|
Taking Wellness to New LevelsBy Kay Van Norman & Jan Montague Senior living communities have recognized and responded to the need for quality-of-life initiatives offering residents valid opportunities for fulfillment and personal growth. The six dimensional model of wellness has emerged as a valuable tool to accomplish this important mission, addressing resident needs through the physical, social, emotional, spiritual, intellectual and vocational dimensions of health. It brings a unified focus and sense of purpose to guide program development, implementation and evaluation. However, the process doesn't stop with creating the framework. A culture change must be made that ensures a community-wide environment of wellness. This change requires educating staff and residents about the six-dimensional approach to wellness. It involves a team effort to transform the activity offerings and health-related offerings into a comprehensive "whole-person" wellness program. It also requires a conscious effort to change the mindset of staff or residents who may equate age and/or physical frailty with an inevitable decline in function and well-being. One of the most satisfying aspects of implementing the "whole-person" approach is changing belief systems about aging. "Whole-person" wellness focuses on abilities rather than disabilities, providing opportunities for growth in any or all of the dimensions. It encourages residents to become active partners in maintaining and improving their own well-being to the best of their ability. Staff-driven model Successfully implementing the "whole-person" approach requires multiple options for involvement within each dimension of wellness. This could be an overwhelming task if attempted primarily through a traditional staff-driven model of scheduled group programs, informational newsletters and periodic medical-related offerings. A serious limitation of this model is providing opportunities for involvement primarily during set days and times, creating a restricted number of entry points into programming. If an individual is not able or willing to attend activities at the specific time, then they often do not participate at all. In addition, the quantity and quality of programming in a staff-driven model depends entirely on staff abilities and experience, and the amount of time they are able to commit to the programs. Unfortunately, very few communities maintain a funding level to adequately support this model, resulting in harried activity personnel and frequent staff turnovers. This seriously compromises program quality and cohesiveness. Finally, this approach unintentionally reinforces the concept that wellness is "a class I attend three times per week," making it easy for residents to take a customer approach to wellness programming rather than accepting a strong measure of self-responsibility for maintaining well-being. Meeting individual needs A program model consisting primarily of group offerings also has difficulty addressing differences within the group. It relies on individuals being at the same place in their journey toward personal wellness. In addition it ignores behavior change research showing that people move through various stages of change before taking action. These stages of change include pre-contemplation (not even thinking about change), contemplation (thinking about it) and preparation (gathering information and getting ready). The action stage involves taking action (i.e., engaging in something or making a change) and the maintenance stage refers to maintaining the action or change. Research shows that only about 15 percent of the population is ready to make a behavior change (take action) at any one time, with the rest at various stages of change along the continuum. When compared with the average 15 percent to 20 percent of residents regularly attending group offerings in a community (i.e. taking action) this statistic provides an interesting parallel. It may provide insight into why such a large percentage of residents are not regularly involved in wellness offerings, even in the absence of common barriers such as cost, transportation or lack of information and access. Alternative model An alternative model is needed to effectively address individual needs. This new model must provide numerous points of entry into programming that don't require additional staff time. It must encourage residents to explore each dimension of health in ways that bring personal fulfillment. Finally, it must blend traditional staff driven group approaches with individualized, self-directed approaches at various levels of ability and stages of change. Wellness Stations As wellness consultants we have worked individually with many communities to help them create and implement the six-dimensional model of wellness. In 1998 we began collaborating on resident-directed approaches that would help communities support whole-person wellness. One very successful approach has been wellness stations. We began as simple posters of functional exercises to provide older adults with on-going opportunities to take an active role in maintaining physical function. The evolution During the past four years, the posters have evolved into multi-dimensional stations giving equal importance to each dimension of wellness. Sketches have given way to original watercolor artwork created to set the stage for the theme of each station. Each activity, word and phrase has been carefully