The next issue of On Our Way: Recovery News will be exploring the theme of wellness. We plan to post the entire issue as a document linked to this site. In anticipation of the newsletter coming out, we have some supplemental content related to wellness that will be appearing as blog entries.
Wellness, Older Adults & Peer Support
Yun Leong, Occupational Therapist
So what does wellness mean? If you Google the word “wellness” you’ll get a huge slew of definitions. So much so, you begin to ask yourself “where the heck do you start?!?!?” Some definitions, like the one from the World Health Organization, include many domains: physical, psychological, social, spiritual, and economical. So many areas are described that it begs the question “Do you need to be doing “well” in ALL of these domains? If that is the case, is that possible or feasible? Or is it enough to function or flourish well with a few or “core” domains? For seniors, certainly there are a few which you could describe as core or important to one’s well-being. With the help of a member of the team (e.g. occupational therapist or case manager), the peer support worker (PSW) plays an important role as he or she is often responsible for implementing many of the interventions suggested by the rehabilitation team (e.g. occupational therapist or recreational therapist).
So what can a peer support worker do to help? Let’s start with the physical domain. Certainly, many people have heard about this before. Nutrition, sleep and exercise are all important and basic to seniors like it is for adults of a younger age.
When it comes to nutrition, the peer support worker can play a valuable role. For instance, the senior, who is depressed, in this case may be socially isolated and also not eating well. The peer support worker can connect him or her to a social / lunch program. By doing so, the senior gets access to nutritious food. Additionally, being in a group socially, may also help brighten the senior’s mood, encourage him or her to engage in an activity (e.g. learning about wellness matters), and also help establish some new and old relationships. See “Social Connections and Health Aging”. As these programs usually occur weekly, the peer support worker at the same time helps the client establish a routine or structure. Sometimes the role of the peer support worker is also to teach the senior how to get to the program (and back home) safely and independently. This may entail learning the bus routes or getting comfortable with using (and booking) the Handy Dart.
An important factor to consider when attempting to engage a senior in a program involves the availability of transportation. Often seniors have lost their driver’s licence, and are therefore more dependent on either the buses or the Handy Dart for transportation. In Vancouver, these modes of transportation are not as fast and convenient (waiting for the bus then becomes not only inconvenient, but also more tiring). As a consequence, many seniors end up staying at home rather than go out and enjoy the things they used to do, or would like to try.
Other further barriers preventing seniors from participating fully in programs include a loss of hearing or a loss of vision. In such a case, the peer support worker can help the client get safely to the hearing clinic, for example, to get repairs or to obtain replacement batteries. This is especially important in situations where the senior does not have any support from family.
The social component of the program is also beneficial for purposes other than developing relationships. Socializing with others is considered a good activity for the brain as it requires the client to focus on what others are talking about, and this in turns forces one to formulate a thought for discussion. As the senior becomes more part of the group, he or she may gain in confidence as he or she feels better about himself/herself. See “Socializing Appears to Delay Memory Problems”.
From a cultural perspective, the social / lunch component, in Chinese culture for example, can be an important one in terms of reestablishing some of the roles seniors had when they were younger. For Chinese women, cooking meals for their respective families may have been their role when they were younger. As they become more frail and their children get older (and assume some of their cooking duties), these women become less active in the cooking and lose their role as “head chef” in the family. Often being able to cook for a group for lunch, even if it is only once a week, can return some sense of belonging to the senior. Plus, the subject of the meal can be an excellent starting place for a discussion. The peer or consumer support worker commonly can work in tandem with the therapist to facilitate this process.
Of note, regular nutrition becomes that much more important if the senior has diabetes. If you do not already know, some of the symptoms of this disease are: Lethargy/fatigue and if left unchecked enormous damage to many organs in your body. Some of the consequences include kidney damage, artery damage (thereby increasing a person’s risk of stroke and heart attack). There is also the possibility of vision loss and nerve damage, which sometimes can lead to a loss or amputation of one’s limbs.
