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A man in a black shirt, black shorts, and wearing a prosthesis running on a sidewalk with grass on both sides. A bridge is in the background.

E, the seventh letter in the MY SCORECARD acronym used in our MENTOR program, stands for exercise.

Exercise is highly effective in reducing the risk and severity of chronic conditions such as heart disease, cancer, diabetes, depression and anxiety.

Exercise offers significant benefits for both your physical and mental health. Even on days when you’re not motivated, a few minutes of exercise can boost your energy and improve your mood.

Challenges to getting regular exercise

Both people with and without disabilities face exercise barriers like lack of time and interest.

However, people with disabilities often encounter additional challenges, such as pain, fatigue, and depression, which may deter them from exercising due to fears of worsening their condition. Environmental barriers, such as poor transportation access, also make regular visits to fitness centers difficult.

We often assume everyone has easy access to exercise, but people with disabilities may require upper-body routines or modifications to lower-body exercises. Some gyms or exercise areas may not have proper adaptive equipment.

How much do you need?

The U.S. Physical Activity Guidelines recommend that adults get 150 minutes a week of moderate-intensity exercise. You can break this up into small increments throughout the week. Even 1 to 2 minutes of exercise counts!

A simple way to describe moderate-intensity exercise is to remember that while you’re exercising, you need to get to a point where you can still talk but that singing would not be possible. This can be achieved with many cardiovascular exercises, activities and sports, like walking, wheelchair rolling, cycling and swimming (among many others!). The main point is to get moving!

High-intensity interval training (HIIT) is one of the most effective and rapid methods for improving health. If you can handle higher intensity, increasing the challenge of your exercise is beneficial. However, it is very important to make sure that short HIIT sessions do not cause extended bouts of exhaustion or additional health issues.

In addition to simple cardiovascular exercise, strength training is also recommended twice a week for all adults. Those with chronic conditions or disabilities should also engage in moderate or higher-intensity muscle-strengthening activities targeting major muscle groups at least two days a week.

Making exercise accessible

Specialized exercise equipment can help people who use a wheelchair or those with a mobility limitation get effective moderate-intensity exercise.

The standard stationary exercise bike is one option, but there are variations designed for individuals with physical disabilities. An ergometer can be accessible to wheelchair users, as most ergometers use hand or foot pedals. Some arm ergometers feature removable seats for accessibility, and hand grips or foot straps can accommodate various levels of grip.

Strength is crucial for daily tasks such as transferring in and out of a car, dressing, climbing stairs and wheeling up ramps. Both heavy and lighter weights can be beneficial. Strength training can be done using bodyweight, free weights, portable equipment (like elastic bands) and machines.

What about when I don’t feel like exercising?

People with disabilities often experience secondary issues like pain or fatigue that can make them feel unwell and reluctant to exercise. Factors like poor sleep, stress, weather or other unknown reasons can contribute to a lack of motivation. However, exercising or even gentle movement can be beneficial, as it can alleviate some pain and fatigue.

Pushing through these feelings to engage in low-intensity activities like adapted yoga, stretching or light weights can often lead to improved feelings during and after the activity. Even a little bit of movement can contribute to this positive effect.

The acronym SELECT can help keep you motivated to stay physically active:

S is for Social Engagement.

Social interaction can support the maintenance of a regular exercise routine. Most people who consistently exercise do so with others, engaging in activities such as walking, tennis, golf, group aquatic exercises, dance and more.

E is for the Enjoyment Factor.

If an activity isn’t enjoyable, it’s likely to fail once the novelty wears off. To maintain motivation and interest, combine different fitness and recreational activities, such as yoga, pickleball and swimming, especially if you find it challenging to stick with exercise.

L is for Learning Something New.

Learning a new physical activity or enhancing an existing one in a social and enjoyable environment is highly rewarding for many and helps maintain long-term engagement. Golfers, tennis players, line dancers and others in similar groups frequently seek new skills to improve their performance. When choosing physical activities, opt for those where skills can be broken down into manageable steps, fostering a sense of learning and achievement.

E is for Exploration a Key to Discovery.

People who hike or cycle enjoy exploring new trails or roads for hours without getting bored or tired. Their strong commitment to exercise is linked to the pleasure of discovering new surroundings, even on familiar routes. Similarly, mall walkers stay engaged by browsing stores and seeking sales, enjoying the sensory stimulation of the mall. This low-intensity activity is superior to remaining sedentary at home near food, TV or computer screens.

C is for Competition (Friendly Competition).

Elite athletes aren’t the only ones motivated by sports. Many people enjoy challenging themselves. This can be done by beating personal exercise records or competing in groups against others. Competition can push individuals to perform their best and offer a strong sense of achievement. Consider engaging in friendly competitions by setting exercise goals or trying a new sport with others.

T is for Task Completion.

High responders to exercise are often termed “task completers” because they enjoy checking items off their list. Common tasks include daily exercise and chores. Marking something off a checklist can be satisfying and may boost motivation to achieve more, helping to integrate these tasks into your daily routine.

