Supporting Senior Clients

Hello, today my guest is Sherri Betz. Sherri and I have known each other for a long time. I think when I first met Sherri she was living in Miami and then she was living in San Jose and now she's living in Louisiana. But throughout that time, she's been really involved in the research committee of the PMA. And we both volunteer at the PMA and we've enjoyed doing things together.

And then when it comes to Pilates Anytime, I don't know how many years ago it was that we first met, but it's probably like seven or eight years. And Sherri has done some amazing things on Pilates Anytime. And it's always a joy to to meet, see you and meet you. And I hope that we get to meet in person soon. So can you tell?

So what we're gonna focus on today, our subject is all about seniors and talking about working with seniors and Pilates and how do we do that safely and effectively. So that's what we're gonna talk about. Today we're not promising that we have the answers to every question that you have, we'll do the best we can. Some of this stuff is a gray area. And we're gonna talk about things like face masks and operating procedures for the studios and all of those things.

And there are many opinions on these things but we're gonna talk about what Sherri's doing, what she thinks is the right thing and we're gonna cover a bunch of things. So I'm gonna start off with a quick poll question here. I'm gonna ask everybody about how do you feel given the coronavirus, how confident are you your comfort level with working with senior clients? Are you confident, are you're okay, a little bit anxious, scared or you just avoiding doing it all together? So if you could just interact with the poll kind of interesting and it helps Sherri and I understand exactly who we're chatting with and kind of where where people are.

So the good news is if you can see this Sherri, 45% are confident, 30% are okay and the other parts are either avoiding it or somewhat anxious or scared. So hopefully we're gonna provide advice that is gonna help everybody here. And can I admit my answer? What's your answer? My answer is anxious.

I'm confident working with seniors but in this environment, I'm anxious about it and I'm very careful and I've come up with a six step plan of how I'm gonna handle it with people. Who? I'm gonna admit my fears about it. Fantastic. Well, I'm gonna share your six step plan as we go through this.

Let's just catch up a little bit like so you're now in Louisiana as I was telling you, you've been moving around. I thought you were doing a Louisiana, San Jose kind of lifestyle, what's happened? Yes, I've had a clinic, PT clinic/Pilates studio in California, in Santa Cruz, California for 20 years. So this was our 20 year anniversary and it was painful because I feel like I started with 911 and that was the year I opened my studio and then finished with corona. I was open for about three years simultaneously with my moved to Louisiana.

And my decision for moving to Louisiana was for two reasons. One, my mother lost her husband and was needing a lot more assistance and care and support. And we questioned as to whether or not we would move her to California she kind of got excited about that but when we looked at the financial aspects of doing that and having a living arrangement that we could afford, that we could, you know, have her retire and me continue to live in a not in a one bedroom apartment or a mobile home, which was that was probably my option. And I knew that God helped me that I have to live in a one bedroom apartment with my mother. So anyway, I love my mother but I don't wanna live in a one bedroom apartment with her and I'm sure you all can relate.

And so I decided to make a move to Louisiana and it was kind of a trial thing, what my plan was was to buy a home and I actually bought my home that I'm sitting in now, sight unseen. So I saw pictures, my mother looked at it, my brother came to look at it, we had it inspected by someone we trusted and then I bought the home and I drove across country and moved into it. Now I kept TheraPilates open for three years and my teachers have been autonomous, they've been with me for a long time, they were saying, "Hey, we can do this. "I think that we can make it work." And they made it work beautifully for three years. So we were operating on a kind of a shoestring budget and in with a very small margin of profit.

And any hit was going to make that decision. So if I lost a teacher, if somebody was sick for a long period of time, something happened, I would have to, I knew that was my answer that I would have to close. And they knew that to that we were very prepared for that. So I said, look, if you drop in your schedules, anything changes, I'm gonna have to close and they were very aware of that. So, corona happened and I thought, okay, well, we had to close and we closed on March 15.

On the day that we were required to close in California, it may not be that date, but something like that and we've been closed ever since. So what I did immediately after that closure was pivot the business and start doing virtual classes. So within one week of that closure, we started doing virtual classes, so I could keep my teachers teaching and they could also get a little bit of income and then we can stay connected to our community. So that's kind of the path open and close of TheraPilates. Yeah.

So what what in terms of your business here, we're in your home today, what have you been doing in Louisiana? So when I came here my intention was to open a business in my home. I bought this particular space because it's perfect for a dual space. So the front of my house is dedicated to an office, a mat space and a studio space. It's about 700 square feet that is dedicated to the Pilates studio and it has a front entrance.

The back entrance is where I enter my home and any visitors as well, you know, family and things like that enter through the back. So it's a perfect space for that I love this house. It's older, built in 1947, all wood floors, just an amazing house and I'm so grateful to live here. But anyway, so that being said, what I've done is, let me back up, my banker said you cannot qualify for this loan to buy this house and I'm gonna tell you my house was $220,000 so the people in California can just go, it's 2,400 square feet. We have a pool or I have a pool and I have a screening port and a brick patio in the back which is my dream sort of setup, screened in porch in a pool if you're gonna live in the south and so I was able to get that.

But my banker said you have to have a job, Not a 10 to nine job but a W2 job. So I applied online at local hospitals and I got hired in one day with an interview like this and worked for Glenwood, I worked for Glenwood hospital. In March, though, we closed our outpatient clinic so I had zero income, we closed TheraPilates, I had to close my studio here and I did not have my hospital job because the outpatient clinic completely closed. I could have helped with acute care, but the surgeries, the elective surgeries, the hip replacements, all that dropped, so they even furloughed therapists that were gonna keep care. So they didn't need my services at the time.

So I had no job, I'm a fighter, so I said, okay, we're gonna work this out. I talked to Michelle Dozois who is my right hand person in Santa Cruz and I said, let's do a virtual program. She goes, "If anybody can make this happen, you can. "So let me know what I have to do." So we did it and we did our first classes on March 27 and did them for free and then got everybody kind of on board with taking virtual classes. So that's kind of where we're at now.

Fantastic. So I believe that your profession there is classified as a getting the phrase wrong here. What is the phrase? An important business now? Essential business.

