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DR. KAREN BREECK MD JAN 18, 2012 Staying Healthy Now and in Retirement.

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Presentation on theme: "DR. KAREN BREECK MD JAN 18, 2012 Staying Healthy Now and in Retirement."— Presentation transcript:

1 DR. KAREN BREECK MD FEEDBACK@MDPOTENTIALS.CA WWW.MDPOTENTIALS.CA JAN 18, 2012 Staying Healthy Now and in Retirement

2 Readiness to Retire 2 Financial readiness (money) Lifestyle readiness (time)  Substitution preparation for job satisfaction, socialization, intellectual stimulation, challenge, routine etc

3 Readiness to Retire 3 Financial readiness (money) Lifestyle readiness (time)  Substitution preparation for job satisfaction, socialization, intellectual stimulation, challenge, routine etc HEALTH !! Both assume your HEALTH !!

4 4

5 Lecture Limitations 5 This presentation is not intended to provide specific individual medical advice. The nature of this presentation is general guiding principles and not individual advice. If individualized advice is needed or desired, please see your primary health care provider.

6 Objectives 6 As a result of this session, participants will : Know what their expected lifespan is 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”

7 How many years are YOU going to live ? 7 Why is this important?  Don’t want to outlive your money For 1000’s years life expectancy = 25 yrs 1800’s = 37 yrs 1900’s = 48 yrs 1950’s = 65 yrs Exercise

8 8 Round 1. What age and cause of death did you pick ? Round 2. Why do you think you picked those ? Round 3. What things could you change right now in your lifestyle that would likely result in an increased age at death and/or change your cause of death ?

9 Our “SMART” Goal H 9 To die at _____ years of age and To die of ______________

10 Predicted Life Expectancy - Birth 10 Average 80.9 78.5 Men 78.5 83.1 Women 83.1 Stats Can 2008 data last modified 09/27/2011 http://www40.statcan.ca/l01/cst01/health72a-eng.htm

11 Predicted Life Expectancy - Birth 11 Average 80.9 75.2 - 81.4  Provincial Range 75.2 - 81.4 (6 years) Men 78.5 72.5 – 79.2  Provincial Range 72.5 – 79.2 (7 years) Women 83.1 78.5 – 83.6  Provincial Range 78.5 – 83.6 (5 years) Stats Can 2008 data last modified 09/27/2011 http://www40.statcan.ca/l01/cst01/health72a-eng.htm

12 Predicted Life Expectancy - Birth 12 Average 80.9  ON 81.3 Men 78.5 79.0  ON 79.0 Women 83.1 83.4  ON 83.4 Stats Can 2008 data last modified 09/27/2011 http://www40.statcan.ca/l01/cst01/health72a-eng.htm

13 Predicted Life Expectancy - Age 65 13 85.0 Combined = 85.0 (+ 4.1 years - 80.9 ) 83.3 Men = 83.3 (+ 4.8 years - 78.5) 86.5 Women = 86.5 (+ 3.4 years - 83.1)  3.2 year gap between W > M (- 1.3 years gap) Stats Can 2008 data last modified 09/27/2011 http://www40.statcan.ca/l01/cst01/health72a-eng.htm

14 Ray Kruzweil - Futurist 14 IT doubling every yr in exponential manner 1960s computer = ½ building @ MIT 2010 cell phone = 1,000 x powerful, 1m x cheaper and 1 m x smaller = 1b x improved price/performance 2037 (25 years) = 1 b x more powerful and 100,000 x smaller = size of a blood cell

15 Ray Kruzweil - Futurist (2) 15 2039 (27 years) = reverse engineer brains = A.I. 2045 (33 years) = “Singularity”  Technology > Human brains  Will need to amplify our brains with technology  Will spend majority of life in VR. 2050 (38 years) = extension of life  Human aging and illness will be reversed  World hunger and poverty will be solved  We will “cure” death – “immortality medicine”

16 Ray Kruzweil – Futurist (3) 16 Within the next 20 - 40 yrs (?) Genetics (biotechnology)  reprogramming our biology for disease or death Nanotechnology  keeping us healthy from the inside out Robotics  combined with Artificial Intelligence

17 How many years are YOU going to live ? 17 For 1000’s years life expectancy = 25 yrs  1800’s = 37 yrs  1900’s = 48 yrs  1950’s = 65 yrs  1980’s = 75 yrs  2000’s = 80 yrs  1 in 6 alive today will live to be 100  Born in 2007 = 104 yrs - Lancet Journal and www.hrsdc.gc.ca What age are you going to use for your financial planning ?

