My physical health record explained

Transcription

1 My physical health record explained Name:...

2 This booklet has been produced by staff and patients in CNWL, with funding from the Health Foundation, Shine

3 Contents 4 My physical health record explained 6 Your physical health profile 8 Weight 11 Cholesterol 12 Blood pressure 14 Alcohol 16 Smoking 18 Cardiovascular risk 20 Diabetes 22 Lifestyle changes 28 We have referred you on to 29 Places that can help you 32 Notes 3

4 My physical healthcare explained What is this for? This booklet is yours; it is designed to explain the results of the physical health assessment which was done with you on the ward. It is yours to keep at home and to take to appointments with anyone involved in your care, if you find this useful. Why are we interested in physical health? People who have long-term mental health needs tend to be in worse health than other people of the same age. For instance they are more at risk of heart disease, diabetes and breathing problems. Having a long-term mental health condition can make it hard to look after yourself and maintain a healthy lifestyle. How do you use this booklet? Your clinical team will enter the results of your physical health assessment in this booklet and discuss them with you. You can use the plan in two ways. Firstly you can show it to anyone else involved in your healthcare who you want to share it with. They can then see at a glance some of the ways they might help you. More importantly we know that people with long-term mental health problems can often make changes in their lifestyle which will reduce their risk of ill-health. But in order to make changes you have to know what changes you need to make and how you can make them. This plan provides that information so you can make your own choices and take control of your own health. 4

5 Besides this plan you should expect: An annual physical health check with your GP or community team. Regular reviews of your mental health medication with your team. With this plan you should have been given a medication passport and British Heart Foundation booklet called Everyday Triumphs. Please ask for these if you haven t received either of them. 5

6 Your physical health profile Health area Body Mass Index (BMI) Needs attention You are fine Waist measurement Cholesterol Blood pressure Smoking Alcohol 6

7 Date : 12 month review due: Cardiovascular risk Diabetes risk The following pages go on to explain your results in more detail, what improvements you can make, and how to do that. 7

8 Weight Excess pounds do more than increase your weight, they increase your risk of major health problems. People who are overweight or obese are more likely to develop heart disease, strokes, diabetes and cancer. The good news is that reducing your weight has a big effect on your risk level for these problems. There are two weight measures you need to think about: Body Mass Index (BMI) BMI is a measure that adults can use to see if they are a healthy weight for their height. For most adults, an ideal BMI is in the range. Your BMI is:... If your BMI is 25 or more it would be good for your health if you tried to lose some weight. Waist measurement Is a good indicator of where body fat is stored. This is important because people who carry their weight around their middle are particularly at risk of developing heart disease and type-2 diabetes. Your waist measurement is:.. 8

9 If you re a man you have a higher risk of health problems if your waist size is more than 94cm (37 inches). Your risk of health problems is even higher if your waist size is more than 102cm (40 inches). If you re a woman you have a higher risk of health problems if your waist size is more than 80cm (31.5 inches). Your risk of health problems is even higher if your waist size is more than 88cm (34.5 inches). Your results explained: Your BMI and waist measurements are ideal. To maintain a healthy weight for your height you should maintain a healthy lifestyle by following the tips at the end of this booklet. Your BMI is too low If your BMI is less than 18.5 it would be good to talk to a health professional, such as your GP, about gaining weight. Your care team will discuss this with you. Being underweight can increase your risk of health problems, such as: brittle bones (osteoporosis), iron deficiency (anaemia), and absent periods in women (amenorrhoea). continued 9

10 Your BMI and/or waist circumference indicate that you are overweight and/or at increased risk. But don t panic - making simple changes to your lifestyle can help you lose weight, and decrease your risk. Losing excess weight can make you feel better and help you live a longer, healthier life. Even losing a modest amount of weight and keeping it off will lead to significant health gains. For instance In one study people with high blood pressure who lost 10 pounds over six months reduced their blood pressure by the same amount that they would have by taking tablets. In a study of people who were at high risk of developing diabetes, those who lost 7% of their weight and exercised 30 minutes a day cut their risk of diabetes by nearly 60%. Losing weight can be difficult. People tend to gradually put on weight over many years. If you eat one extra biscuit a day for a year you will put on half a stone (3.6kg) of fat. It follows that cutting out a biscuit a day can reduce your weight by the same amount. Many people get discouraged because they have tried crash diets which they just can t keep up. Many people find they lose weight by changing to eating healthier foods. Weight loss needs to be sustainable. Exercise is also important, if you can burn more calories then that will reduce your weight. Again it is most important to find types of exercise that you enjoy and which fit into your lifestyle. The drugs used to treat mental health problems can make losing weight more difficult. Your doctor should be able to discuss with you whether your current tablets might be contributing to your problem and whether there are any alternatives. See the end of the booklet for more information on diet/exercise 10

