creating a healthy further life
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Creating a Healthy Further Life. Florence Clark, Ph.D., OTR/L, FAOTA Fit for Life Symposium February 7, 2014. The White Queen/Tudor Period (Mortality). Name Age at Death Elizabeth Woodville (White Queen) 55 Edward IV ( White Queen’s husband) 41 - PowerPoint PPT PresentationTRANSCRIPT
Creating a Healthy Further Life
Florence Clark, Ph.D., OTR/L, FAOTA
Fit for Life SymposiumFebruary 7, 2014
Name Age at Death • Elizabeth Woodville (White Queen) 55• Edward IV (White Queen’s husband) 41• Elizabeth of York (White Queen’s daughter) 37 • Margaret Beaufort (Red Queen) 66• Richard Neville (The Kingmaker) 42• Anne Neville (Kingmaker’s Daughter) 28• The Tudors
– Henry VII (Red Queen’s son) 52– Henry VIII (Henry VII’s son) 55– Elizabeth I (Henry VIII’s daughter) 69
The White Queen/Tudor Period(Mortality)
Birth Age Married Age of Death Cause
Catherine of Aragon
1485 24 51 Executed
Anne Boleyn 1504 29 32 Executed
Jane Seymour 1508 28 29 Died
Anne of Cleves 1515 25 42 Died
Kathryn Howard 1521 19 21 Executed
Catherine Parr 1512 31 36 Died
The Life Span of the Tudor Queens
Life Expectancy in U.S. Today
• Traditional Age - Groups– Childhood– Parenthood– Grandparenthood
• Adulthood I– Very busy, productive time, building careers, raising
children• Adulthood II– Stage of active wisdom preceding old age
Composing a Further Life: The Age of Active Wisdom
From: Bateson, M. C. (2010). Composing a further life: The age of active wisdom. New York: Vintage Books.
Adulthood II is an “improvisational art
form calling for imagination and the willingness to learn”
Composing a Further Life: The Age of Active Wisdom
Adulthood II
Long lives, Better health
Freedom from work
and raising a family
Rich Experiences
Wisdom combined
with activity
From: Bateson, M. C. (2010). Composing a further life: The age of active wisdom. New York: Vintage Books.
So how can we optimize the chances of staying healthy
during Adulthood II?
THEME:
We become what we have done
THE PERSPECTIVE ON HEALTHY AGEING THROUGHOUT THE CONTINUUM OF TIME
What to do:
Allegory of the Fountain of Youth
• Garden of Eden: “River of Immortality”
• Ayavanna: “Pool of Youth”
• Alexander the Great: “Water of Life”
Advice Through the Ages
44 B.C.E.• Cicero
1214-1294• Roger
Bacon
1484-1566• Luigi
Cornaro
1558-1609• Andre du
Laurens
1903• Sir Herman
Weber
• “We ought to take due care of our Health, and to eat and drink sparingly, and use moderate exercise, that we may be enlivened, and have fresher spirits, not be oppressed, and overloaded”
• Powers of the mind “become more refreshed and invigorated the more they are used.”
• Cicero, A Dialogue On Old Age, 44 B.C.
Longevity – 44 B.C.
• “Nothing hastens old age more than idleness.”– Andre du Laurens (1558-1609)
• “A temperate life would enable the body’s finite supply of vital spirits to last until life ebbed peacefully away between the ages of five and six score.”– Luigi Cornaro (1464-1566)
Longevity – 1500’s
• “By moderation and abundant exercise of body and mind, including walking, climbing and breathing exercises, I have escaped death from these causes, have greatly prolonged my life, and am now in good health in my 91st year.”– Case Study from Sir Hermann Weber, On Means for
the Prolongation of Life, 1903
Longevity – 1903 A.D.
“Heath risks such as smoking, physical inactivity, being overweight or obese, consumption of high fat diets, and inadequate fruit and vegetable intake are major determinants of morbidity and mortality.”