18 Our “SMART” Goal 18 To die at _100__ years of age How can I increase my How can I increase my odds of doing that ?

19 Objectives 19 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Learn how to take more control of their health 6.Identify your personalized next action steps for a “healthy now and in retirement”

20 Live to 100 = Centurions 20 In Okinawa, Japan studies show  Low-stress lifestyle  A diet that heavy on grains, fish, and vegetables light on meat, eggs, and dairy.  Emphasis on walking and gardening.  Older adults not isolated within community, taken care of and continue to work  Spiritual sense of purpose Santrock. Physical Development and Biological Aging.

21 Live to 100 = Centurions 21 In Okinawa, Japan studies show  Mind:  Low-stress lifestyle  Body:  A diet that heavy on grains, fish, and vegetables light on meat, eggs, and dairy.  Emphasis on walking and gardening.  Social/Spirit:  Older adults not isolated within community, taken care of and continue to work  Spiritual sense of purpose Santrock. Physical Development and Biological Aging.

22 New England Centenarian Study 22 Centenarians handle stress better (resilient).  If gave birth > 40 yrs old = 4 x chance of living to 100 Few are obese. Men are especially lean. Smoking history rare. Most have at least one old 1 st degree relative.  Many children of centenarians (age 65 - 82) follow parents’ footsteps - low rates heart disease, diabetes and mortality. 1 in 3 = no changes in their thinking abilities.

23 Predictors for Male Centurions 23 Are married Are not overweight Have low blood pressure Strong grip ( overall strength and fitness) Have high education level Have low blood sugar Avoids heavy drinking Do not smoke Have a low cholesterol. – JAMA Nov 2011

24 Keys to living real old (100) H 24 Diet: low meat, fish, high vegetables Lifestyle: education, don’t smoke, limit drinking, thin, active, marriage, don’t be poor Stress: low or well managed stress Social: Have lots of close friends, be a believer Purpose: family, community, work, volunteer Don’t get chronic disease (cardiac or cancer) Move to Japan and have really old parents Take www.liveto100.com and make changes !www.liveto100.com

25 Objectives 25 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”

26 Our “SMART” Goal H 26 To die at _100__ years of age and To die of ____?______

27 27 1. Cancer H 29.6 % 2. Heart Disease H 21.3 % 3. Stroke H 5.8 % 4. Lung Disease 4.6 % 5. Accidents 4.3 % 6. Diabetes 3.8 % 7. Alzheimer's 2.8 % 8. Flu/Pneumonia 2.3 % 9. Kidney Disease 1.6 % 10. Suicide 1.6 % Sources: Statistics Canada, 2008 data, Last modified: 2011-11-01 Total (all causes of death)

28 28 ALLMENWOMEN 1. CancerCancer Cancer 2. Heart Disease Heart DiseaseHeart Disease Accidents 3. StrokeAccidents Stroke 4. Resp DiseaseResp Disease Resp Disease Alzheimer’s 5. AccidentsStroke Alzheimer’s 6. DiabetesDiabetes Accidents Suicide 7. AlzheimersSuicideDiabetes 8. Flu/PneumoniaFlu/Pneumonia Flu/Pneumonia 9. Kidney DiseaseAlzheimer’sKidney Disease Sepsis 10. SuicideKidney DiseaseSepsis Sources: Statistics Canada (2008 data) Last modified: 2011-11-01

29 Total (all causes of death) 29 CANADA 1. Cancer 2. Heart Disease 3. Stroke 4. Lung Disease 5. Accidental 6. Diabetes 7. Alzheimer's 8. Flu/Pneumonia 9. Kidney Disease 10. Suicide *Accidental – cars, drugs, guns, poison, drowning, falls UNITED STATES 1. Heart and Stroke Disease 2. Cancer 3. Accidental * 4. Lack of Health Insurance 5. Suicide 6. Infections (Sepsis) 7. Alcohol induced 8. Homicide 9. HIV 10. Hepatitis (liver disease) Statistics Canada, 2008 data Last modified: 2011-11-01 US data (2010) http://drugwarfacts.org/cms/?q=node/30

30 Increase Odds of Dying Healthy Source: US data 2000 Wikipedia 30 DO NOT DO NOT: % of deaths 1. Smoke 18.1 2. Have poor diet & be inactive 15.2 3. Abuse alcohol 3.5 4. Get infectious diseases 3.1 5. Expose to Toxicants (Pollution) 2.3 6. Have traffic accidents 1.8 7. Have firearms accidents 1.2 8. Get STDs.8 9. Abuse drugs.7__ 5 1.7 %