Another core component in a senior’s wellness lies with exercise. In this instant, the exercise program would ideally involve a mix of strength training, cardiovascular exercises, and stretching. Given the complexity of all these components of exercise, it is often beneficial to do this through a program in the community in a group, where there is instruction available. Many of these programs are geared towards seniors and their health concerns such as fall prevention. In Vancouver, there is Osteofit, the Steady Feet program (for fall prevention) and Aquafit (where the exercises are performed in the pool). Exercising in the pool is beneficial for seniors who have difficulty weight bearing. The buoyancy of the water helps supports a person’s joints while exercising, making it less painful in the process. Once again, the peer support worker can play an important role in motivating, and supporting the senior in participating in the program.
Before starting an exercise program, it is worth noting that obtaining a check up from the person’s family doctor is beneficial. This will help the senior determine to what extent he or she could exert himself/herself.
Other exercises that are done in a group setting would be walking and working out in the gym. There are groups throughout Vancouver that focus on this type of exercising. Often, many of these groups have a social component to it. Many of them often go for either some coffee or a meal after exercising. Studies indicate that an exercise program that has a social component is an important one as the socializing helps seniors to stick with their respective exercise programs. See Mayo Clinic, Walking: How to Start a Walking Group.
There is sometimes a misconception that seniors would not benefit from weight training. However, studies indicate that weight training benefits a senior, especially in regards to his or her mobility and balance, even in their 80’s and 90’s. The senior may not want to look like Arnold Schwarzenegger, but certainly that person’s quality of life is dependent on whether he or she is able to mobilize himself or herself. Think about it. If you couldn’t walk without someone supervising you, you would not be able to do many of the small things in life that you take for granted. For instance, if you were thirsty, you would need someone’s help to get a glass of water. If you needed to go to the washroom, you would need to ask for help. If you needed to take a shower, you would need someone to help you shower in the event that you fell. I could go on, but I think you get the idea….
The added bonus about exercise, whether it is an aerobic exercise like walking or a more anaerobic one like weight training, is that it helps to keep your brain sharp. Studies indicate that exercise may help a person’s cognition, including your memory. See “How Exercise Benefits the Brain”. This applies to both younger adults or seniors. The added advantage of exercising is that it helps lubricate your joints, which may help relieve a person with arthritis. Often persons with arthritis report that it is too painful to exercise, and that this prevents them from exercising. According to the BC Arthritis Society website, “research shows quite the opposite: A properly designed exercise program can not only decrease your pain, but also increase your flexibility and overall fitness – and it can do wonders for your spirits.”
One other area to consider when helping a senior keep well lies in the importance of keeping mentally stimulated. This can possibly be accomplished by either social or physical means as suggested above. However, this can also be accomplished by engaging in a variety of mentally stimulating activities. What can they be? Well, some possible activities include learning a new language, working on Sudoku puzzles, or engaging in a hobby (e.g. photography). Studies suggest that keeping stimulated is important as it may help delay or reduce one’s risk of dementia. See “Preventing Dementia: Mental Stimulation”. Plus, engaging in such activities makes a senior’s life more meaningful and possibly more purposeful. Once again the peer support worker can help the senior find that meaningful activity, which often can be found in the community in locations such as a Neighbourhood House or Seniors Community Centre.
At first glance, the components of wellness for seniors do not seem immediately related to the concept of recovery, especially with regard to the physical aspects such as nutrition and exercise. However on closer examination, even in the physical domain, the goals of these areas are to enable and empower seniors to participate more fully in their life. The consequence of this is that many of them become more hopeful. Let’s also not forget the role of supportive relationships (family, case managers, rehabilitation team) to get seniors pass many of the barriers that can present itself as one ages. Hope, empowerment, supportive relationships – these are all concepts integral to the concept of recovery. As all of these components are essential in keeping a senior well, it follows then that practising Recovery is an essential part of keeping seniors well. Don’t you think?