Taking the road less travelled

roads less travelled-new horizons  

I was thinking about quality of life the other day – what it is and what it means for residents, directors and managers of Senior Housing communities. My guess is that the goal of every Senior Housing director and manager is to enhance and improve the quality of life of their residents – but while they all might agree with that goal – there may not be such agreement on what Quality of Life actually is – or how to achieve it in their facility.

A common approach to this has been to make the living environment as comfortable and pleasant looking as possible – nice décor, fine dining, good quality carpets, attractive drapes etc. In addition to this, what could be considered a more direct approach to quality of life improvement – ‘Universal Design’ – has made an appearance in some areas of Senior Housing. This is a concept and philosophy that encourages the design of products and environments aimed at making it possible for older adult to live, if not more independently, then at least more comfortably or conveniently.

A whole range of individuals and professions are involved in this concept: architects, interior designers, builders, community planners etc. The primary driving force here is ‘accessibility’ something considered an ever more important factor to seniors as they age. After all what could be more important than being able to negotiate stairs, get up out of chairs, cross the road, open your own jar of pickles etc. Everyday activities of daily living (ADL) such as these that used to be taken for granted become, for the great majority of seniors, increasingly inaccessible challenges to an independent lifestyleWhile the “3 D’s” of Senior Housing (Décor, Dining and Design), together with a concern for ‘accessiblity’ have tended to be in the forefront of the quest for increased resident quality of life, I have observed that the implementation of these approaches mainly emanate from a ‘deficit-based’ approach that is concerned with (and concerned about) the ‘inevitable decline’ aspect of aging. The two main guiding principles here seem to be “Let’s make it comfortable for these old people by making things look nice (and taste nice)” and also “Lets make it easier for these old people to do things by making those things easier to use”

I was reading an article recently posted on the GeroDesign page of one of my LinkedIn Groups http://www.linkedin.com/groups?gid=140635. It was written by an architect for the online journal ‘Design for Aging’ who strongly advocated the application of the ‘Form Follows Function’ design principle for senior housing. This principle states that the design or shape of a building or object should be primarily based upon its intended function or purpose. The article listed a range of design suggestions that would reduce necessary functional effort for residents in a variety of ADL and also enhance the accessibility of the building itself: low rise curbs, wider doors, carpet pile height, non-slip floors, ramps, accessible light switch, window blinds, lamps, kitchen appliances, telephones etc. While this was an excellent and comprehensive article which made some very important points, what struck me very powerfully was that the design philosophy so eloquently stated in this article was predicated on a “Form follows (the acceptance of a declining) Function”. Everything was designed to be ‘accessible’ with far less functional effort required; easier to use, easier to navigate, easier to reach, easier to walk etc

This is “The Road more travelled” in many older adult communities

I am not arguing against this approach by any means, my point is that by focusing solely on passive, extrinsic approaches (The 3D’s and ‘accessibility’) through the prism of a ‘deficit based’ approach we cannot help but give credence to the negativity associated with getting older (e.g. the ‘declining years’). This, if they but knew it, makes the task far more difficult for Senior Housing directors ‘to enhance and improve the quality of life of their residents’.

While decline with aging might be inevitable in physiological terms, the way we think about and feel about and respond to this decline is inextricably tied to the way we think about and feel about ourselves, our physical capacities and so our quality of life. This applies as much to the operating philosophies of Senior Housing as it does to the individuals who live in these communities

I believe it is time to ‘think different’ about aging in older adult communities. Rather than ‘passive, extrinsic, deficit-based’ let’s think about  ‘active, intrinsic, asset-based’

Such an approach would still predominantly involve issues of accessibility, i.e. the ‘Form and Function’ of the environment etc, but would also include and address the ‘Form and Function’ of the individual! In other words, as well as designing approaches that enable ADL to be safely performed with less functional effort, let us also consider designing approaches that enable older adults themselves to safely exert greater functional effort! After all, as Etta Clark has famously said “Growing Old is Not for Sissies!” http://www.amazon.com/Growing-Old-Not-Sissies-Portraits/dp/0876544782

We can do this by adopting a comprehensive and evidence-based wellness approach which advocates and supports ‘Successful Aging’

This is “The Road less travelled” in many older adult communities

‘Successful Aging’ is not just a phrase for your Marketing or PR department – but like ‘Wellness’ it is a dynamic and purposeful idea – a journey rather than a destination – a process rather than a product – an intention rather than a wish – a commitment rather than a ‘maybe’ – and an ‘I will’ rather than an ‘I should’.

