Authored by Sydney Moore, Owner & Occupational Therapist; a reflection of “Emotional Wellness & Aging,” presented by Amber Wilson of Ananda Mental Wellness & Yoga.

What does emotional wellness mean to you? What does emotional wellness entail?

The National Institutes of Health defines Emotional Wellness as the ability to successfully handle life’s stresses and adapt to change and difficult times.

I don’t know about you, but to me that sounds a whole lot like the phrase, “rolling with the punches.” But there’s a bit more to emotional wellness than just rolling with the ups and downs of life. Those who are emotionally well have an awareness and acceptance of their emotions as well as those of others. This includes the wide range of emotions from negative emotions like fear, anger, disgust and sadness to positive emotions including love, joy, forgiveness and hope. Those who are emotionally well likely see the glass as half-full, rather than half-empty. The emotionally well maintain satisfying relationships with others.

Often, emotional wellness changes as we age. A 2016 study found those 65 and older generally tend to be happier, less stress and more satisfied when compared with those who are younger. However, how we react to experiences can change over time and can be impacted by many factors. Changes that may impede our reactions include physical health, declining cognitive function, life cycle changes, decreasing social supports and fewer opportunities to engage in activities of interest.

Several of these changes may sound very relevant with the current COVID-19 pandemic. With quarantine and social distancing guidelines, many of us have fewer social supports and are no longer able to participate in our preferred routines. Maybe we have had to cease our typical weekly schedules, from regular coffee with friends, game nights or other fun social activities. Not only have we decreased our participation in activities of interest, we have ceased many social connections. Many individuals have found alternative ways to connect socially, via scheduled phone calls, video conferencing and more. However, this isn’t always plausible for older adults. Many do not have access to the technology or maybe have the mindset, “my friend will call when they’re available, I don’t want to bother.” The combination of fewer activities and less social engagement has been truly detrimental for aging adults residing in private homes, in apartment buildings, assisted living facilities and long-term care settings. In my professional experience, this combination has often been the root of both physical and cognitive decline. Keep in mind, changes in physical health and cognitive function directly impact how we react to experience and remain emotionally well.

Sometimes when we’re talking about the importance of these factors like maintaining good physical health, cognitive function, social supports and participating in leisure activities with older adults, responses can be something along the lines of “so what?” Or… I’m just not willing to participate because I don’t feel up to it this week, but it’ll be fine next week. Unfortunately, if we aren’t emotionally well there is a higher possibility we will develop a mental health disorder, like depression or anxiety. While participating in preferred hobbies may not seem like an “urgent” issue to many seniors, it most definitely should be!

We’ve touched on how to support emotional wellness, but let’s dive into the details. The National Institutes of Health detail a few secrets to emotional wellness including:

• Brightening your Outlook
• Reducing Stress
• Quality Sleep
• Being Mindful
• Coping with Loss
• Strengthening Social Connections

Achieving each of these pieces will be an individual process. Of course, there are things that bring some of us joy that may cause other intense stress. I think of the times I’ve brought my French bulldog, June Bug into assisted living facilities. If you don’t know what a French Bulldog is, imagine a dog that’s about 12 inches in height, but 35 pounds. They have flat faces, but tall ears and snore like a freight train.  Some folks LOVE dogs, and they find June Bug’s quirky looks very comical and it truly brightens their outlook. BUT, there are many people who have had a poor experience with a dog. Maybe they were bitten as a child, maybe they recently had to re-home their dog to move into an apartment. I definitely wanted to tell you about my sweet June Bug, but the true moral of this story is that everyone has their own preferences. We’re each individuals after all! When we discuss possibilities to progress toward each of these pieces, keep in mind that what works for you may or may not work for someone else.

Brightening your Outlook

The first way to support emotional wellness is brightening your outlook. This can be a difficult process, particularly in a pandemic when the world feels unsteady and uneasy around us. One of the most simple ways to brighten your outlook is to start identifying the positives of each day. This can be done by thinking about the good things that occurred during the day, or in a more formal process like discussing with a friend or spouse, journaling or completing a workbook. I generally prefer a more formal process for identifying the positives because it seems to create a better routine.

