“Wellness is an active process of becoming aware of and making choices toward a healthy and fulfilling life. "...a state of complete mental, physical, and social well-being, and not merely the absence of disease or infirmity,”
The World Health Organization.
Emotional wellness inspires self-care, relaxation, stress reduction and the development of inner strength. It is important to be attentive to both positive and negative feelings and be able to understand how to handle these emotions. Emotional wellness also includes the ability to learn and grow from experiences.
A clinical understanding of bereavement, depression, grief, stress emotions are
essential for a positive life experience:
Bereavement is the experience of the death of a loved one. Grief is the emotional response to a loss. Note that grief can also include the emotional response to the losses discussed above that don't include death.
Studies of grief among older adults suggest that older adults who lose a spouse may grieve longer than many others. Plus, older adults who have lost a spouse have shown significantly more symptoms of grief than adults who lost a family member other than a spouse.
This difference has been found up to seven years after the death, which led the researchers to suggest that some later-life widows and widowers may never entirely resolve their grief.
While depression can be common in elderly people, it is not a normal part of aging. A disorder that affects mood, feelings, behavior and even physical health, depression is a medical condition that can and should be treated.
Depression affects nearly 6 million Americans over the age of 65; however, only about 10 percent receive treatment, which means that the normal functioning of millions of seniors is interfered with on a daily basis. Among seniors, approximately 10 percent of primary care patients and nearly 20 percent of long-term care residents suffer from major depression, the most severe form of depressive illness. Suicide, which is closely linked with depression, is almost six times higher for white males over the age of 85 than it is for the general population. Beyond its direct effects on senior’s quality of life, depression is a risk factor for increased mortality and disability.
Depression is a biological illness that affects behavior, thoughts and feelings. It is manifested as an intense feeling of sadness that may follow a loss or other traumatic event but is out of proportion to that event and persists beyond an appropriate length of time. Eran Metzger, M.D., says that most people get the “blues” now and then, but are not depressed. The following signs— in yourself and others —can indicate depression:
Persistent sadness, anxiety or an “empty” feeling.
Feelings of hopelessness, helplessness, guilt or worthlessness.
Decreased energy and fatigue.
Restlessness and irritability.
Difficulty concentrating, remembering or making decisions.
Loss of interest in pleasurable activities.
Persistent thoughts of suicide or death.
Depression can be successfully treated with antidepressant medications, psychotherapy and self-help (e.g., meditation, relaxation techniques, and support groups). In addition, developing a hobby, staying involved with activities that keep your mind and body active, and keeping in touch with family and friends are all proven ways of keeping major depression at bay. The good news, says Dr. Metzger, is that once depression has been recognized and treatment sought, symptoms will lessen. About 60 to 80 percent of people diagnosed with depression are treated successfully outside the hospital.
Social isolation and loneliness, the presence of other illnesses such as Parkinson's, Alzheimer's, cancer or stroke, recent bereavement, the use of certain medications (some of which can cause or worsen the symptoms of depression), and family history of depression can increase a senior's risk of suffering from depression. Doctors and family members may miss the signs of depression in seniors. As a result, many seniors end up having to cope with symptoms that otherwise could be easily treated.
It is not unusual for older adults to experience sadness when faced with changes that are associated with aging; however, clinical depression may exist when persistent sadness does not lift and this altered mood affects the individual's ability to function normally, says Eran Metzger, M.D.
Family members and doctors should look for the following signs if they suspect an older adult may be depressed:
Unexplained weight loss or gain
Lack of attention to personal care
Loss of interest in normally pleasurable activities
Feelings of discouragement or hopelessness
A physical exam can determine if a medical illness is contributing to or causing the depression, while blood tests can rule out thyroid, kidney or liver problems, some of the symptoms of which can mimic depression. A psychiatric evaluation can help determine what depression is and what might be dementia, a significant loss of intellectual and cognitive function.
The most common treatments for depression in seniors include treatment of underlying medical conditions; psychotherapy, which involves talking about your condition and related issues with a mental health professional; antidepressant medications (these are often used with caution due to side effects and because they may take longer to work in older adults); and, for cases of treatment-resistant depression, electroconvulsive therapy, or ETC.
Medications such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants work by increasing the amount of the neurotransmitter serotonin, which plays an important role in the regulation of mood, in the brain. Monoamine oxidase inhibitors (MOAIs) prevent the breakdown of serotonin, but carry potentially serious side effects, so they are used infrequently.
Properly treating depression in older adults may help reduce the likelihood of death from physical illness, prevent suicide, and reduce health-care costs, which are nearly 50 percent higher for seniors with depression.
"While most seniors are happy, content and positive, others need assistance in helping them adjust to life's changes as they get older," says Dr. Metzger. "Social interaction with family and friends can help them adjust to losses and change. Participating in activities, either alone or with others, can help keep seniors occupied and their minds engaged. And exercise has been shown to be an effective measure to ward off depression or to prevent symptoms from worsening."
The grieving process is the normal human response to loss. Each person experiences grief differently, depending on his or her inner resources, support, and relationships (Dossey & Keegan, 2009). According to Feinstein and Mayo (1990) grief work has three characteristics:
It furthers the healthy grieving process by encouraging ventilation, planning, and insight.
It does not exploit others. The mourner has a healing team that provides comfort.