Essential business. Yes, 'cause I'm a physical therapist and that's the primary umbrella that I practice under. So as a physical therapist here, you've been treating clients or consulting with clients in the space that we're looking at today. Yes. I pretty much only taken people that need rehabilitation, pain relief that, you know, when they do an exercise class they take three steps forward and four steps back and they're having trouble moving or having difficulties.

So I don't really take people to just teach Pilates, you know, for fitness. And I don't mean that in a derogatory sense but I don't take people just to teach classes, I teach classes to people that wanna do Pilates for fitness and don't need the skills of a physical therapist. So I try to kind of shape my practice so that people come to me when they need help and they can't exercise with their Pilates teacher, with their personal trainer or in their group classes and I get them through that period of time, get them on their feet again and get them back into classes. So that's kind of how I've structured my position in the fitness and Pilates community and physical therapy community. That I see people one on one for an hour, hands-on usually for half an hour and then followed by Pilates based instruction either on apparatus or on a mat, then give them a home exercise program, we follow up once a week doing that same kind of format.

I kind of lean back on the hands-on, get them doing more exercise and when they can do a whole hour of exercise, then they can go into group classes. So that's kind of my approach and how I progress a patient that has a difficulty. Cool. They always stay with me if they want to but it's expensive, so I don't, you know, feel that people need to pay that kind of fee for physical therapy skill when they can just exercise. So I try to get them into a lower cost classes and then maybe Pilates with Pilates teacher and then when they need me, they've got me, you know, as a consultation, I can do a one off consultation.

So a lot of times at TheraPilates when one of my teachers would have a problem with a patient or client that they're seeing, I would do a consultation with them, give them some recommendations and sometimes I can give them a quick exercise to add to the program and then I can tell my Pilates teacher, you know, don't do that exercise with them but do this one and then they can take over right easily and sometimes I've never seen it. And that's the best scenario is that I don't see him anymore 'cause they're healthy and happy and exercising. Well, let's just pretend for a minute that I have an appointment with you in the space that we're looking at here. Tell me what I should expect? And I'm particularly focused on the coronavirus aspects of it.

Right, so things have changed since then. 'Cause I used to have people coming in and they would wait in my little lab lobby area and we would switch over and they would talk and chat with each other how are you doing and get to know each other. Well, now they pull up in the driveway, I can actually see people when they pull up. And they either text me to let me know they're here or they will pull up and then I'll see them and I'll stick my head out and wave and when they see me waive them in, they're allowed to come in. So what I'm doing in the interim is I'm changing my scrubs.

I wear scrubs when I work with patients. And then I have five or six sets that I use during the day and I just switch them between each patients, so a 15 minute window between sessions. It's actually 25 minute window because my sessions are 50 minutes and so I don't do the next one till a quarter after. And then, so I changed my scrubs, I clean all the doorknobs and the equipment and change out the loops if I need to and just basically clean everything with a hospital grade solution. I use fuzion which is harsh.

It's got a little bit of bleach in it but not enough to discolor clothing and it's called Clorox Fuzion. Okay, so (mumbles) Of course, that's the product. Let me grab it. Sure. We used this at the hospital and actually I found a box of 12 on eBay.

And I bought them for $25 each. They shouldn't be that much but it was worth it at the time, so I couldn't find anything. So if you guys wanna know, that's what I use. Is that the same product that they use in the hospital where you work? It's exactly the same product.

We started using about six months ago, when all of the procedures change, this was pre-corona. We couldn't use Velcro, we couldn't use TheraBand, we couldn't use wood, and it no cloth, no tape, so we had to get rid of everything that had any porous substance that can harbor bacteria. So then I took those things into account, but you know, they're still the cloth loops that we're using, they're still the wood dowels that we use. So I called Balanced Body immediately when this all happened. I called Ken Andelman and I said hey, can you send me some vinyl cover for the loops, or some fabric that I could use to cover them and he got on it right away and they started producing these wonderful Velcro covers.

Now there's still Velcro in there but that's better than the alternative of having a cloth which I had to wash between each patient. So I'm still watching those once a day instead of after every patient. So I do that and that minimizes some of the cleaning. And I've also ordered a loop or a cover, a vinyl cover for the wooden roll down bar. And so I think everything is covered now.

Everything covered in vinyl, metal or plastic, that's the three substances that we can use right now. The TheraBands, but those are also porous? Yes, yeah, we're not allowed to use TheraBands but what we can do with those is I put them into plastic baggies and I labeled them and I also write the patient's name on the TheraBand. So that's what we're doing at the hospital to say we don't have to throw out there and away or give it away after every patient, that would be very expensive. So we put into the plastic baggies and label them.

Same with blood pressure cuffs too, hospitals are only using single use blood pressure cuffs now. So anything that touches the patient is single use. Wow. Unless it's plastic vinyl format. So all my wood dowels they got to be covered or I got to get PVC pipe or something to use with my-- This was a trend that was happening before corona for certainly that magical environment?

That happened six months ago. Yeah, Interesting. So you've gone through all the things that you're doing. So, you're putting your clothes in the washing machine, new pair of scrubs, you're sanitizing the studio base. Things like Clorox product, is that causing damage to your equipment, are you seeing it?

It's kind of harsh on the equipment. While I was leaving I would spray it and just leave it and then on my last patient, of the day, I sprayed it and just left it and I don't think that's the right thing to do. I think if you wipe it and leave it wet, it just the whole substance surface needs to be wet for two minutes in order to kill the virus with this particular product. So I wipe it down and that's better but it is pretty harsh on the equipment. And you probably have to go back and wipe it again with something else after you've cleaned it with that to get the residue off.

It's completely damaged the keypad on my front door which was brass, you know, that's, I'm gonna have to replace that at some point. So, some of the things are not surviving well but all my Pilate's equipment is doing fine. So the client is outside, you've used that 25 minutes to refresh yourself, get everything clean, change your clothes, they come in, what happens then? Then I take their temperature and I have a thermometer that's a forehead thermometer and I do that and I asked them-- Is that like one of those sort of infrared gun things? I can show you that too.

