This is Claire. She works as a dental hygienist in town. Claire is 30 years old and has been recently diagnosed with Colitis. Colitis is a complex autoimmune disease that affects the colon. This has added to the stress she deals with.

Claire is very underweight for her age. This could be due to inflammatory bowel disease as well as her smoking. Colitis is a very individualized disease, which take time to understand and determine how the disease will affect her and her family.

Proper nutrition is vital when dealing with colitis, especially in the early stages of the diagnosis. Finding a dietician who specializes in IBD, and trying to follow a low residue diet are key to maintaining her health. A low residue diet offers easily digestible food to minimize flare-ups. Boost or Ensure are excellent protein drinks that help with weight gain and don't affect digestion.

Mental health and self-care are two big aspects of looking after yourself Claire is going to have to emphasis in her life. Especially with her chronic disease diagnosis.

There are many health professionals who deal with chronic diseases. They are easy to talk to can help Claire relieve stress, as well as the anxiety and depression that may come along with an IBD diagnosis.

Claire could try practicing 'adult play' which would allow her mind to forget about daily stress and focus on something more enjoyable. This is key to living successfully with Colitis.

Claire can manage stress with yoga, meditation and essential oils. These will reduce flare-ups and active disease processes. Claire's two children may want to join in, which would benefit their mental health as well!

There are many Colitis support groups for people like Claire. She should not have to suffer in silence. Talking to people who go through the same daily battles can help keep a positive outlook on IBD when times get tough. Learning about others' battles and way to thrive with colitis are inspiring and encouraging.

Inflammation in the intestine creates fatigue, which is different than just being tired. Fatigue is tiredness that never goes away, even when you get enough sleep. Living a busy life makes it hard to rest. When dealing with colitis it is vital to get as much sleep as possible. Claire may have to work a reduced schedule or apply for disability until she find the right medical regime. It will take some time before she can continue on with her life.

This is going to be hard; Jim recently lost his job.

Claire is a smoker. This will have a negative impact on her health. The nicotine in cigarettes will cause more inflammation within her intestines, and will slow the healing process. The Heart & Stroke Foundation is an excellent resource to help quit smoking, and provides information on the affects of chronic disease and smoking.

Claire's gastroenterologist will also have information packages and guidance tools to help

with the quitting process.

This is Jim. He is 38 years old. He was laid off recently, but he used to work in an office. He smokes a pack of cigarettes a day. Jim is feeling more stress lately. He feels like he is not contributing to the family's needs. This is putting more stress on Claire and his mother-in-law June. This is straining their relationship. He is trying, but is having difficulty finding a new job.

The amount of stress Jim is under is causing him to have difficulty sleeping, restlessness and and upset stomach. His mental health is also being affected. He has developed anxiety and depression. Due to the stress, he has been smoking more cigarettes per day to help him cope. This adding to the financial strain the family is experiencing. Smoking can lead to many types of cancer, respiratory issues and heart problems. Jim is already at risk for these things due to being obese.

Jim has been staying home now that he is unemployed. He is snacking to help cope with the stress. His weight has hit 243 pounds. Jim is obese. This puts him at risk for cardiovascular problems, heart failure, hypertension, high cholesterol, stroke, diabetes, and arthritis to name a few. His excessive smoking on top of this is leading him down a very unhealthy path.

Erickson's Generativity vs. Stagnation

During middle adulthood we establish our careers, settle down with a relationship, begin our own families and develop a sense of being a part of a bigger picture. We give back to society through raising our children, being productive at work, and becoming involved in our community.

Since Jim lost his job he no long feels like a contributing member of society. The strained relationship with his family and the health issues they are facing are causing him feel like an inadequate father. This is stagnation, which causes an individual to feel unproductive if left unchanged.

There are many resources available to help Jim stop smoking! Prairie Mountain Health has a free Smoking Cessation program that can supply him with free Nicorette gum and nicotine patches. He can

also talk with a Smoking Cessation nurse that can give him

tools to quit smoking and stay that way!

The Town Centre Public Health office also resources

available. They also have a dietician on site that could

help him manage his weight, and counselors available

to assist him with his stress and mental health issues.

Jim should take Claire with him, she could use these

resources too!

The Manitoba Lung Association has a website with great tools to help him quit smoking. They also have the Manitoba Quits Challenge for initiative and support.

