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Strategies for infusing well-being

April 1, 2009
by Pamela E. Toto, MS, OTR/L, BCG, FAOTA and Laurel Cargill Radley, MS, OTR/L
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You can eliminate barriers to physical, social, and mental well-being

What do you think of when you hear the term “well-being”? Does it imply happiness? Do we need perfect health to obtain it? The concept of well-being is certainly not new; however, increased use of the term to define health and measure quality of life has perpetuated a new focus on well-being in healthcare service delivery. The World Health Organization (WHO) defines well-being as a general term that encompasses physical, mental, and social aspects. WHO further suggests that in order to reach a state of complete well-being, “…an individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment.” Well-being is recognized as a direct strategy to promote health.

But it is not a starry-eyed concept. It can be real for anyone of any age. A strong body of research supports that persons of all ages can benefit from activities targeted to help meet well-being needs. Key elements are:

  • The need for sufficient daily physical activity to promote physical well-being

  • A balance in the number and types of daily activity to sustain mental well-being

  • Opportunities to engage in meaningful interaction with others to facilitate social well-being

For older adults who experience chronic health conditions, need daily assistance with care, and reside in a long-term care setting, achieving well-being may seem to be an impossible task. In addition to cognitive and/or physical factors that may limit participation, residents in these settings are generally dependent on the formal resources available within the facility and the people who care for them. How can these resources be maximized?

Strategies to Promote Physical Well-Being

Strategies to Promote Mental Well-Being

Strategies to Promote Social Well-Being

  • Encourage residents to walk to the dining room and use regular chairs during meals

  • Allow residents to assist with self-care transfers, dressing, grooming, and bathing

  • Have residents help with simple chores (e.g., putting away their laundry, making their beds, and straightening up their rooms)

  • Develop specific exercise programs targeting strength, balance, and flexibility as well as sessions for those who must sit and for those who can stand

  • Start an afternoon walking club and encourage residents to join

  • Use the Wii or Wii Fit

  • Offer a wide range of activity programming that includes card games, like bridge or even simpler ones, or brain teasers, such as Sudoku or crossword puzzles

  • Identify residents willing to lead sharing seminars or tutor other residents on subjects related to their own careers or interests (e.g., watercolor painting, Internet surfing, and political science)

  • Set up daily newspaper groups where the residents share information about a specific section to the rest of the group

  • Have activity items available on the unit for residents to “borrow” (e.g., craft or scrapbooking supplies, playing cards, lending library, sewing materials, model building supplies)

  • Establish a welcoming committee of residents who mentor new arrivals for their first month by answering questions, encouraging participation in activity groups, and making introductions to other residents

  • Encourage the formation of clubs (e.g., poker, book, drama, politics, and debate)

  • Hold contests that promote interaction (e.g., scavenger hunts, team competitions, and dance contests)

  • Schedule “open mic” events for residents to share poetry, comedy, and musical talents with each other

  • Organize residents to complete volunteer activities together for the local community

Occupational therapy practitioners are key partners in promoting well-being in the long-term care setting. With science, research, and evidence-based background that places equal importance on the physical, mental, social, and environmental factors that impact participation in meaningful daily activities, occupational therapy practitioners can expertly identify and eliminate barriers to wellness for this specific population of older adults. For example, occupational therapy practitioners can:

  • assess a resident's physical and cognitive capacity to engage in various facility activities (e.g., confirming a resident has the motor skills and attention to safely assist in assembling lottery calendars for a facility fund-raiser);

  • modify the environment to promote participation (e.g., installation of wheelchair-height flower boxes in the garden to allow residents to do their own spring planting);

  • adapt activities to facilitate engagement (e.g., introducing one-handed stabilizing devices and one-handed typing skills to allow a resident with a recent stroke to be able to return to publishing the monthly facility newsletter); and

  • assist residents in identifying and engaging in those activities of greatest importance to them (e.g., working with staff to develop a morning routine that enables a resident to get up and be ready in time for daily church services).