Health and wellness in older adulthood is a realistic possibility, and older adults are resilient and important members of our community with unique strengths.

On Sept. 12, Citizen Potawatomi Nation Behavioral Health Services hosted a panel discussion at the Cultural Heritage Center featuring experts from several fields to speak about the topic.

Panelists included Burt G. Patadal, Healing to Wellness Cultural Leader; Michael Brand, Ph.D.; Alicja Carter, MHR, BHWC; J.J. Jones, PMHNP; Jeanie Jones, LADC, LBP, CPN Behavioral Health; Tribal member Crystal Marcum, APRN, CPN West Clinic; and Tribal member Pamela Vrooman, Ph.D.

Dr. Julio Rojas, Ph.D., moderated the discussion. The event was funded by the Tribal Opioid Response Grant and the Community Opioid Intervention Pilot Project. Alicja Carter led a low-impact exercise activity for attendees during the event (cpn.news/chaironefitness).

Nine Dimensions of Wellness

Panelists began by introducing “9 Dimensions of Wellness” paradigm. Each of these dimensions, including emotional, spiritual, cultural, intellectual, financial, environmental, occupational, physical and social wellbeing, are essential aspects of overall health and wellness at any stage of life.

This framework builds on 8 dimensions of wellness by the Substance Abuse and Mental Health Administration (SAMHSA), differing from SAMHSA’s model by including cultural wellness as the ninth dimension — an integral component in culturally responsive care.

Panelists said each of these dimensions impacts the others, so considering each of them together is important for maintaining wellness.

“As adults, a big part of our identity is the work that we do, and as we stop doing that work, we can flounder,” said Jeanie Jones, a licensed alcohol and drug counselor at CPN Behavioral Health Services. “Work can also be a social function. As we lose identity and social relationship, there might be a sense of isolation, which can lead to boredom, which can either exacerbate or cause a depression, and all of the above can lead to increased substance use.”

Additionally, without a work schedule, some older adults may experience changes in their sleep patterns that negatively impact other areas of their health.

Dr. Vrooman, a therapist working in Tulsa, Oklahoma, and Alicja Carter, Gateway to Prevention and Recovery wellness director, advised that classes and activities that engage an individual’s interests and hobbies can help cultivate a resilient sense of self during this phase of life.

Carter emphasized that a friend or loved one providing a ride to such an activity can be invaluable.

Primary care

Crystal Marcum, APRN, discussed the importance of regular visits to a primary care provider in older adulthood, even if a patient does not have a complaint. Primary care providers are in a unique position in a patient’s life and care team, she said, to flag any concerns about polypharmacy or to make connections between various complaints the patient may be experiencing.

If a person is being treated by multiple specialists for various health concerns, they may be prescribed multiple medications, some of which might be contraindicated.

A good practice, Marcum said, is to talk with your primary care provider about your medication list so that they can check for any contraindications that may be missed by specialists treating one condition rather than the whole patient.

J.J. Jones, a psychiatric nurse practitioner in private practice, added that some complaints may be side effects of a medication, and simply medicating that complaint may not get to the root cause of the issue.

A primary care provider can also help patients create healthy patterns around physical activity, diet, sleep hygiene and even getting outside — which are all important parts of a proactive approach to wellness.

Older adult patients are encouraged to discuss concerns about mental and emotional wellbeing, or any other dimension of wellness, with their primary care physician, as primary care providers are uniquely situated to have the patient’s holistic wellbeing in view and can help a patient build a team to support all their needs.

Caregivers

Caring for others can be a beautiful expression of love, respect and healthy interdependence, but it can also be a demanding and challenging experience. The wellbeing of caregivers is an essential component not only to their own health but also to their ability to care for those around them.

Panelists advised caregivers to make a regular practice of taking breaks for something that brings them enjoyment and refreshment. It may take some time to be able to do so without a lingering sense of guilt, but this is what makes dedicating oneself to the routine even more important.

“If you’re not taking care of yourself, it limits your ability to care for your loved ones,” said J.J. Jones.

Dr. Michael Brand noted that, increasingly, there are many older adults who are also caregivers themselves, whether of older parents or of younger children. He recommended caregiver support groups, where individuals can share stories and understanding, as well as access information and resources particular to their experience.

Wellness is possible

Health and wellness in older adulthood is possible, and it starts with reducing stigma and stereotypes about older adults and older adulthood.

“We always talk about ‘normal changes in aging,’” said J.J. “But is it normal or is it common? Because not getting sleep is not normal. Common does not mean normal.”

It’s important to advocate for oneself and one’s loved ones in health care settings, and it’s important for medical providers and caregivers to recognize the agency, wisdom and dignity of their older patients.

“People are not just their accumulated weaknesses, they’re also their accumulated strengths,” said Dr. Vrooman.

“Older adult patients are wiser, committed to getting better and more patient with the process,” added Jeanie Jones.

“It’s one of the things I love about Indigenous culture,” said Dr. Vrooman. “It feels like, under settler colonialism, most people view elders as a throwaway, like they no longer have purpose or value. But that is intrinsically reversed in Native cultures. Elders are the wisdom keepers, the story keepers, they also are the ones responsible for passing on traditions, they are there for advice and guidance and counsel, they are consulted for many different things depending on their areas of expertise. So in most ceremonies that include feasting, elders go first. It is acknowledged that they have an important part in the culture, and that their life experiences and traditions enrich the lives of other people.”

Learn more about CPN Behavioral Health Services at cpn.news/health.