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Creating a Healthy Further Life

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

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Creating a Healthy Further Life

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

  2. The White Queen/Tudor Period(Mortality) 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

  3. The Life Span of the Tudor Queens

  4. Life Expectancy in U.S. Today

  5. Composing a Further Life: The Age of Active Wisdom • 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 From: Bateson, M. C. (2010). Composing a further life: The age of active wisdom. New York: Vintage Books.

  6. Composing a Further Life: The Age of Active Wisdom Adulthood II is an “improvisational art form calling for imagination and the willingness to learn” 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. We become what we have done Theme:

  9. What to do: The perspective on healthy ageing throughout the continuum of time

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

  11. Advice Through the Ages

  12. Longevity – 44 B.C. • “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.

  13. Longevity – 1500’s • “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)

  14. Longevity – 1903 A.D. • “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

  15. Longevity - 2000 “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.” • Robert Butler, M.D.,founder, International Longevity Institute, founding director of the U.S. National Institute on Aging, Pulitzer Prize winner, gerontologist

  16. Hippocratic Medicine Traditional Chinese Medicine What to do: Seventh Day Adventists Okinawan Secrets Ayurveda Bush Medicine Ageing around the world

  17. Seventh Day Adventists: Loma Linda, CA • 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 Lifestyle Factors Longevity Statistics • 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. Hippocratic Medicine: Ancient Greece • 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

  19. Eastern Models of Ageing • 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

  20. Okinawan Secrets: Japan • 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

  21. What to do: Contemporary models of successful ageing

  22. What do older adults believe contributed to their health and well-being? • Reichstadtet 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 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.

  23. The Secrets of Centenarians • 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 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. 463-482.

  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

  26. The USC Well Elderly Studies 1994-1997 National Institutes of Health (R01 AG11810-01S1) NIA, AHCPR, NCMRR American Occupational Therapy Foundation PI: Florence Clark, PhD, OTR/L, FAOTA 2004-2008 National Institute on Aging (R01 AG 021108-01A3) PI: Florence Clark, PhD, OTR/L, FAOTA

  27. USC Well Elderly Study 1 Team 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

  28. USC Well Elderly Study 2 Team Florence Clark, PhD Occupational Therapy Jeanne Jackson, PhD Occupational Therapy Stanley P. Azen, PhD Preventive Medicine, Biostatistics Chih-Ping Chou, PhD Preventive Medicine Barbara J. Cherry, PhD Cognitive Psychology Maryalice Jordan-Marsh, PhD Nursing Brett White, MD Family Medicine Douglas Granger, PhD Biobehavioral Health, Penn State Robert Knight, PhD Psychology, Gerontology Michael Carlson, PhD Social Psychology Rand Wilcox, PhD Psychology, Statistics Deborah Mandel, MA Occupational Therapy Jeanine Blanchard, MA Occupational Therapy

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

  30. Well Elderly Study 2: Intent-to-Treat Treatment (n=187) vs. Control (n=173) * * * * * * * * one-sided p values

  31. 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

  32. 1. Identify general healthy lifestyle practices Healthy Lifestyle Practices

  33. 2. Perform a personal inventory of goals, strengths, & weaknesses Relevant Personal Factors

  34. 3. Bring the two together into a daily routine DAILY Relevant Personal Factors Healthy Lifestyle Practices ROUTINE

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

  36. 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)

  37. 1. Learning to listen to your body • Follow your circadian rhythms • Become mindful of when you are at homeostasis • Use technology to track your biomarkers and activity pattern

  38. 2. Trying to avoid chronic inflammation • Through simple everyday practice • i.e. avoid wearing high heels, carrying heavy purchases, wearing uncomfortable or binding clothes, using heavy suitcases, etc.

  39. 3. Trying to eat a healthy aging diet • 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 From: Agus, D. B. (2011). The end of illness. New York: Free Press.

  40. 4. Minimizing your stress • 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

  41. 5. Knowing your risk factors • Genetic risk factors • Predisposition to common conditions • Lifestyle factors can counteract these risks • Physical exercise changes gene expression From: Agus, D. B. (2011). The end of illness. New York: Free Press.

  42. 6. Incorporating health-promoting practices • 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

  43. 7. Developing in new ways • Explore what you care most about • Engage in life more profoundly • Explore your deepest priorities and potentials • Pursue new forms of meaning From: Bateson, M. C. (2010). Composing a further life: The age of active wisdom. New York: Vintage Books.

  44. 8. Getting started • Taking action is self-perpetuating

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