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Editors note: Julie Walsh-Messinger is a clinical psychologist who studies the effects of long-term smell loss. Her research has focused on smell loss in people with serious and persistent mental illnesses, but since the beginning of the coronavirus pandemic, she has also studied smell loss caused by COVID-19. In this interview, she talks about how COVID-19 can affect your sense of smell, the effects of long-term smell loss and resources that can help.

COVID-19 is not the only virus that affects our ability to smell, but its unique in the way in which it does so. For example, the common cold causes an inflammatory response in the nose, and that builds up mucus which reduces your ability to smell, making it a muted sense.

Whats unique about COVID-19 is that it actually is not nasal congestion or that nasal inflammatory response that is causing the smell loss. The virus actually crosses the blood-brain barrier and gets into the nervous system. It affects the nervous system and the neural connections that are necessary to detect odor and interpret it.

COVID-19 affects the nervous system and sometimes results in profound loss or a complete inability to smell. Some people recover their ability to smell within a few days or weeks, but for some people its been going on for much longer. Scientists are still not sure how many people lose their ability to smell completely, a condition known as anosmia.

This is really taking its toll on the people who have not had their sense of smell, sometimes for months, or even upwards of almost a year at this point. It can have real consequences. For example, if you cant smell smoke, you are relying on a smoke detector to tell you theres a fire. It is also affecting quality of life. Food doesnt taste good anymore because how you perceive taste is really a combination of smell, taste and even the sense of touch. Some people are reporting weight loss due to loss of appetite, and theyre just not able to take pleasure in the things that theyve previously found pleasurable.

Our sense of smell is really important for daily functions. Theres research that suggests that our sense of smell can influence our attraction to certain people unconsciously. Its one of the ways in which we select mates who are less genetically similar to us, which can be an advantage for reproduction. It can also help us detect fear in others, which is important for survival.

It is a sense that subtly drives a lot of the decisions that we make on a daily basis but are not consciously aware of.

There are resources available to people who have smell and taste loss, though some of these arent just COVID-19 related. The Global Consortium for Chemosensory Research is a group of scientists who came together very quickly in the spring of 2020 to study the effects of smell and taste loss. You can participate in our research so we can learn more about whats causing this and how to deal with it. There are links to many other resources on the site.

There are also people and organizations doing smell training. Smell training is essentially smelling the same odors over and over so that you can retrain your bodys ability to detect and identify that odor. We are optimistic that the sense of smell will come back for some of the people who lose their sense of smell for several months. One of the groups that is involved in smell training is the nonprofit Abscent. It wasnt set up specifically for COVID-19 patients but has been a pioneer in smell training.

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Anosmia, the loss of smell caused by COVID-19, doesn't always go away quickly but smell training may help - The Conversation US

Its no secret that intermittent fasting is the weight-loss method du jour. Instagram is packed with people who swear intermittent fasting (IF) helped them lose weight, feel more energized, and have better overall health.

But with all of the info out there about intermittent fasting, its easy to gloss over the fact that IF has actually been a used as a medical intervention for years. Its helped people with a range of health conditions, including diabetes.

In fact, the American Diabetes Association (ADA), which is considered the leading educational organization for diabetes in the country, published this in its journal Diabetes in 2018: In both experimental and clinical studies, intermittent fasting has been shown to improve insulin sensitivity and glucose control along with modest decreases in body weight.

And last year, the ADA released a nutrition consensus report that also addressed intermittent fasting. In it, the ADA wrote that somebut not allsmall studies have shown that intermittent fasting reduced A1C in people with diabetes. (A1C is a measure of your average blood sugar over time.) Still, there isnt a mainstream, blanket recommendation for diabetes patients when it comes to intermittent fasting for better health, but there does seem to be some link here.

So whats the deal with intermittent fasting and diabetes, and should you try the eating pattern if you have the condition? Doctors weigh in.

Again, this isnt an eating plan thats widely recommended by diabetes specialists, but there is some data to suggest IF could help with diabetes management.

A case report published in BMJ found that intermittent fasting helped treat the insulin resistance in three patients with insulin-dependent type 2 diabetes. It also lowered their A1C levels. And, this is definitely worth paying attention to: After using intermittent fasting for several months, the patients were able to stop using their insulin medication.

Intermittent fasting may even help with prediabetes. A clinical trial published in the journal Cell Metabolism that had men with prediabetes try intermittent fasting. Some were asked to follow a plan for five weeks where they could eat for six hours a day; the others were asked to eat for 12 hours a day. Those who followed the six-hour eating plan ended up having less insulin resistance at the end vs. those who followed the more regular 12-hour eating pattern.

But all of that said, a meta-analysis of research on intermittent fasting published in the journal Cell Metabolism found that intermittent fasting had the same results on a persons insulin resistance and A1C as eating a diet with limited calories.

Basically, there is no evidence that intermittent or any other type of fasting is better than caloric restriction in losing weight, says Mark H. Schutta, MD, medical director of the Penn Rodebaugh Diabetes Center. And, he points out, weight loss can help reduce a patients insulin resistant and A1C levels, regardless of how it was achieved.

The research on the impact of intermittent fasting and diabetes isnt perfect, says Lissette Cspedes, MD, assistant professor of medicine in the Division of Endocrinology at Rutgers Robert Wood Johnson Medical School. In clinical studies, the study sizes have generally been small and the follow up period is short, she says. Studies also vary by which method of fasting is employed. As such, long-term benefit and generalizability cannot be determined.

All in all, it's unclear if intermittent fasting is helpful for any other reason than the fact that it may help you cut calories, since you're eating in a shorter window of time.

