Closing the wellness gaps

Research shows overwhelming commitment to wellness as a priority across the active-aging industry. But a lack of clarity about wellness itself may present a barrier to effective implementation

A movement is afoot that has simmered over the past 20 years and, contrary to popular belief, boiled over during the pandemic. The COVID-19 pandemic has shone a bright light on wellness—or rather on what happens when the focus on wellness pauses. Increased social isolation, frailty, and mental health issues are only a few undesired outcomes in the past 2.5 years.

With the world’s changing priorities over this period, the priority level given to wellness in industry settings has also shifted, as the International Council on Active Aging’s just-released report demonstrates. In “ICAA State of the Wellness Industry 2022,” 81% of 419 survey respondents believed that wellness is now a high or essential priority for their organization.1 In comparison, 55% of respondents said the same when polled for the 2019 “ICAA State of Wellness” survey.2 Yet, progress in prioritizing wellness does not necessarily make organizations effective in implementing it.1,2

Figure 1. Five important priorities for wellness culture. Importance v. organizational effectiveness, All respondents. 2019 ICAA State of Wellness. Source: 2022 ICAA State of Wellness Industry.

In 2019 roughly 9 in 10 individuals polled for the ICAA survey thought it very or extremely important that staff in all departments support wellness2—in fact, it was one of their top 5 priorities. Only 34% of respondents, however, thought their organization had been very or extremely effective in achieving this objective2 (see Figure 1 above). This significant gap (a gaping hole, in reality) is one of many wellness gaps highlighted in the two reports.

What stands in the way of organizational effectiveness in fulfilling a commitment to wellness? One barrier, no doubt, is the term itself.

Discovering how colleagues view wellness

Here’s a telling exercise for your next team meeting: Ask each team member to write the definition of wellness on a piece of paper and immediately give it to you. How they (and you) answer this question will directly impact everything your organization does—from your mission statement, to programming, to the built environment, to staffing, to educating your team.

Let’s say you are among the nearly 61% of senior living staff and management who in 2022 responded that they expect their community to transition to a wellness-based model with care by 2023.1 Everything you develop will be driven by and reflect your view of wellness. How can you possibly change your business model or create or evolve a wellness culture without a grounded understanding of wellness? (Figure 2 below shows the disconnect that respondents to the 2019 ICAA survey described in talking to colleagues about wellness.)

Figure 2. Top 3 challenges of managers and staff. Senior living & care. Source: 2019 ICAA State of Wellness.

The definition-of-wellness exercise will help you ascertain what your team members know about wellness, including your CEO and management. It’s valuable to take some time to reflect on the results and to ask yourself questions: Is wellness defined consistently across all staff and departments? Does your marketing reflect the definition, for example? Are your partners, investors, suppliers and customers aware of how you define wellness and all you do to support it? How about the families of your residents or members?

Figure 3. Disconnect between respondent and colleague when talking about wellness. Senior living & care. Source: 2019 ICAA State of Wellness.

Unless people understand what wellness means to your organization, they will fail to see how a culture that supports wellness is important to your success, or to life options for residents/members to enhance quality of life. Perhaps this lack of understanding and connection is why 48% of staff and 30% of managers responding to the 2019 ICAA survey said most coworkers do not feel wellness is part of their jobs2 (see Figure 3 above).

Without clarity in how your organization defines wellness, you might feel uncertain about who to hire and what expertise they need to fulfill your wellness vision, or which spaces to build and what programming to develop to support wellness. And, importantly, what return on investment wellness offers your organization and your customers.

The reality is you are not alone if you struggle with the question, What is wellness? For many people, including many industry professionals, wellness is an ambiguous term. Let’s consider why.

Exercise and physical activity are clearly defined concepts backed by science and supported by guidelines.3,4 In contrast, the concept of wellness can seem widely open to interpretation. A wellness nurse dispenses medications and takes vital signs in one setting, while in another, a wellness center and its staff focus only on physical fitness.5 When concepts are fuzzy and terminology inconsistent, misunderstandings and inconsistencies abound. Bottom line, the industry would benefit from a standard definition for wellness.

