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Archive for February, 2009

Little by Little

Posted by telos on February 19, 2009

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?


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Well, Well, Well,

Posted by telos on February 8, 2009

body mind spirit

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 WellnessTM 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 WellnessTM culture in your facility, either leave a comment on this post or check out our website . You may also call Dr. Wayne T Phillips @ (602) 793-0752

Posted in Behavior Change, Senior Housing, Wellness | Leave a Comment »

Getting Wellness down Pat

Posted by telos on February 4, 2009

Wellness Wheel

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.

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