Achieving Wellness as We Age

What does WELLNESS actually mean? According to Merriam Webster?s dictionary, wellness is defined as “the quality, or state of being in good health especially as an actively sought goal”. Other definitions go on to say, “an active process of becoming aware of and making choices toward a healthy and fulfilling life”.  The common word in both of these definitions is “active.” Wellness does not come upon us by passively watching life go by, by hoping for health but refusing to make any changes, or by denying the influences and impact our daily choices have on our health and well-being. In order to achieve wellness, one must make the conscious choice to make a change, to take that first step, and to keep moving forward even after life?s set backs and unforeseen obstacles.

People often define their wellness by their physical health alone. Actually, there are seven domains of wellness and each one is equally important to achieving true wellness and quality in our lives. Here is a list of the seven domains of wellness:

  • Physical
  • Emotional
  • Social
  • Intellectual
  • Spiritual
  • Environmental
  • Occupational

It is important to reflect on each of these domains and determine what they look like and mean to you now, at this stage of your life. In the upcoming entries, we will be diving in and exploring each domain in further depth.


Maintenance Therapy – The Best Kept Secret in Senior Care!

By Above & Beyond Senior Services

mainttherapy1Have you ever needed physical or occupational therapy (PT/OT)? Conditions that cause decreased strength, range of motion, balance deficits, difficulty with walking and memory issues are leading reasons seniors might need therapy. Most therapy is based on a model that requires patients to meet certain qualifying criteria. Typically, a person must demonstrate measurable, skilled progress or the therapy provider is required to discharge. Over the course of the last decade, a new option for wellness and exercise has become increasingly available to Minnesota seniors!

Maintenance therapy is the same PT/OT that you are familiar with, but with a few differences:

  • Starts after traditional therapy ends.
  • Has no requirements for frequency or duration of service.
  • Can continue on a long-term basis.
  • Comes into the home, while allowing freedom to be active throughout the community.

Let’s meet Mary:

mainttherapy2Mary had a massive stroke at 68. She was left with an inability to walk, difficulty with speaking, and decreased movement on the left side of her body. After completing rehabilitation in the hospital, then a care facility, she was able to return home with her husband, Ed. She also qualified for Medicare home therapy. When Mary was no longer considered home bound, she transitioned to an outpatient clinic. Mary was very motivated to get better, but this proved more difficult than imagined. It was hard to be disciplined in completing the home exercises her therapists assigned. Ed began to notice declines, despite Mary going for therapy twice a week. They were disappointed in her regression. It was time for a change. She wanted home therapy that focused on the tasks and activities that were important to her and allowed them to be in control of her rehab. Thanks to a recommendation from a trusted health care worker, Ed inquired about direct-pay, maintenance therapy.

The maintenance therapists helped discover Mary’s abilities and limitations. The couple’s therapy goals were set collaboratively. These weren’t goals for the purpose of insurance coverage, but the goals that were important to both of them. They were finding their “new normal”. Her desire to maximize her mobility, strength and balance was met by creative exercise instruction from her therapists. Over time, with PT/OT each week, Mary had many successes. Eventually she was able to walk throughout her home, enjoy her swimming pool and an adaptive horse-riding program! Her quality of life was significantly improved as she met her goals of participating in community activities and going out to dinner with Ed. She felt empowered, engaged and happy about her accomplishments.

While many people desire and achieve goals of improvement, maintenance therapy also understands that sometimes, true “maintenance of ability” IS the goal. Many seniors get caught in a cycle of decline which leads to hospitalization and rehab. Once home again, it’s difficult to maintain exercise programs independently. Lack of adequate maintenance leads to progressive decline and the cycle begins again. Introducing maintenance therapy can be a life changer for a senior.

When a client has ongoing, one-on-one therapy, they are able to maintain their physical abilities. This makes the difference between staying at home vs. moving to assisted living or nursing home. A benefit of maintenance therapy is the same therapist can continue with clients if they change the place they call home.

If you are a senior who wants to either regain or maintain your quality of life through wellness and exercise, maintenance therapy may be the missing link that you have been searching for.

Seniors and Exercise

Exercise should no longer be a dirty word for seniors. At one time, exercise was judged to be too dangerous, too vigorous for older adults due to frailty and/or fear of being injured by exercise. However, a number of well-conducted studies over the last several years have shown that a variety of exercises are not only safe for older adults but have enormous advantages. In fact, staying active can help you:

Keep and improve your strength so you can stay independent.

Have more energy to do the things you want to do.

Improve your balance.

Prevent or delay some diseases like heart disease, diabetes, and cancer.

Perk up your mood and help reduce depression.