Defining wellness

Nearly four years ago ICAA convened a work group of thought leaders to develop the association’s definition of wellness. The goal was to create a clear, consistent understanding of wellness—supported by evidence-based or evidence-informed practices—not only for the industry, but for customers, suppliers, investors and potential funders as well. (Funders might include insurance companies, health maintenance organizations [HMOs], governments at all levels, and Medicare or Medicaid, for example.)

The work group was tasked with developing a contemporary definition for wellness that is person centered, relevant, clear and actionable. Here’s what the group produced:

Wellness is derived from our ability to understand, accept and act upon our capacity to lead a purpose-filled and engaged life. In doing so, we can embrace our potential (physical, emotional, spiritual, intellectual, social, environmental, vocational) to pursue and optimize life’s possibilities.

Since then, ICAA has added one vital word: identity. The ability to embrace who we are and where we are in our lives lies at the heart of a person-centered model. After all, how can we be person centered if we don’t understand the person? Today, the ICAA definition reads as follows:

Wellness is derived from our ability to understand, accept and act upon our identity and our capacity to lead a purpose-filled and engaged life. In doing so, we can embrace our potential (physical, emotional, spiritual, intellectual, social, environmental, vocational) to pursue and optimize life’s possibilities.

What is the thinking behind the ICAA definition, and how can your organization use and support it to strengthen your wellness culture? Let’s break the meaning down by phrase.

“Wellness is derived…”: The definition starts with the end result—that is, wellness—and its origins. The remainder guides the individual and/or organization in understanding wellness, a positive state of being continuously influenced by and responsive to what happens in our inner and outer worlds.

“[F]rom our ability to understand…”: Before people can create a wellness lifestyle, they must understand how their identity and their capacity influence the decisions they make. Support for self-discovery and for health literacy are two ways to create environments that help customers better understand their current identity (which evolves as people go through life) and capacity, and how embracing these aspects of themselves leads to a purpose-filled and engaged life.

“[A]ccept and act upon our identity and capacity…”: Individuals are more able to challenge and cast off ageist beliefs or self-doubts when they better understand themselves. Once they realize their capacity to live well—through their decision-making and physical and/or cognitive abilities, for example—they will be able to make informed decisions on how best to act upon this information in a way that resonates with their identity as they pursue a purpose-filled and engaged life.

Organizations can support the ability of individuals to embrace who they are and realize their capacity by, for example, providing education and programming that support a selection, optimization and compensation strategy. What does this mean? With this strategy, an individual and/or organization would first understand who the person is and what needs acting upon (selection)—say, for instance, building cardio capacity for a trip that will require endurance. The goal would then be how to optimize the individual’s abilities to maximize the desired experience on the trip. It’s possible the person might have to compensate and use different ways to achieve this goal. An example is someone who cannot run due to knee issues but who compensates for that limitation (and its impact on the person’s identity) by maximizing cardiovascular health with walking or cycling.

Organizations play a key role, as do family members, in a person’s process of accepting and acting upon their identity and their capacity to live well. Staff who understand the challenges that a customer faces can support acceptance of these issues; they can also inspire the individual to look beyond personal limitations to what is possible. By encouraging self-directed choices based on both an individual’s sense of identity and on current capacity (while striving to grow and to improve capacity for new life options), staff can lend support to the person’s efforts to live an engaged life with purpose.

“[T]o lead a purpose-filled and engaged life”: When people understand, accept and act upon their capacity to live well, they can engage more in life. Organizations can support customers in moving towards a purpose-filled lifestyle by learning about such things as what makes someone smile, what personal dreams are unfulfilled and what an individual expects life to be. With this knowledge, staff may create a person-centered strategy or way of life that offers individuals the chance to “live it.”

Here are two questions to explore with customers during this discovery process:

??What will you need to understand, or accept, before you can act upon your purpose?

??Who and/or what is needed to support your choices?

The answers will point the way to the services they need and want.

“In doing so, we can embrace our potential (physical, emotional, spiritual, intellectual, social, environmental, vocational)…”: Once people achieve the first part of the definition, they will be capable of embracing their potential. Think of potential as simply “unrealized abilities.”