Additional Resources for Exercise

You can check out our home workout playlist on YouTube with adapted exercises for people with disabilities that can be done anywhere!

Participate in adapted exercise classes and get fitness guidance in the NCHPAD MENTOR (Mindfulness, Exercise, Nutrition to Optimize Resilience) program! MENTOR is our 8-week program focusing on physical, mental and emotional health for individuals with an existing disability or a recent diagnosis.

If you’re searching for specialized recommendations or resources, our team of expert inclusion specialists is here to help! You can contact our EIS team through the NCHPAD Call Center. Our Call Center team works with individuals to enroll them in NCHPAD Connect, answer questions about programs or connect them to an EIS for community resources and technical assistance. Our EIS expertise is always free and available 7 a.m. – 7 p.m. Monday-Friday.

To contact the NCHPAD Call Center, call 866-866-8896 or email nchpad@uab.edu.

Four people sitting next to a fire pit on the beach

The first R in the MY SCORECARD acronym from the MENTOR program stands for relationships, an essential part of human life.

People who have recently acquired a disability, diagnosis or health condition often face challenges in both existing and new relationships.

The increased need for assistance from a spouse, partner, loved one or personal care assistant can strain these relationships. The individual’s and family’s world can feel turned upside down, and a relationship already facing difficulties may be on the brink of collapse. Families often struggle to balance providing enough support without blocking the individual’s desire for independence.

These health conditions can affect social skills and speech which can make it difficult to relate others or take more time to process questions or requests. Friends and loved ones try to relate to the person like they did before the disability and may not realize that their communication methods must change to match the person’s comprehension level.

After a recent disability, diagnosis or new health condition, many people are unable to return to full-time work or find a job, with some opting for early retirement. Limited mobility, lack of transportation and the need for extra time to complete personal chores can strain existing relationships and negatively impact forming new ones. This often leads to high rates of loneliness, despair and depression.

Negativity, Pessimism and Criticism in Relationships

Negativity, pessimism and criticism create hurtful and painful relationships. No one likes to be around people who exhibit these behaviors.

These traits feed the ego. The ego wants and needs to feel superior to other people. Our egos thrive on negativity, pessimism or criticism to gain strength.

When your ego dominates a relationship, whether with spouses, family members, friends or coworkers, it focuses solely on its desires, ignoring the other person’s perspective. This leads to one-sided conversations and showing little interest in listening to others.

Unfortunately, most people never realize that their behavior is driven by their ego. However, if they were to look beyond the ego’s surface, they would discover joy, love and happiness.

Forming Positive Relationships

Forming positive relationships doesn’t come easily for many people and requires practice. Many factors play into building better relationships, but it ultimately comes down to three principles: nonresistance, nonjudgment and nonattachment.

Nonresistance: This means not letting criticism get under your skin. If someone critiques your actions or decisions, resist the urge to react defensively. Instead, respond calmly and thoughtfully, avoiding hurtful exchanges.

Nonjudgment: Avoid making accusations or judgments about others. It’s okay to disagree with someone’s actions but direct your comments to the behavior, not the person.
Nonattachment: Throughout life, you’ll encounter people with high levels of negativity, criticism and pessimism. The first step in handling these difficult relationships is to recognize that their negativity stems from their ego, not from anything about you. Harsh words are ego-driven. Never attach a critical statement made by someone about you to who you are.

Three Ways to Handle a Challenging Relationship

Removal from the Situation:

The first defense against a toxic relationship is to remove yourself from the situation before it escalates. In relationships that must be maintained, such as with a spouse, partner, child or other family members, over time they will recognize that you will not engage their ego. They will learn that to maintain and grow the relationship, they must use positive, optimistic and objective statements instead of sarcastic or critical ones.

Changing the Situation:

Sometimes, it’s necessary to address the negative or critical comments that make the relationship difficult. This can be done without triggering the other person’s ego by using good timing, gentle expression and personalizing the feedback rather than criticizing. Changing the topic or offering a neutral comment can help.

Accepting the Situation:

If changing the situation isn’t possible, you may need to accept the current relationship while seeking ways to improve it. Acceptance doesn’t mean being a ‘punching bag’; you can still express your feelings positively and constructively.

Tips for Building Stronger Relationships

1. Reflect on Yourself

The first step in improving a negative relationship is to consider if you might be contributing to the issue. Reflect on your actions and words: Are you doing or saying something that triggers a negative reaction in the other person? In long-term relationships, past habits and unintentional statements can increase toxicity. Avoid comparing the present to the past, especially when someone is recovering from a disability or new health diagnosis.

2. The Power of a Smile

Even when you don’t feel well, a genuine smile can positively change interactions. A friendly smile can win over a new acquaintance or improve a relationship with a loved one, as it’s hard to be critical of someone warm and welcoming.

