• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.

• nostril breathing
• asanas on the mat – child pose, knee to chest, spinal twist, and cat-cow
• heel drop exercise

This was the first session after intake at the beginning of June, we had to wait due to her wheelchair-bound son’s spinal surgery. I asked Karen for any changes, I observed she was relieved by his successful surgery.

I explained an overview of the plan for the next several weeks, I described the benefits of each practice, breathing practice, gentle stretch and meditation.

For centering, I led 5 minutes of guided breathing practice and asked her to observe her own breathing, suggesting deep slow breathing to calm the body and mind. This reminded her of the importance of deep/slow breathing.

Then we moved to physical movements, she chose to practice on the chair.
I began with gentle arm/shoulder movement and moved the modified sun salutation on the chair. I demonstrated spinal twist, knee to chest, cat-cow and child pose both chair and mat version, and explained to her the benefits of those especially for her lower back pain and improving her digestion. She expressed that her bone density is lowering so I recommended heel drop exercise to prevent osteoporosis.

I invited her to 15 minutes of yoga nidra practice to relax her body and mind.

Then, I explained to her my suggestion to establish daily meditation with animation, and she agreed to do so. She mentioned that she already has daily devotional reading with her mother at the care home at the end of the day.

This was the first session, nothing to compare with but I am sure she will make good progress over the next weeks.

I sent an email a day before to prepare for floor practice if she could, and she appeared on Zoom seated on the floor. She said it was a long time ago she sat on the floor because she could not do so due to the pain in her hip. With the hip replacement in 2022 and losing 60 lbs 6 months ago, she looked happier sitting on the floor. She described she could walk better, and could move up/down from the chair after the surgery. She is ready for the next step, reduce her lower back pain and maintain physical and mental well-being.

I will follow a care plan I created and encourage her to practice daily. I pay attention to her physical practice as she hasn’t done exercises for a long time.