Physical and Mental Well-being

Physical & Mental Well-Being

Studies have found that if a person believes they are well, they are in fact, healthier. In other words, there is a correlation between self-report and actual health. Nevertheless, the majority of older adults do face declining functional abilities, due in part to chronic illness, which is accompanied by increasing health care costs.
70% of total health care costs in the United States are related to the treatment and management of chronic disease, with the greatest percent of all health care dollars consumed by chronic conditions in the last six months of life.^[1]
Prevention has the potential both to save dollars and to enhance quality of life. For instance,

• Health promotion activities such as exercise can strengthen well-being and reduce the use of health care services (e.g., lowered number of hospitalizations and visits to primary care).
• Comprehensive health promotion programs also address mental health — feelings of wellness and control over one’s ability to understand and manage personal health issues, including depression.
• Training older adults to be more active in the self-management of their chronic conditions supports their autonomy which can enhance their life satisfaction.

There are ways to optimize physical and/or mental heath services for older adults. One way is to help adults with developmental disabilities or older adults with disabilities to maintain or enhance functional ability and live well with the disability.

Non-skilled services support functioning in Activities of Daily Living (ADLS) for people with progressively declining disease (e.g., dementia, cancer, Parkinson’s).

Skilled services provide care in-home or at an adult-day health center for chronically ill older adults to improve or maintain the ability to function.

Health promotion or wellness programs that motivate, educate, and encourage self-management of areas like nutrition and exercise are found to be effective in enhancing physical and mental well-being. These programs include

• screening and referral
• peer mentoring and support
• education and self-management of chronic conditions
• problem-solving techniques
• training and education around specific topics

Health promotion education may be offered in

• community settings
• congregate living and health service programs
• in-home
• electronically

Comprehensive health promotion programs move beyond personal responsibility for well-being to include changes in broader community environment, programs, and infrastructure to facilitate success in making healthy personal choices. Consider these statistics:

• 45.9 % of people age 65 and older in King County reported meeting recommended levels of physical activity^[2]
• 16.1% of people age 65 and older in King County reported ‘vigorous’ activity^[3] however,
• 18% of 65-74 year olds and 24% of 75+ adults reported “no physical activity during the past month”^[4]

Given advances in health promotion, more senior centers, adult day care/day health programs, retirement centers, and HMOs/MCOs are incorporating exercise and wellness programs into their overall programs and covered benefits. However, these benefits tend to be more widely available to, and accessed by, middle and upper income white older adults than by lower income older adults and older adults of color. Targeted and new strategies are needed to enhance and expand health promotion, particularly for underserved groups, and given the high rate of depression among older adults.

Depression is an issue for many older adults

Of the 35 million Americans age 65 and older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness.^[5] If left untreated, depression can create a diminished quality of life, and may ultimately lead to suicide.

Depression among older adults is often undiagnosed, treated inappropriately, or not treated at all.

It is more cost-effective to treat older adults’ mental health needs when their conditions are diagnosed early rather than after they become severe. Additionally, depression itself is associated with poorer physical health outcomes and resultant higher health care costs. Despite this need, only 3% of older adults nationally receive treatment for their depression in community-based settings.^[6]

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