I should have warned Sherri, should neither, this was a show. And yeah, so here's my little, whoops, there's a camera here. And so I've got to get in front of the camera and have to get it just right, so you can see the words. This one, it took me four weeks to get this, I ordered it, you know, right in March, right when I thought we needed it. It was funny, the hospital said, okay, if the outpatient clinic is gonna be open, we're gonna need to measure everybody's temperature.

And I said, well, do we have a thermometer that we can use? That's not my mouth and they're like, I don't think so. So I ordered one, I was planning on using this at the outpatient clinic and then the next week we closed, so I've been using it here and it's just really simple. It just has a little digital readout. So obviously it says low but once your mind is probably high, right?

It's in Celsius every time so I have to change it to Fahrenheit, 98 so I'm doing okay. And then after that I take their temperature and ask them questions about health. I use some sanitizer myself. Beatrice, quite the dog. I use the hand sanitizer myself and with them.

And anytime I see that the patient has touched their face, so some of them have allergies and need to take the mask off and blow their nose, I hold the trashcan out in front of them and then I don't let them touch the tissue box, you know, give it to them. It's just an amazing mindset you... It's like oh my God, I just realized I touch that you know. And so I hold them the tissue box, let them take the tissue out, blow their nose then I give them a hand sanitizer, I squirt it into their hands and I've ordered a Purell automatic one that you can just hold your hand under and that's just gonna make it a lot easier. But they were back ordered forever, I still don't have it yet.

So that is something I've been doing on often during the session. If I need to touch my face during a session, I will use the sanitizer or if I notice they touch their face or their mask. People touch their mask a lot. And that's also a risk because the mask is what's filtering the particles that you're trying to protect yourself from so if you touch your mask, adjusting it or whatever you're doing, you're actually you've got potentially the virus on your fingers. So If you touch your mask even, you still have to clean your hands.

Yeah. There's so many ways we can go with this conversation. I just wanna go through the journey experience of coming to the Pilates with you, then we'll address. And also I see some really good questions in the chat. And let me just say it's easier if you put the questions in the Q&A because then that's a bit I'm gonna try and work through with Sherri.

So I'm outside in the car you've sanitized the house, texted you to say I'm here, what happens? In the door, walk, come in, they want to touch the door like no, don't touch the door. You walk in into my little lobby space, I take their temperature, they clean their hands, right? Or they put their things down first. I haven't put them on the floor right next to the lobby area and they put them all in one little section and then they clean their hands, they go sit on the trapeze table, I clean my hands, I ask them if they're feeling okay, are there are any issues fever, cough, chills, nausea, anything?

Any unusual symptoms and then we get started. Right. And they've come in wearing their mask? Yes, that's, thank you. If they are not wearing a mask, I issue one to them.

I have a whole box of them, so I have masks to issue people. And those are those disposable kind of once we see lots of... It's the blue fabric ones. Sometimes are yellow but most of them are blue. I have an N95 mask.

And this is too funny, but I've been baking it every night. So 158 degrees supposedly kills the virus and I only have one N95 mask that was issued to me by the hospital. And so I bake it, I don't always use that one but I've been baking it at 170 degrees for 15 minutes every night. I don't know if that kills it or not, but I'm hoping. Yeah, yeah, wow.

And then during the session, are you doing hands-on adjustments, you're touching the patient or the client? Yes, that's why I changed clothes because I am in close proximity, because of my physical therapy. You know, they're coming for that. So I am doing hands-on and that feels no different than any other treatment session. I'm touching their back, I'm touching their shoulder, you know, so I'm all over them.

And then you know, all I have to make sure that I do is remove my clothing that I've left touch them and clean, you know, my hands. So, yeah, that's and I suggest that they take off their clothes when they get home and take a shower. Yeah, so with the N95 that's fitting pretty tight to your face. It's not like one of the... Yes, this is a traditional mask that is ill fitting.

Okay, so look at this. I cannot get this to bend to me, I'm so bummed because I... Do you see that red mark on my nose? That's from wearing a mask. And then I have a scratch on this on my face for my two but I cannot get this to stay.

So what I do is I take medical tape 'cause I don't wanna get rid of the mask. I mean, I can't get them so I paid a fortune for these things. So I tape it with some medical tape, just cloth, you know, the paper tape that they used to hold a bandage on when you get your blood taken to get it to stay put. And then it's fine but that's a traditional mask and it's just that that cheap cloth. And then this one is my N95.

And it was fit to me by my hospital 'cause we go into people with airborne precaution to treat patients all the time in the acute care setting. So it has a very nice nose clip and it fits completely onto my face and it's very tight. I cannot pitot and I cannot breathe very well when I use it and you can see it fits really well here and when I breathe in, I don't feel any cool air coming in. And I had to have an extra small 'cause my face is narrow. And so I have to really have it and sometimes I have to if I went in to see a COVID patient in the hospital that I knew was COVID positive I would take this part because there's a little bit of a gap there but it's very gets really tight.

And if your mask is hot, it probably is working right. If your mouth feels cool and it's easy to breathe, it's probably not a good mask. So you really want it to be completely tight on your face. And even taking it off. Once you take it off, I mean there's a procedure about taking it off, I put it immediately into a case where it's just sitting in there and then I have to clean the case and then once I bake it, then I make sure I clean the case after that and then put it back in.

But it's a whole another world with procedures like this. It's like doing surgery, it's like if you think of a surgeon who wants to prevent the spread of infection during a surgery, because the most popular way to get an infection after surgery is from dirty hands or dirty something in the operating suite. So you think of it like that. They scrub for hours to try to get the, not hours but long time to get the particles off their hands and our fingers and hands harbor so much bacteria, so we really have to be careful with that. Yeah.

We're doing our best, we just do our best, you know, it's not gonna be perfect. But we do our best to try to prevent the spread of the infection. And I don't want on my heart to know that I caused someone to get this virus. I just couldn't bear it if I knew that I had done something. I know that I'm doing everything possible to keep people safe in my environment and that's all I can do.