3. Make Eye Contact and Ask Questions

Strong relationships require good eye contact and active listening. Asking follow-up questions shows respect and interest, makes the other person feel comfortable, and fosters empathy and understanding.

4. Focus on the Positive

Amidst widespread negativity, finding something positive to say can strengthen relationships. Optimism, even in difficult times, can improve interactions and relationships.

5. Share Your Perspective Through Stories

Sharing your perspective through storytelling rather than strong opinions is effective. Stories capture attention, provoke emotions, elicit empathy and enhance recall.

6. Limit Screen Time

Screens can be distracting during conversations. Focus on the person you’re speaking with by removing yourself from the TV or having them turn off their devices for a dedicated time.

7. Prioritize Listening

Good relationships require listening as much as, if not more than, speaking. Listening shows interest in the other person and strengthens connections. Remember, “outflow equals inflow” – the more you listen, the more likely you’ll be listened to.

8. Value Silence

If you disagree with someone, sometimes it’s best to remain silent. Silence can prevent escalation, as arguments require two participants. Use the acronym WAIT (Why Am I Talking) to create space between a negative comment and your reaction.

9. Show Gratitude

Never take relationships for granted, especially when someone is helping you through a challenging time. Some people may feel a sense of entitlement because they are the ones with the disability/diagnosis and family members are expected to be supportive. Express gratitude regularly with simple words like “thank you” or “I appreciate everything you do for me.”

10. Be Aware of Negativity

Monitor how often you express negative, pessimistic or critical statements. Increasing awareness is the first step to reducing their frequency and fostering more positive interactions.

Summary

Relationships either make us strong and healthy or wear us down and damage our health but it starts with your actions. Avoid negative behaviors that can drive people away and prioritize good communication. Try these tips to maintain good relationships with family, friends and coworkers and build new relationships.

On May 1, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), finalized a rule that prohibits discrimination based on disability. This ruling is an important landmark in the disability rights movement because it is the first comprehensive update to Section 504 of the Rehabilitation Act in 47 years.

The rule, titled Discrimination based on Disability in Health and Human Service Programs or Activities, provides a comprehensive set of regulations to protect people with disabilities against discrimination for activities or programs receiving funding from HHS.

“Our rules ensure that the medical treatment decisions are not based on biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or beliefs that [the] life of an individual with a disability has less value than the life of a person without a disability,” said Melanie Fontes Rainer, Office for Civil Rights U.S. Department of Health & Human Services Director. “It also, for the first time, implements a legally enforceable standard to ensure non-discrimination in the use of technologies that are routinely used in healthcare, including web content and mobile app and kiosks.”

Since its inception, Section 504 of the Rehabilitation Act acted as a civil rights law to prohibit discrimination on the basis of disability. The new ruling continues to recognize the purpose of Section 504 but also ensures that the rule is enforced and promotes health equity by clarifying the obligations of entities providing healthcare services to people with disabilities.

In detail, the rule:

Guarantees that medical treatment decisions are not based on negative biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or dehumanizing beliefs that the life of an individual with a disability has less value than the life of a person without a disability.
Prohibits the use of any measure, assessment, or tool that discounts the value of a life extension based on disability to deny, limit, or otherwise condition access to aid, benefit, or service.
States what accessibility means for websites and mobile applications and sets forth a specific technical standard to ensure that health care and human service activities delivered through these platforms are readily accessible to and usable by individuals with disabilities.
Adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment such as exam tables and mammography machines.
Details requirement to ensure that children, parents, caregivers, foster parents, and prospective parents are not discriminated against in the services provided by HHS-funded child welfare agencies, including, but not limited to, reasonable efforts to prevent foster care placement, parent-child visitation, reunification services, child placement, parenting skills programs, and in- and out-of-home services.
Clarifies obligations to provide services in the most integrated setting, like receiving services in one’s own home, appropriate to the needs of individuals with disabilities.

Xavier Becerra, Secretary of the Department of Health and Human Services, recognized that one of the major challenges in adopting this ruling is informing the disabled population that they have rights and that this ruling makes those rights more powerful. He believes that a solution to overcome this challenge is by encouraging individuals to help communicate to Americans with disabilities that they have enforceable rights.

Additionally, the Final Rule updates existing requirements to make them consistent with the Americans with Disabilities Act (ADA), as many HHS recipients are also covered by the ADA this consistency will improve and simplify compliance.

Here at NCHPAD, we are grateful and excited for the new ruling but acknowledge the additional effort in upholding and enforcing the rights and regulations.

“This important new rule from the U.S. Department of Health and Human Services strengthens protections against disability discrimination, ensuring healthcare decisions are fair and that people with disabilities get equal treatment in all health and human service programs,” said Zoe Young, PhD, NCHPAD Associate Director. “This is an exciting step forward for those of us in the disability and health field. There is still much more work to be done on the frontline to ensure all healthcare facilitates are properly equipped and personnel are trained to implement these protections effectively.”