As organizations and as an industry, our role is to create intentional and unintentional ways for our customers to realize their untapped abilities within areas of wellness in which they seek to engage and be purposeful (Figure 4 above on shows the dimensions of wellness, which coordinate and overlap). Consider what environments individuals need to support their quests in these multiple areas and interests. And, ask them what they need to realize this potential, whether it is something self-directed or something you can deliver.

“[T]o pursue and optimize life’s possibilities”: Coming full circle, the definition points to the ultimate goal of people embracing their potential to enrich their life experience. Organizations can seek ways to inspire and support customers in pursuing and in optimizing the many possibilities life presents them. Again, as individual organizations and as an industry, our role is to be an ally in this pursuit, self-directed or not.

Now it’s your turn. Take the time to break down ICAA’s definition of wellness with your team and explore how you can support customers in fulfilling their purpose while at the same time you close some of the wellness gaps that may exist in your organization. Here are three things to focus on, but there are certainly more:

??Clarify what wellness means to your organization, which will bolster everything you do to create, implement or evolve a business model whose primary focus is wellness. The ICAA definition of wellness offers you a starting point. Consider how you will educate your team to better understand and embrace wellness. What role will your human resources department play? What about policies? Will you provide upskilling for those who are new or unfamiliar with wellness? No matter what, it’s important to reflect and to act on developing a clear definition embraced across your whole organization.

??Build wellness into all departments and all roles to support your wellness culture. Help staff to see the role they play in the implementation of your wellness strategy. Rather than a constant challenge to get buy-in, wellness will become an automatic way of thinking.

??Show all staff that your organization’s executive team understands the value of wellness. Ask your executives to embrace and participate in the implementation of your wellness strategies, to demonstrate they are committed to wellness and they support your organization’s transition to a wellness culture, if one does not yet exist. If the executive team has not totally bought into developing a wellness culture, find out what they need for this to occur

To advance, sometimes it’s necessary first to step back and assess the landscape. Are there gaps between the priority your organization places on wellness and the effectiveness with which wellness is being implemented? Consider where things are now and what actions your organization needs to move forward.

One strategy is to create a wellness blueprint that includes your business plan for wellness. If you’re unsure how to proceed, you might turn to ICAA’s wellness blueprint as a guiding document. This publication’s guidelines are based on recommendations that industry thought-leaders provided at the ICAA Forum 2019. You might be surprised how much it will help you advance wellness within your organization. And the next time someone asks what wellness means to your organization, you will have your clearly defined vision and comprehensive plan of action to share.

Colin Milner, CEO and founder of the International Council on Active Aging?, is a leading authority on the health and well-being of the older adult. The World Economic Forum has recognized Milner as one of “the most innovative and influential minds” in the world on aging-related topics. The award-winning writer and speaker has stimulated business and government leaders, industry professionals and older adults worldwide with his incisive and inspiring perspectives. In 2010, canfitpro [Canadian Fitness Professionals] presented Milner with its Lifetime Achievement Award for his contributions to the Canadian fitness industry.

References

1. Ryan, P. (2022, June). ICAA State of the Wellness Industry 2022: Wellness-focused organizations are expanding opportunities for older adults. Vancouver, BC: International Council on Active Aging. Available at https://www.icaa.cc//listing.php?type=industry_research.

2. Ryan, P. (2019, September). ICAA State of Wellness: Documenting the progress and priorities for developing a culture of wellness within active-aging organizations. Vancouver, BC: International Council on Active Aging. Available at https://www.icaa.cc//listing.php?type=industry_research.

3. United States Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition, p. 29. Washington, DC: US Department of Health and Human Services. Available at https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf.

4. World Health Organization. (2018). Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World. Geneva: World Health Organization. Available at www.who.int/health-topics/physical-activity#tab=tab_1.

5. International Council on Active Aging. (2014). ICAA Wellness Readiness Survey 2014. Available in the “Reports” section of the ICAA website (search keyword readiness) at https://www.icaa.cc//listing.php?type=industry_research.