Recent research into aging demonstrates that social connections and developing a sense of purpose are fundamental to living a longer, healthier life. But how often are these concepts discussed in the context of long-term care? Unfortunately, not often enough.
In this article, we investigate the meaning of successful aging in LTC and how you can help your residents live their best lives. Dr. Roger Landry, a preventive medicine physician and top authority on successful aging, joined the LTC Heroes podcast to talk about taking a holistic approach to successful aging, or, going beyond the conventional wisdom of just diet and exercise to include efforts in creating purpose and meaning.
Read about his effective methods for using preventive medicine, proper techniques for instituting exercise and meditation, and instructions for regulating diet and sleep at LTC facilities below.
What Is Successful Aging?
Successful aging means maintaining both physical and cognitive functions. It doesn’t involve taking shortcuts, finding a fountain of youth, or drinking an elixir. Rather, successful aging is a combination of healthy practices that – if done well and consistently – add to a resident’s lifespan, or, at the very least, make the remaining years more enriching.
Caregivers at LTC facilities are well aware of their residents’ physical needs. They keep track of seniors’ health through specific diet programs, exercise, and even medication plans. These communities take a resident-centered approach to make the experience of living at a nursing home as pleasant and safe as possible.
Sometimes, though, spiritual and mental needs are overlooked. This is despite the fact that isolation and lack of purpose are two of the biggest reasons seniors feel restless or unwell. These issues were only magnified during the COVID-19 pandemic.
Each facility must evaluate itself in terms of how much it meets the needs of its residents. It then must organize a plan to improve. We provide actionable steps in this article.
Prevention is the first step in LTC
“Successful aging” is a term that goes back over fifty years, but it only became popular in the 1980s, when John Rowe and Robert Kahn discovered that many of the effects of aging were actually due to disease.
Thus, before we discuss some of the more overlooked components of successful aging in LTC, we’ll include an obvious one: preventive medicine. By taking the necessary precautions and staying vigilant of early signs of illness, you will elevate the standard of life at your LTC facility.
Here are some simple steps to take in preventive medicine:
- Hiring a wellness coordinator. This will help organize and streamline activities. And knowing they have someone specifically appointed for their health will help motivate residents, much like a personal trainer.
- Establishing preventive programs for staff and residents. These can include fitness classes and nutrition seminars.
- Making environmental changes. You can add more natural light to increase alertness during daytime hours when most activities occur or repaint rooms as appropriate.
So long as upper management supports these efforts and remains persistent, they will get results, even if such measures are not always appreciated. As Dr. Landry said: “The problem with prevention is, when you do it right, nothing happens. And so you don’t get the incentive or the funding.” Instead, administrators need to recognize the value of this work on their own. “It’s a road of internal satisfaction and internal positive incentives,” Landry said. In other words, enacting a plan for successful aging requires patience, vision, time, and prolonged effort.
One area of preventive health that is of particular concern in long-term care facilities is infection control. Every LTC professional knows how common ear/eye/urinal/skin/respiratory infections are in the elderly. Worse, they spread like wildfire. The practice of infection control essentially means that every single infection is prevented from happening and spreading before the signs are seen. This crucial matter was made even more apparent during the COVID-19 pandemic.
The pandemic has changed how we view infection prevention and the necessity of infection preventionists. Even now, there are still important guidelines that the CDC has provided for preventing another outbreak. You can get your infection prevention and control program on track by hiring the right infection preventionist and monitoring infections electronically. For more, read this guide or take a look at our interview with Laurie Laxton, RN, BSN, CCFA, RAC-CT, IP-BC, and a professional preventionist.
The value of holistic care in LTC
Preventive medicine will help keep your residents alive. And, while that is a noble cause, it is not enough to ensure the fulfillment of the people in your care. Similarly, proper diet and sufficient exercise are essential for healthy bodies.
But is that enough to make your residents happy? You can move them to exercise every single day and provide them steamed chicken breasts and veggies for the duration of their stay. But those alone will not bring them joy.
That is where holistic care comes into play. A holistic approach to long term care goes beyond striving for mere survival and instead asks what needs to be done for seniors to enrich their quality of life in their final years or decades.
Holistic care looks at all dimensions of a human being, not just one’s physical needs. It goes beyond the age-old pillars of diet and exercise to also evaluate our mental well-being and engagement with the world around us. In this way, it treats people as individuals with unique perspectives, purposes, and worth.
