1. Shoulder pain/shoulder and hand pain.
  2. Urinary tract (bladder) infection.
  3. Constipation/diarrhea.
  4. Sliding or falling out of wheelchair.
  5. Behaviors problems.
  6. Aspiration (Choking/coughing after swallowing).
  7. Bedsores.
  8. Depression.
  9. Double vision or – Only seeing on one side.
  10. Reactions from a prescribed medication.
  11. Stroke centers/units/support /Treatment.



  1. Physiotherapist/ Occupational therapist.
  2. Clinic/doctor/nurse.
  3. Clinic/doctor/nurse.
  4. Physiotherapist /occupational therapist.
  5. Occupational therapist/Clinical psychologist /social worker.
  6. Speech and language therapist /nurse.
  7. Doctor/nurse/physiotherapist/ Occupational therapist.
  8. Clinic/doctor/occupational therapist /social worker.
  9. Clinic/optometrist/occupational therapist.
  10. Doctor/pharmacist/Hospital/clinic.
  11. SASNET-GHANA Team/Help line.

IMPORTANT : Person living with stroke and their carers could also receive  answers to the above stated problems by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).  online or

by signing up to  Ask Dr Charway –Felli Platform for support .

Register for free support online here












The Coronavirus Ain’t Leaving So Fast

In a recent Time article entitled Nearly Half of Coronavirus Spread May Be Traced to People Without Any Symptoms by Alice Park, The Annals of Internal Medicine concluded “at
minimum, 30%, and more likely 40% TO 45%,” were spreading the virus to others without realizing they were also infected at all. There is a name for those people without symptoms (fever, fatigue, shortness of breath, coughing) to the COVID-19: asymptomatic.

Eric Topol and his co-author, Daniel Oran hunted for studies that included asymptomatic people and focused on different groups of people tested for COVID-19 worldwide. Among others, included were:

  • More than 13,000 people in Iceland who volunteered to be tested for COVID-19
  • Residents of Vo, Italy
  • Passengers on the Diamond Princess cruise ship where an outbreak was witnessed
  • Visitors to homeless shelters in Boston and Los Angeles
  • Prison inmates
  • College students
  • Nursing home residents in King County, WA.


Follow-up testing of those participants showed that only a small fraction who were asymptomatic when they tested positive on the first go-round went on to develop symptoms, permitting the researchers to choose between people who were pre-symptomatic (who went on later to develop symptoms) and those who are accurately asymptomatic and test positive for COVID-19 but never develop obvious symptoms. For example, among the more than 2300 people tested in the Vo population, 41% who had no symptoms when they tested positive and never developed symptoms over a 14 day period.

Topol and Oran concluded that while they may not be showing any signs of illness on the outside, asymptomatic people are still transporting a dangerous and infectious virus that they can spread to others.

“The virus may be damaging the bodies of asymptomatic in other ways,” says Topol. Among the 331 passengers aboard the Diamond Princess ship who tested positive but did not have symptoms, it was revealed that 76 CT scans of their lungs showed signs of lung tissue damage typical of coronavirus infection.

In another study, this one in South Korea, that studied 10 asymptomatic people from a group of 139 COVID-19 patients and warranted similar findings. The lung was affected in all asymptomatic patients, and researchers decided it was necessary to extend the evidence of COVID-19 testing.

“Given that public health officials aren’t testing the entire population, there are still huge gaps in understanding what asymptomatic disease,” Topol says.

Then there is the question of how long asymptomatic people are infectious. No one for sure, but wearing masks in public settings means less infection from those who are asymptomatic. So does social distancing and washing hands frequently given the numbers of asymptomatic people.

“If even a portion of the 100 million Americans who have a smartwatch or fitness band are involved, then we could go in and do studies for information we are missing now—antigen testing, antibody testing and we can look for transmissibility,” says Topol. “The priorities during a pandemic are absolutely to look after the sick. But we also shouldn’t miss how important this area of asymptomatic spread is to understand. For every one person who is sick, there are a whole lot of people who have the virus and don’t know it.”

So what does all this mean for the public? Remember the numbers: “at minimum, 30%, and more likely 40% to 45%.” Scary though it is, I, for one, won’t be going to the beach where people sit willy-nilly next to each other. No public settings at all for me like concerts or sports events that may open to the public, until much more is known about asymptomatic people. You can’t spot one because they’re like the rest of us, except they’re harboring a death-defying  disease silently.