While some people swear that intermittent fasting will completely change your life, those claims are a little overblown. Still, theres some research to suggest that IF has perks. Those include:

A lot if it comes down to personal preference. Patients need to work with their physician to find a plan that works best for them [that] poses the fewest risks, and that they can sustain over a long period of time, Dr. Cspedes says.

That said, a 16:8 schedule may be easiest to follow and the most beneficial for maintaining good blood glucose controland several studies have found this eating pattern to be beneficial. I often tell my patients that the most impactful change they can make is to eat less at dinner, go to bed with a normal or close to normal glucose, and then wake up with the same, Dr. Schutta says.

But, again, There truly is no one-size fits all approach to selecting a regimen for patients with diabetes who want to improve their insulin resistance and glucose metabolism, Dr. Cspedes says.

Intermittent fasting isnt perfect, and there are some side effects to consider.

If youre interested in trying intermittent fasting to better manage your diabetes, its important to talk to your doctor first, Dr. Cspedes says. They may have some concerns you havent thought of, and may even need to adjust your medication.

Its also important to think about what youre eating during a feeding window. In general, we recommend that patients eat a healthy diet, which will improve their cardiometabolic risks, Dr. Cspedes says. This includes increasing intake of fresh foods, such as fruits and vegetables, and complex carbohydrates and minimizing highly processed foods or simple carbohydrates.

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The quality of your calories matters too, Dr. Cspedes says. A person with diabetes should also take into consideration the amount of carbohydrates being consumed in the diet, she says. Generally, eating fewer than about 150 grams of carbohydrates in a day will improve blood glucose levels, insulin resistance, and help with weight loss.

Complex carbohydrates with a higher fiber content, like using cauliflower instead of white rice, are better options since these are absorbed more slowly and lead to less glucose excursions, Dr. Cspedes says. Given that youll probably be ready to eat as soon as your feeding window starts, its important to plan ahead to make sure you have quality food ready to go once your fasting period is over.

Finally, youll want to create eating and fasting windows that work best for your diabetes management. Breakfast is truly the most important meal of the day for people with diabetes, Dr. Schutta says (your body is better able to process glucose when youre up and moving). But youll want to make sure youre actually hungry in the morning and not still full from a huge dinner you ate. "Patients have to figure out a way to restrict food after dinner and make sure that they eat breakfast every day, Dr. Schutta says.

The bottom line: If youre interested in trying out intermittent fasting to help manage your diabetes, talk to your doctor first. They should be able to offer up personalized advice to help steer you in the right direction.

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Intermittent Fasting And Diabetes - Is It Safe, How Do You Do It? - Women's Health

Colitis refers to the inflammation of the lining of the colon. Many different conditions can cause this to happen.

The most common type of colitis is ulcerative colitis. With this type, ulcers or sores develop in the stomach. The inflammation extends from the rectum along the inner lining of the colon.

Types and causes of colitis may differ, but most symptoms overlap. How the condition affects an individual varies from person to person.

This article will discuss the different types of colitis. It will also look at the causes and risk factors, as well as when to contact a doctor.

Colitis refers to inflammation within the lining of the colon. This can occur due to several different conditions. The main two are ulcerative colitis and Crohns disease, both of which are types of inflammatory bowel disease (IBD).

With colitis, the lining of the colon becomes inflamed as a reaction to harmless bacteria and molecules present in food.

Colitis is often a lifelong condition, and there is currently no cure. However, there are treatment options available to help manage the condition.

Colitis typically develops when people are within the age brackets of 1535 years or 5570 years.

Ulcerative colitis is the most common variation of colitis. It begins in the rectum and spreads up the colon in different ways, depending on the type.

People with chronic ulcerative colitis may experience episodes of acute severe colitis during their lifetime.

Acute severe ulcerative colitis is a condition that can be life threatening and almost always requires hospitalization to balance out fluids and electrolytes and, in some cases, to obtain nutritional support.

Although most people do not experience extreme flare-ups, an estimated 20% of those with chronic colitis may experience a severe flare-up that requires hospitalization.

Learn more about ulcerative colitis here.

Some types of ulcerative colitis include:

This type of colitis is limited to the rectum. The Crohns & Colitis Foundation note that there is not an increased risk of cancer.

Symptoms of ulcerative proctitis can include:

Inflammation begins at the rectum and continues along the left side of the colon. It can also include proctosigmoiditis, which affects the rectum and lower part of the colon above the rectum, or the sigmoid colon.

Symptoms of left sided colitis may include:

This condition affects most of the colon. In the case of pancolitis, it affects all of the colon.

Symptoms of extensive colitis include:

Ulcerative colitis can occur due to:

Crohns colitis is one of several types of Crohns disease. Unlike other variations of the condition, Crohns colitis only affects the colon.

Symptoms overlap between Crohns conditions, but people with Crohns colitis are more likely to develop skin lesions and joint pain.

Some other symptoms include:

Crohns colitis may occur due to:

A healthcare professional can only see microscopic colitis with a microscope.

There are two types of microscopic colitis: lymphocytic and collagenous.

With the lymphocytic type, there is a higher number of white blood cells than usual, and the lining of the colon is of a normal thickness.

With the collagenous type, the layer of collagen under the epithelium is thicker than usual.

The symptoms of each type are similar. A person will typically experience watery diarrhea that does not contain blood.

Some other signs and symptoms include:

Microscopic colitis may occur due to:

In these cases, a persons immune system attacks its own cells. Autoimmune conditions that may be a cause include:

Medications that may be associated with microscopic colitis include:

Bacterial and viral infections may cause inflammation of the gastrointestinal tract.

Bile acid is a fluid that helps carry waste out of the body.

Bile acid malabsorption occurs when the intestines are unable to reabsorb the bile acid. If it reaches the colon, it can lead to diarrhea.