Here are some small, actionable items that will bring great peace of mind and comfort to your residents and provide improve their quality of life:
- Let the residents do as much as they can on their own. This sense of autonomy and independence will build their self-confidence and create ambition to do more.
- Organize daily activities according to the residents’ needs and preferences. Make sure each week the activities are different and engaging.
- Ask the residents for feedback. After all, it is their opinions on the facility itself, activities, and the overall experience that matter most. Utilize this input to improve your care.
- Make sure the residents are interacting with one another and building relationships. For many, relationships are what make life worth living. Thus, they are critical components of residents’ mental and physical health.
The roles of purpose and meaning in aging well
Implementing holistic care, or, one that considers residents as complete human beings with a wide range of needs, might be challenging at first. So how does one begin addressing such a large task?
Dr. Landry, who authored Live Long, Die Short: a Guide to Authentic Health and Successful Aging, boils the answer to successful aging and healthy longevity down to finding purpose and meaning.
In this 2014 book, he argues that, if received positively and approached with the right mindset, the process of aging can be far more comfortable. Pain may be inevitable, but self-inflicted pain – in the form of things like cutting off ties with others or not maintaining a balanced diet – is entirely preventable.
That is where long-term care comes in.
Most recently, on the LTC Heroes podcast, Dr. Landry, who is also a successful motivational speaker, advanced his theories about aging a step further by including a discussion on the meaning of life. In his interview with Peter Murphy Lewis, Dr. Landry discussed:
- Ageism and its impact on the senior community
- Healthy practices in aging and how to incorporate them at LTC facilities
- Aging successfully in an LTC facility and actionable steps
- Meal and diet plans for the elderly
- How to keep mentally sharp
- The importance of meaning and purpose for the elderly
Older adults must find new interests and goals each day to keep their minds active and busy, he argues. New hobbies are just one way to keep seniors engaged. Learning something new – such as an instrument, a foreign language, a new game, or a new sport – will not only help keep their brains active but also help them develop. This is part of what Landry terms “paying attention to our lifestyle in a very holistic way.”
It is important to keep in mind, though, that you cannot hold your residents’ hands and walk them through the process of finding their purpose and meaning. Indeed, it is an independent journey that each individual traverses at his or her own pace and in the way most in line with his or her disposition and particular situation. But that doesn’t mean you can’t help guide residents toward the path that works for them.
Here are some easy ways to support your residents in finding their purpose and meaning:
- Encourage them to pick up a new hobby or skill or remind them to practice an old one. Perhaps Sally stopped playing the piano twenty years ago and just needs some warm words to find the motivation to play again.
- Encourage them to do something silly once in a while. Adults take themselves too seriously, and it’s great if you can remind them to let loose sometimes. Karaoke or even improv or standup comedy nights might help bring out their playful side.
- Place musical instruments and books strategically. Perhaps a shiny guitar or the compelling cover of a novel will catch a resident’s eye and end up sparking an interest that then burns for months or years. Of course, this should be a gentle nudging and not the application of pressure that might put them off.
- Have conversations with them about their childhood and the struggles they’ve faced or the wisdom they’ve acquired along the way. This might create in them the desire to pick up something they had to give up due to circumstance.
- Arrange special events that allow residents to share their new purposes with others. Feeling loved and receiving communal support are major contributors to mental health.
So what kind of results can you expect to get from following the guidelines stated above? Some of the benefits you will see from residents finding their purpose and meaning are:
- Residents will have more energy and reduced stress.
- Relationships will improve among residents.
- They will be healthier and happier physically, emotionally, and spiritually.
The importance of social connection in long-term care
Aging is hard enough on its own, but aging surrounded by strangers and caretakers in LTC instead of your loved ones at home can make things a lot worse. Everyone has a system for how they organize their lives and belongings. And people who have been on this earth for over six decades are even more set in their ways. Residents who are used to living alone and carrying out their daily activities in a certain way may not like you touching their things or trying to strike up a conversation. By contrast, one who comes from a vibrant household with many children and pets might be used to multitasking and being asked to do things for other people.
The degree or nature of social connections with which people are comfortable may vary, but, in the end, a social network is necessary for the mental health of all, extroverts and introverts alike. Research shows that individuals who maintain social contacts are at a decreased risk for depression when compared with lonely people who do not maintain friendships.
Dr. Landry notes that keeping in touch with others keeps your mind active and relationships growing, both crucial factors for longevity. He discussed this and more in a special three-episode conversation available on LinkedIn.