By quitting smoking, Jim will save money which is very beneficial for his family while he is not working. He will improve his health drastically, as well as the health of his family because of reduced secondhand smoke.

In order to help Jim deal with his stress, he can take a class called Mindfulness Based Stress Reduction. This can help him discover mindfulness, gain control over his anxiety and depression, and gain the motivation and energy to find a new job.

This 8 week course takes place at the Brandon University. While having the University as his surroundings he may be inspired to continue his education and gain more meaningful employment.

By getting out of the house and going for a half hour walk everyday Jim can work on losing weight, relieving stress and distracting himself from smoking or overeating. This is a cost free activity which is beneficial while Jim isn't working.

He can also used this time to bond with his family members to encourage their health and help mend their relationships.

This is June. She is Claire's Mother. She is 58 years old, and works as a health care aide.

She smokes heavily.

Prairie Mountain Health's Smoking Cessation program would also be beneficial for June. She could go with Jim.

If June quits smoking she will be able to improve her respiratory condition, which will benefit her career.

She will also reduce the secondhand smoke in her household to benefit her family.

Erickson's Generativity vs. Stagnation

June has been constantly working to help her family, and her daughter's family financially. Because of this she feels like she has no time for herself to things she is passionate about, or to spend time with her grandchildren.

Their increased health struggles have caused her to feel like she has failed. She is stagnant and feels stressed.

Because of June's age, her increased tobacco consumption poses many problems.

With age our diaphragm muscles weaken, our lungs are less functional, and our immunity decreases.

If June were to contract a respiratory disease or infection it could be life threatening.

June works for Prairie Mountain Health, which means she has access to many free workshops offered by her employer.

The "Got Stress?" workshop is aimed toward helping Prairie Mountain Health employees manage their stress, learn to identify their triggers, and apply relaxation techniques to their lives.

The PMH Smoking Cessation nurse can offer June the same resources Jim has available to him.

This is also an opportunity for June to be educated on the risks of smoking, and the emphasis on problems related to her age.

This will give her more resources to help her quit.

This is Bobby. He is seven. Bobby has autism. Autism or Autism Spectrum Disorder (ASD) is what a group of developmental disorders is referred to.

ASD includes a wide range or ‘spectrum,’ of skills, symptoms, and levels of disability. Bobby

doesn't sleep well and can become disruptive.

Bobby has a full time caregiver during school hours. At home the adults in his life may not have the time to focus on him as much, and his younger sister is much younger than him. For a child with autism, consistency is an essential part of their daily living. A disruption in his routine can lead to an increase in his disruptive behaviour, tantrums, and possibly aggression or self harm behaviours.

Prevention of these outbursts can be identifying the triggers, providing consistency, and finding a way to communicate effectively with Bobby. Depending on his place on the Autism spectrum, his communication skills may be basic, or non-vocal.

Bobby does not sleep well. This is a common problem among children with Autism. Up to 80% of children with ASD have a form of a sleep problem. The lack of sleep Bobby is getting could be leading to his disruptive behaviour. Autism Manitoba has suggested that these 7 things can help.

1) Sleep Environment - Cool, dark, and quiet.

2) Bedtime Routine - Predictable and relaxing. No electronics.

3) Sleep/wake Schedule - Regular on weekdays and weekends.

4) Falling Asleep Alone - Falling back to sleep at night is associated with falling asleep the first time. He will remember falling asleep alone, and be able to go back to sleep.

5) Exercise - Daytime exercise can make falling, and staying asleep easier.

6) Avoid Caffeine - No chocolate, soda, or caffeinated tea before bed.

7) Naps - Can be helpful but should not be taken too late in the afternoon, as they can interfere with playtime.

Autism Society of Manitoba hosts various events, such as a LEGO skills workshop. Bobby's family does not have a lot of extra money for events like this. Autism Manitoba offers subsidies to help with costs for these events.

A year membership to Autism Society of Manitoba is regularly $25. ASM offers a free membership to families with children recently diagnosed with autism. This is a good opportunity for Bobby and his family to join a society that supports and encourages families, and children.

The Autism Society of Manitoba offers many supports and services such as:

Parent support groups

Peer and sibling programs

Social skill programs

Family events

Awareness events

Monthly rural outreach via MB Telehealth broadcasts

Inclusive parent mentor programs

Lending library of current printed and digital resources relating to ASD

Assistance to families and individuals on how to navigate the system