Another type of colitis is ischemic colitis. It occurs due to a reduced blood flow to the colon.

A person may experience abdominal cramping and pain. Within 24 hours, they may notice bloody stools.

Other ischemic colitis symptoms include:

An older 2012 article states that there are three main categories of ischemic colitis:

Most people have the transient type, which causes milder symptoms, but some have the gangrenous type.

Gangrenous ischemic colitis is particularly severe. People with this condition are likely to require surgical intervention when symptoms appear.

Learn more about ischemic colitis here.

Ischemic colitis occurs due to a lack of blood flow to the colon. This can happen for a variety of reasons, such as heart disease and other conditions that affect blood flow.

Pseudomembranous colitis is usually the result of Clostridium difficile bacteria.

These bacteria are always present in the body, but there are usually enough good bacteria to override them.

When these good bacteria die, often after a person has taken antibiotics, the presence of C. difficile increases, causing inflammation in the colon.

Pseudomembranous colitis can occur due to taking medications that destroy healthy bacteria, such as antibiotics.

Colitis can also come from conditions that are not related to IBD. One of these is cytomegalovirus (CMV), which is a common strain of the herpes virus.

One 2020 article notes that symptoms can be nonspecific and mimic those of IBD. However, a person may experience:

Rectal bleeding and diarrhea appear to be the most common symptoms.

If a person with CMV develops symptoms of colitis, they should contact a doctor as soon as possible.

Learn more about CMV here.

CMV is a strain of the herpes virus that affects approximately 70% of the general population. It does not typically cause any symptoms.

However, symptoms can occur, especially in those with a compromised immune system.

Treatment options will depend on the type and severity of symptoms that a person is experiencing.

There are different types of medications that a doctor may suggest, including:

If medication does not work, the doctor may suggest surgical intervention.

Surgery may also be desirable to people who are benefiting from medication but still finding that the condition affects their quality of life.

There is no way to prevent colitis. However, a person can take steps to help manage the condition and reduce its symptoms.

These steps include:

Research indicates that people who smoke are twice as likely to experience IBD than people who do not smoke. This is because of a certain protein in the lungs that smoking can activate.

Learn more about natural remedies for managing ulcerative colitis here.

It is always best for a person to make a doctor aware if they believe that they have colitis. Even if medical treatment does not seem necessary, the support can be beneficial.

People should contact a doctor if they experience any of the following symptoms:

If a person thinks that they may have acute severe ulcerative colitis, they need medical attention immediately.

When the inner lining of the colon becomes inflamed, it is known as colitis.

This can be the result of several conditions. However, the most common type is ulcerative colitis.

If a person develops colitis, they are likely to experience abdominal discomfort, rectal bleeding, weight loss, bloody diarrhea, and an urgent need to have a bowel movement.

A person should contact a doctor if they suspect that they are experiencing colitis.

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What is colitis? Definition, types, symptoms, treatment, and more - Medical News Today

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Seniors, or older adults, may wish to use a meal delivery service for convenience and ease. Some brands cater to older adults by specifically considering their health requirements.

Older adults may only need meals for one or two people and may be unable to shop for ingredients or cook meals easily.

Using a meal delivery service can help save time and effort. There are many brands available online, but some may be more suitable for an older persons health and lifestyle requirements.

This article looks at five meal delivery services that are suitable for older adults. It discusses how they work and looks at their menus. It also looks at potential health benefits and drawbacks of meal delivery and some alternatives that people can consider.

Meal delivery services offer either ready-made meals or meal kits.

Meal kits include ingredients and a recipe, which a person can use to prepare meals at home.

Some older adults may prefer the convenience of heating up a ready-made meal. Others may enjoy cooking but like not having to source recipes or shop for ingredients, in which case they may prefer a meal kit.

Brands that deliver meals for one or in smaller portions may suit older adults. Additionally, some older adults may have health conditions or need to eat special diets, so they may prefer services that provide meals to suit them. Depending on their health, some older adults may need to eat pureed food, and some brands offer this.

Older adults may prefer to use a service that is easy to order from and has the flexibility to skip weeks or vary the number of meals they choose.

With these points in mind, the following meal delivery services may be suitable for older adults.

Please note that the writer of this article has not tried any of these products. All information presented here is purely research-based.

Magic Kitchen offer a menu of preprepared meals specifically for older adults and their health requirements. These meals simply require heating up before eating.

Customers can choose to enroll in the senior meals program for regular meal deliveries, or they can opt for one-time deliveries.

Magic Kitchen prepare meals that are suitable for conditions such as diabetes and kidney disease. They also offer vegetarian, low sodium, and gluten-free options.

Dietitians formulate these complete meals, which contain around 300500 calories each.

The a la carte menu has options for:

The following are some examples of menu options:

Some available desserts include:

Magic Kitchen meals are available for order online.

Silver Cuisine deliver meals to meet the nutritional needs of people aged 50 years and over. Customers can order their meals online or by phone.

They offer breakfasts, lunches, and dinners that people can filter with the following preferences:

The following are some meal examples from the menu:

Silver Cuisine also offer shakes and snacks.

Silver Cuisine meals are available for order online.

Learn more about Silver Cuisine here.

For older adults who enjoy cooking their meals, Home Chef offer weekly meal kits to prepare at home.

People can select calorie-conscious or vegetarian meals and customize them to double up on protein or swap ingredients. People can choose meals that they can prepare in 5 minutes or meals that take longer.

Home Chef also offer oven-ready or grill-ready meals that people do not need to prepare, only heat up.

The following are some examples from the menu:

Home Chef meals are available for order online.

Learn more about Home Chef here.

Moms Meals deliver ready-made meals. People can store them in a refrigerator for up to 14 days.