Isabel Goes Back to Work After Covid-19

As a 74 year old with a brain-stem stroke who lives alone I was terrified about getting covid-19 from my cleaning lady.  A teleconference with my primary doctor helped me let go of my fear that only massive repeated testing would keep me safe until a vaccine is widely available.  After listening to a few suggestions from my doctor I was able to calm down and think.  Below are nine strategies that make me feel safer when my cleaning lady spends two hours in my house.

1.  I insist that both my cleaning lady and I wear masks.
2.  I put away all the knick-knacks that Isabel used to pick up and set down as she cleaned.
3.  After washing the sheets I make my bed so Isabel does not touch bed linen that comes close to
my face.

4.  Before each visit I gather some items I touch every day. Bathroom items go on a tray.
I cover this pile with a towel to let Isabel know not to touch it.  Make-up items on my dresser go in a shoebox in a drawer.

5.  I walked Isabel through my house to show her where I wanted her to use disenfectant wipes to
clean door knobs, light switches, and handles on the toilet, shower, refrigerator, stove, cabinets,
and faucets.
6.  If the weather permits I leave my front door open with the glass panel that covers the screen
in the up position.
7.  When I eat lunch I need to take off my mask.  To keep my droplets from accumulating in the air
in the house I eat outside on my patio.  I bring my ipod to listen to music after lunch.  I have an
awning to protect me from the sun and rain.
8.  After Isabel leaves I turn on exhaust fans in the bathroom and kitchen to clear the air while I
take a short car ride.

9.  After I use a mask I put it on a window sill for a few days with
the hope that sunlight will kill the virus.  I turn it over to expose
all surfaces to sunlight.

Simple Pleasures for This Simple Stroke Survivor

Looking back over my life, I had very complicated pleasures. For example, when I wanted to convince people in the office to maintain their opposition to a particular practice, it all depended on what other people would do. Crowd mentality indeed. Or when I celebrated holidays, the host would make what she liked rather than what the compan liked. Mom mentality. 

But as a stroke survivor, I found that my preferences transformed into simple. Here are the top ten, all of which I didn’t do before my stroke:

Waking up to greet the day

Waking up every day is my top simple pleasure. What do I do to achieve that goal? Well, there are no guarantees in life, but switching over to the plant diet almost a year ago gave me so many chances to stay healthy. In pretending about the pandemic, I maintain that eating high Vitamin C oranges somehow kept me immune from the coronavirus. That theory is not on the proven list, but eating Vitamin C is great for preventing or lessen the severity of so many other diseases anyway. 

Adding the perfect amount of water to my oatmeal

I actually celebrate with an audible “Yes!” multiple times when my oatmeal comes out of the microwave perfectly. Of course, nobody is there to hear it, and I find that reassuring. It’s a game I play with myself, guessing which amount of water is suitable to add to the instant variety. Somebody who lives with one or more people doesn’t get it, but I get it. I am the only one I have to please. 

Watching the washer wash

I like the sound of the washer wash clothes. I like the “Spin” cycle the best. Oftentimes, I find myself watching the washer wash the clothes–my clothes, mesmerized–which I could have worn over again but didn’t because the washer sound is relaxing, which I wouldn’t hear on re-wearing.

Balancing my checkbook

I used to balance my checkbook as drudgery, something I had to do to keep my sanity in check, often getting frustrated when I reversed numbers or got the period in the wrong place. Now, I welcome it every month because I remembered my math functions. And I like the way my handwriting improved in 11 years, keeping the figures inside the lines.

Monitoring the vegan cooking

I was always a participant, from jumping rope as a youngster, to playing my songs as a teen in the talent show, to throwing events as an adult. Now, cooking-wise, I’m still a participant. Clare, my nurse friend, who prepares all my meals, brings the pot over to me to check on the consistency or taste or color. I’d rather cook myself, but having got the handle on do’s and dont’s. this method is the next best thing.

Observing the houses surrounded by nature

Normally, in those normal times before the stroke, I went around the block and that was it, not noticing the fine points. Now, my friend and I find something new every time we go like a new fence, plants and trees in bloom, or a missing shingle or the roof. That’s the game we play, because remembering what we found a few days ago keeps my memory sharp. 

Making a schedule

Every time my friend comes which are on weekdays, I present her with a to-do list of things that should be done. I can move the entries if she doesn’t have time to finish, and she likes to check off completed tasks. Most importantly, this system, too, helps me remember the current and future tasks.

