotage you from the start. That said, if you do have large goals, great! Break them down into smaller, realistic stepping stones (such as daily and weekly physical activity goals). This will help keep you on track and keep you from becoming too overwhelmed with trying to accomplish your goal. "Using a fitness tracker, activity log, or fitness app may also be a good idea for helping you reach your exercise goals," says Dr. Colberg. "Figure out what works best for you."

Don't forget to reward yourself.

Having goals is great, but with no reward, what motivation do you have for reaching them? When you reach an exercise goal, be sure to reward yourself (but preferably not with food!).

"No one ever said that sticker charts and non-food treats are just for kids. Maybe you can promise yourself an outing to somewhere special, the purchase of a coveted item, or another treat that is reasonable and effectively motivates you to exercise. If you do miss one of your goals, try to make the rest of them happen anyway. Then reward yourself when you meet any of your goals, even if you don't make them all happen."

Have a plan b ready just in case.

Always have a backup plan that includes other activities you can do in case of inclement weather or other barriers to your planned exercise. For example, if a sudden snowstorm traps you at home on a day you planned to swim laps at the pool, be ready to walk on the treadmill or try out some resistance activities (like  abdominal crunches and leg curls). Even if you don't enjoy your second-choise exercise as much, you can always distract yourself to make the time pass more pleasantly. Read a book or magazine, watch your favourite TV program, listen to music or a book on tape, or talk with a friend on the phone while you're working out.

 "Keeping an exercise routine can be a slippery slope – especially when you're starting out. One roadblock can be all it takes to set you back. By having a backup plan, you are still keeping your body active in some capacity and are less likely to quit altogether."

ON YOUR TOES: It takes some planning ahead and a firm commitment to make exercise a priority.

Schedule your workouts.

 You show up for your doctor's appointments, so why should scheduling your physical activity be any different? Write your exercise down on your calendar or to-do list just like you would any other appointment. Scheduling it into your daily activities will help keep you from making excuses. If you already have the time blocked off, you will be more likely to do the activity.

Take advantage of opportunities for "spa time." 

How many times have you driven around a parking lot to find a spot close to the door instead of just parking farther away and walking? When you do that, you're missing out on an opportunity for spontaneous physical activity (SPA). There are plenty of ways to incorporate SPA into your daily routine. If you have a sedentary desk job, take the stairs rather than the elevator whenever you can. Walk to someone else's office or the neighbor's house to deliver a message instead of relying on the phone or email.

"Keep in mind that you don't have to do activities at a high intensity for them to be effective." says Dr. Colberg. " Adding in more daily movement in any way possible is likely to benefit your health. These could include gardening, doing housework, walking the dog, or even just standing while talking on the phone."

Take small steps to get yourself back on track. 

Even after you've developed a normal activity routine, it can be easy to get off track. If you're having trouble getting restarted, simply take small steps in that direction. You may find you need to start back at a lower intensity by using lighter weights, less resistance, or a slower walking speed. Don't overdo it to make up for lost time. Starting out slowly with small steps will help you avoid burnout, muscle soreness, and injury.

"If you don't want to exercise on a given day, make a deal with yourself that you'll do it for a short time to get started. After all, getting started is often the hardest part. Even doing only 5 to 10 minutes at a time (rather than 30 minutes or more) is fine. After you're up and moving, you may feel good enough to exceed the time you planned on doing in the first place. The key is to begin through any means possible."

"When it comes to living with diabetes or prediabetes, exercise is very powerful medicine, and the side effects are all good ones," concludes Dr. Colberg. "This is why it's so important to get motivated and commit to an exercise routine, because it will change your life and put you on the road to wellness. Make 2018 the year that you take charge of your life, get fit, and discover better health at last."

ABOUT DR. COLBERG

Sheri R. Colberg, PhD, FACSM, is the author of Diabetes & Keeping Fit For Dummies. She is professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert. She is the author of 12 books, 25 book chapters, and over 300 articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites SheriColberg.com and DiabetesMotion.com

Diabetes & Keeping Fit For Dummies (Wiley, February 2018, ISBN: 978-1-119-36324-8, $22.99) is available from all major booksellers, and direct from the publisher at wiley.com