Welcome

How could you make a difference
to this patient’s life?

Your challenge today is to find ways to connect with a patient, and learn how they can make changes in their lives to improve their health and wellbeing.

TAP YOUR PATIENT TO BEGIN

Josh

How can we help Josh and his parents?

Language for Josh

Josh is a young lad in his mid-teens. He has been overweight all his life, and enjoys coming home after school and getting straight on the PlayStation for the entire evening, playing with his gaming friends online. His parents are at his beck and call, bringing him snacks and fizzy drinks when he asks for them, also bringing up his dinner which they allow him to eat in his room. He dreads PE lessons on a Wednesday afternoon, where he has been teased in the changing rooms about his weight. From a very young age, he’s had a sweet-tooth, regularly buying chocolate bars at the school’s tuck shop. Josh frequently keeps his feelings to himself, putting a brave face on at school as much as he can.

Josh wants to explore the world when he finishes school – his favourite Geography teacher has told him about how he has climbed mountains all around the world which sounds extremely exciting. In the meantime, he’s happy with his PlayStation and room service from the parents!

Josh's parents both work full time and Josh's dad often works evenings too. They do their best to encourage Josh to eat more healthily but they find it really hard to spend time together as a family. Every day and every week is always a big rush and it unfortunately slips in the priority list.

Your task:

What words and phrases do you think would help motivate Josh and his parents to make better decisions about his health? Is there another way of looking at some of their issues that might help to change behaviours?

SAVE

Healthy choices for Josh

The diary below shows a typical day in Josh’s life. What changes can you identify that Josh could make in his daily routine to improve his health? These changes can be small or large.

7:20am Alarm goes off. Josh is very tired, even on waking, and struggles to get out of bed
7:40am Josh gets up, dresses and leaves the house. He catches the school bus at the end of the road
8:15am Josh gets off the bus outside his school and goes straight to the canteen
8:30am Has a bacon bap with a can of Fanta
11:05am Break time. Josh will regularly have a bar of chocolate
1:00pm For lunch, Josh goes to the canteen and has a burger, chicken dippers and fries, with a chocolate brownie afterwards. He washes it all down with a bottle of Diet Coke
3:30pm Josh finishes school and goes to the shop over the road to buy a bag of Haribo, eating them on the bus home
6:07pm Josh has a pepperoni pizza and garlic bread in his room, with a large bottle of Diet Coke
8:00pm After a few hours of gaming, Josh has a bowl of ice cream with marshmallows

Your suggested changes:

SAVE

Walking challenge.

How easy is it to fit exercise into your day?

Your challenge is to rack up as many steps as you can in the next 30 minutes, and record all your team’s results below. This will help us all to see how even exercising gently for a relatively short time each day can have positive effects on our health and wellbeing.

TOTAL STEPS 0
SAVE

Christine

How can we help Christine?

Language for Christine

Christine is a cheerful retired lady who has lived on the same street since the 1970s. She has a number of good friends in the area, including neighbours and people she knows from the Over 60s club in the nearby community centre. Her children are grown up and both live over 100 miles away in different directions, but she is in good contact with them by phone. She’d like to use email or Skype but is a bit fearful of new technology – she has a very old blood glucose monitor and is unwilling to update to a “fancy” one as she feels she’d be unable to use it.

She is reasonably active in the sense that she gets out of the house at some point nearly every day, sometimes visiting neighbours, sometimes going to the club – she also has a morning out every Friday when a friend drives her to the out-of-town supermarket. There she loves to buy exotic fruit and veg that she can’t get in the local shop.

Now she is living on her own and getting older, Christine finds that she is losing interest in food and can’t see the point of cooking a proper meal just for one. She eats a lot of snacks –mostly fruit- and has a weakness for carrot cake, although she tries to limit it to just one slice a week as a treat. She eats a lot of sandwiches and toast instead of meals.

Christine feels that at her time of life, it’s too late to start a big health kick or change the habits of a lifetime. She also feels her age sometimes, and doing too much walking tires her out. She lives in a bungalow so doesn’t have to deal with stairs.

Your task:

What words and phrases do you think would help convince Christine to make different decisions about her health? Is there another way of looking at some of her practical circumstances that might help to change what she eats and how active she is? Take into account her age, attitude and life circumstances.