According to their website, Moms Meals work with over 500 health plans providing access to meals for people with Medicare or Medicaid coverage.

Moms Meals offer the following meal preferences for older adults:

Examples of meals include:

Moms Meals meals are available for order online.

Learn more about Moms Meals here.

All the meals that Real Eats deliver serve one adult. They contain 600 calories or fewer and work for lunch or dinner, according to the companys website.

Real Eats serve their meals in bisphenol A-free pouches that people can either heat up in boiling water or empty into a container and put into the microwave. People can choose from gluten-free, plant-based, or high protein options.

People can order breakfasts, brunches, and snacks from Real Eats.

Example meals include:

Real Eats meals are available for order online.

Some older adults may be eligible to use services such as Meals on Wheels America or arrange meal delivery through their health insurance provider.

Some restaurants also deliver meals, but people should make sure that they are healthful if they eat them often.

Some people may offer to take friends or relatives home-cooked meals when they can. They could batch cook an extra portion and freeze it for someone who needs it. People may also be able to find local groups or communities offering food or meal sharing.

Meal delivery services can cater to a persons health conditions and help them remain independent. Consuming meals designed by chefs and dietitians helps ensure that people get the essential nutrients they need.

According to one 2017 review, some of the health challenges that older adults may face include:

The review suggests that all people can reduce the risk and impact of age-related disease by paying careful attention to their nutrition and diet.

Some research indicates that eating a healthful diet enhances cognitive function and may delay unhealthy aging.

It is essential to choose a meal delivery service that suits the individual.

People with cognitive challenges may not be able to communicate their preferences adequately and may not like to eat meals that someone else has ordered for them. Other individuals may find it difficult to eat certain foods or textures.

People should choose a service that follows nutritional guidelines for older adults. Also, the regular variation of meals will help people consume a variety of nutrients.

Older adults may also have an increased risk of dehydration, so they must be sure to drink enough liquids. Some meal delivery services also provide soups, smoothies, and drinks for this purpose.

Meal delivery services are a convenient way for older adults to eat a healthful diet. This arrangement may suit people who find it difficult to plan and prepare meals.

People can choose a delivery service that fits their health and dietary needs. Costs and plans vary, so people should try to research what suits them best.

Some older adults may be able to access meal delivery through their health insurance provider.

Learn about Medicare and meal delivery here.

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Meal delivery for seniors: Options and services - Medical News Today

@jesmartini

Reposted bc its so impt and I want as many parents to see it as possible- cc this time #momsoftiktok #fyp #foryou #psa #dadsoftiktok #besafe

Have you ever been out with your family and you lose track of one of your kids? If you're like most parents, you'll scan your surroundings, you'll dart from one spot to another trying to find them, and eventually, you'll start shouting their name. Ideally, you locate your kiddo, but if you don't want to risk a far more frightening fate, a mom on TikTok offered up a PSA on the very first thing you should do if your child goes missing in a public place.

"If you look around and your child is no longer with you, what you want to do is you want to start loudly looking for them," Jess Martini, a parent to three boys, who has used this advice successfully in her own life. "Do not start silently looking for them. You want to look loudly."

And she doesn't just mean calling out to them.

"You start shouting their description while you look," she said. "It's going to sound like this: 'I'm looking for a boy, age 5, short brown hair, brown eyes, Caucasian, red Nike t-shirt, black shorts!' You're going to keep repeating yourself while you look over and over again."

At this point, she said, "you've got every single person who is around you looking for your child, instead of just you."

Best-case scenario? Someone finds the child and returns them to you. And the ideal worst-case scenario? If "someone was walking away with your child, they are more likely to let them go because they don't want that sort of commotion."

Although parents might not be going to a lot of crowded public places like amusement parks, zoos, or shopping centers amid the pandemic, this tip has already helped families. Another parent, Kelli Hoobler, recently took to TikTok to explain how her middle child had gone missing. While the other adults in her group took off running in one direction and simply shouted his name, she began running in the opposite direction and followed Jess's advice to loudly describe her child. "We found him within 15 seconds."

Scariest moment of a moms life...

Jess wants to remind her viewers to not feel ashamed for losing their child in public and to certainly not let that keep them from practicing this tactic in the moment. "Remember: these things happen to even the best parents," she said. "You may feel you look stupid doing it and maybe you do, but it is so much better to look stupid than to be sorry."

Image Source: Getty / Jan Kjerrman / EyeEm

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You Probably Don't Know the Most Important Thing to Do If You Lose Your Child in Public - POPSUGAR

The world suffered a great loss when Cicely Tyson died on Thursday. The Emmy- and Tony-winning actress's manager, Larry Thompson, announced her death in a statement to Variety that read: "I have managed Miss Tyson's career for over 40 years, and each year was a privilege and blessing. Cicely thought of her new memoir as a Christmas tree decorated with all the ornaments of her personal and professional life. Today she placed the last ornament, a Star, on top of the tree." She was 96.

Cicely made her film debut with her role in 1957's Twelve Angry Men, and she starred in numerous TV shows and movies, including Sounder, The Autobiography of Miss Jane Pittman, Oldest Living Confederate Widow Tells All, The Help, and How to Get Away with Murder. She also appeared in several Broadway plays, such as The Trip to Bountiful and The Gin Game. In 2018, she made history by becoming the first Black woman to win an honorary Oscar, and two years later, she was honored with the Peabody Career Achievement Award for her decades-long career.

Throughout her career, Cicely solidified herself as a pioneer for Black actresses by refusing to take on roles that were demeaning to Black women and addressing important social issues like gender and race. "I used my career as my platform in an effort to address these issues, and every now and then when I receive an achievement award I realize that I did make the right choices," she previously told People. "The sacrifices that I made as a result were worth it."