Pronouncing words until I say them perfectly

I have trouble pronouncing some words. Sometimes, if I say it over and over in a day, that will be enough for future times. Sometimes, like with the “scr” words, as in prescription and subscription, having practiced for 8 years, I still get tripped up. I used to be a public speaker so it’s difficult I can’t do that anymore, but just saying words correctly is the next best thing in order to communicate effectively. When somebody says, “I can’t understand you,” my heart just breaks.

Getting a coffee package from Amazon

Not that trillionaire Jeff Bezos need free advertising, but I look forward to this Amazon coffee coming because it wakes me up with a jolt in the morning. A jolt equals instant awareness of my surroundings so that I have an uninterrupted and clutter-free path when I’m going to walk around. At $4.95 for a 12-ounce bag, you can sample all the flavors while staying alert. In a sense, priceless.

Counting the birds that fly by in 10 minutes

Birds, predominantly crows, fly by in groups. I never see one crow without another one to follow. Especially now that it’s mating season, the birds are frequent. And no, I don’t watch the birds “fornicating.” Sheesh! Birds, too, need a little privacy. And don’t think I’m a nerd. People need something to do in this pandemic.

Bathing Can Be Exhausting

As an OT I did not know how tiring a.m. care is because I never watched a stroke survivor do one task after.  Here is why bathing leaves me feeling refreshed instead of exhausted and frustrated.

Washing.  I do not struggle to soap up a washcloth one-handed or chase a bar of soap after I drop it.  I pour shower gel on a nylon poof and knead it a few times to get it soapy.  To wash my sound arm, I use a gross grasp in my affected hand to hold the nylon poof.  I do not struggle to wring out a washcloth one-handed.  I hang the nylon poof on a suction-cup hook, hose it down, and let it air dry.  I use shampoo suds to wash my face.

I press down on the nylon poof that is resting on my thighs to squeeze out suds so my sound hand can soap up my crotch.  Before I could hold the shower hose with my hemiplegic hand,
I used my forearm to press the shower hose against my stomach to rinse my crotch.  Water runs downhill.  This freed my sound hand to deal with the nooks and crannies.  If my husband was alive I would still want to bathe this private part of my body.

Drying.  My towel rack is next to the shower so I can reach it while sitting on my shower chair.  I drape the towel over one shoulder while I dry my arms and trunk.  When I get out of the shower I stand to dry my crotch with the towel draped over my shoulder.  My shoulder carries the weight of the towel so it is easy for my sound hand to manipulate the free end.  I never hold up my affected leg to dry it.  I don a terrycloth bathrobe which dries my buttocks and thighs and I let my calves air dry while I brush my teeth and comb my hair.

Dressing.  For the 1st year after my stroke, dressing was easier if I rested after bathing.  I laid on the bed in my bathrobe with a towel under my wet hair and listened to music on the radio.

*Read This at Your Own Risk*: Being Media Savvy during COVID-19

As a physician and public health doctor, sometimes I wish that some of the articles that are available to digest by the avid online reader about COVID-19 carry a disclaimer:  Read this at Your Own Risk.

We have been bombarded by information on various media outlets during the COVID-19 pandemic: some of it is accurate, some of it is conjecture; some of it is instructional, and some of it is proverbial snake oil.  As we comb through this information, we build a narrative of an otherwise great unknown that is unraveling in real time.  Statements given with some assurance are walked back after more information is gathered from epidemiologic studies and research – which too are subject to challenges of interpretation.  First no maskes, then masks; the epidemic is controlled versus it is an uncontrolled pandemic.  It causes mostly mild disease versus it is a “fatal” virus.  The shift in words begin to shape a different realities, one of which is of hopeful optimism and acceptance, another of growing distrust and even fatalism.

Our brains are intrigued by natural phenomena        Photo by Nastasya Day on


Our realities are as much factual as they are individual or group narrative.  Reality is shaped by our senses and higher levels of cognition, which apply meaning or weight to information, accepting or discarding it to shape a narrative.  Just like we can be fooled by a two-dimensional object spinning on the paper, so too can our higher levels convince us of a possible reality that is inaccurate.  We don’t always know our blindspots in this either.  These blindspots that affect our reality are known as biases.