SAVE

Healthy choices for Christine

The diary below shows a typical day in Christine’s life. What changes can you identify that Christine could make in her daily routine to improve her health? These changes can be small or large.

6:20am Christine wakes without an alarm. She often wakes early.
6:22am Christine makes a cup of tea with milk and two sweeteners, and settles down to watch TV. She has a daily schedule of favourite programmes that keeps her company all morning
9:45am Breakfast is a piece of toast with butter, and another cup of tea
12:15pm A neighbour comes to visit. They have a cup of tea and a biscuit each
1:34pm Christine makes herself a cheese and tomato sandwich on wholemeal bread, but not being hungry finds it hard to eat and she leaves about ¼ of it
2:45pm Remembering that she has some fruit that needs using up, Christine makes a fruit salad with pineapple, banana and grapes. She eats a cereal bowl’s worth over the course of an hour
4:00pm A friend drops by to walk with Christine to the community centre, approximately 200 meters from her home
4:26pm Christine has another cup of tea with 2 sugars, as no sweeteners are available, and a chocolate biscuit from a tin being passed around
5:35pm At home, Christine falls asleep in her chair in front of the TV
7:18pm Waking up and feeling hungry, Christine looks in her cupboard for something to eat. She heats a small tin of low-sugar baked beans and has them on one piece of toast
8:53pm Christine goes to bed with a book and reads. She has trouble falling asleep and usually reads until gone midnight

Your suggested changes:

SAVE

Walking challenge.

How easy is it to fit exercise into your day?

Your challenge is to rack up as many steps as you can in the next 30 minutes, and record all your team’s results below. This will help us all to see how even exercising gently for a relatively short time each day can have positive effects on our health and wellbeing.

TOTAL STEPS 0
SAVE

James

How can we help James?

Language for James

James is a data analyst, so his job is mostly sedentary. He never exercised or dieted until being diagnosed with type 2 diabetes in his late 40s. This diagnosis made him realise that he couldn’t go on abusing his body with unhealthy choices indefinitely – he describes the diagnosis as “my lifestyle finally catching up with me”. With two teenage children and a long-term partner, James is conscious of the possibility of dying young and leaving a family behind, when he could have prevented it.

This is a big motivator for James, who has taken his diagnosis seriously and implemented sweeping changes. He has joined a badminton club, set himself the task of walking at least 8,000 steps a day, and volunteers to help coach his younger son’s weekend football team as a way of not only connecting with his son but also getting a bit more active outdoors.

James has also taken a look at his diet, and although he has made some quite drastic changes his HbA1C remains stubbornly high. He tries to eat his 5 portions of fruit and veg a day, although he admits he finds it “boring”. He finds it hard to resist his old favourites, including red wine, roast potatoes, dark chocolate, chip-shop fish and chips, beef Wellington and lamb rogan josh. He caves in and indulges in at least one of these things at least once a week, but then feels incredibly guilty about his lapse and feels he is letting his family down. Food has therefore become something of an issue for James – he struggles to enjoy healthier food, then feels terrible when he has something he really wants.

Your task:

What words and phrases do you think would help James make more positive decisions about his health? Is there another way of looking at some of his fears and motivations that might help to change his behaviour? Take into account his age, attitude and life circumstances.

SAVE

Healthy choices for James

The diary below shows a typical day in James’s life. What changes can you identify that James could make in his daily routine to improve his health? These changes can be small or large.

7:45am James gets up and leaves the house without anything to eat or drink
8:15am The commute to work is long – James goes to the train buffet and gets a black coffee with no sugar, a banana, and a large white pretzel. Although hungry, he realises the pretzel is probably not very healthy, so he begrudgingly stashes it in his briefcase to perhaps give to a colleague
9:30am A breakfast meeting worries James – the food provided is either high fat or high sugar, including cookies, pastries and orange juice. He finds a mini white bagel with cream cheese and takes that to have with some water
11:42am Feeling absolutely ravenous, James nips out of the office to get a low fat poppyseed muffin, a skinny latte, and a ham sandwich with mayo on granary bread. He also buys a prepared salad bowl for later
1:36pm James has his salad without dressing on it. Still hungry, he pops out again to buy some reduced fat hummous and brown pitta bread. He eats 4 pittas without thinking, while absorbed in his work
5:30pm James joins his colleagues for a drink after work. He wants red wine, but opts for sparkling water instead. He doesn’t enjoy it, and leaves early
7:00pm At home, James’s partner has made a lasagne with lean mince, no white sauce, and half the quantity of cheese, plus a large green salad. It tastes great, but James still feels the lack of a glass of red wine and some garlic bread to go with it
8:30pm Badminton club meets, and the group warm up together and then play a few practice games. It is enough to make James sweat heavily, and get out of breath, but he very much enjoys the evening
10:00pm The group go to the leisure centre bar, where low- and no-alcohol options are available. James has a zero alcohol beer, as do several of his friends – others choose soft drinks, one has a normal lager. James enjoys his drink – he is sick of sweet drinks being the only choice and likes this more “grown up” tasting beverage
10:20pm Bedtime – James falls asleep quickly and easily