From Yara Shahidi to Zendaya to Shonda Rhimes, see how stars are remembering the legendary icon ahead.

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Legendary Icon Cicely Tyson Dies at 96: "Her Power and Grace Will Be With Us Forever" - POPSUGAR

St. Louis-area nursing homes find creative ways to keep residents engaged amid pandemic

Activity Director Kristi Gard, wearing a poodle skirt for "40s Day," walks resident Helen Werling back to her room after a small group gathered for a candy trivia game on Wednesday at Oak Hill in Waterloo."We have a lot of costumes from themed days. Tomorrow we are dressing as snowmen," Gard said.

A snowman sits outside on the window sill of resident Penny Chart's room on Wednesday at Oak Hill in Waterloo. An aide built Chart a snowman and even brought her a snowball to hold inside since Chart was lamenting she could not play in the snow.

A resident of Bethesda Southgate throws a ring at a football goal post during a football party the staff threw for them.

The Moolah Shriners Band prepares to entertain the residents of the Sarah Community nursing home in its Naomi House Courtyard in the fall.

Every year, the Sarah Community, a nursing home in Bridgeton, hosts its own Oktoberfest. The event usually lasts for five or six hours, with live music, carnival games, a Kona ice truck and loads of barbecue.

Despite COVID, recreation director Kelly Potter wanted to make it happen again this fall for the residents. As in normal years, they brought in performers. They laid out food. They even set up a beanbag toss and a makeshift bowling lane. There were a few differences, of course everyone wore a mask, and workers wiped down the bean bags between each game but Potter said it was the closest to normal weve had in a while.

Throughout the pandemic, nursing homes have scrambled to create a sense of normalcy in a non-normal situation. As of Jan. 17, nursing home residents have accounted for nearly 52% of deaths in Missouri, despite representing just 4.5% of the total COVID cases. The risk forced most nursing homes to lock their doors to outsiders early on, and confined many residents to their own facilities, and sometimes, their own rooms.

So activity staffers are trying to think outside of the box to keep residents entertained. Theyre holding happy hour on roving carts instead of the dining room. Theyre bringing musical performers to the window instead of the multipurpose room. And theyre interrupting bean bag competitions with a little sanitization.

Bill Cowell spins the roulette wheel for a candy prize with the help of activity aides Wendy Juenger andBecky Hueslmanon Wednesday outside his room at Oak Hill in Waterloo. It's always great when they came around, Cowell said.

The hope, said Tara Powell, the activity director at Bethesda Southgate in Oakville, is that residents still feel like they have some kind of a purpose, and they still have life happening around them. ... We want them to feel like life and fun is still happening, no matter what's going on.

The activities

At the Sarah Community, staff members begin each day with one-on-ones, going room-to-room, reading books with residents, talking with residents and even giving out manicures. At 9:30 a.m., they broadcast exercise class. At 10:30 a.m., they hold rosary and mass. At 2 p.m., they play a movie. Each week, residents receive activity packets stuffed with crossword puzzles, brain teasers, word searches and coloring sheets to fill their free time.

Virginia Clarke participates in art class at the Sarah Community.

Like many long-term care facilities, Bethesda Southgate has supplemented these everyday activities with special events, ranging from a hippie dress-up day to an indoor light tour to food truck visits. Recently, they organized a trip to "Nashville," where the staff dressed in Western attire and pushed a Nashville-themed cart down the hallways.

Some of these activities have moved to online. Vanessa Woods, the owner and founder at Vitality in Motion, teaches dance classes, like ballet and Broadway-style choreography, to seniors on a screen. Woods said dance not only allows residents to work on their balance and strength, it provides a mental escape from the pandemic.

But some mainstays remain.

Oh they wanted their bingo, said Kristi Gard, the activity director at Oak Hill in Waterloo.

"You can't have my snowball," resident Penny Chart jokes to Activity Director Kristi Gard, who was bringing root beer floats to residents at Oak Hill in Waterloo.An aide built Chart a snowman outside her window and brought her the snowball because Chart was lamenting she could not play in the snow.

The size, the location, the makeup of the long-term care facility it doesnt matter. Bingo is a staple, regardless of the pandemic. Most senior living facilities have shifted to hallway bingo, with residents playing from their doors.

But this wide variety of events isnt possible for many nursing facilities, said Marjorie Moore, executive director at VOYCE, a St. Louis-based nonprofit advocacy organization for long-term care communities. In actuality, most nursing homes are understaffed 36.9% of Missouri nursing homes at one point during the summer, according to an analysis by AARP a problem that has only been exacerbated by the pandemic. At Clinton Manor Living Center in New Baden, for example, theyve had to move multiple activity assistants back to their original jobs in nursing.

Unfortunately, in a lot of cases, Moore said, a lot of the creative things that family members may want to do, or nursing home staff want to do, get kicked to the curb because staffing in nursing homes is so low.

Throughout the pandemic, this has often left residents cooped up in their rooms, sometimes with up to three other roommates, and sometimes without a whole activity plan.

We've seen a lot of depression, Moore said. We've seen a lot of people, who went into long-term care with mild dementia get much worse because they're not getting the sort of social interaction that they need to be able to maintain their health. ... It seems like a lot of facilities are really trying. But under a lot of the current conditions, it's really hard.

Staying connected

Nursing homes have found that the best way to combat loneliness isnt a fancy party or a special dress-up day. Its pretty simple: Residents want to be connected with their loved ones.

A resident of the Clinton Manor listens to a virtual Christmas concert in her room on the tablet.

I think the biggest missing factor, no matter what we did to try to improve quality of life and promote activities, was family, said Dr. Angela Sanford, an associate professor of geriatric medicine at St. Louis University and the certified medical director at a nursing home, NHC HealthCare Maryland Heights.

