#Improve Health Outcome

[dolivia]

Improve patient outcomes by using patient education and navigation strategies that work. Check out our blog on LinkedIn to see what is healthcare navigation and how can help you make better health decisions by improving your understanding.

[aeide-thea]

thinking abt how like. ~recovery~ sort of necessarily involves going against yr maladaptive instincts to some degree but also if yr bullying yrself into it out of, like, guilt or whatever (as opposed to some degree of actual positive hope) it doesn't really qualitatively feel any different than the dynamic that overrode yr autonomy and crushed yr spirit in the first place…

[publicheath]

Upcoming Public Health Conferences: A Look into 2025

[girlwithrituals]

GLOW UP GUIDE FOR 2025⠀

READ: On average, it takes more than 2 months before a new behavior becomes automatic — 66 days to be exact. And considering that 2025 is precisely these many days away, why not start with our glow up plan already?

Physical Glow Up-

BODY

— 5-10K steps a day.

— 7-8 hours of sleep.

— workout everyday for 1 hr atleast- yoga/stretching/pilates/cardio. a workout may take one hour, but your mood will be boosted for the next 12 hours.

— posture training.

— sunlight exposure after waking up for at least 10 minutes.

NUTRITION

— 2-3 liters of water every day.

— limit your caffeine intake.

— avoid sugars as much as you can.

— high protein diet, pre and probiotics.

— more fruits and veggies (+ green smoothies if you like).

— no junk/processed food/trans fat.

— no eating after 8 pm.

SKINCARE

— be clear on your skin type (oily, dry, combination, sensitive).

— once you're clear, use these accordingly- cleanser, toner, targeted serum, eye cream, moisturizer, sunscreen (≥50 spf).

— keep your bedding clean as well.

— no picking of skin on your lips, cuticle etc.

— gua sha to help improve blood circulation and lessen toxins.

— cold therapy may take three to five minutes of being uncomfortable, but your energy levels will be boosted for the rest of the day.

— remove makeup before you go to bed.

BODY CARE

— shower every day.

— exfoliate 2x a week.

— use body lotion (shea butter/aloe vera gel/coconut oil).

HAIR CARE

— wash hair 2-3x a week

— oil your scalp 2x a week, at least 3 hours before shampoo.

— hair mask 1x per week.

— never brush wet hair.

— use silk pillow case.

HYGIENE

— brush your teeth 2x a day, clean tongue and the roof of the mouth daily.

— floss daily.

— cut your nails 1x a week, never remove the cuticles.

— glycolic acid under arm for odor and discoloration.

— never use soap on your coochie.

Mental Glow Up-

MINDSET

— set clear goals- define and breakdown your aspirations.

— start your mornings with positive affirmations.

— surround yourself with uplifting content and people.

— be shamelessly selfish to your career and mental health, remove anyone or anything that doesn't align with your priorities and wellbeing.

— boost your brain health by these 4 neuroscience tools:

difficult first: start your day with the most difficult task (cortisol and dopamine are high in the body meaning that your body/mind is primed to work).

rest your eyes: introduce a micro-pause after learning by resting/closing your eyes - will help retain information better.

tomorrow's worries: write tomorrow's to-do list before bed as it is proven to be effective in helping you fall asleep.

find time to play: engage in low-stake play. can be anything you find fun but where the outcome doesn't matter (induces neuroplasticity + reduces stress).

MIND

— meditation might take as low as ten minutes, but your focus will be improved for the rest of the day.

— no social media after waking up and at least an hour before bed.

— keep aside 1 hr of time to read daily! reading a new book may take five hours, but you will keep the knowledge forever.

— journaling, gratitude.

— digital detox once a week or for 12 hours.

— limit unnecessary screentime, unfollow or cut off people you don't want to see.

JOURNALING

— choose a regular time each day to journal, making it a part of your routine.

— find a quiet, comfortable place free from distractions. light a candle if you want.

— allow your thoughts to flow without censoring or editing.

— write about your feelings and emotions to understand them better. write about things you are thankful for to boost your mood. write about your short-term and long-term goals. identify what triggers certain emotions or reactions

— set a timer for 5-10 minutes and write continuously during that time.

— reflect on both positive experiences and challenges.

— make lists, journal your thoughts on these questions.

— journal at night to clear your mind before bedtime, because emotions and thoughts lose their power once we acknowledge them.

— a gratitude practice may take five minutes, but your mindset will be shifted for the rest of the day.

AFFIRMATIONS

— customise affirmations to your needs.

Personal Life-

WEEKLY TASKS

— initiate small changes: begin with small, manageable tasks such as making your bed or cleaning your room every sunday.