The PEAK Center at Craig Hospital in Englewood, Colorado, is a pioneering adaptive health and wellness facility dedicated to enhancing recovery and promoting lifelong health for individuals with neurologic disabilities nationwide. Learn more about them and their great resources in our newest spotlight article!

When did the PEAK Center at Craig Hospital start?

We started in 2011. Craig Hospital is a world-renowned rehabilitation hospital that exclusively specializes in neurorehabilitation and research for individuals with spinal cord injury and brain injury. Craig is a 93-bed, private, not-for-profit inpatient/outpatient hospital that offers acute, short and long-term follow-up care.

What are your goals or mission?

The PEAK (Performance, Exercise, Attitude and Knowledge) Wellness Center at Craig Hospital offers specialized health and wellness programs focused on enriching the quality of life for those affected by neurological conditions. With knowledge and passion, we inspire our community to live healthier lives through unique, innovative and traditional wellness strategies.

Where are you located?

Craig Hospital is located at 3425 S Clarkson St, Englewood, CO 80113.

How many employees do you have?

3 administrators
2 Physical Therapists
8 Clinical Exercise Specialists
3 Aides

What do you all do?

We are an adaptive health and wellness center serving individuals across the United States with neurologic disabilities to optimize their recovery and create a lifelong plan for their health and wellness. Our services are open to anyone in the community with a neurological diagnosis. Clients do not have to be current or former Craig patients and we accept clients with any neuro diagnosis. Our services include:

Personal training
Group classes
FES bikes
Open gym – fully accessible gym with a variety of strength and cardio equipment

Tell us a success story or brag about yourselves. What would you like us to highlight or share about your organization?

We provide specialized personal training programs to clients in the community as an adjunct to their outpatient therapy services. We are also available to clients who are no longer in therapy as an accessible and inclusive environment to continue their health and wellness journey. We utilize traditional training methods and have access to state-of-the-art technologies to provide clients with the opportunity to move and exercise in ways they can’t do on their own. Some of the specialized equipment we use includes:

Robotic exoskeletons
Body weight support devices to safely walk clients overground or over a treadmill
Several different functional electric stimulation technologies
A pool and an underwater treadmill

Here is a link to an article about a few of our clients! https://craighospital.org/blog/achieving-goals-at-the-peak

When did PEAK/Craig and NCHPAD start working together? What do you all hope to gain (or for your participants to gain) from this partnership?

In the fall of 2020! During the COVID-19 pandemic, we needed to be very careful about exposure, as many of our clients were at a higher risk of severe illness due to their injuries. We saw it as an incredible opportunity to provide our clients with a free online training program to improve their understanding of the mind, body and spirit connection. The information provided in the MENTOR program is extremely valuable to our clients, and this program offers an invaluable form of peer mentorship and education about the health and wellness of the body and the soul.

Tell us about your resources. Do you have a current resource campaign you’d like to highlight? What resources have been the most successful or important to you all?

We are thankful to have the incredible support of the Craig Hospital Foundation, which works with our generous donors to provide three essential resources for our clients:

Specialized, state-of-the-art technologies to get our clients out of their wheelchairs and safely moving their bodies for exercise
A scholarship program for our general gym memberships, which allows our clients who may need some financial assistance to access the open gym at no cost
A strong electrode donation fund, which allows us to provide the electrodes we use for many of our services to our clients at no cost

What are some resources or services you provide that people may not know about?

One-on-one personal training services for any neurological injury or diagnosis
Group classes currently include:
- PEAK Beats (cardio)
- Happy Hour
- Weights on Wheels
- Glutes, Core and More (strength classes)
- Adaptive yoga
- Tai Chi

FES (functional electrical stimulation) bike program – utilizing the RT300 from Restorative Therapies or the MyoCycle by Myolyn
Open gym membership for independent use, including access to standing frames, weights and cardio equipment

Engaging in outdoor physical activities is crucial for the overall well-being of individuals with physical disabilities. Being in nature offers unique benefits that are not always available indoors. Exposure to fresh air, sunlight and the natural world can significantly improve mood, reduce stress and enhance emotional health. Being outdoors can also provide a sense of adventure and connection with nature, whether hiking or doing simple activities with friends or family.

Health Benefits of Being Outdoors

Being physically active can have many health benefits such as preventing heart disease, stroke and diabetes. Physical activity can also reduce the risk of cancer and other diseases. Physical activity can be done anywhere, so why not take it outside?

Outdoor physical activities (PA) improve the physical, mental and emotional well-being of all individuals, including those with mobility disabilities. Research shows that people with disabilities often achieve greater levels of accomplishment and personal growth from outdoor activities compared to those without disabilities.

Although outdoor PA provides benefits like indoor PA, these activities also offer additional advantages such as enhanced mood and increased relaxation. Being in nature can also motivate people to participate in outdoor physical activities more than indoor recreation. [1]

For some, simply going outside may not be enough enjoyment. Try finding parks or trails to visit! A 2015 study published in the Proceedings of the National Academy of Sciences discovered that individuals who walked for 90 minutes in a natural environment, compared to those who walked in a high-traffic urban setting, exhibited reduced activity in a brain region linked to a major factor in depression [2].