11 Cholesterol Cholesterol is a type of fat that the human body needs. Your body produces some or its own cholesterol and you get some from food, particularly meat and dairy products. While some cholesterol is needed to have a healthy body if there is too much of it in your blood it increases your risk of heart attacks and stroke. Your fat levels are dependent on your age, sex, genetic makeup. Obviously you can t change these. However diet is also important. Healthy eating reduces cholesterol. If that does not reduce your cholesterol levels then a group of drugs called statins can. Your cholesterol level: Ideal Cholesterol levels tend to rise as you get older so: Ask your doctor to check your cholesterol regularly Eat healthily to reduce the risk of high cholesterol High High cholesterol will increase you risk of developing heart disease and stroke. Your doctor will discuss this with you. If your cholesterol is a little bit high you may be able to reduce it by healthy eating, follow the advice at the end of this booklet. If it is very high you may need to take tablets- statins as well as eating healthily to reduce your cholesterol. This will be discussed with you by your doctor. 11

12 Blood pressure What is blood pressure? When your heart beats, it pumps blood round your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes. Blood pressure is measured in millimetres of mercury (mmhg) and is written as two numbers. Systolic (top number)/diastolic (bottom number). For example, if your reading is 120/80mmHg, your blood pressure is 120 over 80. Both numbers are important. 12 Your blood pressure is:... Low Ideal High-normal High It is important that your blood pressure is within the ideal to high-normal range. Lifestyle is a very important influence on blood pressure. Taking more exercise, eating more healthily, giving up smoking and reducing how much alcohol you drink can all have important effects on blood pressure. You may need to take tablets as well as making lifestyle changes if you blood pressure is very high. Reducing blood pressure dramatically reduces your risk of strokes and heart attacks. There is some lifestyle advice at the back of the booklet.

13 Systolic (top number) Low blood pressure Ideal blood pressure High-normal blood pressure High blood pressure Diastolic (bottom number) 13

14 Alcohol Units a day:... A little alcohol can be very pleasant, it helps people relax. However if you drink too much on a regular basis it can have very negative effects: It can damage the liver, liver failure is now a major problem in the UK It can affect your memory and mental functioning It can cause you to put on additional weight It can lower your mood and make your mental health worse. In the short-term alcohol usually makes you feel better but in the longer term you feel worse Drinking alcohol with some tablets used to treat mental health problems can be dangerous But how much alcohol is too much? No drinking is acceptable if you are pregnant. As a man if you are regularly drinking more than 3-4 units a day you are drinking more than the recommended daily limit. As a woman if you are regularly drinking more than 2-3 units a day you are drinking more than the recommended daily limit. You are drinking within the recommended daily limit if: As a woman you are regularly drinking no more than 2-3 units a day. As a man you are regularly drinking no more than 3-4 units a day. It can lead to you putting yourself at risk. 14

15 What is a unit of alcohol? 1.5 units Small glass of wine (125ml/ABV 12%) 2.1 units Standard glass of wine (175ml/ ABV 12%) 3 units Large glass of wine (250ml/ ABV 12%) 2 units Pint of low strength beer/cider/lager (ABV 3.6%) 3 units Pint of beer/cider/ lager (ABV 5.2%) 1.7 units Bottle of low strength beer/cider/lager (330ml, ABV 5%) 2 units Can of beer/ cider/lager (440ml, ABV 4.5%) 4 units Can of strong beer/ cider/lager (440ml, ABV 9.0%) 1 unit Single shot of spirit (25ml, ABV 40%) 15

16 Smoking Smoker: Yes / No day:... Cigarettes a Quit smoking to live longer Half of all long-term smokers die early from smoking-related diseases, including heart disease, lung cancer and chronic bronchitis. Men who quit smoking by 30 add 10 years to their life. People who kick the habit at 60 add three years to their life. In other words, it s never too late to benefit from stopping. Quitting not only adds years to your life, but it also greatly improves the chance of a diseasefree, mobile, happier old age. Quitting smoking helps to make you feel less stressed. Studies show that people s stress levels are lower after they give up smoking. Nicotine addiction makes smokers stressed from the withdrawal between cigarettes. The good feeling of satisfying that craving is only temporary and is not a real cure for stress. Improved levels of oxygen in the body means that ex-smokers can concentrate better and have increased mental wellbeing. Smoking and mental health medication It is important to talk to a health professional before quitting if you are taking medication for your mental health, as the dosage may need reducing. 16