— celebrate your success: reward yourself when you achieve your goals or have a consistently productive week. consider treats like buying flowers for yourself or watching your favorite show.

DAILY WORK

— set achievable goals: establish realistic goals for the day, week, or month ahead.

— track your progress.

— organise your work space, declutter your shelves etc.

— embrace the power of lists: keep a list of tasks to be done and their deadlines. this way, you start each day with a clear plan. to make it visually appealing and motivating, consider using productivity apps like evernote, habit tracker, or notion.

PRODUCTIVITY TIPS

— wake up early.

— plan ahead everything, do scheduling. you can use:

google calendar / notion / tasks .

— if the task takes less than 2 minutes to finish, do it immediately.

— countdown rule, if you are procrastinating, count 1-2-3-4-5 and jump.

— start slow, don't rush and try to do everything at one time.

— follow a proper routine, use app locks based on screentime.

— pomodoro technique, 25 min work, and 5 min break.

— schedule longer break times as well e.g 30 min nap.

[leanonmehomecareinc]

Home care can contribute to a care recipient’s health and well-being in myriad ways, encompassing both physical and emotional aspects. If this is something you would like to explore further, Lean On Me Home Care, Inc. has you covered!

[shubhragoyal]

Explore the significance of endoscopy in empowering fertility for couples - a comprehensive guide. Learn how it can visualize your dreams.

Do Visit: https://www.drshubhragoyal.com/welcome/blogs/visualizing-dreams-the-role-of-endoscopy-in-empowering-fertility-for-couples

[qr-sa]

This kind of depends on what type of homelessness we’re talking abt, because the demographics vary and in some places the research shows that they aren’t any better and they die at the same rate despite pouring in more money than anywhere else

Homelessness as an umbrella term is currently being used to harmful effect in many places by treating everyone in it the same way when they need different specialized support

Studies about how giving people money is more effective at stopping homelessness than anything else are never actually going to make conservatives support UBI or anything like that. Under capitalism, homelessness is necessary as a threat to keep workers in line; you're more likely to accept bad wages and exploitation and abuse when the alternative is being thrown out into the street.

Homelessness is the stick that keeps the mule moving. The person riding the mule knows that the stick hurts it, that's the entire point.

[peachtacular-home-health-care]

For vulnerable populations, including the elderly or the medically compromised, receiving compassionate care can go a long way toward fostering their health and wellness. Would you like to gain a better understanding as to why? Peachtacular Home Health Care, a premier provider of at home care, will be more than glad to lend you a hand.

[fatliberation]

I saw a comment on your blog that says 'the way you eat does not cause diabetes'...are you able to expand on that or provide a source I could read? I've been told by doctors that my pre-diabetes was due to weight gain because I get more hungry on my anti psychotics and I'd like to fact check what they've told me! Thank you so much!

Pre-diabetes was rejected as a diagnosis by the World Health Organization (although it is used by the US and UK) - the correct term for the condition is impaired glucose tolerance. Approximately 2% of people with "pre-diabetes" go on to develop diabetes per year. You heard that right - TWO PERCENT. Most diabetics actually skip the pre-diabetic phase.

There are currently no treatments for pre-diabetes besides intentional weight loss. (Hmm, that's convenient, right?) There has yet to be evidence that losing weight prevents progression from pre-diabetes to T2DM beyond a year. Interestingly, drug companies are trying to persuade the medical world to start treating patients earlier and earlier. They are using the term “pre-diabetes” to sell their drugs (including Wegovy, a weight-loss drug). Surgeons are using it to sell weight loss surgery. Everyone’s a winner, right? Not patients. Especially fat patients.

Check out these articles:

Prediabetes: The epidemic that never was, and shouldn’t be

The war on ‘prediabetes' could be a boon for pharma—but is it good medicine?

Also - I love what Dr. Asher Larmie @fatdoctorUK has to say about T2DM and insulin resistance, so here's one of their threads I pulled from Twitter:

1️⃣ You can't prevent insulin resistance. It's coded in your DNA. It may be impacted by your environment. Studies have shown it has nothing to do with your BMI.

2️⃣ The term "pre-diabetes" is a PR stunt. The correct term is impaired glucose tolerance (or impaired fasting glucose) which is sometimes referred to as intermittent hyperglycemia. It does not predict T2DM. It is best ignored and tested for every 3-5yrs.

3️⃣ there is no evidence that losing weight prevents diabetes. That's because you can't reverse insulin resistance. You can possibly postpone it by 2yrs? Furthermore there is evidence that those who are fat at the time of diagnosis fair much better than those who are thin.

