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Creating a Healthy Further Life Florence Clark, Ph.D., OTR/L, FAOTA Fit for Life Symposium February 7, 2014.

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Presentation on theme: "Creating a Healthy Further Life Florence Clark, Ph.D., OTR/L, FAOTA Fit for Life Symposium February 7, 2014."— Presentation transcript:

1 Creating a Healthy Further Life Florence Clark, Ph.D., OTR/L, FAOTA Fit for Life Symposium February 7, 2014

2 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)

3 BirthAge MarriedAge of DeathCause Catherine of Aragon Executed Anne Boleyn Executed Jane Seymour Died Anne of Cleves Died Kathryn Howard Executed Catherine Parr Died The Life Span of the Tudor Queens

4 Life Expectancy in U.S. Today

5 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.

6 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.

7 So how can we optimize the chances of staying healthy during Adulthood II?

8 THEME: We become what we have done

9 THE PERSPECTIVE ON HEALTHY AGEING THROUGHOUT THE CONTINUUM OF TIME What to do:

10 Allegory of the Fountain of Youth Garden of Eden: “River of Immortality” Garden of Eden: “River of Immortality” Ayavanna: “Pool of Youth” Ayavanna: “Pool of Youth” Alexander the Great: “Water of Life” Alexander the Great: “Water of Life” Garden of Eden: “River of Immortality” Garden of Eden: “River of Immortality” Ayavanna: “Pool of Youth” Ayavanna: “Pool of Youth” Alexander the Great: “Water of Life” Alexander the Great: “Water of Life”

11 Advice Through the Ages 44 B.C.E. Cicero Roger Bacon Luigi Cornaro Andre du Laurens 1903 Sir Herman Weber

12 “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.

13 “Nothing hastens old age more than idleness.” – Andre du Laurens ( ) “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 ( ) Longevity – 1500’s

14 “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 91 st year.” – Case Study from Sir Hermann Weber, On Means for the Prolongation of Life, 1903 Longevity – 1903 A.D.

15 “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 Robert Butler, M.D., founder, International Longevity Institute, founding director of the U.S. National Institute on Aging, Pulitzer Prize winner, gerontologist

16 AGEING AROUND THE WORLD What to do: Seventh Day Adventists Bush Medicine Ayurveda Okinawan Secrets Traditional Chinese Medicine Hippocratic Medicine

17 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  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)

18 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

19 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

20 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

21 CONTEMPORARY MODELS OF SUCCESSFUL AGEING What to do:

22 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),

23 Genetics Staying active Lifelong learning Optimism / Love of Life Helen “Happy” Reichert with her caretaker 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 102 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 102 Helen Reichert and Irving Kahn in Time Magazine

24 Easterlin, R.A. (2006). Life Cycle Happiness and Its Sources: Intersection of Psychology, Economies, and Demography. Journal of Economic Psychology/Elsevier, pp

25 What we have learned about occupational therapy’s role in facilitating healthy ageing USC Division of Occupational Science & Occupational Therapy Well Elderly Research Program Well Elderly Research Program

26 The USC Well Elderly Studies National Institutes of Health (R01 AG S1) NIA, AHCPR, NCMRR American Occupational Therapy Foundation PI: Florence Clark, PhD, OTR/L, FAOTA National Institute on Aging (R01 AG A3) PI: Florence Clark, PhD, OTR/L, FAOTA

27 Florence Clark, Ph.D. Occupational Therapy Ruth Zemke, Ph.D.Occupational Therapy Jeanne Jackson, Ph.D.Occupational Therapy Michael Carlson, Ph.D.Social Psychology Loren G. Lipson, M.D.Geriatric Medicine Stanley P. Azen, Ph.D.Preventive Medicine, Biostatistics Joel W. Hay, Ph.D.Pharmaceutical Policy & Economics Barbara J. Cherry, Ph.D.Cognitive Psychology Deborah Mandel, M.A.Occupational Therapy Karen Josephson, M.D.Geriatric Medicine USC Well Elderly Study 1 Team

28 Florence Clark, PhDOccupational Therapy Jeanne Jackson, PhDOccupational Therapy Stanley P. Azen, PhDPreventive Medicine, Biostatistics Chih-Ping Chou, PhDPreventive Medicine Barbara J. Cherry, PhDCognitive Psychology Maryalice Jordan-Marsh, PhDNursing Brett White, MDFamily Medicine Douglas Granger, PhD Biobehavioral Health, Penn State Robert Knight, PhDPsychology, Gerontology Michael Carlson, PhDSocial Psychology Rand Wilcox, PhDPsychology, Statistics Deborah Mandel, MAOccupational Therapy Jeanine Blanchard, MAOccupational Therapy USC Well Elderly Study 2 Team

29

30 Lifestyle Redesign ® Lifestyle Redesign ® is the process of infusing healthy & meaningful activities and measures into day-to-day routines.

31 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-D Social Function Vitality Cognition Bodily Pain Memory - CERAD ns Composite: Mental Visual Search ns Composite: Physical ns Psychomotor Speed ns General Health ns Physical Function ns Role Physical ns <.05 Role Emotional ns one-sided p values * * * * * * * *

32 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

33 1. Identify general healthy lifestyle practices

34 2. Perform a personal inventory of goals, strengths, & weaknesses

35 3. Bring the two together into a daily routine

36 Can be delayed, even prevented, through lifestyle changes – Coronary heart disease – Certain cancers – Diabetes – Dementia – Arthritis Age-related Diseases

37 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)

38 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

39 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

40 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.

41 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

42 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.

43 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

44 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.

45 Taking action is self-perpetuating 8. Getting started


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