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18 How much of a risk is your lifestyle? We can work out how much of a risk your lifestyle is to your health, and so how much changing your lifestyle will help. It helps to think about two problems, the risk of strokes and heart attacks, and the risk of developing diabetes. These are not the only health risks you need to consider. If you give up smoking you reduce your risk of dying of cancer and risk of lung damage and if you reduce your drinking you reduce your risk of liver failure. However strokes/heart attacks (cardiovascular disease) and diabetes are very important avoidable risks. What is your cardiovascular risk? Using the information input into the healthcare assessment you had on your arrival to the ward, we can calculate your risk of having a heart attack in the next ten years. Remember this is a risk you can reduce. The information we use includes: Smoking status, Diabetes status, Cholesterol, blood pressure, BMI, and your family history. Based on that information your risk of having a heart attack or stroke within the next 10 years is...% 18

19 Your results explained: Ideal. You have the same score as a typical person with the same age, gender and ethnicity with optimal risk factors. To keep your risk of having a heart attack or stroke low maintain a healthy lifestyle by following the tips at the end of this booklet Your risk of having a stroke or heart attack is higher than it needs to be. This will be discussed with you when you re given this booklet. It is important that your GP and others involved in your team monitor this by regular checkups, at least once a year. There are lots of things you can do to lower your risk. Start by living a healthier lifestyle, see the advice at the end of this booklet. The main things that increase your cardiovascular risk are: Cholesterol Blood Pressure Smoking: risk associated with smoking begins to decrease soon after you quit. It continues to decrease over time. Your risk is cut in half 1 year after quitting. If you have not developed heart disease within 15 years of quitting, your risk is nearly the same as the risk in someone who has never smoked. Lack of exercise: Doing more than 150 minutes (2 hours and 30 minutes) of moderate physical activity or an hour of vigorous physical activity every week will reduce your risk of coronary heart disease by about 30%. Please read the British Heart Foundation Everyday Triumphs booklet, ask staff for one if you haven t been given one. 19

20 Diabetes Diabetes is the most common cause of ill-health in the UK today. It occurs when your body is not able to process sugars properly. Untreated this can lead to an increased risk of heart attacks and stroke and also to damage to your internal organs. It can be controlled by lifestyle changes and medication if it has already developed. However it is better to try to avoid it if possible. Generally the same factors which affect your cardiovascular risk also affect your risk of developing diabetes. Your Diabetes risk level: Your risk of having Type 2 Diabetes within the next 10 years is...% The score of a typical person with the same age, sex and ethnicity as you is...% Unfortunately some older people will develop diabetes whatever they do, but for the majority of people lifestyle is very important in avoiding diabetes. 20

21 Your results explained: Ideal. You have the same score as a typical person with the same age, sex, and ethnicity as you. To keep your risk of developing type 2 diabetes low maintain a healthy lifestyle by following the tips at the end of this booklet. Your risk of developing diabetes is higher than it needs to be. This will be discussed with you when you re given this booklet. It is important that your GP and others involved in your team monitor this by regular checkups, at least once a year. The main things that increase your diabetes risk are: Lack of exercise: One study showed that walking at least two hours a week reduced the incidence early death from cardiovascular disease by about 50%. If you do have diabetes, keeping physically active will better protect your heart. There are lots of things you can do to lower your risk. Start by living a healthier lifestyle, see the advice at the end of this booklet. Please read the British Heart Foundation Everyday Triumphs booklet, ask staff for one if you haven t been given one. EVERYDAY TRIUMPHS Small steps to a healthier heart for mental health service users High BMI High blood pressure 21

22 Lifestyle Changes Below are some areas of your life that make a significant difference to your physical health. For more detailed advice see the Everyday Triumphs booklet we gave you. Talk to your care team or GP if you would like help making changes in any of these areas. Regular Exercise Taking regular exercise is one of the best things you can do for your health. Exercise can help to lose weight or keep your weight down. Even if your weight doesn t change taking regular exercise should help you to live longer and feel better. Ideally you should do two and a half hours of moderate to vigorous exercise every week. That is exercise that puts your heart rate up and makes you breathe harder. However any increase in the amount of exercise you take will help. The more you do, the greater the effect. 22