Reducing Stress

Stress is an interesting animal. Speaking of animals, one of my favorite reads is “Why Zebras Don’t get Ulcers.” Which sounds like a comical title, but it turns out that animals often don’t have prolonged stress like humans. When animals face stress, such as a predator, they have two options: fight or flight. Animals quickly choose their method and act on it. I want you to think about the last time that you experienced stress, did you come to a quick decision on how to resolve it? Or did you ruminate on what to do next? If I had to guess, whatever matter you were stressing about likely didn’t have an easy solution. Heck, that’s why we stress in the first place right? Anywho, it’s possible that adding a physical component or accomplishable task when we experience stress may work to reduce stress.

Quality Sleep

Before we talk about sleep, I want to discuss the importance of regular checkups with primary care providers and specialists. Addressing pertinent medical concerns prior to tackling sleep interventions is crucial. Sleep is a time for our brain to refresh and recharge, it’s a very necessary process. In many cases, poor sleep is attributed to poor health outcomes.

My most common recommendation for quality sleep is addressing the bedtime routine. Are you watching screens before bed? Screen time most often puts our brain in a “wake” phase, making it hard to go to sleep. Are you thinking of all the things you need to do tomorrow, or what could’ve gone better today? Make a list! This may help to “unload” your brain prior to shutting your eyes. Do you prefer music when you’re going to sleep? Consider a device like a Google Home or Amazon Alexa that can be programmed to play music and shut off automatically.

It may take trial & error but building a bedtime routine is important!

Being Mindful

Mindfulness is technique to bring awareness to feelings and sensations without attaching judgement. Maybe this sounds somewhat similar to emotional wellness.  Those who are emotionally well have an awareness and acceptance of their emotions as well as those of others. Being mindful is an important part of emotional wellness, as being mindful means we are in tune and aware of our current state, surroundings and feelings without becoming overly reactive. I want to share this mindfulness exercise from the Mayo Clinic with you, to complete at your own convenience.

Sit comfortably with your back straight, feet flat on the floor and hands in your lap. Breathing through your nose, focus on your breath moving in and out of your body. If physical sensations or thoughts interrupt your meditation, note the experience and then return your focus to your breath.

You’ll find in this exercise that you do not push the thoughts out, but rather accept them and then continue on.

Mindfulness is a skill and truly requires practice. While I encourage you each to start these exercises, it may take time to become consistently successful with mindfulness practice.

Coping with Loss

When we think about coping with loss, we often think of grieving the loss of a loved one. However, there are several other events that we may process as a loss. Specific to aging, we may find older adults perceive a decline in physical function or cognitive skills as a loss. A decline in skills, fall or other unexpected event may require an aging adult to need increased assistance with daily activities and move into a facility. There are many factors of moving into a facility that can be construed as a loss. If the individual needs to sell their home, donate items, spend down to receive state assistance they may be experiencing a loss. The other loss I commonly experience working with aging adults is the feelings of loss related to moving into late adulthood. There are fears related to aging that may or may not come to fruition as individuals move into late adulthood.

Coping with loss often requires being proactive and having a preventative mindset. If an individual feels they may have a difficult time with an experience, it may be helpful to work with a mental health counselor. Grief groups or support groups can be help in processing and coping with loss as we age.

Strengthening Social Connections

Socialization and staying connected is a hot topic in our pandemic world. If you are technologically blessed, you may have found video conferencing and social media to be helpful. If you’re more the traditional type, routine phone calls with friends and family may be helpful. If you’d like to become more involved, try getting volunteering to be a pen pal.

In Conclusion, we’ve talked a lot of about how to achieve and maintain emotional wellness. But what happens when it’s just not working? Depression and social isolation commonly occur in the aging adult population. However,  depression is not a normal part of aging. Some common symptoms of depressing to lookout for include: low mood, loss of interest and pleasure, sleep disturbances, changes in appetite, trouble concentrating, feeling of hopelessness or worthlessness and lastly thoughts of suicide or self harm.

There are resources available if you or a loved one would benefit from mental health services. Medicare Part B covers mental health services with psychiatrists, psychologists, clinical social workers, nurse practitioners or physician assistants. If you or a loved one is struggling with thoughts of suicide, there is a national suicide prevention lifeline at 800-273-8255.

While COVID-19 has brought many unfortunate events, one of the few benefits is the increased access to Telehealth services. For older adults wanting to mitigate the risk of COVID-19, Telehealth can be an opportunity to receive services without increasing infection risk. And sometimes, it can feel a bit more comfortable to receive services from your own home!