Another study in 2017 evaluated the impact of nature access for people with mobility disabilities. Parkinson’s disease (PD) patients improved their mobility more significantly when engaging in activities in nature compared to non-nature environments. They also saw other health benefits, such as better cardiorespiratory capacity and lower and more stable blood pressure and heart rate. These improvements often appeared right after the activity and lasted into their daily lives. Researchers think the long-term benefits may come from being more physically active or increased self-confidence and motivation after exercising in challenging mountain environments [3].

Breathing can be easier outdoors as well. Environmental Protection Agency (EPA) studies have shown that indoor pollution concentration levels are 2-to-5 times higher than outdoor air [4].

Outdoor activities offer advantages that indoor activities cannot, but they can come with their challenges. It’s important to remember that every destination can have different levels of accessibility for people with disabilities, so it’s best to be prepared for your next outing.

Best Practices for Being Outdoors

Do your research: Contact the location ahead of time or review their website to plan before visiting to ensure the destination is accessible and provides reasonable accommodations. Informed decision-making can lead to a worry-free experience.

Be prepared: If you plan on being outdoors for a lengthy amount of time, pack the necessary items to ensure you can have a fun and safe time.

Water bottles
Sun Protection
Insect Repellant
Appropriate clothing (depending on the physical activity involved)
Navigation tools (phone or map)
First-aid kit
Flashlights (if necessary)
Prescription or over-the-counter medications (if needed)
Food or snacks

Find accessible activities to try yourself or with others: There are now more inclusive activities than ever. Here are a few physical activities to try on your own or in a group!

Swimming
Group nature hikes
Outdoor sports
Kayaking or sailing
Snow skiing
Cycling
Fishing
Yoga
Gardening
Camping
Visiting an accessible park.

Rest: Even the most physically fit people need to rest after a long day of being active. Allow time to rest during or after your activity to avoid fatigue or injury.

Try these activities and enjoy all that the great outdoors has to offer!

References

Derakhshan, Pegah, William C. Miller, Andrea Bundon, Delphine Labbé, Tanelle Bolt, and W. Ben Mortenson. “Adaptive Outdoor Physical Activities for Adults With Mobility Disability: A Scoping Review.” Frontiers in Rehabilitation Sciences 4 (January 8, 2024). https://doi.org/10.3389/fresc.2023.1331971.
Gregory N. Bratman et al., “Nature Experience Reduces Rumination and Subgenual Prefrontal Cortex Activation,” Proceedings of the National Academy of Sciences of the United States of America 112, no. 28 (June 29, 2015): 8567–72, https://doi.org/10.1073/pnas.1510459112.
Zhang G, Poulsen DV, Lygum VL, Corazon SS, Gramkow MC, Stigsdotter UK. Health-Promoting Nature Access for People with Mobility Impairments: A Systematic Review. Int J Environ Res Public Health. 2017 Jun 29;14(7):703. doi: 10.3390/ijerph14070703. PMID: 28661433; PMCID: PMC5551141.
US EPA. “Indoor Air Quality | US EPA,” July 14, 2023. https://www.epa.gov/report-environment/indoor-air-quality#note2.

The essence of mindfulness is recognizing that the present moment is all we can control. This is done by resting our attention on the present, focusing on our breath or other bodily sensations and returning to the present when our mind wanders. These simple practices can create more happiness and joy in our lives.

Mindfulness has many benefits. Mindfulness enhances emotional well-being, reducing stress and anxiety. It also improves focus, leading to better decision-making and overall mental clarity. Mindfulness can also have other health benefits like regulating inflammation and sleep as well as reducing blood pressure.

So how can you practice mindfulness? Mindfulness can be practiced in numerous ways throughout the day. It doesn’t even require much time. Here are some ways to practice being mindful in your everyday activities:

You can be mindful in the car. Focus on the steering wheel in your hand, the vibration of the vehicle or the sound of the vehicle.
When you’re making the bed, feel the texture of the bedspread, the softness of the sheets, and the firmness of the mattress or pillow.
When you’re in the shower or bath, feel the water on your skin. Notice the smell of the soap and texture of the bubbles of the soap on the skin. Acknowledge the warmth or coolness of the water.
If you’re eating, take in the sensation of biting into food along with the taste or texture of the food. Be aware of how the food feels in your mouth and how it feels swallowing the food.
When you’re brushing your teeth, feel the bristles of the toothbrush against the gums and teeth. Recognize the texture and taste of the toothpaste.

Sometimes we can get so caught up in daily activities that we forget to focus on the present moment. Focusing on tasks or responsibilities from the past or future can prevent us from being in the present.