31 Our “SMART” Goal H 31 To die at _100__ years of age and To die of natural causes “old age”

32 Objectives 32 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy Understand how to “age healthy” 4.Understand how to “age healthy” 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”

33 What is “Age” ? 33 Chronological – age based on birthday Biological H – age based on body  www.RealAge.com (US) www.RealAge.com  Must do a sign in  Sends you personalized action plan  Let’s you update scores / determine priorities  Translates your data to a “Doctor’s Visit Plan”  Yes your age can get “younger next year”

34 What is “Health” H ? 34 What does “health” mean to you ?  How do you define it ?  How do you decide if you have it ?  Or don’t have it?  How do you decide if someone else has it ? “Disease is gender specific, health is not”

35 Self - Rating of Health 35 22% excellent - 38% very good (60 %) 29% good - 11% poor health (40 %) No significant difference by sex More good - poor with age (+55) Varies with provinces  Best health in NL and AB Sources: Statistics Canada ( 2005 data) Last modified: 2011-13-01

36 Define “Health” ? 36 A person’s mind, body and spirit, being free of illness, injury or pain (Wikipedia) The level of functional or metabolic efficiency of a living being (Wikipedia) A state of complete physical, mental, and social well being and not merely the absence of disease or infirmity (WHO) Brain’s perfect adaptation of your body to the world it thinks you live in (YNY)

37 “Age Healthy” Pre-Requisites 37 An individual must be able to identify and to realize aspirations, satisfy needs, and change or cope with their environment. - Peace - Shelter - Education - Food - Stable eco-system - Equity - Social justice- Income - Sustainable resources WHO’s “Ottawa Charter for Health Promotion” 1986

38 How To Age Healthy 38 You may have to chronologically age but you can get “younger next year” biologically Key is to remember: “An ounce of prevention is worth a pound of cure”

39 39 Prevent cancers, BP, heart disease, stroke, lung disease and just about everything else... Men 24.3% Women 18.9% Best thing to improve your health... QUIT TODAY  DrivenToQuit.ca contest open until Feb 29 H  Quit for month of March and can win a Ford Fusion Second hand smoke effects – other adults, kids, pets  Kids 300 x > asthma, ear infections “Smoking is the only form of socially acceptable suicide” http://www.worldlifeexpectancy.com/country-health-profile/canada Don’t Smoke H

40 Eat Right H 40 Prevent heart, diabetes, obesity, BP, dementia Use “Eat Right Ontario” dietician line Heart and Stroke www.healthcheck.orgwww.healthcheck.org Vegetables > White meat/fish > Red meat Fresh > Steamed > Broiled > Frozen* > Can* > Fried > Deep Fried No white sugar, flour, rice Mediterranean diet  Accountability partners

41 Use of Supplements 41 Omega 3  Prevent heart, depression, dementia, cancer, arthritis  Fortified food, 1 gm fish oil, algae Vitamin D  Prevent cancer and arterial diseases  400-1,000 IU / day

42 NPN Supplements (2) 42 Health Canada: www.hc-sc.gc.cawww.hc-sc.gc.ca  8-digit Natural Product Number (NPN) on bottle  Natural Health Products Database  license if safe, effective and high quality If not licensed  No pre - market evaluation or testing  No specific disease prevention or treatment claim  No manufacturing consistency assurance

43 Exercise, Exercise, Exercise 43 Prevents heart, obesity, BP, dementia, falls Improves energy, bones, muscle mass, self- confidence, increased independence Cardio, flexibility, balance and strength Even 5 minutes a day is better than zero Can still catch up if starting “late” in life Walking 20-30 min most days will do it Key is find something you like to do

44 Limit Alcohol 44 Prevent Disease and Death  Liver, pancreas, respiratory, immune  > disease in women with > 1 drink/day  Cognitive loss, depression, addiction  Car accidents, falls, drowning, suicide  1/3 motor vehicle deaths alcohol related Average 9.8 Litres per person (Rank 46) Screen for addiction  Men 5x > Women http://www.worldlifeexpectancy.com/country-health-profile/canada www.tc.gc.ca