23 Ideally you should try to make sure you do some exercise every day. You can often fit in more exercise into your everyday life. For instance you could: Walk rather than taking the bus or underground. Even getting off the bus one stop earlier will help Climb the escalator rather than stand Take the stairs, not the lift Walk faster than you normally do Do stretching exercises whilst watching TV Cycle rather than drive. Particularly if you have not taken much exercise for some time it can help to start gradually and build up over a few weeks. There is no right or wrong exercise. The best exercise is exercise you enjoy and that fits in with your everyday life so that you do it regularly. Going to the gym is a very good idea but if you don t enjoy it you probably won t keep it up. What about dancing? Or going for a regular walk in the park? Taking exercise with other people is more rewarding for some people. You could try joining a sports club for instance. Other people get their exercise from things they are interested in, like gardening. At the end of this booklet we provide some information on people who can help you to identify what will suit you. 23

24 Eating healthily Eating healthily makes you feel better and stops you putting on weight. If you need to lose weight it helps to have some advice and we can put you in touch with people who can help. However healthy eating is not just about when you want to lose weight. You don t need to eat special things and you don t need to spend a lot of money to eat well. There are some simple rules that will help you to eat healthily. Make sure you get variety in what you eat Plenty of fruit and vegetables. At least five portions a day. It doesn t matter if they are fresh, frozen, dried or tinned. Whole fruit and vegetables are better for you than smoothies or fruit juices so try to make sure that at least four out of your five portions are whole fruit and veg Some meat, fish, eggs, beans and other non-dairy sources of protein. If you are vegetarian lentils and beans are particularly important Only a small amount of foods and drinks high in fats and/or sugar If you are eating ready meals choose options that are lower in fat, salt and sugar. A portion of fruit and veg is not a precise amount. It s easiest to think of as about a handful (roughly 80g or 3oz), for example: 4 broccoli florets 1 pear 3 heaped tablespoons of carrots 7-8 strawberries. Plenty of starchy foods such as bread, rice, potatoes and pasta. Choose wholegrain varieties wherever possible Some milk and dairy products 24

25 Regular sleep It is important for your health to get enough sleep. Keeping regular sleeping hours can be very helpful. Most adults need between six and nine hours of sleep every night. Winding down is a critical stage in preparing for bed. There are many ways of relaxing: A warm bath or shower (not hot) will help your body reach a temperature that s ideal for rest. Writing to do lists for the next day can organise your thoughts and clear your mind of any distractions. Listening to relaxation CDs or music. Reading a book or listening to the radio relaxes the mind by distracting it. If you don t know how to relax, you can get help and advice from your care team or GP. Try not to watch the TV or use a smart phone for 30 minutes before you try to go to sleep. 25

26 Drink enough fluids It is important to drink enough non-alcoholic drinks regularly through the day to stay hydrated. Alcoholic drinks can make you pass more urine and so they are not good for keeping hydrated. It is difficult to be precise because how much you need to drink will depend on things like how big you are, what you are eating (some foods contain a lot of water) and how much exercise you take. Of course you should drink whenever you feel thirsty. But should you have a target? Most scientists recommend that you drink about 8 glasses of fluid (for example water, semi-skimmed milk or diluted fruit juice, tea, coffee) that is roughly 1.6 litres for women, 2 litres a day for men. If it is a hot day or you are doing lots of exercise you need to increase the amount of liquid you drink. There are several things to keep an eye on: One of the first signs of dehydration is feeling thirsty. If you feel thirsty, drink something. It is common sense but sometimes people don t do it. If you think you may not be getting enough fluids, check whether you have any of these other common signs of dehydration: dark urine and not passing much urine when you go to the toilet headaches lack of energy feeling lightheaded Try drinking more, that should solve the problem. If it doesn t, talk to your doctor about this. 26

27 We also recommend that you: Read the British Heart Foundation Everyday Triumphs booklet, ask staff for one if you haven t been given one. Attend annual physical health assessments with your GP or community team to ensure that any problems are picked up early. Request regular reviews of your mental health medication from your psychiatrist, nurse, pharmacist or GP, whoever is dealing with your medicines. Getting Help Most people know many of the things they need to do to stay healthy. We hope this booklet will have helped you identify what you need to do. You have to take charge of your own health. No-one can do it for you. But that doesn t mean you have to do it on your own. Everyone needs help sometimes. It can be tough to lose weight, or to give up smoking or to sort out a better diet. But there are many people who can help. We work with other agencies who can help you with your lifestyle generally, particularly health trainers and stop smoking services. We also list some other services who can help, because it often helps to have a choice so you can find the service which best meets your needs. On the following page are some services that offer interventions and help in these areas. 27