4️⃣ Weight loss does not reverse diabetes in the VAST majority of people. Those that do reverse it are usually thinner with recent onset T2DM and a low A1c. Only a tiny minority can sustain that over 2yrs. Weight loss does not improve A1c levels beyond 2 yrs either.

5️⃣ Weight loss in T2DM does not improve macrovascular or microvascular health outcomes beyond 2 years. In fact, weight loss in diabetics is associated with increased mortality and morbidity (although it is not clear why). Weight cycling is known to impacts A1c levels.

6️⃣ Weight GAIN does NOT increase the risk of cardiovascular OR all causes mortality in diabetics. In fact, one might even go so far as to say that it's better to be fat and diabetic than to be thin and diabetic.

Dr. Larmie cites 18 peer reviewed journal articles (most from the last decade) that are included in their webinar on the subject, linked below.

[onlinpakistan]

Black Cobra Tablet in Pakistan

 Black cobra tablets in Pakistan is the active ingredient that has made Viagra famous worldwide and indispensable today. Millions of men around the world rely on “miracle pills” to deal with their erectile. It inhibits the enzyme phosphodiesterase-5 and thereby delays the degradation of cyclic guanine monophosphate (cGMP). Blood flows better through it to the penis and leads to the penis. Sildenafil causes more cGMP to be maintained in the bloodstream and increases muscle relaxation.

How do black cobra pills work

  It works by improving the blood circulation in the penile area so that you can develop a healthy and strong erection. Black Cobra tablets block enzymes that prevent proper blood flow to the penis and increase blood flow within the penis. The erection of the penis is caused by a strong shock that lasts for a long time. In this era of busy and fast paced life, the life of men becomes more and more difficult. The fast and busy life is affecting the health badly. Men face many health problems including psychological and sexual. Dysfunction is the most common sexual problem affecting 2 out of 3 men worldwide. Black cobra tablets price in Pakistan blocks this chemical and helps the blood vessels inside the penis to expand and improve blood circulation to the penis

Ingredients of Black Cobra Tablets?

 Black Cobra is a odd creation that contain energetic ingredient that have useful outcome. The most common ingredients used in Black Cobra tablets online in Pakistan are:

► Anhydrous dibasic orthophosphate

► Croscarmellose sodium

► Hypromellose

► Lactose, triacetin

► Magnesium stearate

► Microcrystalline Cellulose

► Sildenafil citrate

► Titanium dioxide

► FD & C Blue #2 Aluminum Lake

[reasoningdaily]

My former U.S. Track and Field teammate Tori Bowie, who was found dead in her home in Florida on May 2, of complications related to childbirth at 8 months pregnant, was a beautiful runner. She was effortless. At the Rio Olympics, I ran the second leg of the 4 x 100 relay. Tori was the anchor. When she got the baton, I remember thinking, “it’s over.” She just accelerated. When she crossed the finish line, I couldn’t wait to run over to her to celebrate. It was her first, and only, Olympic gold medal.

She also picked up a silver (in the 100-m) and bronze (200-m) in Brazil. The next year, at the 2017 World Championships in London, Tori won the 100-m title, earning the title of “world’s fastest woman.” Tori started out as a long jumper. So seeing her thrive as a sprinter was a huge deal. She was just such a bright light, and people were getting to see that.

Tori grew up in Mississippi and had this huge Southern accent. She didn’t take herself too seriously. You felt this sense of ease when you were around her. I last saw her in early 2021, in San Diego, where she was training. She gave me the biggest hug; something about her spirit was just very, very sweet. I felt her sweetness come over me that day.

Tori was 32 when she died. According to the autopsy, possible complications contributing to Bowie’s death included respiratory distress and eclampsia—seizures brought on by preeclampsia, a high blood pressure disorder that can occur during pregnancy. I developed preeclampsia during my pregnancy with my daughter Camryn, who was born in November 2018. The doctors sent me to the hospital, where I would deliver Camryn during an emergency C-section, at 32 weeks. I was unsure if I was going to make it. If I was ever going to hold my precious daughter.

Like so many Black women, I was unaware of the risks I faced while pregnant. According to the CDC, in 2021 the maternal mortality rate for Black women was 2.6 times the rate for white women. About five days before I gave birth to Camryn, I was having Thanksgiving dinner with my family. I mentioned that my feet were swollen. As we went around the table, the women shared their experiences during pregnancy. My cousin said she also had swollen feet. My mom didn’t. Not once did someone say, ‘oh, well, that’s one of the indicators of preeclampsia.’ None of us knew. When I became pregnant, my doctor didn’t sit me down and tell me, ‘these are things that you should look for in your pregnancy, because you are at a greater risk to experience these complications.’

