Chapter 7:

Promoting
Healthy Aging,
Independence,
and Quality
of Life
 Learning Objectives
• Apply the health contract technique and
nutritional bull’s-eye for behavior change.
• Describe several model health promotion
programs.
• Explain the concept of re-engagement and
provide examples of it.
• Identify the components of Medicare
prevention.
 Learning Objectives (cont’d.)
• Explain the importance of life review.
• Recognize the importance of exercise and
nutrition for healthy aging.
• Discuss the importance of the Green House
project to the future of long-term care.
 Key Terms
Bariatric surgery Life review
Center for Science in the Medicare prevention
Public Interest (CSPI) Mediterranean diet
Complementary and Mental health
alternative medicine Model health promotion
Dependence programs
Depression Nutrition
Exercise Nutrition bull’s-eye
Green House Quality of life
Health behavior change Re-engagement
Health contract/calendar Vietnam War
Healthy People initiatives
 Promoting Healthy Aging

• Health promotion works for all ages, but it

does not work for everyone, all the time.
– Exercise
– Nutrition
– Re-engagement
 Medicare Prevention
• Changes over the last decade
– An initial physical examination that includes prevention counseling.
– Annual wellness visits.
– Smoking cessation—no longer limited to those who have an illness
caused by or complicated by tobacco use.
– Comprehensive health programs that include complementary and
alternative practices, developed by Dean Ornish and Herbert Benson for
cardiac rehabilitation.
– Screening and intensive behavioral therapy for obesity.
– Depression screening in a primary care setting that can provide follow-
up and referral
– Alcohol misuse counseling sessions, up to four per year, in a primary
care setting with a qualified provider.
– Elimination of all deductibles and copayments for prevention services to
enhance access.
 Health Behavior Change
• Health contract/calendar as a possible tool
• Exercise
– Motivation is the key.
– 30 minutes cumulative exercise most days.
• Nutrition
– Older adults are vulnerable to both obesity and malnutrition.
– Social isolation, dental problems, medical disease, and
medication contribute to malnourishment.
– “Nutrition bull’s-eye” targets most nutritious foods for the older
adult to consume.
– Mediterranean diet:
1. More costly
2. Reduces risk of cardiovascular disease
 Health Behavior Change (cont’d.)
• Dietary implications for older adults
– Balancing low fat, low cholesterol, and low sodium
diets.
– Highly restricted diets can lead to deficient dietary
intake and malnutrition.
• Nutrition advocacy and education
– Center for Science in the Public Interest (CSPI)
– Increasing the details on food labels
 Mental Health
• Resiliency of older adults to adjust to present life
• Life review
– Preserved by print, tape recording, or video taping
• Depression
– Experiencing loss
• Dependency
• Quality of life and wellness
 Model Health Promotion Programs
for Older Adults
• Healthwise
• Chronic Disease Self-Management Program
• Project Enhance
• Cardiac wellness
– Dean Ornish Reversing Heart Disease program
– Herbert Benson’s Mind/Body Medical Institute
 Re-engagement Instead
of Retirement
• Baby boomers began turning 65 in 2011.
– Most will not disengage from life upon
retirement.
– This cohort of older adults is the:
• Longest lived
• Best educated
• Healthiest
• Most engaged
• Largest cohort of retirees
 Re-engagement Instead
of Retirement (cont’d.)
• Ways older adults can re-engage
– Experience Corps: 2,000 older adults are
tutors and mentors for 20,000 low-income
children in urban public elementary schools
and afterschool programs in 19 cities, boosting
students’ academic performance and
enhancing older adults’ well-being.
 Green House
• Revolution in long-term care.
• First constructed in Tupelo, Mississippi.
• Looks like surrounding homes in the
neighborhood.
• 10 residents have private room and bath
with shared areas for cooking, socializing,
and garden.
• Promotes autonomy.
 Summary
• Many exciting changes in fields of health
promotion and aging.
• Pro-aging movement—in contrast with the
commercial and exploitive anti-aging
movement.
 Summary (cont’d.)
• Older adults are free to be themselves;
have an opportunity to be freer, wiser, more
engaged in helping others, and more willing
to be an advocate not only for their own
health, but for the well-being of society.