Even as we click on articles, there is a natural, confirmation bias, applied to the titles of studies or reports that we would read.  To some extent, a story was already starting to take shape in our minds before further information is available to disprove it – and even afterwards, we discount that new information.  This is known as anchoring bias.  It is in the current time of media frenzy that a structured approach is useful to gain a greater sensitivity in the biases that shape the messages we read and the stories journalists tell, to enhance our approach to detecting the reason of the article (instruction, narrative shaping, fear mongering), and to determine the validity of the article.


**Read This at Your Own Risk**

Myths that are currently circulating in the news:

  1.  The virus was engineered to be more lethal in causing a pandemic and was leaked out of a high security lab in Wuhan, China.
  2.  The Chinese government deliberately released the virus onto its population and the rest of the world to create instability, so that at a later point, they could reap the benefits economically.
  3.  Information about the COVID-19 is deliberately being withheld to the public to have control over the population.  This could have several extensions: the government is forcing doctors to code deaths as related to COVID-19, so that it can inflate the death statistics or doctors are incentivized to code deaths as related to COVID-19, because they receive a higher reimbursement (not exactly the reason).


The possible stories are as endless as the imaginations that construct them.  Once these ideas are framed, our brains will start building this alternate reality by looking for material that supports it, while negating material that opposes it.  Commonly, these stories rely on assumptions that large groups or governmental entities would need to keep a secret from others or be consistent in their actions.  The other common fallacy is the requirement that multiple unproven, unplausible suppositions would need to be true in order for the endpoint to be true.  This is known as the Narrative fallacy.  When one point is disproven or pseudoscience, then all of the dominoes fall.

Other important cognitive distortions, biases, and fallacies:

  1.  The Dunning-Kruger Effect:  bias that leads people of limited skills or knowledge in a topic to believe mistakenly that their abilities are greater than they are.  One example that I see in the clinic is “Dr. Google,” where someone, after doing a google search on their symptoms and reading a few articles, has been able to diagnose themselves with a rare disease and speaks as a specialist in the field.
  2. Brainwashing: This refers to the “read at your own risk” disclaimers.  The idea is that somehow information online could completely persuade someone or radicalize them after reading it.  Fortunately, we can prevent this from happening and put on our cognitive goggles to dampen the power of suggestion (see below article link).
  3. Deliberate Ignorance:  This is a fallacy where one’s mind is made up and they refuse to listen to additional information that may change their conclusions.  “Don’t try to confuse me with facts, my mind is made up!”
  4. The Big Lie Technique:  This is directed toward a deliberate practice.  It is a concept of repeating half-truths over and in different forms until it becomes accepted as truth.  Some of the narratives that have emerged during the pandemic have developed from repetition of half-truths or initial information as well, such as the efficacy hydroxychloroquine, but this was not deliberate – pointing to more to an Anchoring bias.



Suggestions on how to interpret the Media


Let me control the media and I will turn any nation into a  herd of pigs.”  -Nazi Propaganda Minister, Joseph Goebbels.

If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”  Joseph Goebbels.  (Example of The Big Lie Technique)

He who controls the media controls the minds of the public.”  Noam Chomsky.

How do we know that two and two make four? Or that the force of gravity works? Or that the past is unchangeable?  If both the past and the external world exist only in the mind, and if the mind itself is controllable – what then?”  George Orwell


Joseph Goebbels, the Nazi Propaganda Minister fed lies and half-truths to the public by fashioning media messages, in order to garner support and appease concerns during the Third Reich.  Although not as deliberate of an action nowadays, any news that we read can have a subtle or explicit narrative that shapes our perspectives. The media has the daunting responsibility to ensure that the information provided to the public is informative, free of bias, and does not breed misinterpretation.

The cognitive biases that fuel our narrative, allow us to detect patterns, and even think creatively “outside the box.”  Although we cannot (and need not) completely escape our biases, a greater sensitivity to them and understanding of the red flags for narrative traps can protect us from untruths and hone our resilience from the harmful states that result from negative, sensationalistic news:  where fear develops and triggers the self-preservation instinct of fight, flight or freeze, resulting in a negative impact on our bodies.


I had the opportunity to collaborate with a friend and colleague, author and founder of Becoming Better People, Jacqueline Jannotta Rothenberg.   She is an excellent writer and author of Let’s Leave the Country!.  She wrote an article about our interview along with her insights, which provides instruction on how to address the media storm amid the COVID-19 pandemic and how to keep what Jacqueline refers to a “good media diet.”  The link to her website is embedded in the title that follows.


