“Coaching for a Lifetime of Wellness: Five Keys to Sustainable Behavioral Change”

2nd Ed Cover - MedThe theme of the 41st Annual National Wellness Conference was “Spotlight On Sustainability”. While we often think about sustainability and our environmental practices, as a wellness coach and psychologist I immediately thought of sustainable behavioral change. As I prepared for my presentation on this topic my research revealed that we actually know very little about how effective our efforts at helping people improve their lifestyles actually are.

Maintaining success at lifestyle change is often daunting. Most wellness coaching clients have a history of initiating efforts at losing weight, stopping smoking, managing stress, etc. For many, however, there is a trail of failures at maintaining those new ways of living in the long run. The result is a lowering of self-efficacy and lingering feelings of discouragement. As I explored in a previous blog post “Lessons From Albert Bandura For Wellness Coaches” (http://wp.me/pUi2y-dB) there is much for coaches to learn about self-efficacy.

 When we go to trusted sources looking for help with making healthier behavior last, what do we find? Unfortunately, not much. From Harvard Medical School’s online publication Healthbeat I found “The Trick To Real And Lasting Lifestyle Changes”. (http://www.health.harvard.edu/healthbeat/the-trick-to-real-and-lasting-lifestyle-changes) Though this title sounds like the exact resource to look for, all it advised was a simplistic review of SMART Goals.

Turning to the APA Psychology Help Center we find “The key to making lasting lifestyle and behavioral changes: Is it will or skill?” (http://www.apa.org/helpcenter/lifestyle-behavior.aspx) This disappointing short article could only offer this: “Lasting lifestyle and behavior changes don’t happen overnight. Willpower is a learned skill, not an inherent trait. We all have the capacity to develop skills to make changes last,” said Katherine C. Nordal, PhD, executive director for professional practice at APA. “It is important to break down seemingly unattainable goals into manageable portions.” The article mostly talked about how ineffective we are at making any changes in our behavior and did not even address making changes last!

As I deepened my research quest I found that other behavioral scientists had been concerned enough about this issue to establish an impressive research consortium to tackle it. The result was a publication in The American Journal of Health Behavior (2010 Nov-Dec; 34(6): 647–659) entitled The Science of Sustaining Health Behavior Change: The Health Maintenance Consortium. The authors (Marcia G. Ory, PhD, MPH,1 Matthew Lee Smith, PhD, MPH, CHES, CPP,2 Nelda Mier, PhD,3 and Meghan M. Wernicke, MPH4) did a thorough research synthesis of articles spanning 2004-2009, amassed resources and funded twenty-one projects to look at this issue of lasting change in health behavior. Here is what they concluded.

elderly_hikingWhat we are up against when it comes to lasting change.

• How long can positive gains be sustained without additional long-term support?
• In most cases this is unknown because studies only track maintenance for a year or two after the post-intervention phase.
• In the majority of cases, intervention effects on lifestyle behaviors are often strongest in the one or two years closest to active intervention.
• Without additional support, positive effects tend to diminish over time, or treatment differences vanish.

What they found was frankly, not a lot.

• It’s not realistic to expect long-term maintenance based on initial interventions. (Single-variable research)
• Moderate-intensity behavioral interventions may need to be coupled with more environmental changes to sustain long-term effects.
• In other words people need the support of healthier communities and workplaces, peer groups, etc.
• Incorporation of physical activity into the self concept emerged as the strongest predictor, with self-efficacy having a major indirect influence confirming it as an important predictor for both behavioral initiation and maintenance

LongWindingRdIn summary:  The authors conclude that no single mediator makes a large impact; rather, there is a “long and winding road” with maintenance achieved through a multitude of modest interrelated meditational pathways from behavioral initiation to maintenance.

There are many reasons for our scarcity of knowledge. One is that much research of this nature is done by universities where graduate students need short-term projects that allow them to finish up and…graduate! We may learn more from larger sociological and epidemiological studies such as The Framingham Study (https://www.framinghamheartstudy.org) , the work of The Blue Zones, (https://www.bluezones.com) etc. However, here we are not isolating variables. We can’t really say if it was the plant-based diet, the supportive extended family, or the red wine that made the healthy difference. It seems we have to be satisfied with the shotgun approach and put our best bets on culture and environment.

What can we conclude about making positive changes in health and wellness behavior last?

• Changes must be sustainable over a lifetime
• Intrinsic motivation trumps extrinsic every time
• Most research looks at single interventions and doesn’t track more than one or two years
• Long-term studies show that a combination of environmental support and “internal” shifts sustain lifestyle improvement better. Culture, environment, attitude and beliefs!
• We must ask how can coaching support shifts towards “well” attitudes and beliefs?

Healthy Choices For A Lifetime
Healthy Choices For A Lifetime

The Five Keys of Coaching For A Lifetime of Wellness

• 1. Build Self-Efficacy
• 2. Nurture Visionary & Intrinsic Motivation
• 3. Focus On The Maintenance Stage (TTM)
• 4. Co-create Relapse Prevention Strategies
• 5. Coach For Connectedness

1. Build Self-Efficacy

Bandura’s Social Cognitive Theory (formerly AKA Social Learning Theory) shows tremendous congruity between it and the foundational principles of coaching. Bandura deeply explored the concept of Self-Efficacy which is foundational to wellness coaching. (Again see the previous blog post “Lessons From Albert Bandura For Wellness Coaches” (http://wp.me/pUi2y-dB)

2. Nurture Visionary & Intrinsic Motivationgreen nature_wood path

Much of our coaching work is around helping people to envision the outcome they want. When we have a clear picture of both where we are (our current state of wellness) and where we want to be (our Well Life Vision) we can “coach to the gap” between the two and coach around what needs to change to attain that Well Life Vision. Such a positive psychology approach is foundational to coaching and motivates better than just fear and illness avoidance.

We know that when clients experience intrinsic joy in activities they will be more motivated to engage in them. Look at the work of Jay Kimiecik, The Intrinsic Exerciser: Discovering the Joy of Exercise: ( https://www.amazon.com/Intrinsic-Exerciser-Discovering-Joy-Exercise/dp/061812490X) and Daniel Pink’s book Drive: The Surprising Truth About What Motivates Us (https://www.amazon.com/Drive-Surprising-Truth-About-Motivates-ebook/dp/B004P1JDJO/ref=sr_1_1?s=books&ie=UTF8&qid=1467763122&sr=1-1&keywords=Daniel+Pink+drive#nav-subnav).

To COACH for intrinsic motivation:
* Notice! – Help your clients to focus on the enjoyment, the pleasure that they perceive as they are performing the behavior.
* Inquire! – Ask about the details of their experience. When a client reports about taking a walk, hike or bike ride outdoors ask about what they saw, what they experienced, what they felt.
* Inquire about Bonus Benefits. Clients sometimes fixate on their goal of weight loss for example, but what else is happening during their efforts? Are they experiencing more energy? Better sleep? More mental concentration?
* Avoid incentivizing. Incentives tend to decrease intrinsic motivation.
* Take a Kai Zen Approach. (https://www.amazon.com/Small-Step-Change-Your-Life-ebook/dp/B00GU2RHCG/ref=sr_1_1?s=books&ie=UTF8&qid=1467763620&sr=1-1&keywords=robert+maurer#nav-subnav) Coach with your client to set up action steps that are so small that they are very doable and allow continuously successful progress towards their goals.

3. Focus On The Maintenance Stage (TTM)

Of all of the Stages of Change that Prochaska talks about in his Transtheoretical Model of Change (https://www.amazon.com/Changing-Good-Revolutionary-Overcoming-Positively-ebook/dp/B003GYEH2Y/ref=sr_1_1?s=books&ie=UTF8&qid=1467763816&sr=1-1&keywords=prochaska+changing+for+good#nav-subnav), coaching around the Maintenance Stage may be the most vital. Here the coach again takes a positive psychology approach and acknowledges and reinforces what is working. As the old saying from coaching goes “Nothing succeeds like success!” A key in this stage is for the client to see the value in Tracking Behavior and to do it regularly. Avoiding self-deception is key. Use whatever works for keeping track of new healthier behaviors: calendars, charts, apps, activity monitoring devices, etc. Then the Accountability that coaching provides makes the process conscious, deliberate and increases consistency. Lastly, coaches really prove their worth here as they coach their clients through the barriers and the “push-back” that sometimes is received by those who clients were hoping would provide support.