That needs to change, now, especially in light of Tori’s tragic passing. Awareness is huge. Serena Williams had near-death complications during her pregnancy. Beyoncé developed preeclampsia. I hate that it takes Tori’s situation to put this back on the map and to get people to pay attention to it. But oftentimes, we need that wake-up call.

The medical community must do its part. There are so many stories of women dying who haven’t been heard. Doctors really need to hear the pain of Black women.

Luckily, there’s hope on several fronts. Congress has introduced the Momnibus Act, a package of 13 bills crafted to eliminate racial disparities in maternal health and improve outcomes across the board. California passed Momnibus legislation back in 2021. These laws make critical investments in areas like housing, nutrition, and transportation for underserved communities. Further, several pharmaceutical companies are making advances on early detection and treatment of preeclampsia.

Three gold medalists from that 4 x 100 relay team in Rio set out to become mothers. All three of us—all Black women—had serious complications. Tianna Madison has shared that she went into labor at 26 weeks and entered the hospital “with my medical advance directive AND my will.” Tori passed away. We’re dealing with a Black Maternal Health crisis. Here you have three Olympic champions, and we’re still at risk.

I would love to have another child. That’s something that I know for sure. But will I be here to raise that child? That’s a very real concern. And that’s a terrifying thing. This is America, in 2023, and Black women are dying while giving birth. It’s absurd.

I’m hopeful that things can get better. I’m hopeful that Tori, who stood on the podium at Rio, gold around her neck and sweetness in her soul, won’t die in vain.

—as told to Sean Gregory

[aleatoryw]

i've started looking at weight and health the way i look at class and income and it really puts a lot of things into a new perspective.

let me explain: in america at least, the lower class have significantly worse health outcomes, even when accounting for other factors. just being poor is enough to make your overall health worse. we don't know that being fat makes your health directly worse, like the data just isn't there, but for a moment, pretend it does.

imagine going to the doctor with a health problem and the doctor looking at your chart and saying well, this problem will be less severe if you go up an income bracket. have you thought about becoming rich? it would really help. start by saving a little money every month.

ridiculous, right?? very few people successfully go from working class to rich, it just doesn't happen on a large scale in society. maybe for a time you pick up some overtime hours, spend a little beyond your means, and appear rich. but eventually you burn out, your car needs to be repaired, and you return to being working class.

we do have this data: only some people can successfully lose large amounts of weight, and only a tiny fraction of people who lose that weight actually keep it off for more than a year. telling people to lose weight for their health is just absurd because they almost certainly can't do it any more than they can double their income for their health.

and yet i see it everywhere. a little poster in my work breakroom tells me to improve my blood pressure by losing weight! a psa on the radio says you need to take care of your heart by losing weight! we can't even conclusively prove that weight is the cause rather than just correlated with a lot of these problems but here it is offered anyway: have you tried being rich?

[ms-demeanor]

You posted about adhd and I was hoping to follow up to clarify something. I’ve explained to my partner a million times about how the borderline-hoarding mess of his space is very mentally draining to me, and he understands but we’ve both essentially accepted he won’t clean his mess because he can’t because of his adhd. You’re saying he’s actually being a shit head?

This isn't necessarily an issue of him being a shithead, but it also isn't a sustainable situation. It's not good for you and there's a level of clutter that's probably not good for him either.

Large bastard is a lot more clutter-y than I am. The solution we've come to is trying to keep our messes at least isolated from one another; he can have his messes and I can have mine, but he can have those messes in his spaces, not all over the place. Sometimes those messes migrate, and that's when it's important for him to make the effort to rein them in rather than trying and failing to make a daily effort to keep our entire shared space tidy.

I think when you say "we've both essentially accepted he won't clean his mess" what I'm hearing is resignation; you're not happy about this but you don't know what to do so you've thrown up your hands and he feels helpless and unsure of what to do to improve the situation. This is the kind of "it's fine" that isn't really fine.

I think it would be worthwhile for you to each separately think about the mess and talk about it together. Are there areas that YOU *need* to have not-messy? Both for utility and your mental health? Are there areas where you can tolerate more mess than otherwise? Are there areas that are going to be harder for him to keep the mess out of than others? Are there things he doesn't *know* about cleaning up the mess?