Social isolation is a serious issue in LTC facilities in the U.S. In a 2020 report from the National Health and Aging Trends Study, investigators found that 24% of community-dwelling adults age 65 and older in the United States (approximately 7.7 million people) were socially isolated, and 4% (1.3 million people) were severely socially isolated. And the COVID-19 pandemic has only made things worse.
That is where an LTC community can help. By planning activities and socialization, these residences make seniors feel surrounded, which naturally increases interaction and reduces the likelihood of depression. Additionally, it is beneficial for residents to be surrounded by professionals in the field who understand their needs and are prepared to assist.
Use these actionable tips to combat depression and reduce the feeling of social isolation in your facility.
Keep your residents’ minds sharp
Always keep in mind the fact that living at an LTC facility can be a trying experience. Imagine the feeling of waking up somewhere other than home, only that is the new normal. Such dread is what your residents might go through for the first few days or weeks of their stay.
All of a sudden, these seniors are distanced from family and the world they knew for so long. That makes staying on top of what matters to them all the more challenging. A declining memory can mean forgetting some of the special things in your life, like a granddaughter’s birthday or a childhood pet’s name. That’s why your LTC facility must do what it can to help preserve the cognitive ability of its residents and stave off Alzheimer’s disease or other forms of dementia.
We’ve already mentioned how you can keep them mentally and physically active, but caring for an older person requires more than the administrative tasks outlined above.
The easiest way to alleviate this stress is to remind residents of how safe they are in your care and point to the number of similarly-aged people surrounding them as a sense of comfort.
Then, you can start to help residents stay on top of their affairs by things like maintaining a routine, giving them personal attention, and reassuring them that their needs are being met. In keeping with Dr. Landry’s recommendations for maintaining autonomy for residents, staff members should remember to act as facilitators and not build a culture of dependence.
Here are some things to use that will help your residents stay alert and sharp:
- Word games and numeric puzzles. The elderly take pride in their reliable memories. They often mention how, in the old days, they had to remember the phone numbers and addresses of all the important people in their lives. Take that pride and turn it into a fun way for them to display their prowess.
- Neurobics (exercise for your brain). These will force them to use different parts of their brain by, say, requiring them to hit a pinata with their non-dominant hand. Such exercises can be both challenging and highly entertaining for them.
- Exercise. Move beyond the standard practices and make them do more than just a few random stretches. Make it a game (with as little possibility of danger as possible), and you will see that they actually look forward to it.
- Proper nutrition. Use healthy fats in cooking, avoid serving fried foods, and make meals as (naturally) colorful as possible. A balanced diet will help them focus and remain active throughout the day
- Music. There’s always a resident who learned to play the violin or piano (or an electric guitar, if they’re particularly cool) when they were 16. Help them find the resources they need to brush up their skills and, ultimately, put on a show for the Sunday Brunch. Music will keep the residents preoccupied and put them in a good mood for the rest of the day.
- Empathy. Aging is a difficult process for most. Seeing your body change, not for the better, is not exactly a walk in the park. Demonstrate compassion, but don’t coddle your residents. Make them believe they have things to which they can look forward even as they face new physical and emotional obstacles.
- Identifying smaller pleasures. Each resident knows what makes him or her feel happy or content. Facilitate access to those little (but highly valuable) things when possible and stimulate conversation about the interests of residents to give them one more thing to brighten up their day.
It will also be helpful to encourage residents to build their vocabulary and teach skills to others. Click here for more brain exercises to try.
Exercise and the power of community in LTC facilities
LTC facilities are a great place for the elderly to take a big step forward in the amount of their physical activity. We all know how helpful it is to have a trainer or even a workout buddy to push you to meet your personal goals. Use the advantage of the community to encourage residents to get into better shape by participating in group activities like:
- Eye exercises, including palming and basic yoga.
- Pranayama – which can help in breathing – and Anulom Vilom, an excellent way to calm your nerves and strengthen your lungs.
- Basic stretching exercises that can be done every morning in the park.
- Exercises specifically designed for seniors, including the single-limb stance, walking heel to toe, and the clock reach.
Does your facility face an issue with available resources for proper physical activity? Consider converting a barren piece of land attached to the property into an exercise park. And you don’t need anything too fancy. Even simple equipment will help promote physical activity.
Don’t forget that the best exercises for the elderly are the ones that provide safety, balance, and strength. They don’t have to become world champion weightlifters. It’s far more important that their knees don’t give in every time they try to bend.