And like I said, I'll just do my best to try to keep people safe and give them the care that they need. Yeah, so when when the client comes in, are you wearing gloves or are they wearing gloves? No gloves. I don't recommend gloves because gloves are single use devices. So they're single use protection.

Once you've touched the patient, once you've touched something that possibly has the virus on it, you got to get rid of the gloves. So as soon as you touch something with the gloves, you got to take them off. There was a woman this morning actually that brought the patient to my clinic and she had gloves on and I asked her to take them off because she had touched almost everything you know, coming in, the patient and the walker and the handrail and the door and the door bell with the gloves. So I said you've touched, you've driven here, then you've opened the car door, closed the car door, you've touched the handrail, you've touched all this stuff but the gloves are contaminated now, so please take them off and could you sanitize your hands? Interesting.

I don't think there's like a false sense of security with that. I have gone to the grocery store in gloves and then I take them off when I'm finished. Right. But I don't always do that anymore. So you know, what is the, you know, what is the logic behind this people who do wear gloves?

What are they trying to achieve with that? I think they think it's a sense of protection, that they're protecting themselves from the virus. But as soon as they touch something and then they touch the gloves to their face, it's worse actually 'cause it harbors bacteria inside too. So if you have something on your hand, it's gonna harbor that bacteria inside. It's actually worse for people to wear gloves than not.

And the type of mask that you're referring to is just this sort of... Yeah, just like that. So this is not an N95, this is just a disposable. You can't get those and N95 right now and I don't want to use them up for the hospitals. I want the people that need them, that are treating coronavirus to happen.

I don't want to take that away from people who are treating known corona patients. So they need that protection and I don't wanna take that away. So the logic or the mask, you know, regular kind of disposable mask like this. Is it more that the happy protects the patient to a certain extent, but it's more protecting you if they sneeze, or there's a lot of bacteria? I know people say that but I really feel like this is an airborne virus that's transmitted through airborne particles.

So if one person's wearing a mask, there is a sense of there is some protection of yourself from a person that has it. And then if two people are wearing it, that's even better. So, yeah, I don't understand even the philosophy of you're protecting others. I do in a sense, you know, because you're, if you have it in you're an asymptomatic carrier, you're protecting others. And I think it's like a sense of empathy that people are trying to generate but I think it works both ways.

I really do 'cause it's like you can protect yourself from airborne coughs, colds, flu by wearing a mask. I traveled a lot in Japan and it's just normal behavior for 10 years, I've been wearing masks there. And I remember asking my host of the course that I was teaching, why are you wearing a mask? And she said, well, today I'm wearing it because I don't want to get exposed to anything. And last week, I wore it because I was sick and I didn't wanna transmit it to anyone.

So I think it has, you know, a dual protection. Yeah, last question about mask. So somebody comes to your studio and says, I'm exercising my rights to not wear a mask. Then you have to leave. You know, yeah, I don't want you to expose everyone that comes in this place to the virus.

If you have it and you're in here, breathing deeply and I'm working on breathing with you and core control then you're exposing everyone to the virus 'cause all the particles are gonna get blown all around and land on everything in here. So no, you are not allowed to come in here without a mask. It's a tough call, you know, but I just don't get the philosophy or the thought process that tells people or that people are talking about that, it's your right, it's a government enforcement. It's like wearing a seatbelt, that's a law now. You can get a ticket if you're not wearing a seatbelt.

And the seatbelt, the only thing it's good for is to protect you from injury. So I think of it like seat belts. And we are just trying to prevent the spread of this thing and live a fairly normal life. So if I go shopping, and I went to target the other day, I walked right back out there was hundreds of people in there and no one was wearing masks. I would say no one, 25% of people probably were wearing a mask.

And you know, I asked the lady why are you wearing a mask? And she was like, what? All that insanity. I'm like, you're only doing it because somebody makes you do it. So I just, I don't know.

There's a lot I don't understand about certain things in this culture. We could go way off on a tangent. So we've talked a lot about kind of transmission by touching and transferring it to your face. What do you think about, you know, we talked a little bit before about the Aaron Bromwich article where he documents the fact of the choir up in Washington State. You know, they're all singing together, they were socially distancing but they were singing which is big breaths, big x, which is a lot about the breath.

And 45 out of the 60 people in the choir ended up with coronavirus from one person that was infected. So when you think about the air that you're breathing all day in the room that we're in here, how are you thinking about refreshing that air and keeping you healthy here? That's exactly. You know, after reading that article, I found it very compelling and interesting and a great understanding of how it's transmitted. So it's exposure and time.

So if someone has the virus and you hang out with them in a small space for six hours, you're probably gonna get that virus. If you're passing them in the street, outside, you're probably not gonna get it because there's not going to be enough of exposure to it to get you sick. I started thinking of a spectrum when you share the article with me. I thought, okay, so just normal breathing and maybe sleeping, normal breathing, we're not exchanging that much air, there's not a lot of particles getting pushed out into the air. And then speaking, like we're doing now there's a lot of particles that come out into the air.

And if you do singing, that's even more, right? Deep breathing. Running might be something that is more. And if you're running on a treadmill in a small room that could probably be the worst or singing in a small room. And I think we learned a lot from that choir that got exposed to the virus, that so many people that were in choir got the virus.

But what we're doing is teaching deep breathing and you go into a TheraPilates studio and you're definitely gonna hear some deep breathing and there's every movement has a breath to it. So I'm a small space doing Pilates like that would be a little bit risky. So are definitely more risk than just lying on the floor doing a restorative yoga class. A little different, you know, than doing a very vibrant Pilates class with lots of deep breathing encouraged. And I'm not saying don't encourage the deep breathing because that's actually what you need to move the virus through.

I shared a Chris commentary about his experience with the virus and what his doctor had told him was to continue deep breathing because that helps to move the virus through and it doesn't settle into the lungs. Your lungs become fibrotic and stiff and you need to do deep breathing to help when you have the virus and also to help you prevent getting the virus so you keep everything moving, so it doesn't settle in. So there's some theories about that, that I find very compelling. And I hope hopefully someone will do some good research on that. Well, if they wanna work with Sherri, Sherri is the?

