Jan Montague, Wiley Piazza, Kim Peters, Gary Eippert and Tony
by permission of the International Council on Active Aging (www.icaa.cc)
from "The Journal on Active Aging."
Montague, Wiley Piazza, Kim Peters, Gary Eippert and Tony Poggiali
are colleagues at Montague, Eippert and Associates, which
specializes in the design, development and implementation of
wellness programs for older adults. For more information, please
call 859-442-5009 or visit www.me-a.com
has its roots indirectly embedded in the Eastern tenets of body,
mind and spirit. Long before the Western world became aware of
the importance of these three entities coalescing as one, early
philosophies such as Buddhism and Taoism subtly laid the groundwork
for what we now call wellness. Out of the firm belief that the mind,
body and spirit must coexist in perfect harmony and balance, the
first real wellness model was born.
370 B.C., Hippocrates alluded to wellness, when he stated the
parts of the body which have a function, if used in moderation and
exercised in labors to which each is accustomed, become healthy
and well developed and age slowly. But if unused and left idle,
they become liable to disease, defective in growth and age
newer Western concept of whole-person wellness is based on this
the 20th century, the logic and sense of wellness formed a new
paradigm within the annals of health promotion. This model has
finally started garnering attention as a living, breathing operation
in the past 50 years. In fact, the term wellness was coined
in the 1950s by Dr. Halbert Dunn. But what exactly does this word
his book High Level Wellness, Dunn calls wellness “an
integrated method of functioning which is oriented toward maximizing
the potential of which the individual is capable of functioning
within the environment.” More recently, Bill Hettler, president of
the National Wellness Institute’s board of directors, defined the
six dimensional wellness model as “an active process through which
people become aware of, and make choices towards, a more successful
existence.” The World Health Organization describes health as “a
state of complete physical, mental, and social well-being, and not
merely the absence of disease and infirmity”; while the American
Journal of Health Promotion says optimal health is “a balance
of physical, emotional, social, spiritual and intellectual health.”
Finally, in their 1998 book Successful Aging, Drs. John W.
Rowe and Robert L. Kahn refer to successful aging as “low risk of
disease and disease-related disability; high mental and physical
function and an active engagement with life.”
above definitions have developed as a conscious move away from
allopathic medicine and towards a more balanced model, such as the
one practiced thousands of years ago in the Eastern philosophies.
But why this conscious change in perspective? And why now?
shift in perspective
factors are contributing to this shift to a wellness focus:
high cost of healthcare;
strategies designed to attract more health conscious older
and focus group findings that support older adults’ interest
in wellness concepts;
Continuing Care Accreditation Commission’s (CCAC)
requirement of having a written philosophy that addresses the
physical, mental, social, spiritual and intellectual needs of
acceptance of integrative therapies; and
demographics and baby boomer influence.
factors drive the change in perspective in an attempt to keep older
adults healthier and proactive towards aging. At the same time,
older adults increasingly recognize the benefits of a healthy
lifestyle. Together, these forces are creating the momentum towards
wellness that we see today.
growing interest in healthier aging coincides with a new model for
health and well-being: the comprehensive whole-person wellness
model. This inside-to-outside approach places personal wellness at
the center of dynamic and multidirectional interaction (see Figure
1). The center interacts with each of the six dimensions of health:
emotional, intellectual, physical, social, spiritual and vocational;
and the individual dimensions also interact with one another.
1. Whole-person wellness model
1994, Jan Montague.
this model to have relevance to the individual, however, personal
wellness concepts must be acknowledged. These concepts are the
hallmarks of wellness and aging successfully. They include
self-responsibility for all six dimensions of health, optimism,
self-direction, personal choice and self-efficacy. But changing
attitudes and beliefs can be difficult. The whole-person wellness
model recognizes this fact by requiring a four-way collaborative
effort among the older adult and his or her families, community, and
health care providers.
The dimensions of wellness
comprehensive approach to wellness respects our complexity by
acknowledging that we are multidimensional beings. The following
paragraphs explain each dimension of wellness and give practical
examples of each.