You can watch life’s quality flow past you – or you can immerse yourself in it fully – and actively – to the greatest extent of your abilities. You can let life happen to you – or you can make things happen in your life by taking a pro-active and purposeful part in it. I will be writing more about this in future posts but here are some final thoughts:

Senior Housing managers and program directors can provide a pathway to ‘Successful Aging’ by incorporating approaches to wellness that go beyond “The 3 D’s” and focus on developing an active, and pro-active, wellness culture that becomes part of the fabric of the building.

We have seen the potential of this approach through our highly successful STRIVE strength and wellness program http://www.strivealive.com/access . We have seen the joy in the lives of older adults who are newly able to get out of a chair unaided, to take the stairs – even to forgo their walker and reduce their insulin medication! We have testimonials from older adults who tell us that they have regained the strength they remember from more than 2 decades ago – and how much this has meant to them in their lives – and in the lives of their loved one. Being strong for their health has not only improved their quality of life – it has changed their life! http://www.strivealive.com/access/index.php?c=stories

Physical independence is at the heart and soul of quality of life. One can passively experience life with comforts and physical aids but only physical engagement with life can enable us to fully engage with its quality. To paraphrase the poetry of Robert Frost

Two roads diverged … and I -

I took the one less traveled by,

And that has made all the difference.

                                                       Robert Frost: The Road Not Taken, 1920

The wellness message for Program Managers and Decision Makers in Senior Housing communities therefore is …

Take the road less travelled – it will make all the difference

With a little help from your friends

surround yourself with friends

On the Beatles legendary ‘Sergeant Pepper’ Album, Ringo sings …

I get by with a little help from my friends …

Leaving to one side for the moment the quality of his singing voice (or lack thereof) I am here to tell you that John, Paul George and Ringo may have hit on something with that sentiment. It appears that ‘The Fab Four’ were way ahead of their time with their philosophy regarding the relationship between friendship, health and even longevity! The reason I make this bold statement (and an even bolder attempt at singing a few bars of this song while waiting in line at Starbucks) was because I spotted something in the newspaper I picked up which caught my attention.

An article in the Tuesday April 21^st issue of Science Times (The New York Times) reported on the rapidly increasing amount of research into the importance of friendships and social networks to overall health. Here’s the lead paragraph in full

In the quest for better health, many people turn to doctors, self-help books or herbal supplements. But they overlook a powerful weapon that could help them fight illness and depression, speed recovery, slow aging and prolong life: their friends. 

The article cites an Australian study which reported that older people with a large circle of friends were “… 22 percent less likely to die” during the study period than those with fewer friends. Also a large US study that reported ” … an increase of almost 60% in the risk of obesity among people whose friends had gained weight”. In the June 17, 2008 issue of the American Journal of Public Health, a  Harvard research team followed 16,000 men and women over age 50 for six years. The results showed a clear connection between being socially active and involved, and preserving memory and cognitive abilities.  There is increasing evidence to suggest that friendship has an even greater effect on health than a spouse or family member.

 

This is all highly interesting and valuable information, and more research of course will bring even greater clarity to these connections. In the meantime however I want to comment on the way this kind of research is conducted and the way it is reported. In my ongoing quest of pursuing an ‘assett-based’ approach to health and wellness, I continually find that ‘benefits’ are almost always reported as ‘reductions in risk’ - or as I have written in previous posts ‘Getting less bad’ (See http://telosity.wordpress.com/2008/01/22/getting-less-bad/).

 

Take the results of the Australian study reported above. The other way of viewing these results is that older people with larger circles of friends were (some percentage)  more likely to live  – and so continue to enjoy life. Now, which would you prefer to experience – being less likely to die – or being more likely to live? Of course it’s all in the way you think about it, but for me, positive is always preferable to negative. I’d rather ‘get more good’  than ‘get less bad’.  I view the US study in the same way. What about the group who had friends that were of normal weight? What positive things happened to them? What is the message being sent when research results are reported in this way? Avoid your friends, or avoid making friends if they are overweight? The point I am trying to make here is that there are many benefits to be gained from building and keeping friendships, perhaps more than we ever realized. More importantly these benefits are positive experiences, best ‘recieved’  (and most effectively recieved) when expressed in a positive fashion. While the research on friendship is still embryonic, there is a large, and still growing body of research in ‘Positive Psychology’ that confirms the relationship between positivity and health. So I say - take this to heart and choose to be ‘positively good’!

positively good!