Longevity - 2000
Robert Butler, M.D., founder, International Longevity Institute, founding director of the U.S. National Institute on Aging, Pulitzer Prize winner, gerontologist
AGEING AROUND THE WORLDWhat to do:
Seventh Day Adventists
Bush Medicine
AyurvedaOkinawan Secrets
Traditional Chinese
Medicine
Hippocratic Medicine
• Abstinence from tobacco, alcohol, caffeine, and other drugs
• Low stress lifestyle• Vegetarian diet and drinking spring water• Weekly day of rest on the Sabbath• Regular exercise• Close-knit family structure• Prayer and worship throughout the
church community
Seventh Day Adventists: Loma Linda, CA
Longevity StatisticsLifestyle Factors Lifestyle factors can add up to
10 years of life expectancy in Adventists (Fraser & Shavlik, 2001).
Life expectancy of Vegetarian Adventists at age 30 Male: 83.3 years Female: 85.7 years
California Adventists are likely the longest living natural population in the world (Fraser & Shavlik, 2001)
• Hippocrates rejected the idea of spiritual causes or cures for illness, appealed instead to scientific reason
• Health was promoted by temperance and self-control
• Moderation in eating, drinking, sex, and exercise
• Striving for a balance among the four humors
Hippocratic Medicine: Ancient Greece
• Ayurveda– Rayasana branch dedicated to
rejuvenation and elder care– Plant extracts used to enhance memory,
improve mood, decrease inflammation, and improve cognition
• Taoism– Ageing process slowed by undertaking
effortless action, taking vital breaths, and eating magical foods such as ginseng
Eastern Models of Ageing
• Traditional Okinawan diet consists of vegetables, tofu, seaweed, and small amounts of meat or fish, is low in fat and calories but high in nutrients.
• Low stress and rigorous physical activity
• Many belong to an Okinawan-style moai, a support network providing financial, social, and emotional help throughout life
• Average life span of 86 years for women, 78 years for men is among longest in the world
Okinawan Secrets: Japan
CONTEMPORARY MODELS OF SUCCESSFUL AGEING
What to do:
• Reichstadt et al. (2007) found that older adults attribute successful ageing to these factors:– Positive attitude and adaptability to change– Sense of security and stability– Overall health and wellness– Engagement and stimulation
What do older adults believe contributed to their health and well-being?
From: Reichstadt, J., Depp, C. A., Palinkas, L. A., Folsom, D. P., & Jeste, D. V. (2007). Building blocks of successful aging: A focus group study of older adults' perceived contributors to successful aging. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 15(3), 194-201.
• Genetics• Staying active• Lifelong learning• Optimism / Love of Life
Helen “Happy” Reichert with her caretaker
The Secrets of Centenarians
• Kahn Family – All four siblings lived to be centenarians!
• Helen “Happy” Reichert, 108• Irving Kahn, 104• Peter Kahn, 100• Lee Kahn passed away in 2005 at
the age of 102Helen Reichert and Irving Kahn in Time Magazine
Easterlin, R.A. (2006). Life Cycle Happiness and Its Sources: Intersection of Psychology, Economies, and Demography. Journal of Economic Psychology/Elsevier, pp. 463-482.
What we have learned about occupational therapy’s role in facilitating healthy ageing
USC Division of Occupational Science & Occupational Therapy
Well Elderly Research Program
The USC Well Elderly Studies
1994-1997National Institutes of Health (R01 AG11810-01S1)
NIA, AHCPR, NCMRRAmerican Occupational Therapy Foundation
PI: Florence Clark, PhD, OTR/L, FAOTA
2004-2008National Institute on Aging (R01 AG 021108-01A3)
PI: Florence Clark, PhD, OTR/L, FAOTA
Florence Clark, Ph.D. Occupational TherapyRuth Zemke, Ph.D. Occupational TherapyJeanne Jackson, Ph.D. Occupational TherapyMichael Carlson, Ph.D. Social PsychologyLoren G. Lipson, M.D. Geriatric MedicineStanley P. Azen, Ph.D. Preventive Medicine, BiostatisticsJoel W. Hay, Ph.D. Pharmaceutical Policy & EconomicsBarbara J. Cherry, Ph.D. Cognitive PsychologyDeborah Mandel, M.A. Occupational TherapyKaren Josephson, M.D. Geriatric Medicine
USC Well Elderly Study 1 Team
Florence Clark, PhD Occupational TherapyJeanne Jackson, PhD Occupational TherapyStanley P. Azen, PhD Preventive Medicine, BiostatisticsChih-Ping Chou, PhD Preventive MedicineBarbara J. Cherry, PhD Cognitive PsychologyMaryalice Jordan-Marsh, PhD NursingBrett White, MD Family MedicineDouglas Granger, PhD Biobehavioral Health, Penn State Robert Knight, PhD Psychology, GerontologyMichael Carlson, PhD Social PsychologyRand Wilcox, PhD Psychology, StatisticsDeborah Mandel, MA Occupational TherapyJeanine Blanchard, MA Occupational Therapy
USC Well Elderly Study 2 Team
Lifestyle Redesign®
Lifestyle Redesign® is the process of infusing
healthy & meaningful activities and measures
into day-to-day routines.
