An influential senior living provider and research organization is introducing a new wellness model, with hopes that the approach will gain traction throughout the sector and better attract and serve a rising generation of older adults.
The “person-centric wellness model” was developed by Mather, a non-denominational, non-profit organization based near Chicago in Evanston, Illinois. Mather operates life plan communities in Evanston and Tucson, Arizona, as well as an independent living community on Chicago’s North Shore. Mather is also in the process of developing The Mather, a highrise life plan community in the Washington, D.C. metro market. The person-centric wellness framework was created through work done in conjunction with the Mather Institute, which conducts research focused on senior living/aging services.
“In thinking about new programs for our existing communities, as well as for The Mather in Tysons … we were looking at what’s next,” Mather President and CEO Mary Leary told Senior Housing News, explaining the genesis of the new wellness model.
The model being proposed by Mather is explained in a new report and underpins the organization’s evolving wellness approach, dubbed ContinuWell.
Reconsidering the 6 dimensions of wellness
Senior living providers have increasingly focused on promoting wellness among their residents, in the interest of enhancing and extending their lives rather than primarily caring for their health conditions. Many factors have driven this shift, including new consumer expectations and changes to the U.S. health care system to incentivize more preventive and coordinated services among older adult populations.
A framework dating to the 1970s, dubbed The Six Dimensions of Wellness, has gained particular traction among senior living providers. Under this model, providers have created programs and initiatives aimed at fostering residents’ emotional, occupational, physical, social, intellectual and spiritual wellness.
We define wellness as the process of engaging in behaviors and decisions that enable people to reach their full potential.
The Person-Centric Wellness Model report
This six-dimensional model has been effective for senior living providers, residents and society at large, Leary acknowledged.
However, in working with older adults, reviewing the latest wellness research and evaluating market dynamics, Mather’s leadership came to believe that a fresh approach is needed.
“I don’t think people intend the six-dimensional model to be prescriptive, but I think it can be interpreted as ‘more is better’ in every dimension — that may not match people’s individual personalities and priorities,” Dr. Catherine O’Brien, vice president and director of Mather Institute, told SHN.
The potential prescriptiveness and lack of personalization in the six-dimensional approach is becoming increasingly conspicuous and problematic, given trends in society. Mather’s report articulates the issue through a question:
“At a time when virtually everything else around us can be customized, shouldn’t our wellness plan be as well?”
The 3 As
About a year ago, conversations among Mather leaders evolved into a more formal effort to create a new wellness model.
Researchers with the Mather Institute delved into the academic literature, studied existing wellness models, and reviewed their own work on the topic, including results from the ongoing Age Well study, which surveys a large group of life plan communities each year.
The resulting model recognizes that wellness-related behaviors are influenced by individual factors — for example, an older adult’s personality — but also by people’s living environments, communities and other external forces.
At the individual level, the researchers zeroed in on three key wellness drivers derived from a psychological model known as Self-Determination Theory. As explained in the Mather report, these “3 As” are:
Autonomy: an individual’s need to have power over their decisions and behaviors
Achievement: the need to demonstrate competence and mastery over one’s environment—that one is learning and developing while taking actions that lead to desired outcomes
Affiliation: the need to have close relationships and meaningful interactions with others
A premise of the person-centered model is that senior living providers can more effectively promote resident wellness by tailoring their programs and initiatives to address the 3 As.
Moving beyond individual factors driving wellness, senior living providers can also be attentive to organization-level factors such as policies, procedures and the physical plant.
And while providers may have limited control over the larger community and society, they can and should forge connections with institutions and organizations beyond their walls or campuses, and participate in activities that positively influence societal forces related to wellness, such as ageism.
Implementing the person-centered model
O’Brien and Leary expect that senior living providers will find various ways to implement the person-centric model in light of their operational structures and goals. But Mather’s own approach is one example of how these principles are being put into practice.
Mather created a guidebook for teams to help them implement the new model under the ContinuWell umbrella, Leary said. Part of this process involves thinking more creatively about what constitutes wellness programming; she cited shinrin-yoku “forest bathing,” in which residents go to the Chicago Botanic Garden and spend time under evergreen trees. The practice has been shown to “calm the body and boost the nervous system,” she said.
In implementing this program, Mather explained the principles and potential benefits and left it up to residents whether to participate, which supports their autonomy. If they do take part and experience benefits, this can lead to a sense of achievement. And the activity is done with others and in a setting outside of the life plan community, supporting affiliation.
As this example goes to show, meeting the 3 As is not necessarily complicated; simply offering programs at different times of day, and for different skill levels, are ways to create more autonomy and achievement, the report notes. And affiliation can be increased through simple steps such as arranging chairs in circles rather than rows during events or activities.
However, more sophisticated strategies are needed to reach more complex or difficult wellness goals, and tailoring wellness to each individual’s personality and objectives is potentially more labor-intensive than current wellness practices.
“We shared this program recently with a group of providers, and a small provider did express that concern about having the resources to implement a customized approach to wellness,” Leary said. “But others in the room said that this is the wave of the future, and you need to find a way to make this work, because this is what the next generation of older adults wants. And we need to make this happen.”
Leary herself has seen evidence that this approach to wellness is indeed a future imperative. The Mather life plan community under development is attracting younger, baby boomer consumers, and they have high expectations related to how the community will support their wellness. Mather is introducing new types of online programs that these future residents can take part in, such as lunch-and-learns about gut health, and the benefits of drinking and cooking with tea.
Mather aims to support other providers’ efforts to adopt the new person-centric wellness model, including through the creation of a wellness assessment tool. And, providers can contact Mather about participation in a wellness coaching initiative with Virginia Tech and Wake Forest University. Such coaches could play an important role in working with residents on personalized wellness plans.
If the past is any indication, Mather’s model will generate interest throughout the industry; the organization has a reputation for innovation and was a driving force behind the effort to shift terminology from “continuing care retirement community” to “life plan community.”
Already, Mather is meeting with providers and working through the Novare consortium to disseminate information about and test approaches to this new model.
“We’re hopeful that this will take off, because we do think it will benefit not only the people we serve, but the staff who work for providers, and will hopefully boost the industry even more in terms of the benefits to older adults,” Leary said.
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