Speaking of ‘positively good’ I wanted to add something else that struck me even more powerfully as I was reading this article. I was really taken by the fact that I have actually seen and experienced – in real life – the positive friendship- and socially- inspired benefits that the research in this article talks about through my involvement with STRIVE – the group-based strength and wellness program conducted by my other company The STRIVE Wellness Corporation (www.strivealive.com)

STRIVE is a fun, socially active, group strength training and wellness program, specifically designed for older adults. STRIVE uniquely combines an ongoing, comprehensive wellness assessment with personalized, expert attention, from highly qualified professionals. STRIVE members experience dramatic improvements not only in their functional fitness but also in their physical, social and mental health. Regular STRIVE members have a positively infectious outlook on life and approach getting older with a youthful enthusiasm. But STRIVE isn’t just a place to get fit… it’s a place to make new friends, share experiences, find support, dream new dreams…

 

Thats what we say about STRIVE – and that’s what we have discovered with STRIVE. You can read and view testimonials from dozens of participants supporting these claims @  http://www.strivealive.com/access/?c=stories. As far as the research in the above newspaper article is concerned, very often life preceeds research – or maybe it’s more appropriate to say that life sometimes prompts research to investigate things that people have ‘known’ for years!

To paraphrase the newspaper quote above

In the quest for better health, many older adults turn to doctors, self-help books or herbal supplements. But some are also discovering  a powerful weapon that increases their strength, independence, vitality, energy and quality of life: STRIVE! 

With a little help from STRIVE, our members are activating their aging as well as activating their engagement with life

- and their engagement with friends -

Windmills of the mind

ever spinning ...

As we think about what we ’should’ do in our quest for health and wellness (and, too often, ‘why’ we don’t do it!) we frequently find our thoughts blowing around and around inside our head just like those child’s colored windmills. As I was writing this, it reminded me of the words of that Michel Legrand song of the late 60’s, “Windmills of your Mind”

“Like a circle in a spiral, Like a wheel within a wheel, Never ending or beginning, On an ever-spinning reel …”

That’s what those kind of ’should’ thoughts mostly feel like – “I know I should do this because … but if I don’t do it, then what? …and if I .. ? etc etc?” Or those ‘why’ thoughts – “Why do I always do this? … why can’t I succeed? … why do I always fail?” I’m sure we’ve all had those kind of thoughts before - “round and round and round they go and where they stop nobody knows!”

Let’s use exercise as an example. You want to become more active and you have done it for a few days or even a few weeks … but then you just stop. What’s the problem here? You know that you should exercise and you know why you should do it – but you just stop. Each time you ‘fail’, you go round and around in your head wondering why you always do this and ultimately deciding that maybe you just didn’t try hard enough.

What is going on here? Does this happen to everyone all the time? Are we all just lazy (because we just can’t be bothered to do it) or stupid (because we know what is ‘good for us’ but don’t do it anyway?). Of course not! It’s something much more basic than this. Very often it’s the kind of question you ask (yourself or others) that ‘pre-selects’ not only the way you set your goal, but also your response to making (or, especially, not making) the goal, and also your next attempt at the goal. Here’s my take on this based on current research in behavioral science and my training as an Intrinsic Coach.

‘Why?” questions are almost always the first ones to be asked post-goal setting. If you set yourself a goal and you don’t make that goal, I can almost guarantee the first thing your trainer will ask (or you will ask yourself) is some variation of ‘Why do you think you didn’t make that goal?” But here’s the thing, ‘why’ questions (however nicely asked) are hardly ever productive. If asked of another person, they tend to produce defensiveness (e.g. I just got too busy, I just didn’t feel like it etc). If asked of yourself, they tend to produce some variation of ‘I don’t know’, followed by ‘maybe I could do this or maybe I could have done that or next time maybe, maybe, maybe …’ … never ending or beginning like an ever spinning reel!