I forgot your official title. Head of the research. Chair of the research committee. Chair of the research committee. Pilates Method Alliance, yeah.

So you know, if it's something that people are interested in researching, you know, please reach out to Sherri, she's done amazing things. I'm fortunate enough to see in quite a few of the presentations you've done at the PMA conference and it's always one of my favorite parts. Aw, thank you. I'm very proud of the presenters that we... Yeah, they are awesome.

So, you know, like a lot of houses have or a lot of studios have an air conditioning system that may be shared with other parts of that building. I assume that there's a chance that air is just getting recirculated through the Pilates studio and then next next door, I don't know what's next door but say it's an office and somewhere else. I'm assuming that duct is there. So there's a chance that even in your room, you may be the only person but if it's shared like that, it could be coming through that system from other people. Right.

Well, you do have filters. And so what we might think about doing is, I've certainly thought about that because I can't always open my doors in Louisiana in the summer. It's hot, it's like 90 degrees and high humidity and so I can always open the windows and have people be comfortable. I do as much as I can throughout the day and in the evening. But anyway, I need to look into some filters for my air conditioning system to see if there are any that are filtering those kind of particulates.

That would be wise to look into that. And running my air conditioning, I actually turned it down quite low. So it's colder in here than usual because I want that air circulating as much as possible. Yeah, I think that this, you know, the kind of airborne transmission if you know, I can control what I touch. You know, I have power over that.

It's really hard with what I breathe, just breathe the air that's in that room and I don't necessarily know where it's been. You know, I think in certain climates, you know, the idea of being able to teach your Pilates classes actually out in the park, doors seems to be though because there's so much dilution and dispersion. That is the best place to do it. Yeah, well, you know, one of my colleagues is a yoga teacher who has a lot of bad allergies. And she said, wearing the mask, this season, this last two months has been amazing for her allergies.

She said, I don't have near as much problems with my allergies this season. Interesting. So I find that very interesting too. So you think about that and people wear a mask when they mow their yard, you know, so there's a benefit to wearing a mask. It's just not fun, I miss people smiles, it sucks.

I hate it, I hate it. I really want us to not be able to not have to do it but for right now, what I do when I wanna talk to my patient is when they're about 10 or so feet away from me after their session, I take my mask off, I give them a big smile. I'm like, I can't wait to see you again. And then you know, try to you know, just be human. But because I like to smile, I'm a big smiley person.

So when I was looking at all the questions for today, a lot of them was about what we've just chatted but originally we wanted to talk today about teaching seniors. This is about teaching seniors and respiratory issues are one of the main reasons that people die. So I think it pertains perfectly to teaching seniors because they need to be protected more than anyone. So if you get a senior in your program, please wear a mask and make them wear one. So anyway, that's...

And then don't let a ball. Let's talk about falling and teaching seniors, we've got five or 10 minutes and then I'll try and do the rest of the questions. Oh, yeah. Tell me about, you know, what's your advice in this Zoom world where people may not be coming in? How are you successfully teaching to seniors?

Yeah, well, the issues of falling. I always love to tell people what I've done wrong before I've done right. Because when I was teaching my first class it wasn't the big group class that I taught for free but my ongoing class, my first virtual class. I'm seeing all the people on the screen, I've got like, you know, 15 squares and I see this one lady, she's got her dowel and she she has MS, so she has some balances so I see this. You know that I'm like, oh my God.

You know, I can't do anything 'cause I'm in Louisiana, she's in California. So I'm freaking out. And I was like, are you, I won't say her name, I want to but are you okay? I mean everything okay? And I'm like, keep your hand on that dresser behind you, that's perfect.

So now, anytime I do any balance work, I'm like, okay, do you have a dowel, you have the wall next to you, you know, put something sturdy, you know, make sure you set your space up so when you do your balance exercises that you have something to hold on to. And then when you just want to challenge your balance a little more, you pick your hand up just an inch off the surface and then pick your dowel up an inch off the floor. So you've got it right there if you need it. And so I never have people just put the dowel aside, I just have them hold it while doing any balance exercises and then they pick it up just an inch off the floor to practice, that way it's there if they need it and I'm super methodical about how I go through that. So when I you know, I get two dowels first or a dowel and a surface, a dowel and a foam roller or a dowel on a tabletop, hand against the wall or a dowel and they stand with their feet together, that's for level one.

Level two is gonna be standing a little tandem stance. So those of you that are pts out there, you know what I'm doing, I'm doing the force for stage bounce test. So then the next step is to go one foot in front of the other, which is full tandem. And the last stage is single leg stance and then we see how they do with that. So every time I see clients that are the first time I've seen them, I might do that as part of my class and then they do heel raises after that.

So I'm gonna tell you, you guys out there, If you don't do anything else with your seniors, make them stand on one leg every session every day, at some point in the day, and then heel raises, heel raises are... I like to call the panacea exercise not the pandemic exercise but it could be the pandemic exercise, but the panacea. It does bone building, it does work on their balance, it works on their leg strength, it activates the calf which I call the second heart that people who are aging or sedentary have pooling of blood in their feet often and swollen feet or painful feet, especially due to poor circulation or swelling. A calf raise fixes that in a second. I took before and after pictures of a patient this morning who has very large swollen feet, who is letting it get away from her and she did her first reformer lesson last Thursday and she loved it.

I wasn't sure how she was gonna like it because she tends to get very sore and just kind of lost a lot of fear around exercise. But I took pictures before and after that I'm actually gonna post without her face in there and you won't know who it is of a reformer footwork lesson with reformer footwork, feeding the straps, circles all that and to see the before and after. Same thing happens with single leg stance, you do a calf raise, up to 20 times, you're working on 20 to 25. And older adults should be able to do 25 repetitions in a row, that's 65 to 80. And everybody's like, what?

I can't even do 25 in a row, you know, so try and do 25 calf raises in a row all the same height. They don't count if you start going lower and lower and lower towards the end, they have to be the first one has to be the same height as the last one where they don't count. So 25 in a row calf raises every day will help prevent a lot of circulatory problems, foot swelling, foot pain, arch weakness, balance disorders and bone density. So do the calf raises if you don't do anything. Cool.