I'm obviously a big "communication communication communication" person so I'm going to recommend a lot of talking about stuff, which is probably going to mean a lot of thinking about and interrogating stuff. I'm going to say "talk to him about why the mess bothers you" which means you also have to really articulate to yourself why the mess bothers you (for instance I'm not actually *bothered* by a messy kitchen, but I know it's going to reflect badly on us - and me specifically b/c of presumed gender roles - if someone pops by and the kitchen is a disaster, AND a messy kitchen is going to be harder to use). Genuinely, sometimes knowing *why* something is a problem might make it easier for someone with ADHD to do something. And it's not that he doesn't care that it upsets you, it's just that "Oh if I don't wash my breakfast dishes Anon won't have clear counterspace to make lunch" might be stickier in his brain (and less hard to look at emotionally) than "this thing I forget to do upsets my partner so I should do it."

For the record, I think that people with ADHD should read up on Demand Avoidance and see if it might explain some of the issues that they have in their day-to-day life; I've seen some really unfortunate situations with friends where trying to do things that their partner needed became the subject of demand avoidance. *I* have experienced negative outcomes of demand avoidance. The solution to that, however, isn't to stop making attempts to do the thing OR to simply try harder to do as they're asked/told (which reinforces the demand), it's to work on setting up a situation where the partners' needs are not interpreted as a demand. This is fuck-off difficult and requires a lot of patience and care and many attempts to succeed and will be different for each person and relationship.

(Also for the record demand avoidance isn't *super* strongly linked to ADHD and it's not a definitive symptom; like Rejection Sensitive Dysphoria, it is something that occurs in some number of people with ADHD and can be a useful lens through which to examine various behaviors; you don't need to have DA or RSD to have ADHD, and having DA or RSD also doesn't invalidate your diagnosis; they're symptoms. For me, DA often feels like "if I don't look at it, it can't get me" - If I ignore all the messages I've got they aren't real and don't have real consequences so I'll just ignore my texts. If I don't look at the vendor email about the order, the problem with the order isn't real and it won't get added to my task list. If I don't look at the requests in my inbox I can't let people down when I don't do them. It's a self-protective coping mechanism but it's *maladaptive* and I can't just ignore the vendor email or all my texts. I need to work on a way of doing the stuff that I'm avoiding in a way that makes it less stressful and doesn't hurt the people relying on me. That takes a lot of effort, personal insight, trial and error, and )

But before I dive into specifics I want to be really really clear about one thing: sometimes people are simply incompatible. Sometimes one person has such a low tolerance for "mess" and the other person has such a high threshold for "mess" that it can't be reconciled. It sucks that this can end up being a thing that people break up over, but it is MUCH better to acknowledge incompatibility as early as possible instead of spending years and years building resentment.

There used to be a great forum called MiL's Anonymous that I spent a lot of time on. It had a lot of people in a lot of difficult situations struggling to get by and hold their relationships together. The question that was used as a litmus test to approach each situation was simple: If you knew today that everything about living with this person would be the same in five years, would you stay?

Because you can't control your partner. You can't control the future. You can only control yourself and your proximity to situations that are harmful to you. If you knew, 100%, that things wouldn't get better in five years, would you be okay with staying in this relationship? If the answer is "no," then that's that. Don't worry about questions of whether or not your boyfriend is a shithead, start the process of ending the relationship because there's a good chance the situation is going to be exactly the same in five years.

If the answer is "yes," and you'd stay in the relationship regardless of whether or not things changed, then it's time to take actions to improve your life within the context of the relationship.

(No judgement on that yes or no, btw. If you would hate living like this for another five years, and you would feel like you'd wasted your time and hadn't done the things you wanted to with your life, get out. Bail. Go. It will be better for you and better for your partner if you split instead of spending half a decade building resentments and and problems that you'll have to spend another half a decade healing from.)

Also, a note: you describe your boyfriend's mess as borderline hoarding - is the issue *mess* or is the issue *clutter*? I have friends who are very tidy, but whose homes are very cluttered. They like things, they have many things, they keep many things around, but their houses are always clean and well-dusted and orderly, just with a tremendous amount of *stuff.* I am addressing all of this as though the issue is mess, not clutter. If your boyfriend's situation is clutter (the space is busy and packed with things but it is functional and clean) and your issue isn't with *mess* (things out of place, things not having a place, things that need to be cleaned up gathering in stacks, falling behind on regular chores like laundry and dishes and taking out the trash) then you definitely need to assess whether or not you are compatible.