More productive and far less circular are ‘What?’ questions – but not a ‘What should I do?’ question, since that’s really the same thing we just talked about above. A different and more clarifying question is “What is important to me (about this goal)?” It is essential to say here that this is not the same as ‘what is best for me’, or ‘what is good for me’, or ‘what will benefit me’, or even ‘what will I get out of this’. No – we are thinking here only about “What is important to me”. Incidentally, if for some reason you don’t make that initial goal, the other ‘What?’ question to ask is “What did I learn from this?” (rather than ‘Why did I mess up?” or similar). I have written about this in earlier posts – check out http://telosity.wordpress.com/2008/02/02/goooaaalll/ and it is worth repeating that for many people this initially is a funny question to be asked (funny ‘peculiar’ not funny ‘ha ha’), and almost always takes some time to elicit a clear answer.  For more details – and more thinking – on this check my earlier post http://telosity.wordpress.com/2008/02/26/get-smart-look-yourself-in-the-i/

If you clarify the ‘What is important’ part, everything else follows, step by step, with each step informing the next

 ”As the images unwind, Like the circles that you find, In the windmills of your mind”

Unwind the images – you are outside the circular – what is important to you?

Nothing happens until something moves

Thought move!

As I do most mornings before anyone else is up, I was listening to an audio book of the Tao Te Ching (Wayne Dyer’s Change your thoughts, change your life – I recommend it to anyone). Verse 59 was about ‘Living untroubled by good or bad fortune’, and in his analysis of this verse he mentioned the Albert Einstein quote which is the title of this post “Nothing happens until something moves”. As I meditated after this verse it came to me that although Einstein was talking mainly through the medium of physics, this quote also applies to lifestyle change – and to meaningful goal setting (Also maybe a kind of physics (physical-ics?).

So here’s my Tao-inspired thinking about this

Meaningful health related behavior change is all about setting ‘action oriented goals’ – which involves two sets of ‘movements’

the thinking and the action

While it is true that ‘nothing happens unless something moves’, it is also true that nothing happens unless someone thinks, and so (stay with me here Albert) no different movement (or behavior) can result without different thinking. Ok, take a deep breath and read that again slowly, I know I’m going to!

The point I am making here is that the first ‘movement’ has to be one that starts inside your head – a ‘thought move’ away from your usual thinking – an ‘aha’ moment, however small.  Without this first ‘different thinking’ there will be no different movement, and even though ’something may move’ physically, there will be no lasting change in behavior – just a return to, or a continuation of, ‘the usual’. Nothing different happens without different thinking. Usual continues Usual, Different produces Different.

 So … two questions

1. If you are doing ‘the usual’ what does ‘the different’ look like to you?
2. What thought is happening to move you?

Think (differently) about it – make a thought move

Options, Actions, Directions

options actions directions

If history is any judge, telling people what to do is not a great way of eliciting behavior change. As I have commented many times in different ways on this blog, goals are best achieved when they are truly/intrinsically important to the individual involved and when they have ‘ownership’ of the goal and the actions and directions leading to its achievement.

However, offering ‘options’ rather than ‘instructions’ or ‘tips’ can be one way of eliciting this kind of ‘intrinsic thinking’. So … here are some great options that have worked for many people who were ready to become more active. Some of these may work for you and some may not. Some may not even be possible or desirable  for you – but prompt a thought that takes you in a direction you realize that you value but just hadn’t anticipated.

So as you think about these options below, what options, actions and directions are coming up for you?

The ‘doc’ Option:  Actually, this first one is a recommendation! Although for the great majority of people, exercise is both safe and beneficial, we recommend that you first talk to your doctor about your ideas and options for becoming active before you start any kind of activity program. Include him or her in your options – they will definitely be interested! The American Medical Association and the American College of Sports Medicine have recently collaborated on an initiative called “Exercise is Medicine”. This recommends that physicians become more knowledgeable about, and involved in, the physical activity goals of their patients.  If you have questions about being active that your doctor can’t answer – or even if he/she can –  ask to be referred to a qualified wellness educator or trainer. You can also refer your physician to the “Exercise is Medicine” website – they’ll thank you for it! Here it is http://www.exerciseismedicine.org/media.htm

The ‘family’ Option:  Research has shown that one option for activity is ’social support’. In other word people are more likely to start and continue to be active if they have the support of others. So ….e.g. ask a family member, or a friend, to join you on your regular walks. This then becomes more of a social event than ‘exercise’ or ‘a workout’. Perhaps you can find someone who enjoys – or would like to enjoy spending some active time with you – from grandchildren to grandparents. Think about and talk to your family about ‘energy using’ ideas around the house or outside the house and incorporate them into your active lifestyle plan. Make it a game for you and/or your children. See “The F Word” for a different kind of thinking about exercise or physical activity http://telosity.wordpress.com/2008/01/17/the-f-word/.

