Multidimensional wellness for people aging with mental health conditions: A proposed framework.

Abstract

Objective: This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. Method: A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. Results: Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. Conclusions and Implication for Practice: People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. Impact and ImplicationsPeople aging with significant mental health conditions can benefit from a tailored integrated multidimensional wellness framework informed by existing models to improve well-being, guide interventions, and frame policies. Developmental wellness is a critical addition to a multidimensional wellness framework to promote positive aging. Mental health providers should be aware of, and address challenges to, positive aging and recovery that can be described as developmental.

What are the evidence bases for developing models of rehabilitation for older people with mental illness in Australia?

“…Application of wellness models to older people with mental illness 12 has added the concept of ‘developmental wellness’ to existing models. The other wellness dimensions are similar to the domains of a meaningful life fundamental to ‘personal recovery’ for older people with mental illness.…”

Mental Health Issues and Frailty

“…Frailty tends to be more common among older, female and African American, with less education, lower income, poorer health, and higher rates of comorbid chronic diseases and/or disability than their counterparts [23]. The circuitous occurrence of social, physical, and emotional changes with age causing mental health issues that can further cause social, physical, and emotional decline is a reality that needs improvement [3,11].…”

“…By keeping an open mind about aging, helping move society away from age stereotypes, providing opportunities older adults can benefit from in the community, and improving mental and physical health care for the aging, a reduction of issues like anxiety, depression, and frailty can occur, and a more balanced approach towards population aging can occur [3,11,20]. Increasing awareness, training, and knowledge of aging, mental health, and older adult's needs can work to help older adults receive the care they need and hopefully work to help improve the rate of successful aging [3,11]. Improving and increasing resources for older adults, like senior programs or services that can help older adults stay active, find new individuals to interact with, and provide health and safety tips, could also be beneficial [3,11,15,18,20].…”

“…Increasing awareness, training, and knowledge of aging, mental health, and older adult's needs can work to help older adults receive the care they need and hopefully work to help improve the rate of successful aging [3,11]. Improving and increasing resources for older adults, like senior programs or services that can help older adults stay active, find new individuals to interact with, and provide health and safety tips, could also be beneficial [3,11,15,18,20]. Connecting older adults, especially those who may be homebound, with these services could be a great way to support older adults as they combat issues of aging, loneliness, and mental health [20].…”

“…These mental health issues can develop in older adults who may be dealing with medical issues, living in an institutional setting, or have experienced unexpected changes [10]. Age-related changes can bring on a decline in memory, low physical activity, unhealthy diet, poor behaviors, and a decrease in social support, all of which can affect mental health and cause frailty in older adults, which often increases the risk of anxiety [3,4,11,12]. An anxiety disorder is more than just short-lived feelings of anxiousness, it is a mental health issue that can affect daily life and make normal tasks daunting or challenging, with anxiety not going away or getting worse with time [10,12,13].…”