When you’re in a conversation, being mindful can lead to better communication and understanding. Check out these tips for better mindful communication:

Sometimes during the day, we may get stressed or overwhelmed with work or life burdens. We might need to recenter. One way to relieve this stress is by going outside and being grounded in nature. Watch this video and discover the benefits of being mindful while being in nature:

NCHPAD Mindfulness Curriculum Coordinator Emily Hornsby shared these benefits and tips for being mindful throughout the day:

Mindfulness is paying attention to what is going on in and around you moment by moment without judgment. Another way of thinking about mindfulness is being in “the flow.” When you are engaged in an activity just for the sake of being engaged in that activity, and you are not thinking about the future or ruminating about the past, you are in “the flow.”

You can practice mindfulness, or being in “the flow,” in your everyday activities like washing the dishes, taking a shower or taking a walk in nature. When you are paying attention to the way the warm soapy water feels on your hands when you are washing dishes, and how the sponge feels in your hand as you clean the dishes, you are mindfully washing dishes.

When you are taking a walk in nature and you pay attention to the sound of the breeze when it blows through leaves on a tree, or the smell of honeysuckle, or the sound of birds or squirrels scurrying on the ground, you are taking a mindful walk in nature.

When thoughts come into your awareness, you acknowledge them without judgment, and then decide whether you want to rest your attention on that thought or if you would rather let that thought go like a cloud in the sky and return to the present moment.

Practicing mindfulness in your everyday activities retrains your brain as you are creating new neural pathways towards more joy and happiness. We are happiest when we are present and not thinking or worrying. Try mindfulness in your everyday activities and see how it goes!

You can learn more about mindfulness through our website articles and videos on YouTube!

A woman using an electric cart to shop for fresh produce at a farmers market. A man is handing her a bag of produce.

We all know that mental health is important, but we often don’t prioritize it compared to our physical health. Sometimes we don’t take the time to manage our thoughts and emotions until we reach a breaking point. Frequent mental distress can also be more common for individuals with a disability compared to those without disabilities.

May is Mental Health Awareness Month, and there is no better time to commit to a new start for improving your mental health.

Better overall mental well-being can start with simple practices. These simple tasks can be done every day, and you don’t need special equipment. You can try these from anywhere!

Kalani Upshaw, NCHPAD Community Health Educator, shares these 10 things you can do every day to improve your mental well-being.

Take up a relaxation practice: Spend a few minutes each day practicing mindfulness, meditation or deep breathing. This can help reduce stress, enhance concentration and promote a feeling of calmness and peace.
Exercise regularly: Physical activity releases endorphins, chemicals in the brain that act as natural painkillers and mood elevators. Even a short 30-minute daily exercise can significantly lift your mood and reduce stress.
Get enough sleep: Sleep has a profound impact on mental health. Aim for 7-9 hours of quality sleep per night to help regulate mood and improve brain function.
Eat a balanced diet: Nutrition plays a key role in brain health. Eating a diet rich in vegetables, fruits, lean proteins and whole grains can help boost your mood and energy levels.
Connect with others: Social interaction is vital. Spend time with friends or family, or foster connections by joining a club or group that interests you.
Take breaks: When you’re feeling overwhelmed, take short breaks throughout the day. A few minutes away from your workstation or daily routines can help clear your mind and reduce stress.
Set realistic goals: Set achievable goals each day, even if they’re small. Achieving goals gives a sense of satisfaction and purpose.
Practice gratitude: Take a moment each day to think about the things you’re grateful for. Keeping a gratitude journal can shift your focus from what’s lacking to what’s abundant in your life.
Limit screen time: Excessive use of screens can negatively impact mental health. Try to reduce the time spent on digital devices, especially before bedtime.

Seek professional help when needed: If you’re struggling with mental health issues, don’t hesitate to seek professional help, especially if it has been going on for two weeks or more. Talking to a therapist or counselor can provide support and strategies to manage your mental health effectively.

Your body and mind are closely connected. When you look after one, you often help the other too. Try these tips and hopefully you will notice a positive impact on your mental and physical health!

Here are some helpful resources from our team to help fulfill these practices:

Relaxation Practices: Our Guided Meditations on YouTube.

Exercises: Our Inclusive Home Workout Playlist on YouTube.

Searching for a way to connect with others? Learn more about NCHPAD’s Coffee Club!

To learn more about NCHPAD’s 6-week mental wellness promotion program, Growing Resilience Out of Wellness and Thoughtful Habits (GROWTH), visit this link.

A female medical worker holding a chart and showing it to a male using his wheelchair.

Mental Health Awareness Month is a crucial time to acknowledge the importance of mental health for all. But awareness alone isn’t enough. Millions of individuals with disabilities experience the path to mental well-being filled with a variety of systematic, physical and attitudinal barriers. Promoting inclusion and accessibility is important for all healthcare providers, including those who focus on mental health, such as counselors, therapists, social workers and more.