The House That COVID Built  by Jacqueline Jannotta Rothenberg




Here is the full video interview:




I leave you with this message from C.S. Lewis, one that was communicated through the poignant art of seventh grader Yara Kanar (The Second Cov-Art Children’s contest)  In the middle of a global outbreak, its empowering to think that each of us can shape the way this story ends through our actions and our interpretations.

Art contest Yara 1
Art by Yara Kanar  “Fragile Mask”





The post *Read This at Your Own Risk*: Being Media Savvy during COVID-19 appeared first on Your Health Forum.

Covid-19 Made Me Smarter

Currently over 4,700 covid-19 deaths in New Jersey have occured in long-term-care facilities so
I am very motivated to do what it takes to stay in my home.  For example, my cleaning lady has not come for 6 weeks because of the pandemic.  When I smelled dust and started to sneeze I felt compelled to try vacuuming until it is safe for Isabel to be in my home for two hours.

I vacuumed years ago so I already knew 2 tricks.  (1) Vacuuming is exhausting because it requires stepping forwards and backwards abruptly a hundred times so I vacuum only one room a day.
(2)  I knew tripping on the cord was a huge fall hazard.  Thankfully I can hold the cord out of my way.  I rest the cord in my partially curled hemiplegic fingers and use shoulder abduction to hold the cord away from my body.

I discovered 2 new tricks to make vacuuming easier.  (3)  I do not step forwards and backwards.
I stand still and move the vacuum forward and backwards only one arm’s length.  Then I take two steps sideways to clean a two-vacuum wide path before moving forward.  Most of my falls have happened when I step backwards but I feel stable when I step sideways.  (4)  Instead of vacuuming in parallel rows the way people cut grass, I start by vacuuming around the perimeter of the room and gradually work towards the center.  Making 90 degree turns is easier than 180 degree turns.

Green Bean Pesto “Pasta” Recipe

Photo by Yulia Rozanova on

Nature provides a palette of foods for all palates.

If your only adventure into eating green beans is opening a can of green beans with vinegar and (more) salt, prepare yourself for a paradigm shift:  a plate of green been pesto “pasta.”

Green beans are a great food for snacking and in meal preparation.  They are replete with fiber and vitamins, particularly vitamin A.  Other vitamins and minerals include vitamin C, K, E, niacin, folic acid, iron, magnesium, potassium and thiamine.  They have a sweetness that even the pickiest child might notice and enjoy – and come back asking for more.


Is there a difference between the sugar found in vegetables compared with table sugar?

The body reacts to sugar the same way, whether it comes from fruit and vegetables or table sugar.  However, that is not the whole story: vegetables and fruits contains intracellular sugar, which means that it comes with a lot of protective fiber.  When sugar is processed, it is removed from all of the fiber and is crystallized.  By virtue of these steps, this is always going to be greater than what can be encountered in nature.

The sugars (fructose/glucose) in vegetables and fruits are not only found in lower concentrations than processed, crystalline table sugar (sucrose) or processed foods like bread, pasta or pizza, but the fiber and water content, that is taken along with it, affects the amount and pace of glucose absorption in the intestines.


Amount of sugar in one cup   note: 4g sugar in 1 teaspoon/1 sugar packet

Natural foods:

1 cup of green beans =   3.3g sugar

1 cup of raw spinach =   1g sugar

1 cup of strawberries =   7g sugar

Processed foods:

1 slice of bread = 14g sugar (in form of complex carbs)

1/4 cup of pasta =14g sugar (in form of complex carbs)

**Take note of the difference in portion between natural and processed foods and remember the fiber and vitamins in the above natural foods.


Preparing Vegetables as a Dish

Green beans can be eaten both raw and prepared.  By making it as a plate, you can combine other vegetables and additives, creating a higher level of culinary enjoyment.

Examine the ingredients of Sol Food Nutrition’s Green Bean Pesto “Pasta.”  Hazelnuts, tomatoes and basil are added.  Some fats are added, including olive oil and cheese.  These ingredients add different tastes and textures, along with benefits.

Now on to the recipe!  Special thanks to Iris Briand, RDN for providing this savory recipe.  She is a colleague of mine who is a dynamic speaker and a great resource to have for nutritional consultative needs.  Check out the solfoodnutrition website.