To get all of the benefits of physical activity, try the four types of exercise:

  1. Endurance: Be sure to get at least 30 minutes of activity that makes you breathe hard on most or all days of the week. That’s called an endurance activity because it builds your energy or “staying power.”  You don’t have to be active for 30 minutes all at once. Ten minutes at a time is fine. Just make sure you are active for a total of 30 minutes most days. How hard do you need to push yourself? If you can talk without any trouble at all, you are not working hard enough. If you can’t talk at all, it’s too hard.
  2. Strength: Strength exercises build muscles. When you have strong muscles, you can get up from a chair by yourself, you can lift your grandchildren, and you can walk through the park. You are less likely to fall when your leg and hip muscles are strong. Strengthening exercises involve providing resistance to your muscles. This can be done with weights or using your body weight, such as push-ups, squats, and sit-ups.
  3. Balance: Balance training allows us to prevent or delay the use of assistive devices for walking and to prevent falls. Balance activities can be incorporated into your strength exercises. Squats and lunges can be progressed from hanging on to a counter or bar to not hanging on to anything.
  4. Flexibility: Stretching can help you be more flexible. Moving more freely will make it easier for you to reach down to tie your shoes or look over your shoulder when you back the car out of your driveway. Stretch when your muscles are warmed up. Don’t stretch so far that it hurts.

You are more likely to keep up an exercise program if you are doing activities that you enjoy. So, no more excuses find an activity or activities that interests you and start working them into your schedule! Remember, your physical and occupational therapists are great resources for starting an exercise program.

Preventing Falls

For people age 65 and older, falls are the leading cause of injury-related fatality. At least a fifth of those that fall have moderate to severe effects, including head trauma, spinal cord injury, and fractures.  All falls are maddeningly unpredictable and usually occur in familiar surroundings. The single greatest prediction of a future fall is a past one.  The chances of recovery are complicated by the fact that an elderly person who has had a fall may restrict daily tasks in order to avoid another one.

Recent studies have revealed that Vitamin D deficiency is becoming a recognized risk factor for falls in older adults. It is currently being recommended that older adults who are housebound or inactive due to physical limitations should take Vitamin D supplements.

The 4 proven strategies for preventing falls include:

  1. Participating in a specialized exercise program that addresses balance and gait disturbances. Studies have shown that personalized exercise programs reduce falls by 20%.
  2. Assessment of home hazards, such as removal of throw rugs and clutter, diminishes risk by 10-15%.
  3. Careful review of medications by your physician and/or pharmacist is also recommended since some medications may cause light headedness and/or lethargy which may contribute to a fall.
  4. A thorough vision examination is also imperative.

A physical therapist can assist a person in assessing their fall risk and work towards reducing that risk by determining an appropriate exercise program that addresses balance and gait disturbances. Physical and Occupational therapists can also assist with home safety assessments to determine home hazards and assist with problem solving to decrease these hazards and reduce the risk for falls in the home.


Allison Bakke, OTR/L
Above & Beyond Senior Services

Finding EXCELLENCE in Senior Healthcare

As a health care professional for the past 15+ years I’ve always felt pretty confident I could find a good doctor, pharmacist, caregiver, physical therapist, or nurse if the time ever came that I needed one – especially in a crisis. I was recently put on the caregiver side of the health care equation nothing earth shattering, but my son broke his leg and it came with a unique set of circumstances. Lost dreams of a summer soccer season, bike riding and swimming with friends, and a choir trip to Alaska were all things that suddenly seemed very much shattered. As his mom and caregiver I found myself wondering about all these things and a hundred others. I was squarely in a situation that was out of my control to direct. We were at the mercy of whatever orthopedic doctor the scheduler assigned to us.

I imagine this is how family members feel when a senior in crisis is referred to a nursing home for rehab or to a home care agency for on-going care. How do I know I’m going to like the person that is assigned to me? Will they take enough time for me? Will they answer my questions? Are they any good at what they do? Do they provide quality care? How do I know that what they are telling me is correct? How do I know what I don’t know?

What happened next on our broken leg journey was nothing short of anxiety inducing. The doctor we saw didn’t have time for us, he couldn’t relate to my son, and looked at me like I was crazy when I asked about pain control. We left his office without any instructions on my son’s restrictions or care. We also left with newfound gratitude for my profession as an occupational therapist; we would have been totally lost otherwise. What I realized after the shock of the appointment wore off was this: a broken bone had become routine to this doctor. It was a mechanical issue that needed repair – there was no passion for the care of the patient. To my son and our family a broken bone was anything other than routine; it was a loss of some short-term hopes and dreams. This is no different for a senior who sustains a fall, has a heart attack, or develops dementia; plans are changed, dreams are shattered, lives are disrupted, that IS NOT routine. How do you find an individual provider or senior care agency that will help you compensate, adapt, and be compassionate around these issues?

Here are a few ideas: