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Senior Health

Dimensions of Wellness - Part 2: Social Wellness

Wellness is a multidimensional concept consisting of emotional, environmental, intellectual, physical, social, spiritual and vocational aspects. These dimensions make up a holistic model that is useful in guiding healthy decision making for optimal wellness. While there is a tendency to focus on the physical aspects of health and wellbeing, the social dimension is equally dynamic in influencing overall wellness. Social wellness involves the ability of people to successfully engage, interact, and maintain meaningful interpersonal relationships. People considered socially well are usually involved with others rather than isolated and they report satisfactory levels of perceived social support.1

Research supports the holistic approach to wellness with evidence indicating that social supports significantly influence the ability to cope with life's stressors. Social networks also help to protect older people against harm and promote emotional and physical wellbeing.2 For older adults, social connectedness is often a priority need and helps people find a balance between quality of life and compromised health.

Social supports can be both formal and informal. Professionals understand that formal support for older adults usually include services from agencies and organizations that meet basic needs such as congregate meals and activities. Informal support is typically provided by family, friends, significant others and pets that meet emotional or psychosocial needs.

A healthy social network provides a safety net for older adults. Those who lack adequate social supports are more vulnerable to safety risks such as elder abuse and substance misuse, and are at risk for depression, impaired decision-making, isolation, loneliness, poor health and decreased life expectancy.3

Assessment Suggestions for Professionals

Professionals need to assess older adults' perceived social support network to identify the strength and adequacy of both formal and informal sources. Researchers recommend these questions to differentiate between an isolated person and those who are not isolated:

  1. "Who is the one special person you could call or contact if you needed help?
  2. In general, rather than your children, how many relatives do you feel close to and have contact with at least once a month?
  3. In general, how many friends do you feel close to and have contact with at least once a month?

Evidence supports the following four questions to assess adequacy of social support:

  1. When you need help, can you count on anyone for house cleaning, groceries, or a ride?
  2. Could you use more help with daily tasks?
  3. Can you count on anyone for emotional support (talking over problems or helping you make a decision)?
  4. Could you use more emotional help (receiving sufficient support)?"4

Professionals need to encourage older adults to take responsibility for choosing activities that involve others either in person, by phone, or via the Internet. Evidence indicates that social support enhances overall health, especially for older women living alone.5 It is important to note that when older adults are in need of formal support services, only 20% of eligible older people use the programs because they are perceived as cost prohibitive, lack a personal touch, and hard to arrange because of rigid structure and scheduling.6 Professionals may need to emphasize to older adults and families that it may be necessary to work with local agencies and organizations to remove barriers to service use that may compromise optimal wellness choices.

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References:

  1. Mauk, K. (2006). Gerontological Nursing: Competencies for Care. Sudbury, MA. Jones & Bartlett Publishers.
  2. Miller, C. (2004). Nursing for Wellness in Older Adults, 4th Ed. New York: Lippincott, Williams, Wilkins.
  3. Miller
  4. Mauk
  5. Saito, E. et al.(2005). Social support as a predictor of health status among older adults living alone in Japan. Nursing and Health Sciences, 7, 29-36.
  6. Miller

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

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Last Reviewed: Sep 16, 2008

Evelyn L Fitzwater, DSN, RN Evelyn L Fitzwater, DSN, RN
Associate Professor Emerita
Associate Director of the
College of Nursing
University of Cincinnati