Sol Food Nutrition’s Low Carb Green Bean Pesto “Pasta” Recipe


  • One large handful of fresh green beans
  • 6-8 dry-toasted local hazelnuts, chopped coarsely
  • 6-10 cherry tomatoes, chopped in half (optional)
  • Raw parmesan or gruyere, to taste
  • A few tsp extra virgin olive oil
  • A few spoonfuls of pesto (optional) – see recipe below, OR fresh basil. chopped
  • Sprinkle of black pepper and Real Salt (unrefined sea salt)


1. Snap off ends + stringy parts of the beans. Then snap them in half.

2. Place a saucepan with steaming basket on stove with high heat and once water is boiling, drop beans in the basket and top it with lid. Turn stove to simmer and let cook for 3 minutes, or until beans are bright green.

3. Shred cheese on cheese grater.

4.  Transfer beans to a large bowl and mix in the remaining ingredients. 5. If skipping the pesto step, just add more olive oil, salt, and basil! Enjoy!


Basil & Parsley Pesto Recipe 


  • 1 bunch Basil and 1 bunch Parsley (if omit ting parsley, add 2 basil bunches)
  • Garlic, 3 cloves or 2 shallots (optional)
  • 1⁄2 to 3⁄4 cup of extra virgin olive oil
  • Real Salt (to taste)
  • Pinch of black pepper

Preparation 1. Blend herbs and garlic in a food processor or finely chop. 2. Add oil, salt, and pepper. 3. Toss a few spoonfuls with the green bean mixture! Serve the rest of the pesto with steamed veggies, meat, fish, or homemade veggie burgers! Lasts one week in fridge.

To schedule a FREE 15-Minute Nutrition Phone Consult, please contact Iris 

Briand, RDN, at 541.908.0632 or visit: 


Photo by Pixabay on

Nurturing the Resilient Spirit: Ways to support Mental Wellness During the COVID-19 Quarantine

Summary:    The COVID-19 Pandemic is an unprecedented event that requires a rift in the societal fabric in order to stop its spread.  This forced isolation, along with the threats on financial and health security, can create pressures on those already with a history of depression and anxiety and lead to challenges in those that don’t.

Here are seven tips to nurture your mental wellness and create resilience during this uncertain time of social distancing.  Not only will these strategies help you to maintain some normalcy through these times, they just might help you excel.


The COVID-19 pandemic has been responsible for widespread upheaval.  Literally overnight, we have been asked to change our behaviors, stay at home other than essential trips out, and wait for this pandemic to pass.  Trips, social events, religious gatherings, and restaurants have been canceled or closed.  We have been asked to work from home and hold teleconferences instead of physical meetings.  For many of us, these are the very ways that we define our social and support network.

Constant reporting of new case numbers and new virus-related deaths has been both emotionally distressing and overwhelming throughout the world. When paired with shelter-in-place orders and the inevitable time spent confined at home, this unprecedented global event has placed tremendous stress on some of the population’s most vulnerable. Current events are making it harder for everyone to protect and promote mental health. Absent of key resources and often unable to receive the same support and social engagement that’s typical of their daily lives, those with diagnosed and chronic mental health issues are finding themselves in an increasingly dangerous space. The good news is that even in times like these, there are still multiple ways to create the conditions for resilient mental health.


Who’s At Greatest Risk Of Experiencing Mental Health Issues During The COVID-19 Pandemic?

Right now and for the foreseeable future, everyone is at risk of experiencing deep depression, anxiety, and stress. So much of what’s going on in the world is impossible for people to control. This sense of helplessness invariably fosters feelings of hopelessness, even in many who have formerly enjoyed consistently good mental health, general mood balance, and overall high life qualities.

However, there is also a very large number of people who are especially prone to mental distress at this time. This includes people who by choice or by circumstance were already spending significant amounts of time alone and in virtual isolation such as: elderly adults with age-related mobility issues, those with agoraphobia or fear of leaving the home, and disabled individuals who largely live in confinement. Those at greater risk for mental and emotional distress at this time additionally include people who are presently battling drug or alcohol addiction, those who have dealt with substance abuse or addiction in the past, recent divorcees, widowers, those grieving close friends, and those with a history of trauma and who may also be living with post-traumatic stress disorder.

Stressors to Mental Health During Quarantine:

A recent review article from Lancet by Samantha Brooks et al. entitled The psychological impacts of quarantine and how to reduce it discussed several risk factors that provoked a greater risk of mental health issues.  It is with hopes that identifying the triggers to depression and anxiety can help us to construct ways to mitigate these risks.