Any other cool questions? There's just so many about yeah, I think we have to invite you back here. You know, I've seen seniors that are kind of a little bit scared and they're kind of not energized or motivated to do their exercises, is there a way you can help them stay motivated, that they don't want to be taking that risk of falling alone in their homes? Right. Well, it's funny.

I have a patient who is 87 and has some heart conditions and things like that and has some very bad hip pain. And he just says, you know, when I get home to do my exercises, I feel like, I'm either not gonna do them right or I'm gonna hurt myself. Like people think they're gonna go home and try to do these exercises and hurt themselves. So I think a great solution, we're all doing the videos right now, is to take their phone and set it up to use their phone. That way you don't have to worry about HIPAA compliance.

And don't use your phone but use their phone to film their exercise session. They'll get the cues that they need, they'll get the advice that you're giving them, the supports, they stand up against the wall, use the dowel, you know, set it up like this and then they are so much more compliant. And then I asked them, did you do your exercises? Did you watch your video, and you know, said they have a little quiz when they come back and I said, I'm gonna quiz you, because I want you to be able to do this one exercise every day. So just give them one to work on and then quiz them.

When they get that one good and they're good with that then give them another one but don't give them more than five. And so you really want to keep it simple and they will not remember and it will frustrate the hell out of you because they'll go, I don't remember. But you have to remember people are aging and they don't remember things as well as they used to. And when I get excited, obviously I'd like to talk fast, I gotta slow it down. So I was trying to give them all this information.

So I have to back it down, slow my voice down, give them very clear loud instructions, film it with good quality sound and have them be able to replicate it. So I just really feel like practicing over and over again and often do the same exercises, you will be bored to death. They are not bored though. Just remember they are not bored, they can do the same exercise 10 times and it's like Groundhog Day for some people. And I used to get so frustrated with this one lady, she just never remembered and it's like, okay, after a year of doing the same exercises over and over again, she doesn't remember, she's probably never gonna remember.

So those people need to do a group class. And that's what the problem is with this coronavirus, is trying to get older adults to do group classes at home on their own. That's the biggest barrier is getting them to the technology where they can do the classes. Yeah, do you got any advice on how to help people through that technology fear? Oh, gosh, boy, do I ever.

I mean, that could be a whole nother program. I worked my tail off. The main thing I did that was helpful was I called every single client and talk them through. This is a browser, turn your computer on, click that little E or the Chrome, you know, whatever the icon looks like that they have or they're using or you are using a Mac or a PC? What is that?

They're like, are using a Dell product or an Apple is it? Doesn't have an Apple watch. And so I would ask them what they're using. It could be a phone or an iPad, or a smart pad, whatever. A smartphone, what kind of phone are you using?

So I had to get really clear on the technology for Android and iPhone, iPads, smart pads, PC and Mac. So I needed to get four basic skills under my belt to try to troubleshoot things. And, so I spent an hour on the phone with a lady walking her through how to log into Zoom using her PC and she had four different options for speakers and we finally got it down to the fourth one that worked. But she wanted to give up and I said, "Look, I'm sitting at home, I'm doing nothing. "If you don't take the class, it doesn't help you or me.

"So let's get this fixed and see. "Let's try each one of these speakers, stay with it. "Tell your husband to go away," 'cause they were fighting. I said, you guys are gonna get a divorce over this. So she was about 78 years old, I guess.

And they're trying and he's like, do this, do this. I'm like, "Okay, go into a room by yourself. "Tell him to go away that you've got it covered, "we're gonna get this." So anyway, we got it, we were so excited. We're like yes, we got it. But the thing is take the time to do it with them because that will endear them to you and you to them and it will get them into your class.

If you don't get them into the class, it doesn't help you or them. So I spent my time doing that. So then I had all of my clients as many of them as possible getting into the classes. And if they had trouble I called before and said, "Okay, Julie, you weren't in class today. "So I was wondering, are you okay?

"Or were you not able to get on? "Was there an issue with the technology or are you ill?" So I wanted to know, literally the answer to that question, whether they were sick or whether they couldn't get into the class. And then it was, "Oh, it was just I couldn't get on. "I was trying to use my iPad," and I find the iPads are the worst. They're very difficult to figure out.

Phones are pretty easy, the computers are the easiest. But yeah, you got to really get savvy with Zoom or whatever application you're using. And 'cause I got no tech support from Zoom on the phone, on chats or email and I seriously want to call them and say you need to hire me because I need a stipend for all this tech support I've been given to people 'cause that's all I did for an entire month, was tech support. And I was so sick of looking at a screen that I was so excited to get people in front of me exercising that I was thrilled. I was doing that one hour a day but I worked three times more than I normally do to make three times less money.

But people were so happy once they got in and doing the classes, it was wonderful. And it's healed us as a community, it's healed me and my teachers. My teachers and I have talked to each other more than we've ever talked to each other. So there have been wonderful benefits to this whole thing. It's just making lemonade out of lemons.

So I have a quick question head. Can you go over a little bit of you know, can you go longer than on the hour? Can you stay with us 10 minutes longer? Yes. Great, I'm gonna switch to the questions and we have lots so I'm gonna do the best.

You know, if you don't mind just giving the shorter answers that I can try. And I love talking to you, you're definitely gonna come back and you know, do something. Is my favorite subject, so, you know, I can talk all day. Deb is asking, "Are the calf raises single or double?" Single, they need to be single. Good question, thank you for asking that because double is way too easy, everyone can do that.

That could be a good starting point. And can I show something really quick? One of my favorite ways to help people that can't do one. 'Cause a lot of times they can't do the single leg because they're too weak. So we do dowel and a roller and then we help them put their foot on a lower stool than this that I'm putting up here because the seat it's too low but it's little stepstool, so that takes some of the weight off this leg and then they can do the heel raise like that a little bit against the wall and on the dowel, they got to have a lot of support and then put the foot on a stool.