Your suggested changes:

SAVE

Walking challenge.

How easy is it to fit exercise in your day?

Your challenge is to rack up as many steps as you can in the next 30 minutes, and record all your team’s results below. This will help us all to see how even exercising gently for a relatively short time each day can have positive effects on our health and wellbeing.

TOTAL STEPS 0
SAVE

Derek

How can we help Derek?

Language for Derek

Derek is a retired administrator, his second career after being in the Royal Air Force for 30 years. As a younger man in the forces he was made to keep fit and active, and so never had to watch his weight or his diet. After adopting a more sedentary lifestyle as a civilian, he continued to eat as he had always done, but with a drop in activity came a rise in his weight. He puts this down to just getting older, calling it “middle-aged spread” and he doesn’t believe that his lifestyle can really be having that much of an effect on his health.

He has always enjoyed woodwork as a hobby, and now he is retired he spends much of his time in his shed. He says that is as active as he wants to get – being on his feet and doing something physical rather than lazing around on the sofa is “as good as going for a jog”. Derek is married, with three grown-up children – one who is in the Navy and two who live within 10 miles and visit regularly. He has two grandchildren, and sees them often, although he always complains that they tire him out. He can’t keep up with them as he’d like to, but again puts that down to just getting on a bit.

Derek takes several medications on top of his diabetes medications, including a statin, an anti-depressant, an alpha blocker and an ACE inhibitor. He’s not sure he needs all these pills, or whether he should really be taking them all together, but he rarely visits the doctor and when he does go, he tends to omit his co-morbidities and just focus on the issue he’s come for. He is simply not interested in his health, and doesn’t often take all his prescribed medications, as prescribed, every day.

He is similarly lax about his diabetes. For many years, he tested his blood glucose only around once a week, and couldn’t really see the point of it. He eats what he fancies eating, and doesn’t think twice about it unless he feels ill. He gets a lot of infections, has trouble with blurred vision, and has lower urinary tract symptoms characterised by frequent urination and strong urge. Once more, he puts all this down to getting older.

Your task:

What words and phrases do you think would help Derek focus more on his health and take more control? Is there another way of looking at his lifestyle that might help to change his behaviour? Take into account his age, attitude and life circumstances.

SAVE

Healthy choices for Derek

The diary below shows a typical day in Derek’s life. What changes can you identify that Derek could make in his daily routine to improve his health? These changes can be small or large.

7:30am Derek’s wife wakes and gets up to make breakfast. Derek has a cup of tea in bed, then toast with butter and low-sugar marmalade
8:50am His wife leaves the house for her part-time job. Derek sits at the breakfast table, reading the paper and drinking white tea with one sugar
10:22am After dressing, Derek goes out to his shed to work on a birdtable he is making for a friend. He brings a bottle of water with him, as he’s always thirsty
11:15am Derek takes a break, coming into the house for a white coffee with one sugar, and a large sausage roll
11:33am Derek goes back out to the shed to carry on his woodwork
1:45pm Derek’s wife returns and makes lunch for them both – roast beef sandwiches. She offers him fruit, but he finds some chocolate biscuit bars and has two of those
4pm Finishing work for the day, Derek has a bath and puts on a good shirt. He walks a mile to the local pub to meet a friend. They sit and do the crossword together over a couple of pints. They also share a bag of pork scratchings, and a bag of peanuts. Derek then calls his wife to come and fetch him, as the thought of the long walk home is off-putting
5:55pm Dinner is a large plate of pork chops, mashed potatoes, peas and gravy, followed by a generous helping of trifle
6:30-11:30pm Derek and his wife watch TV. She has a glass of wine, he has two cans of bitter over the course of the evening. He also gets up and fetches another sausage roll mid-evening. He realises as he goes to sleep that he has forgotten to take any of his medications today, but dismisses the thought and tells himself he’ll just pick it up tomorrow. He has also not tested his blood sugar level for 8 days now

Your suggested changes:

SAVE

Walking challenge.