This year, let’s move beyond awareness and focus on centering accessibility and promoting inclusion in and out of your mental health practice. Seeking mental healthcare should be a supportive and empowering experience, and this requires a commitment of action from mental health providers. Here are actionable things you as a provider can do to start promoting inclusion and create a welcoming and accessible environment that ensures everyone has a path to participate in mental healthcare.

1. Assess Your Practice’s Accessibility: Start by evaluating the accessibility of your practice’s physical space, digital platforms and communication methods. Identify any potential barriers, whether physical or digital, and prioritize making necessary adjustments to ensure individuals with disabilities can access your services with as few obstacles as possible. This may involve investing in new physical accommodations like automatic doors or more accessible parking spots, as well as offering alternative formats for intake forms and documentation.

2. Cultivate a Welcoming Environment: Equip yourself and your staff with ongoing disability education and training to learn more about the spectrum of disability, historical barriers and best practices for providing better mental health support and services. This helps foster a culture of respect and understanding, ensuring everyone feels valued and supported while engaging in mental health services.

3. Create Financial Assistance Programs: Recognize that individuals with disabilities may face financial barriers to accessing mental healthcare. Offer sliding-scale fees, payment plans or financial assistance programs to make services more affordable and accessible.

4. Community Resources Directory: Compile a directory of community resources and support services that are accessible to individuals with disabilities. Include information on accessible transportation options, support groups, advocacy organizations and disability-specific services to help individuals navigate available resources.

5. Provide Accommodations: Be proactive in offering accommodations to individuals with disabilities to ensure better access and support. This may include providing sign language interpreters, offering assistive devices or adjusting appointment scheduling to be remote vs. onsite.

6. Encouragement of Self-Advocacy: Empower individuals with disabilities to advocate for their own needs and preferences within the therapeutic relationship. Encourage open communication and provide opportunities for clients to express their concerns, ask questions and assert their boundaries.

7. Promote Participation: Adapt resources and approaches in sessions to encourage active engagement from individuals with disabilities. Offer resources and materials in accessible alternate formats and adjust communication styles to center participation. By prioritizing accessibility, you empower people with disabilities to take an active role in their mental health journey, which will help foster a sense of agency and ownership in the therapeutic process.

8. Collaborate with Disability Organizations: Reach out to local disability advocacy organizations to establish partnerships and collaborations. Learn from their expertise and insights and work together to identify and address systemic barriers to mental health care access.

9. Seek Feedback and Adapt: Continuously seek feedback from individuals with disabilities about their experiences with your mental health services. Use this feedback to identify areas for improvement and make necessary adaptations to provide accessible and inclusive services.

10. Advocate for Policy Change: Advocate for policy changes at the local, state and national levels to improve access to mental healthcare for individuals with disabilities. Support initiatives that promote disability rights, healthcare accessibility and funding for disability-specific mental health programs.

While these tips provide a starting point, as healthcare providers, it’s crucial to ensure that mental healthcare is inclusive and accessible to individuals with and without disabilities. This month, make a commitment to take action in your own practices to diminish barriers to mental healthcare and enhance access and participation with people with disabilities.

To deepen your understanding and implementation of inclusive practices, consider enrolling in our new 1-hour online training on Disability Education for Healthcare Providers. This training offers a comprehensive exploration of the barriers individuals with disabilities face when seeking healthcare, emphasizing the pivotal role of inclusion. By participating, healthcare providers will gain invaluable insights to foster an environment where every patient’s needs are met with empathy and understanding. Additionally, you’ll explore initiatives by NCHPAD aimed at improving access to health and wellness for individuals with disabilities, empowering you to actively engage and contribute to these efforts. Together, let’s work toward building a more equitable and inclusive mental healthcare system that serves everyone.

Enroll Here

March is National Nutrition Month, and we’re celebrating by embracing the joys of home cooking! This Strawberry Shortcake smoothie recipe combines fruit, protein and vegetables for a healthy, satisfying treat.

A study by the National Center on Disability and Journalism found that only 57% of adults with disabilities reported eating fruits and vegetables daily. Almost 90% of Americans are not getting enough vegetables – and 80% are not getting enough fruits to meet nutrient requirements.

Smoothies are often assumed to be healthy because they are full of fruit, but some recipes may contain large amounts of added sugars. This recipe uses alternatives to give the smoothie a sweet taste and even more healthy benefits!

Ingredients needed for this recipe:

-1 cup spinach

-1 1/2 cups frozen strawberries

-1 tbsp nut butter

-3 dates

-1 cup nut milk

-1/4 teaspoon ground cinnamon

-1 scoop vanilla protein powder

-4 oz vanilla yogurt

-A cupful of ice cubes

Start with the nut milk for liquid and add spinach and berries for our serving of fruits and veggies. Yogurt and protein powder add lean protein to help you stay fuller longer and maintain muscle and skin health. Nut butter is a healthy fat and spices add flavor. Dates, great for the gut and rich in antioxidants, are a great way to add sweetness to a smoothie without adding extra sugar. Once you have all the ingredients, add the ice and blend it well to create your balanced, healthy smoothie!

