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These Annual Checkups Help Seniors Not Only Survive But Thrive

Bea Lipsky shuffled into her wellness coach鈥檚 office one morning this fall and parked her walker by the wall. Lipsky, 89, had had a trying year, enduring a hernia operation and two emergency room visits for heart problems. She鈥檚 losing her hearing, and recently gave up her dream of riding in a hot air balloon for her 90th birthday.

That day, though, she was filled with pride: She told her coach she鈥檇 achieved her goals for the year, including attending her grandson鈥檚 wedding in China.

Lipsky spent two months training, doing leg curls and riding a stationary bicycle, to build up the strength to make it through a 10-day trip to China, accompanied by an aide. 鈥淚t was absolutely divine,鈥 she told coach Susan Flashner-Fineman, who works at the Orchard Cove retirement community in Canton, Mass., where Lipsky has lived for the past four years.

Lipsky鈥檚 check-ins with Flashner-Fineman are part of a well颅ness coaching program, Vitalize 360, that Orchard Cove start颅ed eight years ago in collaboration with the Kendal nonprofit senior living organization in Pennsylvania.

When seniors arrive at Orchard Cove, a coach measures their health and wellness in an hourlong, one-on-one session, assessing common problems for seniors, like loneliness, pain and distress. The coach also asks about se颅niors鈥 families, friendships, and spiritual life. Then the se颅niors meet with their coach every year before their physical checkup with a doctor, to talk about what matters most to them. The coaches, who come from a variety of backgrounds, including fitness, social work and chaplaincy, help seniors set goals for the year 鈥 which could be physical, social, in颅tellectual or spiritual. These goals become the focus for the senior鈥檚 medical team, and the seniors follow up with their coaches every three months to stay on track.

Wellness coaching aims to rethink how we treat aging, said Aline Russotto, Orchard Cove鈥檚 executive director. 鈥淲e used to be at our very best when somebody was in crisis,鈥 she said.

But Orchard Cove staff think they can help residents live healthier and happier lives by shifting the focus away from 鈥渇ixing what鈥檚 broken,鈥 said Russotto, to 鈥渓iving your best day every single day until the end.鈥

Dr. Atul Gawande, author of "Being Mortal" and an expert on end-of-life care, calls the Vitalize 360 approach 鈥渢ransfor颅mative.鈥 It recognizes that 鈥渆ven as you may have health is颅sues and frailty and the difficulties that can come with aging ... people have lives worth living. And in fact have a lot more life worth living,鈥 he said.

When young people become dis颅abled, others often help them find ways to contribute to the world, he noted, but that is much less true for older people.

鈥淚 see it as the kind of thing that you鈥檇 like to see go population颅wide,鈥 Gawande said. 鈥淵ou鈥檇 like to make it routine.鈥

Since the program started at Orchard Cove, fitness par颅ticipation 鈥 the proportion of residents who exercise at least three times a week 鈥 has more than doubled, from 30 to 77 percent, and one study found participants felt significant颅ly less depressed than a control group, with a notable jump in the number who said they felt 鈥渄elighted with life.鈥

The program itself has spread to 35 communities in 12 states, reaching more than 2,600 older adults in independent or as颅sisted living. Since existing staff can be retrained to serve as coaches, the program isn鈥檛 costly, though there is an annual fee for training and data-tracking software.

Flashner-Fineman, who spent a decade as Orchard Cove鈥檚 fitness director, trav颅els to new sites several times a year to run a three-day train颅ing to teach new coaches the skills they鈥檒l need to work with patients and run standardized assessments. She and her col颅leagues also train health professionals, leadership and other staff on how to orient their care around seniors鈥 goals.

At Orchard Cove, where the average age is almost 90, Flashner-Fineman coaches a wide range of seniors, includ颅ing younger, healthy residents, like 74-year-old Janet Don颅noe, a retired consultant.

In a recent visit, an energetic Don颅noe announced 鈥済reat progress鈥 on her fitness goals. She now gets up at 5 a.m. on Tuesdays to drive off-campus for nearly two hours of aqua 鈥渂oot camp鈥 and weight training. Flash颅ner-Fineman asked if Donnoe, who moved there recently, is making time to meet her neighbors, too.

Programs like this have emerged because seniors are living longer and defying predictions of cognitive and functional decline, said John Morris, a researcher at the Institute for Ag颅ing Research at Hebrew SeniorLife, which operates Orchard Cove. Morris designed the assessment tool that Vitalize 360 uses and is helping retirement communities track partici颅pants鈥 wellness.

Esther Adler, a 93-year-old poet, writer and former He颅brew school teacher, moved to Orchard Cove in 2012, a few years after her husband died. She set a goal to 鈥渂e a pro颅ductive person鈥 but didn鈥檛 know exactly how.

After learn颅ing about her background in an extensive intake interview, staff invited her to start teaching Hebrew to patients on the skilled nursing floor. Adler discovered their memories were too short for language lessons, and started teaching Bible les颅sons and prayers instead 鈥 a practice she has continued for three years.

Adler, who also finds purpose in writing poetry and help颅ing neighbors through hospice, has proved resilient amid physical setbacks: She broke her pelvis last year when she tripped in the lobby of a hotel room in Poland, the night be颅fore the premiere of a documentary about her life.

鈥淭hey thought I would never walk,鈥 Adler said. 鈥淗ere I am, I鈥檓 walking.鈥

Lipsky, despite her successful trip to China, confessed she feels 鈥渉esitant鈥 about the year ahead. 鈥淚鈥檓 not as active as I鈥檇 like to be,鈥 she said. As she spoke, her right hand started shaking 鈥 a new symptom she hadn鈥檛 yet told her doctor about.

But Lipsky lit up talking about achieving another goal, finding a new way to cope with loss. She sat with her granddaughter two weeks before and di颅aled up a medium on Skype to try to communicate with her husband, Sidney, who died three years earlier.

鈥淪he breathed in our en颅ergy 鈥 on the computer!鈥 Lipsky said. 鈥淚t was eerie. We felt like he was there.鈥

She said it helped the family grieve and brought her happiness. Since the experience, she said, 鈥渙ur lives haven鈥檛 been the same.鈥

In the year ahead, she plans to attend another wedding, this time in Canada, and continue 鈥渇inding unexpected things that bring me joy.鈥

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