By helping seniors set life goals, coaches motivate them to get stronger and live well
As people live longer, they’re starting new chapters late in life, thanks to a wellness strategy involving goal-setting.
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Bea Lipsky shuffles into her wellness coach’s office one morning earlier this fall and parks her walker by the wall. Lipsky, 89, has had a trying year, enduring a hernia operation and two emergency room visits for heart problems. She’s losing her hearing, and recently gave up her dream of riding in a hot air balloon for her 90th birthday. Today, though, she’s filled with pride: She tells her coach she’s achieved all of her goals for the year, including attending her grandson’s wedding in China.
Lipsky spent two months training, doing leg curls and riding a stationary bicycle, to build up the strength to make it through a 10-day trip to China, accompanied by an aide. “It was absolutely divine,” she tells the coach, Susan Flashner-Fineman, who works at the Orchard Cove retirement community in Canton, where Lipsky has lived for the past four years.
Lipsky’s check-in with Flashner-Fineman is part of a wellness coaching program, Vitalize 360, that Orchard Cove started eight years ago in collaboration with the Kendal nonprofit senior living organization in Pennsylvania. When seniors join the program, a coach measures their health and wellness levels in an hourlong, one-on-one session, assessing common problems for seniors like loneliness, pain, and distress. The coach also inquires about families, friendships, and spiritual life. Then the seniors meet with their coach every year before their physical checkup with a doctor, to talk about what matters most to them. The coaches, who come from a variety of backgrounds, including fitness, social work, and chaplaincy, help participants set goals — which could be physical, social, intellectual, or spiritual — for the coming year. These goals become the focus for the senior’s medical team, and the seniors follow up with their coaches every three months to stay on track.
Wellness coaching aims to rethink how senior living communities treat aging, says Aline Russotto, Orchard Cove’s executive director. “We used to be at our very best when somebody was in crisis,” she says. They still want to excel at “fixing what’s broken,” but Orchard Cove staff also want residents to have healthier and happier lives by emphasizing “living your best day every single day until the end.”
Dr. Atul Gawande, author of Being Mortal and an expert on end-of-life care, calls the Vitalize 360 approach “transformative.” It recognizes that “even as you may have health issues and frailty and the difficulties that can come with aging . . . people have lives worth living. And in fact have a lot more life worth living,” he says. When young people become disabled, others often help them find ways to contribute to the world, he notes, but that is much less true for older people. “I see it as the kind of thing that you’d like to see go populationwide,” Gawande says. “You’d like to make it routine.”
Since the program started at Orchard Cove, fitness participation — the proportion of residents who exercise at least three times a week — has more than doubled, from 30 to 77 percent, and one study found participants felt significantly less depressed than a control group, with a notable jump in the number who said they felt “delighted with life.” The program itself has spread to 35 communities in 12 states, reaching more than 2,600 older adults in independent or assisted living. Since existing staff can be retrained to serve as coaches, the program isn’t costly, though there is an annual fee for training and data-tracking software. Flashner-Fineman, who spent a decade as Orchard Cove’s fitness director, travels to new sites several times a year to run a three-day training teaching new coaches the skills they need to work with patients and to run standardized assessments. She and her colleagues also train health professionals, leadership, and other staff on how to orient care around seniors’ goals.
At Orchard Cove, where the average age is almost 90, Flashner-Fineman coaches a wide range of residents, including younger, healthy residents, like 74-year-old Janet Donnoe, a retired consultant. In a recent visit, an energetic Donnoe announces “great progress” on her fitness goals. She now gets up at 5 a.m. on Tuesdays to drive off-campus for nearly two hours of aqua “boot camp” and weight training. Flashner-Fineman asks if Donnoe, who moved to Orchard Cove recently, is making time to meet her neighbors, too.
Programs like this have emerged because seniors are living longer and defying predictions of cognitive and functional decline, says John Morris, a researcher at the Institute for Aging Research at Hebrew SeniorLife, which operates Orchard Cove. Morris designed the assessment tool that Vitalize 360 uses and is helping retirement communities track participants’ wellness.
Esther Adler, a 93-year-old poet, writer, and former Hebrew school teacher, moved to Orchard Cove in 2012, a few years after her husband died. She set a goal to “be a productive person” but didn’t know exactly how. After learning about her background in an extensive intake interview, staff invited her to start teaching Hebrew to patients on the skilled nursing floor. Adler discovered their memories were too short for language lessons, and started teaching Bible lessons and prayers instead — a practice she has continued for three years.
Adler, who also finds purpose in writing poetry and helping neighbors through hospice, has proved resilient amid physical setbacks: She broke her pelvis last year when she tripped in the lobby of a hotel room in Poland, the night before the premiere of a documentary about her life.
“They thought I would never walk,” Adler says. “Here I am, I’m walking.”
Lipsky, despite her successful trip to China, confesses she feels “hesitant” about the year ahead. “I’m not as active as I’d like to be,” she says. As she speaks, her right hand shakes — a new symptom she hasn’t yet told her doctor about.
But Lipsky lights up when she talks about achieving another goal, finding a new way to cope with loss. She sat with her granddaughter two weeks before and dialed up a medium on Skype to try to communicate with her husband, Sidney, who died three years ago. “She breathed in our energy — on the computer!” Lipsky says. “It was eerie. We felt like he was there.” She says it helped the family grieve and brought her happiness. Since the experience, she says, “our lives haven’t been the same.”
In the year ahead, Lipsky plans to attend another wedding, this time in Canada, and continue “finding unexpected things that bring me joy.”