And so you're taking a lot of weight off the back way. Not all of it, but it's not complete 100% weight, taking a little bit off and then they try the heel raise. If that doesn't work, then you wanna have them step back from the stool and shift their weight forward a little bit, they'll take more weight off. Then you've got a little bit more than 50% of their body weight, but you know, not all the way up to 100%. Then they start to get their tilting back just a little bit, then I get vertical completely vertical.

Then maybe they just put their toe on there and so you're gradually taking some of the weight off of that leg or adding the weight back sorry to that leg. And that has helped so much 'cause they might just do it. They're sitting there, they're trying to do the heel raise. They're cheating and trying to do it bending their knee and they just don't have the strength to be able to do it. So two feet is too easy for most people and one foots often too hard.

And the other thing is just doing a little lunge stance like that. Taking it back like that, that's another really favorites because that's like walking in there. (mumbles) I know that was a short enough time but I love doing those things. They're so simple and so easy to do. I think I see Amy Havens on the call here so maybe I should put me in touch with Sherri and you could do a fabulous.

Okay, I love that Amy. I see you on the panelist there or on the attendee. Yeah, quick question about does the dowel vinyl cover come from Balanced Body is that where you got that? Yes. Those are the stoppers on the ends.

That one is just a wood one that I have here that I'm not using the patients. I have a metal broom handle that I bought a metal broom and I take the broom off the handle because I like to show people that they have something at home that they can use. So the virtual classes I'm not worried about the dowel and I don't want to use a cover for the dowel because I would be afraid they would slip. So I use PVC pipes. Sorry, the patient's are metal.

Is also recommended using dish washing liquid because you can also kill the virus using detergents. You know that they're not obviously the same as a hospital grade cleaner like Clorox but they will protect the equipment. So I kind of feel on this one, it's a little bit to do with risk mitigation. You can't have something in your home or your Pilates studio that's as sterile as an operating theater. No, of course, not.

And it's just not possible to do that. So continuing on with things that if you have a higher risk profile, I think use the stronger products to clean your equipment. It's a kind of continuum here. We used to use doTERRA products, and I love them, they smelled wonderful and I was like, yeah, we can't use those anymore, unfortunately, Cool, I think you kind of approach this but you you scheduled a little bit of social time before and after your online classes? Can you just touch on that this is answering Valerie's question here.

Yeah, I do come on to my class about quarter till or 10 till depending on, you know, how fast I can get my patient out the door and talk with people and ask them questions. So I'm often inspired to create a theme for the class. And, I've been teaching classes for a long time. So I can come up with a theme, just by somebody asked me a question finance before class, and then I'll focus on that. So one lady said you have neck pain.

So I threw the Fletcher towel work in there that I love to do for the neck and focused, all the very same exercises that we do that are gonna help with bone building and posture and all the things that people come to Pilates for, just refocusing it on shoulder and neck function and how they're feeling in their neck and shoulders as they're doing the exercises. So that's kind of what I use the prior, the pre-time for, is to find out what they're dealing with, and not so much social. I really wanna get the information from them about what they want out of class. And then after the class, we talked about what you know, and sometimes before the class, I'll talk about something that's going on. Yeah, I think the social connections that you and I really when we had our chat yesterday, it was just fun to catch up.

In the socially isolated time it's tough, you know, same for me and everybody else. There's some equipment questions here and I'm gonna see if Dave Lippman from Balanced Body can join us. And if Dave's got no pants on, I understand Dave. If you could just message me to say it's okay then I will invite you on. We touched on things about disposable gloves.

I don't think there's anything else to say there. It's not really protect you. It's not something you get through your hands. So I'm not sure disposable gloves are really part of our Pilates well here. I think it makes holding some of the equipment trickier.

Yeah, I don't recommend gloves. Kim's asking when you take your temperature. Then you do record it when you're taking that temperature? If it's a patient, I'll record it. And I'm not so concerned about recording it other than tracking it if somebody gets the virus.

So that's when it's gonna become important and I'll document it in the chart. "Have you ever had to tape the mask on to your client?" Dawn is asking that. I've not done that but I've threatened to. I tell you what I have done. A lady came today with a very loose mask and I'm gonna get her mask.

I have a hanger for my mask. And so her mask was doing this little, sliding down. And it kept falling down when those cloth ones and I said you know we can't really have, so I took a ribbon and I looped it through here and I tied it like this. Tied behind her hair. So I didn't have to tape it to their face.

But I do have that cloth tape now, I ordered some that I'm gonna use for myself so that I can use these masks because I don't want to have to throw these away or not use them. But to get them just hug my nose a little bit too. If you can feel air coming up through to your eyes then the mask is not secure. Kimberly's asking you a question, so another mask related one in particular and people are breathing heavily, do you think they can Pilates with a mask on? I love it, I'm glad you asked that question.

'Cause I was hoping that would come up and I would remember it. What is so cool about the mask and which is a benefit is that we have to work harder to draw air in and that's gonna make our diaphragm work more and strengthen our diaphragm and our respiratory muscles. So it's like a spirometer that you practice breathing in against that resistance. And it's a lot like if you were doing the little pursed lips breath or that, you know, sipping in with a closed aperture. You're working your diaphragm more to pull air in.

So think of it as a benefit and if you can, you always have the opportunity to reframe a situation to a positive outcome. And it's like, look, this is gonna really help you with your respiratory function, you're gonna breathe better without that mask on, if you've practice deep breathing with the mask on because it's gonna provide that resistance that is so helpful for working in dive. That's how I approach it with people is help them to understand that it's a positive thing and it's protection and it's gonna help your respiratory system. Yeah, I haven't heard that point of view. But to me that's a little bit counterintuitive because it's like, this is miserable, I'm hot and I'm finding it hard.

It's just like doing hot yoga. I mean, you know, I hated that too. I don't actually do that 'cause I hate it. I just go outside in Louisiana and beat 90 degrees of humidity. But yeah, you'll get used to it.

I didn't like it at first either wearing it all the time, but now I'm used to it. Interesting. Alexandra asks, "Are you standing six weak feet away from the clients?" No, no, not me, I mean, if I were, here's the thing, you can stand a little closer to people if you wear a mask. It's better to wear a mask and be a little closer to people I think than stand six feet away and not have no protection at all. That's just my opinion.