Before the pandemic, Teva Shirley of Glen Carbon visited her mother at Clinton Manor five to six days per week. Now, she mostly speaks to her mother through FaceTime calls, greetings at the window and the occasional face-to-face visit when permitted.

At Oak Hill, staffers have designed their own indoor visiting area, with plexiglass separating the residents and family members.

Marilyn Kilby, 84, is one of the residents who has used the visitation area. One year ago, Kilby, moved from Carbondale to the Oak Hill nursing home so that she could be closer to her daughter. But when the pandemic hit, she had been there for just a few months. She doesnt know many people in the facility and, for a while, she couldnt visit with her daughter. Her glasses arent working and she cant get them fixed. Naturally, she has started to feel lonesome.

That is, until Christmas Eve rolled around and her daughter made a reservation to visit. From across the plexiglass, they talked for 20 minutes. It was really wonderful, Kilby said. It was almost like being with your family.

As COVID cases have continued to rise in the area, regulations have continued to change, making face-to-face visits tricky and sporadic.

A lot of people that don't work in a nursing home or health care like this, they don't understand the rules that change on a daily basis, Potter said. It's hard to deal with. Because we don't obviously want the residents to have to be in their room so much. We would love for them to be able to interact and get out more and things like that. But we can't we have rules that we have to follow that, like I said, change daily.

Mike Schmidt visits her mother, Oak Hill resident Dorothy Merchant last fall during a community prayer vigil in front of the facility.

Nursing homes have seen the negative effects of lessened social interaction in one specific area: Food consumption. Without dining halls full of residents, residents have stopped eating as much. Sanford, who is still finalizing her study results, has found that isolation has caused more weight loss than contracting the virus. It just isn't the same when you're by yourself in a room eating off of a TV tray and Styrofoam plates, she said.

The Oak Hill staff has tried to mitigate the weight loss by creating events like 12 days of ice cream, where residents receive a different flavor of ice cream each day, from plain old chocolate to cinnamon crumb cake.

Flashing back with music

Most mornings, recreation director Kelly Potter returns to work at the Sarah Community with a voicemail full of movie reviews from the residents. She has found one constant: Basically anything that has a little bit of music in it is always popular.

Especially during COVID, music has become a source of comfort. A source of remembrance. A chance to mentally break away from the pandemic.

Staffers at the Clinton Manor Living Center entertain residents with Christmas carols in December.

Music is really deeply tied to memory, Moore said, ...even before the pandemic music is something that's constantly brought up as a great activity because it gets people feeling good. ... Usually it will bring back good memories of when folks were younger, when they were in their prime.

Some nursing homes have set up courtyard concerts. During the summer, McKnight Place in St. Louis had musicians going window-to-window giving out performances. Clinton Manor has passed around tablets for residents to watch virtual concerts.

When asked about some of the ways she has gotten through isolation, Kilby instantly brought up the Christmas carols that the Oak Hill staff played over the PA system. It was something small, taking place for just a few days and 15 minutes at a time. But, weeks later, Kilby is still talking about the carols. It was, well, it just raised my spirits. And I think it put us in a mood for a good lunch. ... It added so much to get to hear those familiar tunes.

Nursing homes have tried to include residents in the musical experience as well. Oak Hill, for instance, has a music therapist that travels among rooms. During residents sessions with the therapist, they can sing, dance and even bang on the tambourine.

Activity Director Kristi Gard plays waitress behind a diner cart she made to distribute root beers during 40s day at Oak Hill in Waterloo.

Just the act of singing, you take deep breaths and it helps people with respiratory issues, said Brian Koontz, the administrator at Oak Hill. Folks who may be battling pneumonia, it helps to expand the lungs to be able to take a breath and sing. There are a lot of physical benefits with that. And then there are a lot of emotional benefits to having a trained music therapist, being able to lift spirits and help people find their joy. A lot of times they're actually doing respiratory therapy through the music and don't even know it.

Looking ahead

On Dec. 28, long-term care facilities in Missouri received more than 120,000 vaccinations. During the first week of January, Oak Hill residents received their first dosage of vaccinations, with the next batch coming three weeks later. Koontz says he doesnt know what the guidelines will look like in a month. In the meantime, theyll continue the socially distanced and masked events until they know for certain that it is safe to gather again.

Moore and Chien Hung, program director of the Ombudsman Program at VOYCE, are quick to point out that the problems exemplified during the pandemic the depression, the isolation, the understaffing arent going anywhere. Even before the pandemic, Moore said, the loneliness and isolation epidemic in long-term care, and really most all of our elderly, was not something that was new.

Hung added: It's not that when residents get vaccines then done, this isolation is gone, lockdown gone and people start to live their wonderful lives. No, things are never that fabulous. So, I think we have to look at this isolation in a kind of broader kind of context. And that is, that to live in a nursing home itself, with or without COVID, that is actually isolation.

"I had gray poodle skirt in high school. I was a cheerleader," said Loretta Castens, who admires her new hair ribbon for 40s day on Wednesday at Oak Hill in Waterloo.

Photo by Laurie Skrivan, lskrivan@post-dispatch.com

But Sanford has seen something different come out of the pandemic.

I think there's a message of hope and resilience, said Sanford, that the nursing home communities banded together and really worked as teams, without resources and with the public being so negative about what was happening behind the walls of the nursing home. Every day, we showed up to take care of patients, and tried to think outside the box and how we could best achieve those with very limited resources.

"We want them to feel like life and fun is still happening, no matter what's going on."

Tara Powell, the activity director at Bethesda Southgate in Oakville

We've seen a lot of depression. We've seen a lot of people, who went into long-term care with mild dementia get much worse because they're not getting the sort of social interaction that they need to be able to maintain their health. ... It seems like a lot of facilities are really trying. But under a lot of the current conditions, it's really hard.