4. Co-create Relapse Prevention Strategies1369010631_url

Relapse happens! Count on it! James Prochaska is fond of back-up plans. We all know that life throws us curve-balls all the time. Our best-laid plans run up against life realities. This is where coaching can get creative! Coach clients to come up with their own back-up plans for then things don’t go as they would like, or when temptation increases. Going to a potluck dinner where the dietary direction of friends tends to be sabotaging of your wellness efforts? Be sure to bring an entrée to share that will satisfy your own needs. Not enough time to do your hour-long exercise routine? Having a quick and simple set of exercises you can do anywhere fills in “better than nothing” and maintains engagement in your program.

Pivotal to this key is self-compassion. There is a real difference between excuse-making and true compassionate understanding. Coach your client to be less self-critical and more forgiving. Help them keep a healthy perspective on their wellness plan.

5. Coach For Connectedness

Real Balance Faculty At The National Wellness Conference
Real Balance Faculty At The National Wellness Conference

In our Real Balance Wellness & Health Coach training (https://www.realbalance.com) we emphasize coaching for connectedness from day one. The amount of time any client spends in coaching is a brief moment compared to the lifetime they have to live in a new way. In addition to the support of the coach, other sources of support must be encouraged, discovered or consciously developed. For each step of action we ask “Who or what else can support you in this?” If our client has little support then making the development of such support a deliberate area of focus to work on in coaching is vital. This is where the role of culture, community, workplace, peer groups, family, friends, and relationships becomes a part of coaching that cements lasting lifestyle change.

Living a wellness lifestyle is a lifetime job! Providing the kind of coaching that goes beyond simplistic goal-setting and allows our clients to transform who they are can build the foundation for a lifetime of wellness.

A PDF of the PowerPoint from my presentation on this topic at The National Wellness Conference and a complete bibliography are available for download at: http://www.nationalwellness.org/page/2016NWCHando

Coaching The “Boomer Generation” for Aging Well

Expect the unexpected with THIS generation!

Every seven seconds a “Boomer” turns fifty. The American post-war “Boomer Generation” spends more on health care than their parents did.
They visit the doctor more, they consume more services, and aren’t afraid to use their $7 trillion in collective wealth to improve their quality of life. From physical therapy, to cosmetic surgery, to the latest in life-saving technology, Boomers just aren’t built to grow old gracefully or go “quietly into the night.” Their impact on the marketplace for health and wellness products and services is huge and unprecedented, and wellness coaching may just be on their shopping list.

Boomers live longer, but the debate goes on whether they are healthier or not. It is like the tale of two generations in one. Our stereotype of the generation is like most stereotypes, usually misleading. We think of the Boomers as the same folks who went to college in the late sixties and projected an image of rebelliousness, and social consciousness. While this generation did acquire more education than any previous, not everyone went to college, and not all became the health conscious, socially and environmentally aware folks that describe the icon the current media might portray.

They are in fact quite a paradoxical group to look at. While on the one hand there are plenty of physically active, health food conscious “oldsters” in Yoga classes and out on the bike and hiking trails, especially in some parts of the country, many folks the same age are living a very different lifestyle. The Boomers, as a whole, are far more obese, are under more stress at work, and are retiring later, if at all. They are much more sedentary than any previous generation driven by more jobs that limit movement and have longer commutes. While they don’t smoke as much, they self-report being less physically healthy than their parents. They watch more TV and even their recreational pursuits can go either people-powered or “full throttle” (i.e. sitting down revving some kind of engine).

Abbey Road has a new look!

Helping this enigmatic generation create a healthy future takes on two aspects, the individual and the sociological. When we look at long-lived cultures around the world, like the National Geographic-funded Blue Zones project does (www.bluezones.com ), we see cultures that have in place healthy norms and lots of social support. People in all of these longevity hot spots make lots of movement a natural part of their daily lives. They live with meaning and purpose and a strong sense of spirituality. They eat wisely and “belong to the right tribe”. They honor and keep elders within their community. Social isolation is a health risk for all, and only increases in threat as we get older. The challenge is for us to build the kind of families and communities that support being well not just while we’re young, but for our entire lives.

Once again, “coaching for connectedness” may take center stage. Making the goal of obtaining greater social support a central part of a client’s Wellness Plan may be the most helpful thing they experience in wellness coaching.

