Prepared Under Contract to the VHA by Pacific Institute for Research & Evaluation with the University of Wisconsin - Madison. October 1, 2019 IB 10-1127 P96890 The Circle of Health To learn more visit: https://www.va.gov/WHOLEHEALTH/ By J. Adam Rindfleisch, MPhil, MD Medical Director, University of Wisconsin Integrative Health Passport to Whole Health Version 4, October 2019 PASSPORT TO WHOLE HEALTH TABLE OF CONTENTS Foreword ................................................................................................................................................ vii How to Use This Reference Manual.................................................................................................... x PART I. INTRODUCTION TO WHOLE HEALTH: CENTERING ON THE CIRCLE Chapter 1. Whole Health: An Overview ........................................................................................ 1 • What Is Whole Health? .......................................................................................................................................... 1 • What Whole Health Is Not .................................................................................................................................... 2 • Why a Whole Health System? ............................................................................................................................. 4 • The Circle of Health ................................................................................................................................................. 6 • What Does Whole Health Look Like in Practice? ........................................................................................ 8 • What Does a Whole Health System Look Like? ......................................................................................... 10 • Whole Health Tool: Elements of Patient Centered Whole Health Care ................................... 16 • Time to Start Your Journey! ............................................................................................................................... 18 • General Whole Health Resources .................................................................................................................... 18 Chapter 2. Whole Health Clinical Care, Part I: Empowerment, Fundamentals, and Mapping to the MAP ........................................................................................................................... 23 • The Whole Health Clinical Care Journey ...................................................................................................... 23 • Empower ................................................................................................................................................................... 26 • Fundamentals .......................................................................................................................................................... 27 • Whole Health Tool: Introducing Whole Health—Your Elevator Speech ................................ 29 • Mapping to the MAP ............................................................................................................................................. 31 • Whole Health Tool: Mission, Aspiration, Purpose (MAP).............................................................. 32 • Shared Goals ............................................................................................................................................................ 33 • Conclusion ................................................................................................................................................................ 34 • Resources .................................................................................................................................................................. 34 Chapter 3. Whole Health Clinical Care, Part II: Equipping, Personal Health Planning, and Integration .................................................................................................................................... 37 • Equip ........................................................................................................................................................................... 37 • Whole Health Tool: A List of Whole Health Education Offerings ............................................... 39 • TeleWholeHealth ................................................................................................................................................... 42 • Personal Health Planning ................................................................................................................................... 42 • Personal Health Inventory (PHI) ..................................................................................................................... 44 • Creating a Personal Health Plan: Tips on How to Empower and Equip .......................................... 47 • Goal Setting Revisited: Shared Goals and SMART Goals ........................................................................ 49 VHA Office of Patient Centered Care & Cultural Transformation October 2019 i • Whole Health Tool: SMART Goal Setting ............................................................................................... 52 • Integrate .................................................................................................................................................................... 54 • Whole Health Tool: Personal Health Plan (PHP) .............................................................................. 56 • Whole Health Tool: How Do You Integrate This Into Your Work? ............................................ 58 • Conclusion ................................................................................................................................................................ 60 • Resources for Writing Plans, Skill Building, and Support ..................................................................... 60 Chapter 4. Mindful Awareness ....................................................................................................... 63 • What Is Mindful Awareness? ............................................................................................................................ 63 • When Have You Been Most Mindful? ............................................................................................................. 65 • Mindful Awareness Research ........................................................................................................................... 66 • Cultivating Mindful Awareness: Practice Tips ........................................................................................... 70 • SOLAR and TIES—Two Mnemonics ............................................................................................................... 71 • Whole Health Tool: SOLAR/TIES Meditation ..................................................................................... 73 • Mindful Awareness Techniques: Mindfulness Meditation ................................................................... 74 • Whole Health Tool: Seated Meditation ................................................................................................. 75 • Whole Health Tool: Breath Awareness Exercise ............................................................................... 76 • Whole Health Tool: Body Scan.................................................................................................................. 77 • Mindful Awareness in the VA ............................................................................................................................ 79 • Mindful Awareness Resources ......................................................................................................................... 79 PART II. AREAS OF SELF-CARE: EMPOWERING PEOPLE TO CARE FOR THEMSELVES Chapter 5. Moving the Body: Energy & Flexibility .................................................................. 85 • Benefits of Movement and Activity ................................................................................................................ 86 • Some General Physical Activity-Related Tips ............................................................................................ 87 • Questions to Ask About Moving the Body ................................................................................................... 88 • Whole Health Tool: Mindful Movement ................................................................................................ 89 • Whole Health Tool: Writing an Activity Prescription ..................................................................... 91 • Whole Health Tool: Incorporating Yoga ............................................................................................... 94 • Whole Health Tool: Incorporating Tai Chi and Qi Gong ................................................................. 97 • Moving the Body Resources ........................................................................................................................... 100 Chapter 6. Surroundings: Physical & Emotional .................................................................. 107 • The Importance of Healthy Surroundings ................................................................................................ 107 • Questions to Ask About Surroundings ......................................................................................................