Marjorie Moore, executive director at VOYCE

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St. Louis-area nursing homes find creative ways to keep residents engaged amid pandemic - STLtoday.com

Its natural the moment you go on a weight loss program to want to see results right away. If youre going about losing weight in a sensible waymeaning youre using a sustainable approach and not a fad diet thats too low on calories and nutrientsyoure probably going to notice some kind of weight loss pretty quickly. At first, you might just feel lighter or less bloated. Then you start noticing more and more places that youre losing weight. That said, it might take other people a moment to catch on.

Even if it feels like its taking a while, you should still see some noticeable defining moments along your weight loss journey that can help you stay motivated toward reaching your goals. Heres what to keep in mind when it comes to what you'll notice:

As a rule of thumb, healthy weight loss is anywhere from 1 to two pounds per week. At this rate, men could lose anywhere from four to eight pounds in one month and eight to 16 pounds in two months, says Ilyse Schapiro MS, RD, CDN.

Men's Health

One pound of body weight is equivalent to 3,500 calories. So, in order to lose one to two pounds each week, men should aim for reducing their daily caloric intake by 500 calories, she says. If youre losing more weight than that, you may not be meeting your calorie and nutrition needs, and may not be setting yourself up for long-term success.

If you cut carbs, you often lose water weight, and you may feel leaner quickly (although once you add back in the carbs, you get that water back, but by that time, you may have lost actual body weight, too).

Sometimes, youll notice weight loss in how your clothes fit first. Looser clothes indicate weight loss, sometimes before the scale does. Be careful of the scale as your only indicator for weight changes, as many factors can affect this number, says Schapiro.

Sodium and water balance, diet and physical activity habits, sleep duration, body temperature, and time of day are all things that can change the readout on the scale.

There is currently no research that pinpoints where men lose weight firstweight loss efforts and success are different for everyone. Some of my patients lose weight in their face first, and some in their belly, and some in other areas, says Kristin Kirkpatrick, MS, RDN.

One way to keep track of the fact that youre losing is to take a waist circumference and track it over time. Bonus: This measurement is also a good indicator of health (for good health, mens waists should be less than 40 inches in circumference).

Since there are likely more Zoom interactions than physical encounters today, it may be difficult for others to notice your weight loss progress at first if youre not someone who loses weight in your face and neck right away.

If youre lacking positive comments from others, dont let it get in the way of your progress. Instead of focusing on external validation, celebrate your success and know that your personal recognition is worth more than a thousand compliments from others, Kirkpatrick says.

Men can experience weight changes at different times, at different intervals, and for different reasons. Theres no set amount of time it takes to notice weight loss. Sometimes its more important to track how consistent you are with your effortsalways something to celebrate therethan to track what the scale says, which can disappoint you and not completely relate to your efforts.

Stop worrying about how long it takes to notice weight loss and focus on the process of doing it. The weight will come off, without the stress of wishing it would happen faster.

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How Long Does it Take to Notice Weight Loss? - menshealth.com

Does metabolism hold the key to weight management and why some people struggle and others never seem to gain weight? There are conflicting theories on how metabolism works and if it can be boosted to help people lose weight faster. Lets get the facts on whats possible when it comes to weight loss.

What is metabolism?

Metabolism refers to the chemical changes that take place in a cell through which energy and basic components are provided for essential processes, including the synthesis of new molecules and the breakdown and removal of others. In other words, its how your body uses food as energy and then burns that energy to keep your body going.

Do I burn energy if Im not being active?

Yes, even when youre not moving, your body uses energy to perform functions such as breathing and to keep your heart beating. This is known as resting (or basal) metabolic rate.

What determines a persons resting metabolic rate?

Genetics: The hereditary characteristics passed down from your parents and grandparents play a part, but fortunately, there are other factors affecting metabolism which we can control, such as diet and exercise.

Age: For most people, at around age 30 metabolism naturally begins to slow down. According to the National Institutes of Health, it slows by about 5 percent every 10 years after age 40. This is partly a result of muscle loss and an increase in fat that comes with age; therefore, fewer calories are needed to keep our bodies running.

Gender: Women, on average, tend to have slower metabolisms than men. This is because men typically have more muscle, so they burn more calories.

Weight: People who weigh less require less energy (fewer calories) to fuel their bodies. When you lose weight, your metabolism also slows, so it can be harder to lose weight over time and to keep it off.

What can I do to lose weight and maintain it?

It might seem like there are factors working against you, but being aware of the reduced calorie requirement as you age, can help you stay focused on the ones you can control. Here are three more weight loss tips to keep in mind.

Three tips for healthy weight loss

1. Start with a goal of losing 5 to 10 percent of your weight through increased physical activity and healthier eating. The benefits can be dramatic. For example, a person weighing 250 pounds who loses 5 to 10 percent would be shedding 13 to 25 pounds, which could lower his or her risk for diabetes, heart disease, stroke and some forms of cancer. Other benefits you can actually feel sooner may include: having more energy, fewer aches and pains and feeling less winded or out of breath making it that much easier to keep moving.

2. Celebrate your victories at each milestone. When youve reached 5 percent, or start to feel better or notice an increase in energy, give yourself a gold star, do your happy dance, or reward yourself with a favorite activity. Youve earned it and the benefits are only beginning.

3. Slow and steady wins the race! Extreme diets and fitness routines are not sustainable long-term. The saying its a marathon, not a sprint is true. Healthy weight loss and management is about what you can do each day to: move more and eat more fruits and vegetables, lean protein and whole grains, rather than carbs, fried foods and sugar.

Dr. Bridget Gibson is a family medicine physician for Brookwood Baptist Health.