  • Longer duration quarantine (>10 days) or duration uncertain:  Associated with poorer mental health, e.g. PTSD, avoidance behavior and anger.
  • Fears of Infection.  In one review, those who were concerned tended to be parents with young children or pregnant women.
  • Frustration and Boredom.  A change in usual behavior even routine things like shopping or social networking can create a sense of boredom and isolation.
  • Inadequate Supplies Concerns. This includes the ability to get regular medical care and prescriptions.
  • Inadequate Information.  In studies, participants raised the greatest concerns when there was unclear messaging from public health authorities or a concern for lack of transparency.  Some concern with adhering with quarantine protocols was a predictor of post-traumatic stress disorder in one study.
  • Financial Factors.  Many people have been asked to modify their work routines such as working from home and, in certain cases, have even lost their jobs.  Those with a lower financial safety net, such as those with high debt to income burden, are particularly at risk.


The seven simple strategies that follow can benefit anyone who’s feeling the pressure of world and economic events, and who’s struggling to maintain mental health in the face of prolonged and mandated social distancing and social isolation.


  1. Get Outside And Get Moving


Most shelter-in-place orders that are presently being enforced are not intended to prevent people from going outside entirely. Instead, these orders have been designed to limit gatherings and activities that bring large numbers of people together. Moreover, in addition to not restricting solitary outside activities, or outside activities involving two people or fewer, many of these orders have been issued by municipal bodies that are actively encouraging people to get outside and exercise. The general understanding is that too much time spent indoors and leading a highly sedentary lifestyle is not beneficial for anyone at any time.

Pick a time each day to get outside and get moving. This can be as simple as taking a short walk around your neighborhood or going for a ride on your bike during the early morning hours or late afternoon. Although there are fewer recreational areas still open for enjoyment, there is also far less traffic on the streets. You can use this as an opportunity to better appreciate your neighborhood without the hustle and bustle of moving vehicles and busy consumers.

A short walk or bike ride will lift your spirits and give you the opportunity to re-center your thoughts. It can also make you feel more connected to the world around you. Outside exercise can even be as simple as taking your yoga mat out into the yard or onto a patio or balcony.  It might be a good time to get outside to a local park and practice the calming art of Shinrin-yoku, or forest bathing.   In addition to benefiting from conscious and structured movement, you’ll have the benefit of fresh air, sunlight, and a restored sense of normalcy.


  1. Continue Interacting With Others Via Social Media And Other Online Platforms


Now is a great time to start making use of social networking platforms. If you haven’t leveraged them before, these are great spaces for reconnecting with distant family members, childhood friends that you’ve lost contact with, and loved ones that you normally communicate with in other ways. Video chat platforms such as Skype can give you the benefit of both speaking to and seeing the people who normally fill your life, and who provide you with the social stimulation and engagement that’s absolutely essential for maintaining good mental health.


  1. Brighten Each Day With Exploration, New Learning, And Other Enriching Activities


For many, the COVID-19 pandemic has provided a very bittersweet silver-lining; massive amounts of free time. For those who are no longer working or having to physically commute long distances to their jobs, as well as those who are no longer attending in-person classes at school, this event offers countless opportunities to engage in new forms of learning and exploration. If you’ve ever wanted to make your own sourdough starter, crochet a blanket for a brand new or aging family member, teach yourself a new language, or pick up the cello, piano, or guitar, now is a great time to do it. These activities are personally enriching. More importantly, efforts to promote personal growth often give people greater hope for the future.


  1. Engage In Art Therapy


Now is also a time to break out your adult coloring books, or, better yet, start with a tabula rasa mentality and create your own work. Art is one of the most therapeutic activities that you can engage in. It’s immersive, cathartic, and relaxing. When you’re focused on drawing or coloring in the lines, choosing complementary colors, and achieving a very specific aesthetic, you cannot simultaneously dwell on all the outside problems that are beyond your realm of control. Creating art in any form can be both meditative and restorative. This is additionally a good time for art appreciation. Take advantage of online museum tours, free or discounted art or cooking classes, and other arts-related resources. Use online videos to start practicing and exploring martial arts, or start reading and writing poetry. Keeping a journal is also a great way to begin organizing your thoughts, analyzing your own emotions, and venting about your personal discomfort among other things. If you ever dreamed of writing your memoirs, the present moment is offering the perfect opportunity.