The ‘do a little more’ Option: Shopping, doing errands and even housework or chores can also be a way to add activity into your life. The great thing here is that to elicit any benefits, these ‘exercise that isn’t really exercise’ options only have to be at ‘moderate intensity’. For more details on doing ‘a little bit more’, see http://telosity.wordpress.com/2009/02/19/little-by-little . Once you get the idea from this information, then you have endless options to be a higher energy user rather than a lower energy user!

The ‘extra steps’ Option:  A simple and inexpensive pedometer can keep count of your daily activity in terms of the number of steps you take each day. However here’s something to make a note of. When you read about pedometers, you will no doubt discover that you ‘need’ to do 10,000 steps per day to receive any health benefits. This is really oversimplifying things, so don’t get discouraged by this enormous number – physical activity is not solely about arithmetic. Look back at our 3^rd option above and simply ‘do a little more’. In other words use your pedometer to track how many steps you usually take in a day (record 2 or 3 days and take the average) and then look for ways to add more steps to this total. Progress one step at a time! Here’s a great article on pedometers written by one of my old Exercise and Wellness buddies Dr. Catrine Tudor-Locke @ http://www.alcoa.ca/research_u_docs/2001_05may_en_tips.pdf     

The ‘get stronger’ Option: I have left the ‘best’ until last here (my opinion!). Strength training has developed a bad ‘rep’ over the years – at least for older adults. Myths abound about how it is ‘too dangerous at my age’, or ‘it’s only for younger people’, or ‘it’s only for women – younger women’. The reality – supported by more than a decade of scientific research – is that individuals of any age can benefit from an appropriate program of progressive strength training. At the STRIVE Wellness Corporation http://strivealive.com/ we have been conducting strength training programs with adults as old as 92 for more than a decade. The results are astonishing and the benefits remarkable. Check out our STRIVE Stories @ http://strivealive.com/index.php?c=stories to see what older adults are saying about us, about STRIVE, and about how they feel as they get stronger. Also check out our blog @  http://strivealive.wordpress.com/ for an (ever increasing)  series of short articles/posts about the many benefits of strength training. Getting stronger is so much easier – and the benefits so much greater than you may think!

So, again, as you think about these options above …

what action oriented options are coming up that are important to you?

Little by Little

Little by Little

When I was in my earliest years as a University professor I remember my proud mother asking what exactly it was that I did as ‘Dr. Phillips’. I said something like “I do a lot of research to find out what the benefits of exercise are for older people”. She replied “Why do you need to do that? Everybody knows that exercise is good for you – especially if you are older”. My whole carefully planned  research agenda crushed by a loving parent in two short sentences!!

Like my mother you’ve probably also heard that exercise is ‘good for you’ and you’ve probably heard it most of your life. Its one of those ‘conventional wisdoms’ that ‘everybody knows’ is true and has always been true. As a scientist I can tell you that although exercise is certainly an important path to good health and wellness, contrary to conventional wisdom it is not the only path. There is now overwhelming evidence that just being more active little by little throughout the day can elicit great health benefits. Although this is especially good news for  older adults – and perhaps somewhat surprising to most people – it is not exactly new news. 

Way, way back in 1961 two physicians, Hans Kraus and Wilhelm Raab published a book entitled “Hypokinetic Disease: diseases produced by lack of exercise”. Almost 50 years ago these two physicians were warning against the dangers of inactivity. Here’s a quote from their opening chapter: -

“When we analyze our daily lives, we can see how the active function of our muscles has been taken over step by step by labor saving devices. We do not walk, but ride; we do not climb stairs, but use elevators; we do not lift any thing of any weight, but we have devices that do that lifting for us. Most of the chores that used to require a certain amount of physical activity have been taken over by machines. We do not mow our lawns by pushing a lawnmower – it is become motorized. We have push button heating, we have vacuum cleaners, and we have dish washers. In short we do not move at all.”