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Dr. Bridget Gibson: The Mystery of Metabolism and How Can I Lose Weight? - Daily Home Online

Choosing to go on a diet isn't a 100% healthy endeavor. After all, if you're cutting yourself off from certain nutritious foods or entire food groups, drastically limiting your calorie intake overall, fasting for prolonged periods of time, or signing up for a fad-like program that promises extreme results in short order, there's a good chance you're actually embarking on a path that your body may not actually respond favorably to. Whether you're trying the Ketogenic diet or intermittent fasting, going low carb or low fat, below are some common side effects of going on a super-strict dieting regimen you should be aware of. And for more healthy weight loss tips, don't miss this list of Sneaky Weight Loss Tricks That Totally Work, According to Experts.

If you're considering intermittent fasting, in which you restrict your food consumption for long stretches on certain days of the week, you'd be wise to consider some of the consequences. "Depending on the length of the fasting period," write the health experts at Harvard Medical School, "people may experience headaches, lethargy, crankiness, and constipation. To decrease some of these unwanted side effects, you may want to switch from alternate-day fasting to periodic fasting or a time-restricted eating plan that allows you to eat every day within a certain time period."

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A simple fact: If you eat less food (also known as fuel), your body will have less energy to burn and you'll ultimately feel sluggish. One study, published in the Annals of Internal Medicine, found that cutting carbohydrates from your diet was associated with a greater risk of fatigue. Another study, which focused entirely on the Ketogenic diet and was published in the Journal of the American Dietetic Association, found that "low-carbohydrate diets enhance fatigability and can reduce the desire to exercises in free-living individuals."

Cutting carbs completely from your diet isn't your only path to lower energy levels. Other studies have linked diets that restrict nutrients such as vitamin B12, folate, and iron with fatigue, as well as anemia. For more weight loss tips, make sure you're aware of the 12 Foods That Drive the Most Weight Loss of All, Say Experts.

A now-famous study published in the journal Obesity that analyzed the weight-loss efforts of contestants of NBC's wildly popular series The Biggest Loser, which was conducted by researchers at the National Institutes of Health, found that people who go on an extreme crash diet hobbled their metabolisms so profoundly that they never fully recovered. The chief reason, according to the researchers, was the influence of leptin, the body's hormone that tells you you're satiated, or no longer hungry. Over the course of the crash diet, the contestants' leptin levels essentially flatlined. The researchers also tracked their ghrelin levelsthe hormone that tells you when you're hungryand it had actually risen. In effect, the dieters had reprogrammed their bodies to be fat-storing, low-energy machines.

According to a study published in the journal Dermatology Practical & Conceptual, embarking on a low-calorie diet is associated with hair loss, as the lack of nutrients disrupts your hair follicles to function as intended. "Nutritional deficiency may impact both hair structure and hair growth," write the researchers. "Effects on hair growth include acute telogen effluvium (TE), a well-known effect of sudden weight loss or decreased protein intake, as well as the diffuse alopecia seen in niacin deficiency."

For a study published in The American Journal of Clinical Nutrition, researchers from the University of Kiel in Germany took 32 non-obese males and slashed their calories by an average of 1,300 for a three-week period. On the whole, the subjects emerged from the experience having gained weight while seeing a dramatic decrease in muscle massroughly 5% across the board.

RELATED: 15 Underrated Weight Loss Tips That Actually Work

"A lack of proper nutrition due to a fad diet can actually strain your organs and muscles," says Ashlee Van Buskirk, a nurse, health and wellness coach with a BS in Dietetics and Clinical Nutrition Studies, and the founder of Whole Intent. "For instance, a high-protein diet can actually lead to dehydration, which may place a significant strain on your kidneys as you may be more prone to developing kidney stones."

"Most diets fail most of the time [and] repeated diet failure is a negative predictor for successful long term weight loss," writes Anna Guerdjikova, Ph.D., LISW, CCRC, director of administrative services at the Harold C. Schott Foundation Eating Disorders Program at the University of Cincinnati. "Chronic dieters consistently report guilt and self-blame, irritability, anxiety and depression, difficulty concentrating and fatigue. Their self-esteem is decreased by continuous feelings of failure related to 'messing my diet up again,' leading to feelings of lack of control over one's food choices and further life in general. Dieting can be particularly problematic in adolescents."

RELATED: This Diet Mistake Can Make Your Depression Worse, Science Says

"Fad diets are not always terrible, but people should understand the food groups and should try to ingest foods from all of them to keep vitamin and mineral balance," says Stephen Newhart, Ph.D., owner of Vigor Active. "Grains provide energy, fiber, iron, and help with constipation, dairy provides calcium and iron, fruits and vegetables provide vitamins and minerals and protein supports muscle mass. Always try and eat something from all the food groups to sustain health, just be sure to eliminate the sugars."

If you're older and you're trying intermittent fasting, you could be at risk of losing too much weight. "If you're already marginal as far as body weight goes, I'd be concerned that you'd lose too much weight, which can affect your bones, overall immune system, and energy level," Kathy McManus, RD, director of the Department of Nutrition at Brigham and Women's Hospital, told Harvard Medical School.

According to the International Journal of Eating Disorders, 35% of "normal dieters" may become pathological dieters, and 20 to 25% of those are prone to develop an eating disorder. "The onset of eating disorders has commonly been associated with following restrictive diets, as they become a way for individuals to exercise control, counting calories and fat grams, limiting types and amounts of food, and obsessing about a number on the scale," write the experts at Behavioral Nutrition.

As the Cleveland Clinic notes, many health experts believe that "80 to 95% of dieters gain weight back that they've worked so hard to lose." If that's an experience you're aware of, don't miss these tips for Losing Weight and Keeping it Off for Good.

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