How easy is it to fit exercise into your day?

Your challenge is to rack up as many steps as you can in the next 30 minutes, and record all your team’s results below. This will help us all to see how even exercising gently for a relatively short time each day can have positive effects on our health and wellbeing.

TOTAL STEPS 0
SAVE

Helen

How can we help Helen?

Language for Helen

Helen works full time and has a daughter aged 7. Her husband also works full time, so they have a childminder to collect the child from school. By the time Helen and her husband get home from work, it’s after 6:30. They sit with their daughter for an hour or so before she goes to bed, then set about making their dinner. Both like to cook and enjoy making large meals together.

Helen feels she has no time to herself. Weekdays consist of working, then home for dinner, TV and bed, while weekends are taken up with ferrying her daughter to various activities, catching up on the housework, then breaking out a bottle of wine on a Saturday night to try to relax. Although she knows she is not very active, it seems impossible to find time to fit exercise into her life without having to sacrifice something else like time with her family, or household chores. She rarely goes out, although she and her husband get a babysitter once a month and go out for dinner.

For many years Helen lived in fear of diabetes, knowing she was overweight and never managing to shift the pounds. When pregnant, she discovered she had developed gestational diabetes, a diagnosis she found devastating. She was pleased to find that it resolved spontaneously within a few weeks of giving birth, but had been warned that she would be more prone to developing type 2 diabetes later in life. Helen feels she has brought diabetes on herself and struggles with her self esteem, feeling very emotional about every food choice she makes and hating the way she looks. She also feels that having diabetes is something of a life sentence, that it means she will always be overweight, and that things can only get worse from now on.

Your task:

What words and phrases do you think would help Helen feel more positive about her health? Is there another way of looking at some of her fears and motivations that might help to change her feelings and actions? Take into account her age, attitude and life circumstances.

SAVE

Healthy choices for Helen

The diary below shows a typical day in Helen’s life. What changes can you identify that Helen could make in her daily routine to improve her health? These changes can be small or large.

7:45am Helen wakes up and lays out breakfast for the family – sugary cereal for her daughter and husband, a high-fibre low-fat cereal for herself
8:20am Helen leaves for work, driving to her office about 8 miles away through town-centre traffic
9:30am As a client liaison officer, Helen is often out of the office on visits. This involves a lot of driving – she gets into the car for her first trip of the day, and takes a small packet of flavoured nuts and seeds with her to keep her energy up
11:42am At the client’s offices, Helen is offered coffee and doughnuts. She turns down the doughnuts, telling the client, “I’d love to but I’m supposed to be on a diet”. The client encourages her to take one anyway, and Helen gives in
1:13pm Lunch is at the staff canteen. Helen chooses a jacket potato with cottage cheese, and a side salad, with a diet Coke. Then a colleague joins her with a steamed syrup pudding and custard – Helen feels so envious that she gets a portion for herself as well
4:30pm Out on her second visit of the day, Helen passes a drive-thru fast food chain outlet. Tired, she persuades herself she can just get a coffee, but when she orders she also finds herself asking for an apple turnover
7:00-8:00pm Helen and her husband make dinner together, and each has a glass of wine while they cook, and another as they eat. Dinner is chicken breasts stuffed with stilton cheese, dauphinoise potatoes and green beans
8:30pm Helen has a bath, then watches TV for a couple of hours before going to bed
11:56pm Helen is woken by her husband – she has been snoring very loudly and keeping him awake

Your suggested changes:

SAVE

Walking challenge.

How easy is it to fit exercise into your day?

Your challenge is to rack up as many steps as you can in the next 30 minutes, and record all your team’s results below. This will help us all to see how even exercising gently for a relatively short time each day can have positive effects on our health and wellbeing.

TOTAL STEPS 0
SAVE