Here’s another early quote that really grabbed me:-

“From the crib to the playpen, to the television set, perambulator (perambulator!!??), and school bus, our children are raised as a sedentary race, domesticated even from the first day of their lives”

Wow this is really ‘telling it like it is’ – and 50 years later we are still ‘telling’ the same thing.

More positively slanted evidence came some 35 years after Kraus and Raab with The Surgeon General’s Report on Physical Activity and Health. Published in 1996 this was a massive review of the health and exercise literature which examined and analyzed literally thousands of studies on the health benefits of endurance/aerobic activities of various kinds. Their findings were  revolutionary. Not only did they confirm the existing belief that ‘fitness’ – represented by vigorous exercise – was beneficial to health but (and this was the revolutionary part!) they also found that physical activity of what they called ‘moderate intensity’ could provide major health benefits for previously sedentary or insufficiently active individuals. This is the summary sentence I used to make all my undergraduates memorize(!)

“Every American should accumulate 30 minutes or more of moderate intensity physical activity on most, preferably all, days of the week.”

What they called “Moderate intensity physical activity” could be any activity that felt about as hard as a brisk walk. This could include everyday activities such as household chores, mowing the lawn or raking leaves. If you look for new ways to include these types of activities at this level every day, it will increase your stamina (aerobic fitness) and significantly improve the way you feel. In other words you can, little by little, adopt a more active and healthier lifestyle. All you have to do is just ‘a little bit more’. That’s it! Great news for everyone who doesn’t like to exercise!

Not that my mother would have been too impressed with me telling her what she already knew!

 So – as you think about moderate intensity activity – what little thing is coming up for you?

Well, Well, Well,

body mind spirit

 

Building ‘Wellness Cultures’  in Senior communities

In recent years ‘Wellness’ has received much attention and the benefits of adopting what has come to be known as a ‘wellness lifestyle’ has been confirmed and reconfirmed from a wide variety of ‘evidence-based’ research. There can be little doubt that for senior residential and retirement communities a wellness program, appropriately designed, can elicit a whole range of behavioral, health and even economic benefits for the facility, the residents and the facility staff.

Wellness, however is not just about ‘exercising’, ‘eating right’ or taking your medications. It is also, in its fullest expression, not a single ‘program’, or even a collection of separate ‘programs’. Wellness is actually a very broad and somewhat indefinable concept which can be thought of as a journey rather than a destination, a process rather than a product. It is also often described as consisting a number of diverse but linked ‘dimensions’, including physical, emotional, social, vocational, spiritual and intellectual.  I will be writing more about these later but suffice to say that when these dimensions are appropriately implemented, merged and developed, a comprehensive evidence-based Wellness ‘Program’ evolves into a Wellness ‘Culture’, something that becomes an integral and positive part of the community in which it resides.

For any successful senior residential facility manager, resident quality of life is surely at the top of their goals list. Increased quality of life means greater resident satisfaction, morale and consequently less resident turnover (plus, it makes management both feel and look good!). From a ‘bottom line’ perspective, a successfully implemented, values-based wellness program will reduce operating costs, reduce health care costs and be a major PR focus for attracting new residents.

Quality of life is the key to a successful community

Quality of life however depends on more than just bricks and mortar, more than providing fine accommodation, meals and services – it even depends on more than good health care provision, which traditionally has a ‘deficit-based’ or ‘reactive’ approach to health (fix the bad stuff). Our Intrinsic Wellness^TM approach is founded on an ‘asset based’ or ‘proactive’ philosophy (increase the good stuff). It is build, developed and guided in great part on participants choosing and becoming involved in activities that are important to them, that are intrinsically meaningful to them, and in which they have ‘ownership’.

I well remember many years ago as a young man being ‘the wellness bloke’ (it was in the UK and they use strange words like ‘bloke’ over there. In the US I would have been the wellness ‘guy’). Anyway to continue with my story – I would go into the facility or residence, do my ‘wellness program’ (usually an exercise class of some kind) and then leave – taking my ‘wellness’ with me! Before my arrival – and after my departure – things went on much as they did before! These days the awareness of wellness is certainly much greater (as, I am glad to tell you, is mine!), but it is still a word – and an approach much misunderstood and I could say also, much maligned, or at least underestimated. For example, I have experienced ‘wellness programs’ that consist only of medically oriented activities such as blood pressure screenings, or ‘taking your medication’ or ‘regular medical checkups’. Or wellness programs that consist only of ‘brown bag’ talks on various aspects of health. Of course these factors are important – but are not of themselves the whole of wellness or of a ‘wellness program’.