For those of you interested in using this form of expression and participating in an ongoing exhibition of art inspired by these current times, see the art that is posted on Instagram Hashtag #Cov19_art. I would like to compile the art, poetry, photography and writing into book that documents the psyche of these times and celebrates our perseverance.


  1. Unplug And Unwind


For all the resources, information, and assistance that the Internet is able to provide during this crisis, it can be just as harmful as it is beneficial. This is especially true when people spend too much time on the web, and when they spend too much time immersing themselves in activities and ideas that foster stress. While staying informed is vital, you must limit the amount of news that you’re reading. Nothing is currently so dire that it requires minute-by-minute updates. Set a special time for logging in and gathering essential information from trusted news sources. Then, set a special time for turning your phone off, logging off your computer, and turning off your TV. Whether you have diagnosed mental health issues or believe yourself to be in excellent mental health, too much information can lead to overload and can leave you feeling deflated, detached, depressed, or excessively anxious.


  1. Make Sure That You’re Getting Enough Quality Sleep


Getting poor-quality or insufficient sleep at this time is a bad idea. Not only will this undermine your efforts to maintain good mental health, but it can also lead to a flagging immune system. If you had a nighttime ritual before, try to stick to it. Moreover, don’t try to mute your emotions or lull yourself to sleep with increased indulgence in alcohol. Some areas under quarantine are reporting as much as a 40 percent increase in alcohol consumption since the institution of stay-at-home orders. Rather than promoting good sleep, alcohol actually reduces overall sleep quality, and shortens the amount of time that people are able to remain asleep.

Try reading a book or meditating before going to bed, taking a warm shower, and turning off all electronics and Internet-connected devices. If necessary, sip a warm cup of chamomile tea or a large mug of warm milk and honey. Making deep and restful sleep a top-priority is one the best things that you can do to promote physical and mental health at this time.


  1. Practice Mindfulness And Conscious Directing Of Your Thoughts


No other world event has highlighted the value and importance of mindfulness than the COVID-19 pandemic. With so much going on around you, it can be difficult to not let feelings of anxiety and panic set in. There is enough fear and stress in the present movement to exhaust anyone’s ability to mentally process current world circumstances. As such, there is no need, reason, or benefits in worrying about possible problems that might lie far ahead in the future. Practice focusing on the moment. Enjoy what you have you right now and work on fostering a mindset of gratitude. If you’re tired of being stuck alone at home, remind yourself that there are some people who have no homes to take shelter in. Give yourself permission to only worry about and deal with the problems that you’re immediately facing. Practicing mindfulness can help alleviate negative emotions about past events, while also limiting anxiety about what the future might hold.


The state of your mental health should be a key concern right now. Actively promoting good mental health and proactively protecting your general sense of well-being is critical. With greater mood balance, proper stress management techniques, and a focus on enriching and expanding yourself, you can successfully survive the mental and emotional ravages of this global pandemic, and any other unexpected life events.



Advice, Dealing with Covid 19 for stroke survivors and those with Non Communicable Diseases


Looking after your wellbeing while staying at home

Staying at home for a long time can be difficult, frustrating and lonely for some people. You may start to feel unhappy.




It is important to remember to take care of your mind as well as your body. You should ask for support when you need it.




Stay in touch with family and friends over the phone or on social media.



Stay at Home  

  • Observe social distancing  
  • Observe personal  hygiene
  • Cover your mouth when sneezing or coughing

Take your drugs as prescribed 

  • Take a lot of water , fruits and vegetables 
  • Speak to a Health professional
  • if you have any difficulties or call contact center (MoI)311(about restrictions or 112 (about COVID19) Covid19 Info. WhatsApp number  0555311311 or SASNET-Ghana

Think about things you can do during your time at home as a person with Non Communicable Diseases like Stroke, Diabetes, Hypertension, etc




Keep yourself busy with activities such as cooking, meditating, reading, online learning, stroke & NCDs groups like the online Post Discharge Stroke Support (PDSS).


If you feel well enough you can do some exercise in your home or garden, especially aerobics exercises .

The Stroke Association Supportnetwork Ghana (SASNET – Ghana) and Ghana NCD (Non Communicable Disease) Alliance is asking everyone to stay safe and healthy.

Visit us  at

Contact us at:

Many thanks to the leadership and support of