You know, I don't have any research to back that up. But there are some really interesting cases that have been reported about the transmission of the virus. Lesley has a question here. "What type of cleaners use rescue equipment?" I think we talked about the Clorox Fuzion. We also did a webinar earlier with Kayleen and maybe Jia can put that in the chat.

Yeah, I heard she had some great things too. We spent a whole hour talking about the pros and cons of different products. Is a tricky business. I don't think one size fits all on this. I would like something that's little less harsh that will still kill virus.

So if Kayleen has a recommendation or something I can actually get because I couldn't get any of the products that were recommended. Alexandra asked a question about those calf raises, are they good with gout? It depends on their pain, you know, so sometimes you have to wear shoes to mitigate the force on the joints. So people can wear shoes that can stand on a really soft mat. So I might fold up my yoga mat four times and have it be really soft or do it on carpet.

That usually helps with the joint issues in the metatarsal phalangeal joints. Because she's right, that is an issue, that's a barrier to exercise. Oh, I can't do it because it hurts my my gal, like okay, well, let's figure out how we can do it so that you can benefit from it. I'm just gonna ask Dave Lippman to join us if you don't mind. Please, put on your pants on Dave.

He just messaged me back saying he's put on some pants. Hi, big hug. Did you hear me talking about your bone crushing hugs? I immediately commented about social distancing hugs. Okay.

My wife won't let me go on any Zoom call unless I'm wearing a hat now. Oh, oh. Yeah, it's just out of control up here. (mumbles) Okay. I asked Amy Havens to join us as well.

So maybe even Amy is rushing around putting her pants on here. I'm in my nice comfortable sweatshirt. I love it. Yeah. Amy, Dave, I have a couple of questions for you.

Do you have any? I think you heard much of our conversation about the different products. You know, I don't want this to be a Balanced Body commercial, but we all buy your products. Maybe you can talk about the different things that Balanced Body's been doing in this area to help us stay safe and our clients. So Balanced Body has always prided, we've always prided ourselves in listening to our customers and solving problems.

And the vinyl loop covers that, I think might have been inspired by Sherri are a good example of that. That's a product that is been a little bit too successful. They're handmade and for now, I think we've got over 5,000 on order with a production team that's operating with appropriate social distancing at about 50% of capacity. So we're really struggling with that but we're working on some other really cool ideas. So sort of watch this space, there'll be some other things coming.

We do have vinyl, you're talking about hold on bars and push the bars and dowels. We do have orders manhole covers for that which makes cleaning easier with a clear understanding that anything with a seam or Velcro, you know requires some extra attention. With the wooden bars that are they coated in polyurethane, are they? Yeah, that's a really good question. All Balanced Body wood products are painted with a special hospital grade clear paint, but not our hand contact pieces like roll down bars and dowels and not things like risers and stuff.

So, you know with a wood product you got to just be extra careful about cleaning that thoroughly. So one of the things that can I say something about this roll. This is a Balanced Body roll down bar that came with my crappy stable and these are great but they pose a little problem to try to cover. So I ordered the other roll down bar with the loops on the ends and that way and then I ordered the trapeze roll down cover which I have. I took it off of my trapeze to put it on here but it was the loops were in the way.

So I got Jason to send me the wool down bar with the loops on the ends and then I ordered the cover that goes with the trapeze table. So I just kind of went on your website and look for things that would work. And I know that Amy and Rachel's CenterLine® equipment have that end loops, so I thought, okay, I want that roll down bar and give me the trapeze, push through bar cover for it 'cause you'll have that in stock. So I'm like, okay, I think that'll work and I shouldn't get that in the next few days. I think the covers are a good idea but you know, using a bleach based wipe, spray thoroughly on everything that's been in hand and skin contact and breath contact is really the most important thing.

Yeah. And if you do have to use Velcro, just undo it and then spray it with your, whatever, cleaner. That's what I've been. I mean, I'm doing the best I can. I mean, that's what I can do right now.

Cool, thank you, Dave. Excellent presentation Sherri. Really cool to listen to your procedures and your six point guideline. I'm willing to share that graphic with anybody that wants to use it. I've already shared it with everybody on my team.

You can customize the top of it for your own studio. I painted that way specifically, so that you could put your own logos in there and I was gonna share it with a PMA as well. Cool, I think Jay has just put it in the chat. So please do the way. Thank you, Dave.

I'm gonna switch to Amy here. Amy, do you think you could get together with Sherri and you could do a webinar to answer all the questions here that I can't. We just don't have time to about movement and seniors. I would love to and be honored to and that is actually one of the yes, it's in the work. So there are things that we can continue helping teachers with on all levels.

I know this one hour goes by very quickly, so you continue. Oh, that would be wonderful Amy. Yeah, sure. We have a call that we need to get do anyway. First of all, really apologize to the at least seven people who have great questions in the chat that I'm gonna pass them on to Amy and ask her to work with Sherri to kind of fix the time when the two of you can do that.

They're really good questions, there's a lot of material to go. But I also wanna be respectful of everybody's time and just say, you know, thank you so much everybody for joining us. Sherri, you are magical. I have so many more questions for you but I wanna come back and go through this, again. A couple of people are asking in the chat.

We're going to record all of these conversations, they will all be available on Pilates Anytime. And please, please, please make the most of them. There's too many questions. We're still in this turbulent time and there's things to be sorted out. So thank you.

Sherri, thank you. Amy, thank you for joining at the last minute here. Absolutely. My honor always and I love watching all of these all the chats and the thank yous and the thank yous and the thank yous, the gratitude is really just overflowing, so Sherri, thank you. Dave, thank you.

I'm sorry to make you put your pants on. Ah, I'm going out to shovel snow. I love being on this screen with all you amazing people. Thank you Sherri, thank you Dave, thank you Amy. All the people who joined us, you're magical.

And I'll try and answer the questions next time but thank you so much. Thanks Sherri. Thank you John, this was such fun. Cool. I'll send you a note, let's get in touch very soon.

Okay, sounds great. Thanks so much, everybody, bye.