45 Prevent Infections 45 Get vaccinations  Influenza “flu” (Annually)  Tetanus (every 10 years)  Herpes Zoster “Shingles” (age 60 )  Pneumococcal “Pneumonia” (> age 65)  Tropical Diseases (if traveling)  Yellow Fever  Meningococcal  Hepatitis A and B  Typhoid

46 Prevent Dental Decay 46 Screen for oral cancer, neurological issues, gum disease, TMJ, grinding (stress), nutritional deficits Prevent lung and heart disease, stroke and diabetes.  Decay is from neglect not age. Floss daily Brush after meals, sweets, before bed  Power brush or change out soft brush 3 months Use antiseptic mouthwash Have exams every 6-12 months (9 months PSHP)  http://www.cda-adc.ca http://www.cda-adc.ca Canadian Dental Hygienist www.cdha.ca

47 Prevent Dementia 47 1. Work out your brain – Stay curious  Read  Attend educational classes  Learn a new hobby, skills or language  Numbers/math games “Sudoku “  Laugh – 9 belly laughs a day  Play an instrument  Sense of mastery and control in something 2.Stay hydrated (brain > 70% water) - > 50 yrs thirst reflex decreased 3. Diet, Exercise, Socialize

48 Get Enough Sleep 48 Sleep is an active state not a passive one  Regenerative, releases hormones Get 8 hours a night  Same hours every day, 7 days a week  Between 10 -11 pm and 6-7 am Sleep Hygiene  No TV in bedroom  Keep room very dark  Have a “step down” time before bed

49 Take Smart Risks 49 Prevent Vehicle Accidents  Use seat belts  Drive within the speed limit  Use bicycle helmets  Follow boat safety training Prevent STDs  Use condoms Prevent accidental weapons discharge  Have weapon safety training and use lock up Prevent accidental overdoses  Get rid of old pills  Don’t mix pills and alcohol  Don’t share/take other people’s pills www.smartrisk.ca

50 Develop Stress Resilience 50 Stress impacts life expectancy /health  > 80% of Dr visits are stress related No one accepted definition yet  Fight/ flight “stress” reaction  Needs to go “on” and “off” appropriately Stress resilience is a learned skill set  Positive Attitude, Thought Patterns, Exercise  Sense of belonging, Meditation, Prayer, Gratitude

51 Emergency Preparedness (1) 51 CPR - You may have learned it...  But has everyone around you ? 60% trainees did not feel confident to use CPR in an actual emergency New 2010 guidelines...  Call 911  Start chest compressions – 2 inches deep  Do to the beat of “Staying Alive” $35 kit/video from www.cprAnytime.cawww.cprAnytime.ca  Teach your family, friends, and community  20 minutes

52 Emergency Preparedness (2) 52 Discuss the hard stuff now with your family 1. Organ Donation  www.BeADonor.ca or Service Ontario 2. Living Will Advancecareplanning.ca 3. Power of Attorney - Personal Care  www.AttorneyGeneral.jus.gov.on.ca  www.curateur.gouv.qc.ca 4. Funeral Plans

53 Emergency Preparedness (3) 53 Insurance Coverage  Extended Health Care and Dental  Travel Out of Country /Province  Disability  Critical Illness (need to get while healthy)  Long Term Care Healthy Life Expectancy 73.0 (Ranks 20)

54 Emergency Preparation (4) 54 Primary Health Care Provider  Family Doctor / Walk in Clinic  Nurse Practitioner / Physician Assistant Naturopath Osteopath Chiropractor Podiatrist Psychologist Optometrist Dentist

55 Alternative Medicine Practioners 55 Unlicensed - No professional body oversight No standards or code of ethics No one to complain to if things go wrong Red Flags :  Say THEY can heal you, vice helping YOU heal you  Fear mongering against Western medicine  Not interested to work with your doctor/team  You need to go more often, not less to them over time  You feel uncomfortable alone with them

56 Check for Age and Sex Specific Cancers 56 Breast H Prostate Colon Cervix Skin (Melanoma)  Order more documents from form at back of binder H  Or go to www.cancer.ca (province specific)www.cancer.ca

57 Check Blood Pressure 57 Prevent “silent killer”  Heart disease and stroke. Get checked at least once a year  Know your numbers If high at first, check at different times of day over at least 3 days Diet, exercise, stress reduction should be considered prior to medications.