For instance here's a room that is messy but not cluttered compared to a room that is cluttered but not messy:

That first room is a *mess* but it would be very easy to clean up in under an hour. The second room is fairly tidy, but would take significant effort to pare down and declutter. BOTH of these can be difficult to live with but the second one is not dangerous or threatening to anyone's health. (The second one is QUITE cluttered and if every room in a house looks like this it can be overwhelming to live with; this is actually harder to deal with in a relationship than the first one in a lot of ways. I don't have a lot of advice for what to do if your partner is a high degree of tidy-but-cluttered because I don't actually think it's a problem or wrong to have thousands of books or bins full of lego or a million kitchen appliances as long as you have the space and can keep it safe and well-maintained; this is a really significant compatibility issue)

Okay, all that out of the way, here's the hard work.

Talk about this shit

Talk to your partner and define "mess." Make sure you are on the same page about what you mean when you're talking about what a messy room looks like versus what a tidy room looks like. Gather reference pictures. DRAW reference pictures.

Explain not just that the mess upsets you, but *why* and *how* it upsets you. In this context don't think of it as your boyfriend's mess, think of it as an unpleasant roommate. Discuss this using "I-statements". "When I have to pick up laundry all over the apartment, I feel like a parent more than a partner." "When there are piles of miniatures all over the table, I feel like I don't have anywhere to do things I'm interested in." "When there are dishes in the sink, I feel frustrated because I have to clean before I can feed myself."

Discuss, frankly and openly, whether he knows how to clean. I'm not trying to make excuses for him here but a lot of people with ADHD have a lot of stress and avoidance around cleaning because they spent a lot of time getting yelled at for not knowing how to clean properly.

Discuss your needs, be firm about what you require but willing to compromise. You *need* some spaces to be clean, and some spaces may be harder for him to keep clean than others. It may be MUCH harder for him to keep a bedroom tidy than it is to keep a kitchen tidy; if you need a clean and empty bedroom with everything put away and he simply cannot do that, that is a compatibility issue. But perhaps you need *your* side of the bedroom to be very orderly and can tolerate a moderate level of mess and clutter on his side. Maybe you're really really bothered by a messy kitchen, but it doesn't bug you if the dining table is covered with projects and papers. Figure out something more workable than "his mess goes everywhere and i live with it because he's incapable of cleaning" because he probably is not incapable of cleaning and you deserve to have places in your home that are comfortable for you.

Reduce friction for cleaning

Sometimes the problem isn't cleaning, the problem is the many many steps before cleaning, or not knowing where something should go when you are done cleaning. One of the absolute best things I've done for myself for cleaning my space is getting a broom holder and mounting the broom to the wall. Sweeping is now essentially thoughtless. I don't have to find the broom or pull it out from a pile of fans or go scrounging around for a dustpan it's right there on the wall, frictionless. So here are some ways to reduce the barriers to cleaning:

Make sure you and your partner both know how to use your cleaning supplies and know where those supplies are. When I switched dishwasher soap I had to re-show Large Bastard where I was storing it and how it was used, because to him what happened was the dishwasher tabs just vanished one day and he didn't know what I was putting in the machine or the process I used. He sometimes puts tools away in places that I can't see (he's more than a foot taller than me) so sometimes I can't get started on a maintenance project until he shows me where he put the battery pack for the drill.

Consider making a how-to chart to or having him make a how-to chart to keep someplace accessible so he can reference it while cleaning. Goblin.Tools Magic ToDo is great for this. Basically a lot of the time people with ADHD have trouble knowing what to do from step to step even if they've done something before, so having a step by step guide can make it easier (I have notebooks full of step-by-step guides for everything from paying for my tuition to removing licenses for my customers to weeding my yard)

Remove obstacles; don't keep cleaning chemicals in the garage in a box that's behind a stack of parts, keep them in the room you'll be cleaning. Don't keep the cleaning supplies that you use to clean the bathroom in the kitchen. Sometimes this means buying two bottles of bleach solution and two scrubbers and two sets of cleaning gloves but having fewer steps (fetch the windex, fetch the paper towels, fetch the gloves) is often the key to getting things done (open under-sink cabinet and grab windex, gloves, and paper towels that are there instead of in the kitchen).

This sort of overlaps with the next category, which is:

Create Dump Zones

One thing that I've found that seems very different between people with ADHD cleaning and neurotypical people cleaning is that neurotypical people are good at getting to a point where the cleaning is "done." They have checked off their tasks and they have finished and it is over. There are *SOME* chores that are like this (taking out the trash is a binary state, the trash has been taken out or it has not) and some chores are perpetual (horrid cursed dishes) but I think with people with ADHD, some chores that are binary for neurotypicals are actually perpetual chores. For instance "clean off the counter" is not a one and done for me. "Clean off the counter" may involve a three day reorganization project. "Clean off the counter" does not mean "wipe down the tile and put dishes away" it means assessing whether or not I need to make vegetable stock and bleaching three tea containers and reconsidering whether or not the sharps container should live somewhere else and going through the mail and figuring out what needs to be responded to and taking out the recycling and on and on and on.