True wellness is determined by the informed choices or decisions a person makes about how they live their lives with vitality, meaning and purpose. A successful intrinsically derived wellness program appropriately integrated into a senior community can offer these choices to residents, and management alike. This will enable the community to become a place where quality of life is enhanced, a place of rejuvenation rather than a place where the attitude is one of ‘making the best of things’, of inevitable decline and deterioration. In effect a ‘true’ wellness approach is integral to the community rather than simply a ‘program’ that consists of set classes conducted at set times.

The AgeWELL Initiatives philosophy is to cooperatively partner with residents, facility management and staff so that we can collaboratively initiate and develop a wellness culture that becomes part of the fabric of their community, and that they are a part of.

For more details on establishing and developing an Intrinsic Wellness^TM culture in your facility, either leave a comment on this post or check out our website  http://www.agewellinitiatives.com/index.html . You may also call Dr. Wayne T Phillips @ (602) 793-0752

Getting Wellness down Pat

Pat's Wellness Wheel

A few weeks ago I was a guest on the Pat McMahon Show, AZTV 7, Cable 13. It was a lot of fun – Pat is a great guy with a sense of humor and a talent for relating to people of all kinds. I was there to talk about Active Rx a company that does excellent work with older adults – pro-actively working with them to optimize physical and wellness function.

During part of our interview Pat asked some general questions about wellness and though I was happy to answer them as best I could in the time we had, they prompted some more detailed thoughts that I wanted to share in this post

Wellness is a term that is hard to pin down – it always sounds positive of course – and perhaps people could use it accurately in a sentence – but what is it exactly? I Googled this once out of curiosity  - and not surprisingly got thousands of hits! More surprising was the whole range of wellness ’situations’ that came up – here are some examples

The Wellness Revolution: How to Make a Fortune in the Next Trillion Dollar Industry, Marketing to the New Natural Consumer: Consumer Trends Forming the Wellness Category, Wellness Foods A to Z, Reconnecting With Nature: Finding Wellness Through Restoring Your Bond With the Earth, Digestive Wellness, Mystic Healers & Medicine Shows: Blazing Trails to Wellness in the Old West and Beyond, The 22 Non-Negotiable Laws of Wellness: Feel, Think, and Live Better Than You Ever Thought Possible,

 …and my own personal favorite “The Complete Idiot’s Guide to Wellness “ –  LOVE to get my hands on that one! I even found a Quaker Oats Cereal with the words “An expedition into Wellness” emblazoned across the front of the packet. Wellness with fiber! Who would have thought it!

 So to go back to my original question – but what is it exactly? What is wellness? Googling clearly does not help!  

History tells us that a man by the name of Halbert Dunn is acknowledged as the first author to use the term in his book “High Level Wellness” back in the ’60s, and he defined it as follows

… an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable.  It requires that the individual maintain a continuum of balance and purposeful direction within the environment where he or she is functioning.

                                                                                                                                                                 Halbert L Dunn, M.D., Ph.D. “High Level Wellness” 1961.

When I first came across this book and this quote as a graduate student, my first reaction was “Huh?” – and I haven’t travelled too far from that reaction even now! In the world of academia where I came from ‘Wellness’ is typically described as being made up of different ‘components’, or ‘dimensions’, the number varying according to which authority you are reading. The most quoted of these components/dimensions are: ‘physical’, ’social’, ‘emotional’, ‘intellectual’, ’spiritual’, and occasionally also ‘occupational’, ‘vocational’ and ‘environmental’ – check out the Wellness Wheel image above for one Wellness ‘model’. I’ll be writing more about wellness components in later posts but the point to make here is that wellness is a broad and perhaps indefinable concept that I would say is more of a journey than a destination, more of a process than a product. The Wellness Councils of America define ‘Wellness’ as ” …the process of being aware of and actively working towards better health.”

In short Wellness is all about behavior – and lifestyle choices – and it’s always your choice.