28 We have referred you on to: Health Trainers for.. They offer up to six, one-to-one sessions to help you achieve your healthy lifestyle goals. They can offer support with healthy eating, physical activity, quitting smoking, and mental or emotional well-being. Health Trainers can help support you to: Eat more healthily Kick it for help to reduce your Smoking Tel: We have also given you a list of a number of other places that can help you with eating healthily, doing more exercise, quitting smoking and reducing alcohol use. You can either get in touch with them yourself or ask a member of your care team to put you in touch with any of them. Become more active Drink less alcohol Reduce stress levels 28

29 Places that can help you: CNWL Recovery & Wellbeing College CNWL Recovery & Wellbeing College helps to build support systems and strive to remove the stigma associated with mental and physical health. They offer a wide variety of courses, that last half a day to several weeks, there is something to interest everyone. The courses and workshops are designed to: Help people develop their skills and understanding Help people identify personal goals and ambitions Create a fun, positive and safe environment for learning and exploring recovery Give people the confidence and support to access opportunities and resources available to them Their range of educational courses, workshops and resources are freely available to people who use Central and North West London NHS Foundation Trust s services, their supporters (friends, family or carers) and CNWL staff. Website: recovery-college, Tel: recoverycollege.cnwl@nhs. net Self Management UK Self Management UK has been designed to provide support to people so they can take the lead in managing their condition, both physical and mental health conditions. Aiming to improve both health and quality of life. Visit hello@selfmanagementuk.org or call for more information. 29

30 Healthy Eating It is possible to be referred by your care team to a nutritionist or dietician. Talk to your team about this. If you live in Kensington and Chelsea you can contact or health.wellbeing@ clch.nhs.uk Learn how to cook healthy food, on the free Cook and Taste courses, available to residents in Kensington and Chelsea Exercise Walking for health: Supporting you to get active and stay active. Find a health walk scheme near you at: org.uk or call: The Get Active London website allows you to search for sport and physical activity sessions within London com Our Parks free exercise classes in the parks across London. Visit for more information. For more information on London Borough of Hammersmith & Fulham physical activity please contact the Sports Development team on , or sportsdevelopment@lbhf.gov.uk or visit For more information on City of Westminster physical activity please contact the Sports Unit on , sport@ westminster.gov.uk or visit www. westminster.gov.uk. 30

31 For more information on physical activity in The Royal Borough of Kensington and Chelsea please call , or visit or Quit Smoking The recovery college offer a free 10 week course to help you cut down or stop smoking. For more information on this and all their course go to recovery-college, call or recoverycollege. cnwl@nhs.net Alcohol and Drugs Services Speak to a member of your care team if you are at all concerned about your use of alcohol or drugs. They will be happy to help you think about places to help you cut down your use or stop altogether. NHS Smoke Free service offer various support services to suit your needs, either face to face or over the phone. Visit: uk/smokefree or call

32 Notes: You may wish to use these pages to record more information about your results or update your results. You could also write down your healthy plans or strategies and places you ve been referred onto for help with your physical health. 32

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34 This document is also available in other languages, large print, Braille, and audio format upon request. Please Arabic Farsi Bengali Dokumentigaan waxaa xitaa lagu heli karaa luqado kale, daabacad far waa-wayn, farta indhoolaha (Braille) iyo hab dhegaysi ah markii la soo codsado. Somali Mediante solicitação, este documento encontra-se também disponível noutras línguas, num formato de impressão maior, em Braille e em áudio. Portuguese Tamil Este documento también está disponible y puede solicitarse en otros idiomas, letra grande, braille y formato de audio. Spanish Dokument ten jest na życzenie udostępniany także w innych wersjach językowych, w dużym druku, w alfabecie Braille a lub w formacie audio. Polish Gujarati Be belge istenirse, başka dillerde, iri harflerle, Braille ile (görme engelliler için) ve ses kasetinde de temin edilebilir. Turkish Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London NW1 2PL. Tel: Central and North West London NHS Foundation Trust Ref: 0243_AUG2015 August 2015