Well Elderly Study 2: Intent-to-Treat Treatment (n=187) vs. Control (n=173)
Health-Related Quality of Life - SF36V2
Life Satisfaction - LSI-Z
Mental Health Depression - CES-DSocial FunctionVitality CognitionBodily Pain Memory - CERAD ns
Composite: Mental Visual Search ns
Composite: Physical ns Psychomotor Speed ns
General Health ns
Physical Function ns
Role Physical ns < .05Role Emotional ns
one-sided p values
*
*** *
*
*
*
Lifestyle Redesign® Program
• Becoming hyper-cognizant of activity patterns– Notice and name activities– Learn the relationship of activities to health &
well-being• Physical, cognitive, social, emotional and spiritual
• Activity Pattern Analysis– Self-reflect– Identify barriers– Identify options and alternatives
1. Identify general healthy lifestyle practices
2. Perform a personal inventory of goals, strengths, & weaknesses
3. Bring the two together into a daily routine
• Can be delayed, even prevented, through lifestyle changes– Coronary heart disease– Certain cancers– Diabetes– Dementia– Arthritis
Age-related Diseases
Your plan must be customized to be sustainable
But it should include these components…
Based on Well Elderly research and The End of Illness (Agus, 2011)
• Follow your circadian rhythms• Become mindful of when you are at
homeostasis• Use technology to track your biomarkers and
activity pattern
1. Learning to listen to your body
• Through simple everyday practice– i.e. avoid wearing high heels, carrying heavy
purchases, wearing uncomfortable or binding clothes, using heavy suitcases, etc.
2. Trying to avoid chronic inflammation
• As much as possible, try to eat…– On a regular schedule– Cold water fish (i.e. trout, tuna, halibut) 3x per
week– A multi-colored diet– Red wine (if you wish) 5 nights per week• Unless you are at high risk for cancer
– A good-fat diet– Natural, non-processed food
3. Trying to eat a healthy aging diet
From: Agus, D. B. (2011). The end of illness. New York: Free Press.
• Some stress is normal and adaptive• Chronic stress is health-compromising
– Becoming aware of sources of chronic stress is important• Ways of managing stress:
– Finding ways to rest– Avoiding chronic stressors (as much as possible)– Spacing– Taking breaks– Just saying no– Escape– Personal therapeutic activities that are enjoyable, soothing
4. Minimizing your stress
• Genetic risk factors – Predisposition to common conditions
• Lifestyle factors can counteract these risks– Physical exercise changes gene expression
5. Knowing your risk factors
From: Agus, D. B. (2011). The end of illness. New York: Free Press.
• Eat, sleep, and exercise at predictable times every day• Engage in the social, productive, and spiritual
activities you value• Choose physical activities you enjoy (as much as
possible)– Consistent physical activities such as walking or dancing
can be very health-promoting • Take time to rest• Avoid sedentary activity as much as feasible
6. Incorporating health-promoting practices
• Explore what you care most about– Engage in life more profoundly– Explore your deepest priorities and potentials– Pursue new forms of meaning
7. Developing in new ways
From: Bateson, M. C. (2010). Composing a further life: The age of active wisdom. New York: Vintage Books.
• Taking action is self-perpetuating
8. Getting started