58 Check Cholesterol Levels 58 Prevent heart disease and stroke Not everyone needs to...  Men > 40  Women > 50 or postmenopausal  People who have diabetes, BP, smoke or obesity  Family hx premature heart disease or stroke  People with physical signs of high cholesterol (fatty deposits under the skin; xanthoma or xanthelasma)  People with vascular or coronary artery disease

59 Check if you are Obese 59 Negative health impact on about everything 28.4% M (Rank 27) and 29.5% W (Rank 65)  Rates 2 x higher then 1980 BMI ( > 30 kg/m 2 ) Waist Circumference  Pear verses Apple  40”/102 cm Men : 35”/ 88 cm Women “To feel fit as a fiddle you must tone down your middle.” ~Author unknown

60 Check for Diabetes 60 Not recommended for routine screening !  Only if high BP and/or Cholesterol (“Fair”)  Overweight (BMI > 25) and signs of intolerance  Lifestyle interventions (“Good” )  Metformin or acarbose (“Fair”) Canadian Diabetes Association  Screen at 40 and every 3 years http://www.canadiantaskforce.ca/recommendations/2005_03_eng.html

61 Self-Check for Depression 61  2 weeks or more:  Persistent sad, anxious or empty mood  Feelings of hopelessness and pessimism  Feelings of guilt, worthlessness or helplessness  Loss of interest or pleasure in hobbies and activities  Screening quiz - CMHA.ca  Moodgym.anu.edu.au – educational modules (free)

62 Screen for Suicidal Ideation 62 3500 Canadians took own lives in 2010  7662 died of colon cancer and 5105 breast cancer  Most are men aged 15-64  Men 4x more successful then women Use more lethal means and have less warning signs  Many have seen their doc in month ahead  Many overdose on alcohol and prescribed drugs Know when, where and how to get help  dcottawa.on.ca  613-238-3311 or 1-866-996-0991.  Canadian Family Physician Vol 57 Feb 11 p 148

63 Age Healthy H 63 Don’t smoke Exercise Eat right Supplements Limit alcohol Get sleep Take Smart Risk Reduce Stress Cancer Screen BP Screen Cholesterol Screen Obesity Screen Depression Screen  Suicidal Screen Prevent dementia Prevent infections Dental Care Emerg Preparedness

64 Objectives 64 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5. Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”

65 Take control of your health and health care 65 1. Keep a shadow medical file  Keep journal of doctors, dates, tests, findings, symptoms 2.Internet Research  Find support groups – social and often best info  Best medical team and location  Critical appraisal skills required 3.Understand the Canadian health care system  Know how to navigate and advocate

66 Medical Files – who’s is it ? 66 Personal Health Information Protection Act (PHIPA) Doctor OWNS the records (Supreme Court).  Must keep for 10 years after last entry (College Regulation)  30 years if occupational health practice related Doctor or Clinics = HEALTH INFORMATION CUSTODIAN (HIC)  Gather, create, holds personal information as part of their job  HIC/owner relationship is contractual Patient has right to ACCESS from owner or custodian.  Access must be free, copying rarely is.... Ontario Medical Review Mar 2011

67 Internet Research - “Trust No One” 67 Critical Appraisal Skill Sets H  What country ?  Who is paying for the site ?  Author’s Credentials ?  Advertisements ? Type ?  Selling Products ? Advertisements ?  Last time page updated ?  HonCode designation ? Prioritize using:  Canadian Government, National Health Associations, Medical Institutions, Support Groups

68 Understanding the Health Care System 68 Medicare – SK – hospital “tertiary” care  Health care system not on health or health care Rising costs  #1 drugs and #2 salaries  Taking from Peter to pay for Paul  Need education, housing, poverty addressed too... Money isn’t going to solve this problem  We need more “health” and less “health care”

69 Health Care System 69 2014 Health Transfers Agreement Will the system be restructured ? National vice provincial approaches Patient centric outcome measures Human Resource Management of caregivers

70 Need a “Seniors’ Health Policy” 70 Need Public Engagement (2014 PHA)  Palliative care  Home care  City Planning  Recreation for Seniors  Transport for Seniors  Social support for Seniors  Public health programs for Seniors  Long Term Care options and facilities  Eldercare options

71 CARP (www.CARP.ca) 71 National, non-partisan, non-profit ‘New Vision of Aging (+45) for Canada’  promoting social change that will bring  financial security  equitable access to health care and  freedom from discrimination Free newsletters on $, health, lifestyle, advocacy $15/yr membership open to all  Free membership to partner (same address)  Over 300,000 members to date  Many benefits