The physical dimension promotes participation in activities for
cardiovascular endurance, muscular strengthening and flexibility.
This multi-faceted dimension is relative to each person’s
abilities and disabilities. It promotes increased knowledge for
achieving healthy lifestyle habits, and discourages negative,
excessive behavior. The physical dimension encourages participation
in activities contributing to high-level wellness, including
personal safety, medical self-care and the appropriate use of the
principles and movement classes;
and weight control;
abilities (ADLs and IADLs);
habits and safety;
screenings and disease prevention;
partnerships, integrative therapies;
medical treatment, nutritional supplements.
The emotional dimension emphasizes an awareness and acceptance of
one’s feelings. It reflects the degree to which individuals feel
positive and enthusiastic about themselves and life. This dimension
involves the capacity to manage feelings and behaviors, accept
oneself unconditionally, assess limitations, develop autonomy and
cope with stress.
and recognize feelings;
success and failure;
feel and realize consequences.
The social dimension is humanistic, emphasizing the creation and
maintenance of healthy relationships. It enhances interdependence
with others and nature, and encourages the pursuit of harmony within
the family. This dimension furthers positive contributions to one’s
human and physical environment for the common welfare of one’s
self and others;
with the environment;
and maintain relationships;
pets, plants, community;
share interests, share;
and nurture relationships, join, join in;
there, build group cohesiveness, actively participate;
and involvement in social causes.
The spiritual dimension involves seeking meaning and purpose in
human existence. It involves developing a strong sense of personal
values and ethics. This dimension includes the development of an
appreciation for the depth and expanse of life and natural forces
that exist in the universe.
of discovering meaning and purpose in life;
values through behaviors;
hope and abundance;
in touch with one’s higher power;
pray, contemplate life;
death and dying;
beauty, nature, life;
wisdom, listening to the inner voice/heart;
silence, joy, inspiration.
The intellectual dimension promotes the use of one’s mind to
create a greater understanding and appreciation of oneself and
others. It involves one’s ability to think creatively and
rationally. This dimension encourages individuals to expand their
knowledge and skill base through a variety of resources and cultural
of using one’s mind;
to think creatively;
to explore new areas;
listening and speaking skills;
to pay attention;
or environmental awareness (day, month, season, weather);
thought processes, stimulate.
The vocational dimension emphasizes the process of determining and
achieving personal and occupational interests through meaningful
activities. It encourages goal setting for one’s personal
enrichment. This dimension is linked to the creation of a positive
attitude about personal and professional development.
personal mission and goals;
roles, never retire;
plan, hobbies, volunteer, help others.
the personal wellness concepts of self-responsibility, optimism,
self-direction, self-efficacy and personal choice, the wellness
dimensions have little meaning for the individual. Instead, they
become simply words to describe various types of programming.
Personal wellness concepts place wellness on a personal level and
allow individuals to move to a higher level of functioning.
her book Wellness Practitioner, Carolyn Chambers Clark points
out that wellness is not restricted by level of health, and that
wellness is appropriate to persons who are ill, disabled, dying or
relatively well. The personal wellness concepts are what make this
statement come alive for everyone. These tenets change the focus
from what people can’t do to what they can.
more relevant and fully internalized wellness becomes to an
individual, the more each dimension interacts with the center and
with other dimensions. This leads to a more balanced and positive
personal health perspective. Individuals who think they can, will;
and individuals who think they can’t, won’t. This change in
thinking also reflects the change from an external to an internal
center of control. At this point, wellness becomes fully
integrated into a person’s life.
and clubs that adopt the whole-person wellness model enhance the
lives of their residents and members. They also multiply their
business opportunities by six.
wellness programming opens a new door to the mature market for each
dimension of health. Facilities gain more options to market and sell
their offerings, more potential audiences to reach, and more ways to
serve their clients’ diverse needs when they offer
multidimensional programming. With whole-person wellness, what’s
good for the customer is great for business.
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