We have had company at the house for the last two weeks, so I asked large bastard to clean off the dining room table, which is largely a project zone for him. Cleaning off the dining room table meant putting away his meds (and since he's a transplant patient that involves a 30 gallon rubbermade tote), throwing away some trash, and totally reorganizing his workshop. It also incidentally involved picking up a table from facebook marketplace and moving my plants, which has now involved moving my former plant rack outside (moving buckets, finding and organizing planters and gardening tools) and taking the former table to the thrift store (not done yet) and cleaning the rug that was under the former table. So "either the table is clean, or it isn't" isn't really true for us.

HOWEVER "hang on we can't eat until the table is clear so let's drive to Pico Rivera to get that console table right now" isn't a workable plan, so you create dumpzones as areas of holding between the start and the finish of the chore.

A dump zone can be a laundry basket. It can be a craft bin. It can be a back room or under your bed. It is a place to put things that you are going to deal with later because if you deal with them now it is going to derail the thing you are actually trying to do, which is set the table for dinner.

Dump zones are vital to cleaning with ADHD and I recommend them for day-to-day cleaning as well. The day-to-day dump zones might be more for you than for your boyfriend. For instance, Large Bastard works with bullets and he sheds bullets all over the house. I used to get stressed when I found bullets when I was cleaning because are these work bullets? Are these recreational bullets? Are they in testing? Do they need to be pulled? Do they go in the workshop or the office or the garage or does he need these today so they have to stay on the counter? And the answer now is "that's not my problem naughty bullets go in the jar." Which is perfectly sensible because he gets to say "mystery yarn goes in the bin" and "art supplies go in the bucket."

I feel helpless when cleaning a lot of the time. I'm frustrated and lost and I don't know where stuff goes and everything I pick up spins off into three projects in my head and every step feels like a wall to scale. Dump zones help me with that when there's pressure or a reason for cleaning beyond day to day home maintenance. People are coming over? The bedroom is a dump zone, I'll deal with that later. I'm just cleaning up because I need to? Okay I can find a permanent home for this new dish soap.

AS A VERY IMPORTANT COROLLARY TO THIS:

Active projects do not go in dump zones while you or your partner are cleaning. This may mean designating a project sanctuary area like a corner of the table or one particular chair in your main room where a project can be placed so as not to be disturbed. (if my current crochet project ends up in the yarn bin, that may mean that I don't pick the project up for another three months, it lives on the windowsill behind the couch because that's where it'll get worked on)

Do not put things away for your partner, put them in the dump zone for your partner. Your partner has to be the one to put their own stuff away in a way that works for them. I tend to find that this naturally puts a limit on the time stuff sits in the dump zone, because eventually you'll go "hey where's my thing?" and will put stuff away. If that doesn't happen, it's still generally better to have stuff in a dump zone than all over the home.

Do not decide you know what things go together from your partner's stuff and try to "put like things together." The neurotypical urge to put like things together is the mindkiller(j/k). You do not know which things are "similar" in your partner's organization schema and attempting to organize things on your own is going to end up with all of the things "organized" being functionally lost forever from your partner's perspective. Large Bastard's mom would do this and it was infuriating, she'd say "oh I put all the electronics stuff in one box" and she would mean soldering irons, transistors, ham radios, HDMI cables, and cellphone chargers. We are *still* going through boxes of stuff that she "tidied up" when he was hospitalized in 2020 and 2021.

To prevent the need for quite so many dump zones over time, you can work on setting up landing zones and "homes" for projects and tools.

Landing Zones

Landing zones are places where things go when you come inside from doing various things. Sometimes your landing zone only needs to be a tray for your wallet and keys, sometimes your landing zone needs to be a place to take off muddy boots and put a trowel and gloves down before you shower.

To make an effective landing zone, consider what behaviors you're trying to minimize and whether the people using it are ACTUALLY going to use it. For instance I was tired of the corner of my hearth getting cluttered with random junk so I hung up some hooks and put a shelf and a basket there and it became a really effective landing zone for my bag and keys and the mail, but it was VERY ineffective for Large Bastard because it's by a door that isn't the primary door he uses to enter the house. As a result I always know where my keys and bag are but he has trouble finding his keys and wallet. He tends to enter the house through our bedroom and has an overloaded valet next to the door and that's usually where his wallet ends up. Mounting a shelf to the wall above the valet and putting a basket and a hook on it will be a better place for his stuff to land. It's not that he's not using the first zone because he doesn't know that it's there, or because he doesn't care about lost time when I'm searching for my car keys after he borrows them, he's not using it because it's not by the door he uses. That's all.