Exercising in groups at LTC facilities will give residents the support and guidance that they need. Moreover, it will help them stick to a plan and avoid making excuses. LTC facilities should make sure that they have a trainer on-site so that each person’s particular requirements and weaknesses are addressed. Generic exercise will yield generic results. Hiring a specialist is the best way to ensure that residents make substantial progress.
Help seniors get the sleep they need
Many older adults have problems sleeping, which include insomnia, daytime sleepiness, and frequent waking during the night. Some have trouble falling asleep at night or wake up during the middle of the night. Others may be too tired to function properly during the day due to a lack of quality restorative sleep. Seniors above the age of 65 should be getting anywhere between seven and nine hours of undisturbed sleep.
Here are a few ways to overcome sleep problems and help residents develop good sleeping habits:
- limiting their caffeine intake after 2 P.M.
- ensuring their environment isn’t too noisy before bedtime
- turning off all TVs or smartphones in the facility an hour before bedtime
- adequately involving residents in physical activities to ensure that they have exerted themselves enough to fall asleep at night
Other ideas to consider promoting are taking warm baths, avoiding afternoon naps, and drinking fewer fluids at night.
Your facility should also strongly consider appointing a caregiver to monitor residents’ sleep schedules and help keep them on track. That kind of vigilance will help treat inconsistencies like nightmares, sleepwalking, and insomnia immediately. Additionally, all LTC facilities should have a watch guard to prevent anyone from wandering off.
Meditation for LTC residents
While LTC facilities are great for providing consistent medical and non-medical attention, they can also induce anxiety. Regular meditation group sessions can help counter that.
Reasons you should include meditation as part of your facility’s routine include:
- It is proven to reduce stress in old adults.
- It can improve sleep and correct irregular sleeping patterns.
- It can help them control anxiety.
- It is not strenuous and only gets easier with time.
The sense of calm and relaxation that your residents will feel when they step outside on a warm, sunny day to meditate cannot be replaced by watching their favorite program on an LED screen. If they find meditation awkward or overwhelming at first, start with just five minutes a day. They will soon notice the results.
How strict should you make the diet at your LTC facility?
A nutritious and balanced meal plan will keep residents more focused and improve their mental clarity and memory over time. They will also recognize that they are getting more out of their days. A healthy diet includes fruits, vegetables, whole grains, lean meats, legumes (like baked beans), and low-fat dairy products. This will help prevent diabetes, prevent blood sugar spikes, control high blood pressure, and improve overall health.
It’s not, say, eating almonds will make their brains run at the speed of light, but consistent habits add up. While it is okay to have cheat meals once in a while, it should not become the norm. LTC facilities must be persistent in keeping residents on track in terms of what, when, and how much to eat.
One advantage of living in an LTC facility is that it makes it easier to control cravings, as everyone is essentially served the same food. Still, your staff should be greatly aware of the particular needs and requirements of each resident; sharing food carelessly can trigger dangerous allergies.
Understanding your residents’ bodies
It is important to understand the capacity of each body at your facility as well as the lifestyle that each individual adopts. For some, routine is monotony, for others, it provides a sense of comfort. In one LTC facility, you might find residents with “skydiving” on their bucket lists alongside some who put “wheelchair” on their birthday lists. Thus, it is important to remember that not every 80 year old is the same.
Seniors know that the world views them and treats them differently because of their age. Ageism exists, and as Dr. Landry says, ‘‘It’s in the jokes, the greeting cards, and even our language.” He also highlighted the negative connotations that surround the word “elderly.”
An LTC community is that safe space or welcoming environment for which seniors long. Your staff must help residents understand that their physical changes are normal and answer whatever questions they may have. The key is to make them understand that they can have a fulfilling life even though they don’t have as many muscles or aren’t as active or young as they used to be. Encourage them to enjoy the positive aspects of this particular stage in their lives.
Always keep in mind that individuals have their own specific bodily needs and limitations. That is why the holistic approach outlined above is so crucial. By shifting the focus from a rigid diet or predetermined exercise plans, you can tailor your program to individual residents as appropriate. This involves greater consideration for their physical, mental, and spiritual health. And the result is improved quality of life for your residents.
Successful aging in LTC can be achieved by following the actionable advice discussed above. If you loved our tips and Dr. Landry’s interview, consider subscribing to our email list here and listening to other episodes of our podcast. We are deeply committed to producing content that will help you maximize results at your LTC facility.
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