chosen to address the needs of residents at different levels of ability and stages of change. The stations reinforce the concept of self-responsibility by providing ongoing opportunities for self-direction. Self-directed participation and accomplishment of even small goals has been shown to enhance self-efficacy, a leading determinant for both increased physical activity and social connection among older adults. Meaningful art What started as a product to support wellness has evolved into the concept of using "meaningful artwork" to grace the halls of senior living while simultaneously reinforcing a community-wide environment of wellness. This concept currently features four stations; Rise to the Occasion, Stop and Smell the Roses, One Step at a Time and Count Your Blessings. They are placed around the community in easily accessible places and are available on a continuous basis. Each station features simple, safe activities ensuring success for participants at various ranges of functional ability. Physical activities have personal relevance to older adults such as improving the ability to perform activities of daily living, preventing falls and increasing physical function. Of equal importance is the appeal of original artwork blended with positive affirmations promoting self-efficacy, confidence in abilities, self-responsibility and a positive approach to life's challenges. This careful integration of multiple dimensions helps residents address mind, body and spirit, and appeals to residents at varying stages of change. For example, Rise to the Occasion addresses the sit-to-stand function of daily living. This "physical dimension" activity is coupled with encouragement of a positive approach to life and openness to social interaction (emotional and social dimensions). Stop and Smell the Rose invites residents to take the time to enjoy the smallest offerings of joy (emotional dimension) blending it with active breathing and upper body range of motion. One Step at a Time engages participants in a toe-to-heel walk challenging their balance, while encouraging them to see possibilities for improvement rather than limitations (emotional). Count Your Blessings reminds participants to be aware of all the blessings in their lives (spiritual and emotional) while offering a finger-stretching exercise to improve hand function. Personal journey The multidimensional approach and self-directed format of the stations appeals to a broad range of residents, allowing individuals to pursue development of the body, mind and spirit at their own pace. They have relevance to residents regardless of functional ability or where they may be in their personal journey toward wellness. For example, one resident may be drawn to the familiar "banner statements," stop to read the positive affirmation, and then linger to enjoy the artwork. Another may be drawn to the artwork and accept the opportunity to engage in a physical activity. Still another could be drawn to the opportunity for movement but subsequently enjoy the artwork and the encouragement for a positive approach to life. Wellness stations provide numerous points of entry into programming for those who do not wish to attend activities at set days and times. Communities have also reported that the stations draw individuals into programming who, for a variety of reasons, do not generally participate in any activities. When coupled with traditional group classes and staff-driven activities, the wellness stations significantly broaden the spectrum of program offerings without increasing staff costs. They open a variety of doors into wellness dimensions rather than requiring all participants to enter through one door -- scheduled offerings. This approach empowers residents to take an active role in maintaining their overall health, helps improve self-efficacy and gives them ownership of their personal well-being. Visible expressions As "meaningful art" placed around the community, these stations are always available to residents and staff, providing a continuous message of wellness as an ongoing, personal journey. In conjunction with structured programs within the six dimensions of health, the stations create unparalleled opportunities for involvement. Finally, they provide a highly visible expression of what your community is doing to foster resident well-being. Marketing departments will surely appreciate this opportunity to differentiate your community in the marketplace. Kay Van Norman is the founder and president of SENioRS Unlimited in Bozeman, Mont., providing consulting services in all areas of exercise and wellness programming for older adults. She authored "Exercise Programming for Older Adults" along with numerous chapters and articles. She has also created two exercise videos and a variety of health education curriculums for older adults. Ms. Van Norman serves as Director of the Keiser Institute on Aging, is a board member of the American Senior Fitness Association, and is a delegate for the Health Promotion Institute of the National Council on Aging. She may be contacted at (406) 587-0786. Jan Montague, MGS, has been president of Montague, Eippert & Associates in Highland Heights, KY, since 1998. Her lifelong work in wellness and health promotion resulted in the development of nationwide consulting services for the design, development and implementation of wellness programs and centers for seniors.
Click here to purchase reprints |
|
|
|
