'Peripatetic' or 'outside' contracts

Although I have till now preferred to teach tai chi (The Yang Long Form) on an individual basis - here in my home dojo, I have in more recent times taken on a few 'peripatetic' or 'outside' contracts with various groups. These groups - and my assignments are:

1. Solent University - to presents series of 4 (one per week for a month) "taster" sessions for students of 18 years old upwards.
2. Sunrise Senior Living - providing these residential retired people weekly tai chi/chi kung style exercises, and
3. Monthly visits to a regional branch of The Parkinson Sufferers Society.

Just exactly what this last group want or hope for from me is not so easy to summarize but it has in all been by far and away the most interesting and rewarding (for myself as a teacher/instructor) encounter of the three, so I shall begin this newsletter with a report on this my new professional association with The Parkinson Sufferers Society - and describe my 'approach' to providing these people what they think they need in the way of Tai Chi.

First it must be understood that what they require above all is an instructor who is sympathetic to their condition. They had that with their last instructor because he was I believe a friend or relative of one of the Societies members; so he knew a bit about the disease but, as was unfortunately proven, he did not know enough about Tai Chi or perhaps more precisely, how to teach it. He ran out of things to say after only three sessions. Nevertheless I would say that his intentions were good. I should anyway be grateful to him whoever or whatever he was for it was he that prepared the ground for me and stimulated their interest in the first place. I only came into the picture when the Chairperson of the Society had done a Google search, visited my website, read a few articles and from that decided that I just might be the sort of person that might be able to help.

The next step was for them to send me a wad of fact sheets detailing the particular difficulties that Parkinson's sufferers experience and conditions that any therapist or 'healer' [a word that I am not keen on] must be aware of and accommodate within any 'treatment'. Between the receipt of that wad of information sheets from the Parkinson's Society and my first visit with them, I had identified these below as being crucial to understand before any therapeutic Tai Chi could be effectively administered.

1. Communication: The condition can (due to lack of muscle control in the face - see "Muscle Cramps" below) create a misleading impression, leading incorrectly to being perceived of as being difficult, deaf, disinterested, drunk or unintelligent. As a consequence many people with Parkinson's feel very isolated.

2. Speech: Can be slurred. Monotonous with lack of variation and expression. Hoarse and tremulous. Disordered in rate or rhythm. Responses may be very slow. Leads to similar misunderstanding as those detailed above.

3. Freezing: About 30% of people suffering from Parkinson's will at some times experience "Freezing" - which can also lead to an increased risk of falling.
4. Muscle Cramps:

A. Dystonia: Movement disorder. Involuntary contraction of the muscles, causing spasm. Muscles become hard due to contraction without relaxing (not the same as "cramp").

B. Akinesia: Reduction in or absence of movement, muscular rigidity, "cramp". Muscles become hard and less elastic. In Parkinson's, most common in the feet. Spasm in the calf muscles can cause the toes to curl into a claw like position. In other cases the big toe hyper-extends - pointing upwards.

5. Smaller Muscles:
'A. 'Blepharospasm': Intermittent or sustained eyelid closure, caused by the contraction of the eyelid muscle. Aggravated by stress, looking up or down, reading, driving or bright lights (photophobia: abnormal intolerance to light).

B. Sialorrhoea: Drooling a.k.a. dribbling. Saliva pooling and trickling from the mouth. Not because more saliva is produced but because the tendency to swallow every now and again (even when not eating) is slowed down (See "4B. Akinesia" above).

Aggregated by poor (stooped) posture and inadequate lip seal. Everyone has difficulty in swallowing if they cannot close their lips tightly. You try! Try to swallow with your mouth open.
In some cases, simply improving the posture can alleviate Sialorrhoea.
Everyone would drool if the kept their head down and shoulders haunched for any length of time. It happens to us all when we fall asleep sitting up.

An apparently small and insignificant thing like swallowing and consequential eating problems can have a tremendous negative impact upon a person's quality of life at home, and in terms of their social life. Those with the problem can become anxious about swallowing anything for the fear of choking. Many eat less than normal and loose weight. They do not enjoy eating and feel embarrassed, or experience panic or anxiety attacks at mealtimes. All of this has a demoralising effect; because eating and drinking are essential parts of life and the social aspect is as important as the practical, biological function.