Overall, the client is healthy and active. Osteoarthritis in her fingers causes her pain at times. She practices yoga three times a week and takes a Silver Sneakers exercise class twice a week. She is conscious of her diet and follows a Mediterranean diet for the most part. Gardening is a passion of hers. In the warmer weather she grows plants from seeds and enjoys tending to them in the gardens surrounding her home.

Vata dosha with a tendency toward a rajasic mind. When she slows down, she tends to collapse into kapha dosha, possibly from overactivity. Client is active and alert.

The client has a positive attitude. She consciously surrounds herself with people to share a positive outlook on life. Her family is close knit. She is strongly engaged with her two daughters and her extended family. The loss of her husband and his prolonged degeneration due to dementia have deeply impacted her life. Her grief is exhibited by expressing tender memories and admiration for her husband and the life they shared.

She attends weekly Sunday services at the church she has attended since childhood. Her church community is close and includes her in many social events outside of worship services.
 

The client loves playing Mahjong which she does with a consistent group of friends each week. She enjoys reading and traveling. Her positive outlook is reflected in her sense of self which is accepting, reflective, and resilient.

o Adele, Deborah, The Yamas & Niyamas, Brahmacharya/moderation. Moving toward the goal of living in nonexcess, overactivity in this client’s case. Some reflection about what may be underlying the overactivity in her life.
o Wolfelt, Alan D. PhD, Understanding Your Grief, The Essential Touchstones for Finding Hope and Healing Your Heart. Discuss touchstone of telling your story and practicing mindfulness as a means of “soothing and deepening yourself physically, emotionally, socially, and spiritually.”

o Include exercise guidelines and/or contraindications where relevant. Limit spinal flexion due to osteopenia. Slow transitions from floor to standing and vice versa. Emphasize mental focus when practicing standing balance.
o Hand and finger exercises: Hand yoga. By Ann Swanson, yoga therapist and author of Science of Yoga.
 https://www.youtube.com/watch?app=desktop&v=LehkTdGXxjc To increase mobility in wrists and finger joints.
o Upper body nerve flossing.
 https://www.youtube.com/watch?v=t1hLZj_9DTE Selected ulnar and accessary nerve flossing practices to ease restrictions in lateral neck bends and cervical spine rotation.

None at this time.

• 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.