72 CARP Health Wizard 72 Canadian Health Care Guide  Finding care: health care provider, facility, program  Managing your health: decision making, tests, treatments, caregivers  Healthy living: workplace, nutrition, lifestyle, travel Health and Wellness  Age specific screening guides  Health conditions  Medications (OTC, natural and prescription) Directories  Community, groups, associations, provincial guides

73 CARP Health Wizard 73 Novus Health www.novushealth.com  “leader in Canadian Health Navigation, delivers innovative online and telephone support solutions for today's complex health care environment”.  “empowers the member to navigate the health care system and provides the trusted health information that they need to make informed health decisions”. Offered by insurance, employee programs etc Basic level free (higher levels for $)

74 Take control of your health and health care 74 1. Keep a shadow medical file  Keep journal of doctors, dates, tests, findings, symptoms 2.Internet Research  Find support groups – social and often best info  Best medical team and location  Critical appraisal skills required 3. Becoming an “E-Patient”  Understand the Canadian health care system  Know how to self-navigate and self-advocate  Advocate for a patient centric system

75 Health 2.0 - “Let Patients Help” 75 Health care, e-Health and Web 2.0 together Epatient (TED.com) = Epatientdave.com  Empowered, Equipped, Engaged, Enabled,  Equals, Emancipated and Experts Epatients.net  “Health Care Providers Can’t Do It Alone” ParticipatoryMedicine.org  Society of E-patients and Health Care Providers

76 Objectives 76 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your personalized next action steps for a “healthy now and in retirement”

77 Retire Right (2009) Dr. Fraunfelder MD 77 Financial planning is not as important to a fulfilling retirement as many think- the psychological experience is just as crucial. The happiest retirees shared 8 key traits: 1. Plan ahead 2. Keep a healthy lifestyle 3. Engage in leisure activities 4. Lean on their support network 5. Maintain a positive attitude (of gratitude) 6. Accept change 7. Have a sense of purpose 8. Enjoy some expression of spirituality These are all skills. Skills can be strengthened, even learned from scratch.

78 I commit to... 78 1.not living like I will never die 2.not dying with my music still in me 3.considering more then just finances when deciding my retirement date 4.using 100 for my financial planning life expectancy 5.finding out my chronological life expectancy www.liveto100.com 6.finding out my present biological age www.realage.com www.realage.com

79 I commit to.... 79 7. self-rating my health as excellent 8. never starting to smoke 9. not exposing myself to second hand smoke 10. cutting back on my smoking 11. sign up to driventoquit.ca and Quitting ! 12. annual medical check ups 13. annual dental visits 14. doing my age / sex specific medical screening

80 I commit to.... 80 15. keeping a “healthy” waist circumference 16. “working out” my brain daily 17. learning a new instrument, skill or language 18. laughing every day 19. doing a daily act of random kindness 20. developing an attitude of gratitude 21. learning CPR with my family and friends 22. volunteering in my community 23. spending more time nurturing relationships 1.

81 I commit to... 81 24. becoming an organ donor 25. making a living will and POA - Personal Care 26. researching critical illness and LTC insurance 27. defining my own “medical team” 28. knowing the signs and symptoms of strokes 29. knowing the signs and symptoms of heart attack 30. knowing the signs and symptoms of depression 31. knowing where to find help for depression

82 I commit to... 82 32. shopping for healthier food 33. cooking in a more healthy manner 34. eating more at lunch and less at dinner 35. having breakfast every day 34. walking for 20-30 min most days 35. starting exercise for 5 min a day (if at 0 now) 36. checking my stress levels www.cmha.ca quizwww.cmha.ca 37. finding a new “stress buster” strategy

83 I commit to.... 83 38. learning to meditate 39. knowing my blood pressure numbers 40. limiting my alcohol intake 41. screening myself for alcoholism 42. always wearing my seat belt 43. joining FSNA for the travel insurance 44. joining CARP for the health wizard 45. joining FSNA/CARP for the advocacy

84 I commit to... 84 46. making my own medical file/chart 47. critically appraising all internet health research 48. learning more about the health care system 49. becoming an e-patient 50. becoming engaged in the 2014 health care accord.... My life is my health and my health is my life... I am going to live to 100 and die of natural causes I am going to live to 100 and die of natural causes !

85 I “SMART” commit to.... 85 1. 2. 3.

86 Feedback 86 (1) What worked (2) What didn’t work (3) What would you like to see changed for the next lecture? How can it be improved ? Email me: Feedback@mdpotentials.ca Talk to me: at break Course Critique Course notes will be posted within 24 hours to www.MDpotentials.ca


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