Print Archives from Advanceweb.com
Well Elderly: Promoting Healthy Lifestyles
By Hibet Melgoza
Posted on: February 28, 2011
Reflections on Practice
The Baby Boomer population is aging, and along with this comes increased demand for health care services. By 2030, the number of adults over 65 will rise from 37 million to more than 70 million, almost 20 percent of the total projected population in that year, according to the Institute of Medicine. Along with living longer, Boomers want to maintain their quality of life: to live independently in their own homes, socialize with friends, remain physically healthy and continue to participate in everyday occupations that are meaningful for them.
Unfortunately, not all individuals will be able to sustain the quality of life they desire due to physical, emotional, financial, environmental, social and/or other impairments. In some cases, they are not receiving the proper nutrition or medical care. These people also may be prone to depression, especially when they lack support from friends/family and are socially isolated.
Existing literature supports that seniors who are successful at staying within their homes have expressed a better quality of life (Jackson et al.). Through preventive measures we can enable independent living for the elderly and at the same time help to decrease health care expenses. It will require a holistic approach to ensure that each individual's various needs are indeed targeted.
Falls can often lead to physical harm and fear, which may further restrict the individual's ability to engage in occupations/activities. This can in turn lead to further complications, such as a decrease in endurance and/or in coordination/flexibility, and possible muscle atrophy, all of which can lead to a higher risk of falls or necessary medical intervention (Hotchkiss et al). Studies have been conducted to determine the effectiveness of current falls prevention programs (FPP). These programs are often implemented in rehab and long-term care facilities, but are also seen in the community (i.e. home evaluations, home modification programs, etc).
Other possible interventions that can complement healthy living among elderly people can include home exercise programs and ongoing physical activity. When developing home exercise programs for older adults, take into consideration their physical capabilities. Possible barriers to participation in exercise can arise from lack of access to exercise equipment, lack of transportation, poor motivation, existing injuries and physical impairments/restrictions (Heath & Stuart). Research supports that activity leads to psychological benefits, as it helps to preserve cognitive function, alleviate depression/stress, and promote a feeling of wellness (Heath & Stuart).
Activities should be achievable, reasonable for the participant,
and fun (e.g. real live bowling or virtual bowling by using a Wii gaming system). Participation in group exercise also can be a huge motivator as it allows people to socialize. Increased socialization can help reduce the risk of depression among this population.
Adequate diet, rest and sleep also are essential. Possible obstacles to adequate nutrition can include insufficient funds/income to purchase food, lack of transportation to get to and from a local supermarket, being physically unable to go out into the community, and lack of motivation to prepare meals and/or consume food.
Malnutrition also can stem from physical impairments such as denture problems or dysphagia, which render the individual unable to consume certain foods. In other cases, elderly people may not know which diets are recommended for them to ensure that they are receiving all their needed nutrients. This can often be targeted by education on nutrition and healthy life styles.
Existing OT programs do promote healthy living among elderly people. The University of Southern California's Lifestyle Redesign Programs, for instance, have conducted several studies over the years. Two studied the effects of a well-elderly treatment program that promoted lifestyle changes among community-dwelling elders following occupational science theory. Researchers determined that engagement in symbolically meaningful occupations is essential to well-being among the elderly (Jackson et al., 1998). They identified 10 life domains that are essential to healthy lifestyles, including ADL, adaptation to multicultural environments, use of free time, illness/death/spirituality, health maintenance, mobility maintenance, personal finances, personal safety, psychological well-being and happiness, as well as maintaining healthy social relationships (Jackson et al.).
Intervention methods included one-on-one sessions with an OT, social outings, brainstorming exercises (e.g. "25 Ways to Stay Healthy"), among others. According to the overall findings, lifestyle modification programs are an effective prevention method that empowers people to make/sustain positive changes in their lives.
Elderly people have a strong desire to maintain their quality of life. From their stories, we find that they enjoy socializing with other older adults by attending outings and by joining community support groups.
Health care providers can also look to available community resources such as Meals on Wheels, elderly community centers, food banks, and other relevant services. Often there are many services available in the community, but unfortunately, few people may be aware of them.
References available at www.advanceweb.com/OT or upon request.
Hibet Melgoza, OTS, is a student in the master's of occupational therapy program at Utica College in Utica, NY.