This month, we want you to cook with confidence! Our goal is to empower people with disabilities to become confident chefs in their own kitchens. Check out our YouTube channel to boost your confidence and increase your knowledge of fundamental nutrition concepts, info on adapted tools that support cooking and recipes tailored to specific health goals. Try this recipe and many more from our channel to add to your new healthy diet!

15 minutes or less Mediterranean meals with three photos of the meals

The new year means new meals! Try these three healthy meals from the Mediterranean diet. With short prep times and nutritional benefits, each recipe could be a delicious addition to your cooking routine in 2024. The Mediterranean diet is a highly recommended, healthy diet because it includes whole grains, beans, vegetables, olive oil, nuts, herbs and spices.

Recipe 1 – Baked Salmon over Summer Succotash

Serving size: 2 | Prep time: 15 minutes | Cook time: 15 minutes

For the ingredients, you will need:
2 salmon fillets
½ cup black-eye peas
½ cup shelled edamame
½ cup kale, chopped
1 cup squash & zucchini
¼ red bell pepper
1 small tomato
1 garlic clove
1 cup vegetable stock
4 basil leaves
Tabasco (optional)
Worcester
1 teaspoon lemon juice

First, we will prepare the baking sheet and the salmon fillets. Season your fillets with salt and pepper. Then they are ready for the oven, which you will have preheated to 350 degrees. Bake for 15 min or until the internal temperature of the salmon reaches 145 degrees.
While the fillets are cooking, dice all vegetables into ½ inch cubes. The device used in the video demonstration is a food chopper, which is beneficial for individuals with limited hand dexterity or those looking to save time prepping ingredients.
Once the bell pepper and onion are chopped into ½ inch cubes, place to the side and prepare the pan.
Add some oil to your skillet, followed by a spoonful of garlic.
Then add the chopped vegetables and let cook.
Next, dice the tomato. Once chopped, place to the side.
Add the black-eyed peas, salt, and pepper.
Now, chop the zucchini and squash. Add to the pan with some chicken broth and let it simmer for a minute or two.
Toss in the kale, edamame, and Worcester sauce. For a little kick, add some hot sauce.
Cut the end off the lemon and squeeze into the succotash.
Now, we can add the tomatoes and a little more salt and pepper!
Turn off the stove. The salmon should be ready to pull out of the oven. Grab a dish and add the succotash to the base of the bowl. Place salmon on top and garnish with ribbons of basil.

Recipe 2 – Shrimp and Artichoke Linguine with Sundried Tomatoes

Serving size: 4 | Prep time: 5 minutes | Cooking time: 15 minutes

For this recipe, you will need:
1 Lb. frozen shrimp
1 ½ cups artichoke hearts
1 Tablespoon oil
1-2 garlic clove
8-10 oz. linguini
½ cup sun-dried tomato
½ cup shredded parmesan
2 cups spinach
1 Lemon
Basil
Salt and pepper

Preheat the oven to 350 degrees and cook the noodles according to the package directions. Reserve ½ cup pasta water and save for later.
Once the pasta is ready, switch out for a clean pan and heat one tablespoon of olive oil to medium-high heat.
Add shrimp, giving a quick sear, tossing until just pink and season with salt and pepper.
When finished cooking, remove from pan and wipe clean.
Add oil and the pine nuts. Toast pine nuts until lightly golden.
Add artichoke heart and sundried tomatoes.
Pour the leftover pasta water and the edamame.
Now add the parmesan cheese.
Next, add the garlic and sauté until garlic is fragrant, about two minutes.
Turn off the heat, add the shrimp, and top it off with some lemon juice.
Begin plating by adding the drained pasta to the bowl, followed by the shrimp and vegetables.
Lastly, grab some fresh basil and chop finely to use as garnish. Your Shrimp and Artichoke Linguine with Sundried Tomatoes dish is done!

Recipe 3 – Lemon Chicken Soup with Ginger

Serving size: 2 | Cooking time: 10 minutes | Prep time: 15 minutes

For ingredients, you will need:
2 chicken breasts
4 cups chicken broth
4 tbsp ginger paste
2 cloves garlic
2 Lemons
4 oz cooked pasta
1 tbsp Italian seasoning
2 bay leaf
fresh parsley

Start by preparing the chicken breast. Cube the chicken into ½ inch cubes.
Prep the pan with oil and heat the oil on medium-high heat in a medium pan.
Sear chicken in the pan for 3-4 minutes and season with salt and pepper.
Add ginger paste and garlic to the pan.
Mix the ingredients and add the broth to the pan, followed by lemon juice.
Add the noodles and cook for 6-8 minutes until pasta is tender and stir throughout. To help with stirring, we use an assistive device called an automatic stirrer in the video. Place the device in a pan or pot, push the button to turn it on, and the stirrer will automatically rotate.
Add some bay leaves and a little more lemon and ginger paste.
The dish is ready! Ladle soup into a bowl and finely chop parsley to use as garnish.