So, loved the show – and thanks for the opportunity to Get Wellness down, Pat. Looking forward to our next conversation.

Think different – do different – be different

The Sanity Clause

We have known for several decades now that simply providing people with accurate, easy to understand information about exercise and wellness is no guarantee that they will actually act on this information. Never before, on the web and in the media have we had such a wealth of easily accessible information about paths to active, healthy living, and simultaneously never before have we had such a prevalence of inactivity and obesity/overweight in the US.

Clearly knowledge and education are not sufficient agents for behavior change and yet much of the approach in this area continues to provide the same information over and over again and continues to expect a different result.

Hold on a minute …. That reminds me of something

Insanity: doing the same thing over and over again and expecting a different result.  Albert Einstein

Hmmm …time for a different way of thinking

I have posted some ‘thinking’ below which could perhaps be the start of a ‘different direction’. This is not an exhaustive list by any means but hopefully serves as starting point ‘options’. They are not meant to be guidelines or instructions. Some of these ‘options’ have been part of my thinking for a while and some came to me as I was thinking about and writing this article. They all have an evidence-based background. 

Different thinking vs usual thinking

• Different: Adopt a positive attitude and approach to exercise and physical activity by emphasizing the achievement of goals. Usual: Once you have set your goal, think of all the obstacles that can get in your way and then think of ways to avoid or overcome them (HUH?). Research has shown that an “asset-based” (goal oriented) approach is consistently more effective than a “deficit-based” (obstacle overcoming) approach

 

• Different: Focus on getting “more good” i.e. the positive benefits of exercise and activity (more energy, more alertness, greater self confidence). Usual: focus on getting “less bad” (reduce high blood pressure, reduce anxiety, stress etc). Was it Frank Sinatra that sang “Ac-centuate the Pos-itive… E-liminate the Negative”? That gentleman was ahead of his (wellness) time!

 

• Different: Provide opportunities for clients to think about and clarify what is important to them about exercise. Usual: Expert stresses what is “good for them” about exercise. NOTE: this is not the same thing – think about it! 

 

• Different: Consistently emphasize that heath related physical activity is easy to achieve and far easier than most people realize. It’s never been as easy as this to get active! Usual: typically “just do it” or “I just have to do it” or “I should do it”

 

• Different: Consistently “reframe” exercise and physical activity (with lots of examples, case studies and research) so it is presented and viewed as an integral part of a normal enjoyable life. Usual: the approach and attitude to exercise is something that is external to the person and not particularly enjoyable. Something necessary that just has to be endured. What a drag!

Think about it

Thinking S.M.A.R.T., timely

Time passes

NOTE: The SMART series of posts is best read from the first post. Start with http://telosity.wordpress.com/2008/02/26/get-smart-look-yourself-in-the-i/ and read from there.

Timely

Effective goal setting is conducted and expected to be completed within a specific time frame i.e. “How long will you give yourself to achieve this goal?”

While research has shown that a definable, pre-determined time frame is necessary for effective goal achievement , from an Intrinsic Coaching® perspective there are really two time frames

What is important to you RIGHT NOW (Timeframe #1) 

When will you commit to achieving that goal? (Timeframe #2)

An Intrinsic Coaching® approach to Time takes the goal setting process to a whole new level of  involvement.  Anchoring the goal commitment to a time frame allows the coach to ask something far more meaningful and far reaching than just “How’s it going?” A coaching approach to Time provides a valuable context for learning …

You didn’t make the goal in the time frame? What did you learn? What will you do differently? 

You did make the goal in the time frame? What did you learn? What will you do differently?

Applying a coaching approach to Time frames can also be an important part of Accountability (another ‘A’ that could perhaps have been included in this acronym – SMAART?) . For example by asking “How do you want to be accountable for the actions you have committed to over this period? or “How do you want to keep track of your progress?” In this way the Time aspect enables the goal setter to take ownership of the goal he/she has set. Any number of options could be appropriate for this – email, phone call, etc. Research has shown that when goal setters take ownership of the goals they set, such goals are far more likely to be achieved. The important thing here is that whatever the goal setter commits to will continue to elicit the all important ’i’ response. This circles right back to where we started this whole series.

GET SMART – LOOK YOURSELF IN THE ‘i’

http://telosity.wordpress.com/2008/02/26/get-smart-look-yourself-in-the-i/