I have a landing space for when I come in for gardening that's different than the one when I come in from grocery shopping. I have a landing space for when I walk into the dining room instead of the kitchen when I get home.

Landing spaces prevent stuff from piling up all over the place because they are a limited functional space that should be used frequently. Mail ONLY goes in the landing zone. If you have mystery mail or if you're not sure it's safe to toss, you put it in the landing zone. You can't let the mail get piled up too high or you won't have a space for your keys. You can't let the change in your wallet tray get too deep or your wallet is going to slide off, etc., but you also don't just put change on the coffee table or your nightstand because the landing zone is right there.

Homes for items are just what they sound like. They're the place the item goes. It lives there. My meds live on my nightstand. You would not believe how poorly I did with taking my meds on my vacation because they weren't on my nightstand. A while back large bastard lost one of his sets of sorted meds and we tore the house up looking for them because he couldn't find them in his nightstand, which is where they live. *I* found them in his nightstand because I emptied out the entire top drawer (he had only looked on the top layer) and found them underneath a radio and a hammock. Even though they were *hidden* they were in their home, so they were findable. I recently needed ink for an art class. Art supplies live in a dresser by my desk. Ink lives in the art bin or the top left drawer. The ink was not in either of these places (it was on a cabinet in the dining room behind a teacup) so it took me weeks to find it.

Sometimes the reason that ADHD spaces are so messy is because objects have been assigned homes in places that are visible and if they get moved they get lost. This is a genuinely difficult problem that requires a lot of effort to solve and can involve a lot of trial and error for creating a tidy living space. For some people, open shelving and visible storage might be a good solution. For some people, assigning a VERY clear home and inculcating that location by habit is the only way to clean up a space. For some people one very cluttered corner to at least isolate the chaos does the trick (for me and large bastard open shelving doesn't work because anything in one place for too long becomes invisible; that means that I rely on assigning things homes and large bastard relies on having contained chaos and a general idea of where to search but what that DOES NOT mean is that he is clean or tidy. His spaces look like an explosion. But he can mostly find his stuff and do what he needs to do and as long as that's limited to specific places in shared spaces I can live with it; the dining room table can be a disaster, the kitchen cannot).

People organize things differently. It often takes a while for neurotypical adults to settle into an organizational style that works for them and ADHD adults may need to settle into a new system every few months for it to continue working. The cleanup and declutter is most likely going to be a permanent project that is always going to demand some level of attention from everyone in a shared space, but "my ADHD means I can't do it" is not really going to fly. Maybe his ADHD means that he can't keep his space tidy, but it doesn't mean you can't move stuff from shared spaces into dump zones or that he can't do stuff around the house.

If he's insisting that his ADHD means that he can't clean it is possible that he's not being a shithead, he just feels helpless and doesn't know where to start and has adopted the belief that he's a useless piece of shit who can't even keep a tidy space like a grownup because he's internalized a lot of shitty attitudes (hello, my internal monologue about keeping a clean house). But it's also possible that he's just being a shithead.

It's something that's worthwhile to investigate with him. If he's unwilling to make an attempt, then he's being a shithead.

It is also not your responsibility to rehabilitate another person. If he wants to clean and it's something he feels bad about and needs some help and support with the way that someone might need help or support for learning to use a mobility aid, that is fine but you don't have to be the one who gives him that support if it's detrimental to your health, and you don't have to be the one to teach him that stuff if it's not something you're capable of. And if he is NOT interested in working on making your shared living space more accessible for you, that is not your suitcase to unpack and you just have to ask yourself the question from the start: would I stay with this person if I knew the situation was never going to change?

IDK, I'm sure a lot of this reads like "anon you must take on the emotional labor of training your partner to be an adult" but it's really meant to be more of a way of assessing yourself and your relationship. If you created landing zones do you think he'd use them? Would he get angry if you assigned a laundry basket as a dump zone for his stuff while you tidy the living room? Is living with him long-term going to be comfortable for you if nothing changes? Do you have enough of a shared definition of "mess" that you're at least in the ballpark for what counts as a clean house?

anyway good luck, and a reminder to folks that I'm compiling a bunch of adhd resources and other information on my personal website, ms-demeanor.com. It's coming along slowly but it will eventually include stuff like ADHD cleaning tips and how to tackle a hoard, so maybe keep your eye on that space.