Appropriate grief work cannot be rushed. It takes time to accept that death has occurred and to work through feelings. The individual who goes through the grief process may experience a sort of transformation from profound sadness to a sense of comfort.
The stages of grief are subjective and can have a physical, emotional, and social response to a loss. Grief occurs in phases that people can move in and out of during the grief process (Luggen & Meiner, 2001).
Kubler-Ross (1969) is perhaps the most widely cited author on death and dying. She identified five stages of grief. Not all stages may be experienced nor may they be experienced sequentially. General emotional transitions and stages of grief include:
Denial (the individual is not ready to accept the loss)
Anger (may be directed at God, the medical staff, or family members)
Bargaining (an attempt to postpone the inevitable)
Depression (as the full impact becomes apparent, depression may set in)
Acceptance (a time of relative peace or coming to terms with the situation)
It is best not to think of grief strictly as a series of stages. Grief can be a like a roller coaster, with many ups and downs. Sometimes an individual may be doing well and other times not so well. Coping with grief is individualistic, with each person finding his or her own sources of comfort through support groups, activities such as journaling, or through spirituality and religion. Experiencing grief can be very stressful, so it is important to eat well, sleep well, and engage in adequate exercise (Doka, 2000).
Healing Takes Time (2005) David P. Gallagher is filled with 52 meditations and reflections to help people experiencing loss start a journey of healing.
Stress is defined as a physical, chemical or emotional response that causes bodily or mental tension. Hans Selye, the Canadian doctor who coined the term “stress” as it is currently used, said: “Without stress, there would be no life.” While we all experience stress in our lives, overwhelming and poorly managed stress can have a negative impact on our physical and mental health.
Eran Metzger, M.D., offers the following tips for reducing stress in your life:
Identify areas of stress and develop a plan for dealing with them.
Manage your time effectively, giving priority status to your most important activities.
Simplify your life by eliminating unnecessary tasks.
Practice relaxation exercises, including deep breathing, progressive muscle relaxation, visualization, and meditation.
Exercise regularly and eat a healthful diet.
Think positively rather than focusing on negative thoughts and feelings.
Learn to be a good communicator so you can clearly express your feelings, wants and needs.
Learn to say no — without feeling guilty about it.
Get a good night’s sleep.
Recognize that drugs and alcohol do not reduce stress; rather, they increase dependency.
Develop a sense of humor so you can laugh at the ironies of the world around you.
Not all stress is harmful, says Dr. Metzger. Some stress, such as running a race, elicits a different biological response that may be beneficial.
Emotional well-being encourages autonomy and proper decision-making skills. It is an important part of overall wellness.
Attitude is a self-fulfilling prophecy:
Graduating into new beginnings
Creating a positive identity
Balancing greater freedom
Finding a new purpose for living
Memory Loss is NOT a normal part of aging, but learning takes longer; recall may be slower; attention becomes harder to maintain; items are misplaced; and there is minor disorientation in unfamiliar surroundings. Staying engaged is the best indicator for mental health. Examples are including:
Maintain an attitude of gratitude
Read and know the Bible
Worship each Sunday
Fellowship (Identify with the body)
Don’t divorce, cohabitate, watch pornography or commit to any other additive bad habit
Pray for humility daily
Be thankful for God’s love
Speak to others only what will bless them and build them up
Be a ferocious reader
Enjoy God’s outdoors
Be a good listener
Love and respect your parents
Have a self-reliance, determined attitude
Thank God constantly
What others think of you is not your business
Make peace with your past (forgive everyone)
Love heals everything
Do not compare yourself or judge others
Measure three times, cut once
You are in-charge of your happiness
Do not worry
Have a pet
Respect your parent’s preference to be independent and live in their own home
Physical wellness promotes proper care of our bodies for optimal health and functioning. There are many elements of physical wellness that all must be cared for together. Overall physical wellness encourages the balance of physical activity, nutrition and mental well-being to keep your body in top condition. Obtaining an optimal level of physical wellness allows you to nurture personal responsibility for your own health. As you become conscious of your physical health, you are able to identify elements you are successful in as well as elements you would like to improve.
Keys to physical health:
Drinking alcohol in moderation
Maintaining healthy weight
Disease prevention and early detection
Maintaining Faith in God
Jeffrey Levin postulated on the bases of his research that religion affiliation benefits health by promoting:
Healthy behavior and lifestyles
Buffering the effects of stress and isolation
Strengthening the physiological effects of positive emotions
Reinforcing health-promoting personality styles
Nurturing hope, optimism and positive expectations
Activating an altered state of consciousness
Invoking paranormal means of healing
Normal Aging Characteristics:
All five senses tend to decline (hearing, seeing, smelling, tasting, touching)
Lung capacity declines
Physical strength declines
Age spots appear
Skin elasticity diminishes
Body temperature is affected
Social Well-Being Health
Social wellness refers to the relationships we have and how we interact with others. Our relationships can offer support during difficult times. Social wellness involves building healthy, nurturing and supportive relationships as well as fostering a genuine connection with those around us. Conscious actions are important in learning how to balance your social life with your academic and professional lives. Social wellness also includes balancing the unique needs of romantic relationships with other parts of your life.
Relationships are the basis of meaningful connections:
Creative pursuits are the basis for meaningful redirection:
Staying engaged is the best indicator for successful aging