1. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). PRESCREENING

2. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Key Topics to Be Covered What are key drivers of third age health? Pre-screening questions and forms. Referral options for areas of weakness. Educating and empowering clients with resources for further assessment and support.

3. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Key Drivers of Third Age Health Natural Hormone Shifts with minimal symptoms Cardiovascular Health Bone Health Optimal Digestion Balanced Mood Pleasure and Purpose

4. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Assessing Hormone Balance Included in your materials is a sample screening test for symptoms of common hormonal imbalances. The Healthy Hormone Balance Quiz See that PDF, included in your handouts, for a recommended further testing for your client to request from her functional medicine professional or order herself.

5. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Referral options for women with hormone imbalances Functional Medicine Physician who specializes in bio identical hormone replacement. https://www.functionalmedicine.org/practitioner_search.as px?id=117 Functional nutritionist who specializes in natural hormonal balance http://integrativepelvichealthinstitute.com/find-a-provider/

6. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Cardiovascular Health Most general physicians are very good at screening for cardiovascular disease as it’s the #1 killer of women. But, there are a few tests that could be helpful that your client’s doctor may overlook… HS-CRP Homocysteine level Myeloperoxidase (MPO)

7. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Resources for Cardiovascular Health Cleveland clinic online information: http://my.clevelandclinic.org/heart/diagnostics- testing/laboratory-tests/blood-tests-to-determine-risk-of- coronary-artery-disease.aspx Dr. Steven Masley – cardiologist, nutritionist, and chef! The 30-Day Heart Tune Up

8. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Bone Health Vitamin D level If vitamin D levels are too low, the bones may be at risk since vitamin D is key to the body’s ability to shuttle calcium and into the bones (and out of the arteries.) Vitamin K2 may also play a role, but that’s not as well established.

9. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Bone Health DEXA scan Dual energy X-ray absorptiometry – like a low radiation X-ray Recommended for Post-menopausal women over 65 and Post-menopausal women under 65 if History of bone fracture as an adult Current smoking History of ever taking oral steroids for more than 3 months Body weight under 127 pounds Having an immediate family member with a fragility fracture (a broken bone from a minor injury, suggesting osteoporosis).

10. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Resources for women with bone weakness More in weeks 6 and 8 on optimal exercise and nutrition for bone health.

11. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Optimal Digestion Regular bowel movements (1-3 per day) At or near a 4 on The Bristol Scale No abdominal pain or bloating after eating. Good nutrient absorption. No signs of intestinal barrier compromise (leaky gut): NO allergies, skin breakouts or other skin conditions, headaches, chronic joint pain, or inflammation (could be disguised as weight that’s difficult to lose.)

12. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). BRISTOL STOOL CHART

13. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Resources for Optimal Digestion More in weeks 8 and 9 on nutrition to improve Digestion.

14. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Balanced Mood Sadly, we do know that the evidence for the usefulness of screening for depression is very low. See a recent research article in your hand-outs. But, there is a tool that is published online that is used by the US Government Department of Veterans Affairs… https://www.myhealth.va.gov/mhv-portal- web/anonymous.portal?_nfpb=true&_pageLabel=mentalHe alth&contentPage=mh_screening_tools/PHQ_SCREENING.HTML

15. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Balanced Mood Screening mnemonic for generalized anxiety disorders published in Canada. AND I C REST See PDF in your handouts for full details.

16. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s). Pleasure and Purpose The purpose of having a healthy body, is for a woman to express her: Passion Creativity Divine and unique gifts Generosity Partner with her create health, so that she will be inspired to create a life that is in alignment with her soul.

17. © Burrell Education 2014. Do not copy, duplicate or transmit electronically without full permission from the author(s).

18. BE THE INSPIRATION Screen for pleasure, passion, purpose and generosity in your life. Mama Gena (queen of pleasure) http://youtu.be/CU9RAGiRdSE