COACHING BOOMERS – Three Ideas

# 1 – Never assume they are retired, or are even retiring anytime soon. Chances are your client who is still at least in their sixties, is still employed full-time. In fact they may be headed into the most productive time of their lives. Let’s call them late-bloomers. For them Work-Life Balance Coaching is a greater need than ever. Furthermore it may be complicated by some factors of aging keeping them from performing like they would like to, or being able to get the most out of the limited time they have for exercise and self-care. If they are taking medication that makes weight loss more challenging, or are recovering from surgeries, etc. (joint repair and replacement is more and more common with this group) they may not be able to be as “efficient” in their activities to maintain their health. Exploring this in coaching and helping them to create new strategies may become a really valuable use of coaching.

Many of this generation have also found themselves facing retirement with financial problems instead of reserves to draw upon. For them, healthcare issues and wellness lifestyle choices may revolve around expenses, especially for the pre-Medicare group. They may really benefit from coaching that can help them keep their health a priority in the face of the frightening costs of healthcare.

#2 – Coach around the subject of meaning and purpose. Some folks are fortunate and either find meaning and purpose in work they continue to do, or have lived full lives where they have developed rich sources of meaning and purpose outside of their careers. For others “retirement” may result in such feelings losing their anchor. Without a solid sense of meaning and purpose in one’s life there is less motivation to engage in a really healthy lifestyle. Help your client search in directions that align with their values and interests. Reconnecting with old interests, becoming active in organizations, volunteering with non-profits may all bridge this gap in a meaningful way. This may be a great time in life for developing the spiritual side of one’s self. Coach your client through the steps of exploring such new pursuits and following through on creating “experiments” to find something that works for them.

#3 – Always explore the issue of connectedness. Never assume that your client has friends and family that can or will support their efforts at improving their lifestyle. More and more seniors are living alone, especially as spouses die and children move away. Many others have relocated themselves to places where the challenge is establishing a whole new circle of friends.

“Studies have shown that people who are isolated and lonely have a higher incidence of health problems. A 1998 study of patients with heart disease found that 50 percent of the patients who reported feeling very isolated were not married and had no one in whom they could confide died within five years. During the same time span, only 17 percent of those with either a spouse or confidant died. Another 1998 study on women found that symptoms of depression and lack of social support were associated with more heart attacks, open-heart surgeries and deaths from cardiovascular disease. A report has found that seniors, who attend church at least weekly, live longer.” (http://seniorhealth.about.com/od/mentalemotionalhealth/a/lonely.htm)

Also, don’t assume that social networking online is not in the picture. Many boomers are quite tech-savvy, certainly more than any other group of oldsters ever has been. Folks with chronic illnesses may find both information and online groups of others sharing the same health challenges. Whether it is through something online, participating in a Senior Center’s programming, or engaging in community groups in align with their interests, it’s all good.

The individual aspect, again comes back to lifestyle choices, conscious awareness and realizing that we are in charge of our own health. A big part of it is realizing that we can and do affect our own health. Building that confidence, that self-efficacy is crucial. Making the individual decision to connect with others and build a sense of healthy community may create yet another paradox, but one that works for us.

My grandpa, he’s 95

And he keeps on dancin’

He’s still alive

 

My grandma, she’s 92

She loves to dance

And sing some, too

 

I don’t know

But I’ve been told

If you keep on dancing

You’ll never grow old

 

Come on darling

Put a pretty dress on

We’re gonna go out tonight

Dance, dance, dance

Dance, dance, dance

Dance, dance, dance

All night long

“Dance, Dance, Dance” – The Steve Miller Band

What’s your experience coaching this aging “Boomer” generation? Please share in your comments here on the blog.

Wellness And Aging Well: Conversation With Donald Ardell – Part Two

Ageless Don Ardell in the Madeira Beach Triathlon

In our last post Don Ardell contributed to our conversation on Aging and doing it really Well! Don begins by referring to the study he introduced in our last post. Here’s the conclusion of his thoughts and my reply.

(Don)

What are the key variables here? (in aging well and longevity) Is the ability to live unstressful lives the most important factor? Does living independently lend certain resilience to elderly bachelors and bachelorettes? What about the fact that centenarians carry a number of genes common among those who live to 100 or better? The researchers are not sure, just yet, what to make of it all, but they seek to identify the longevity genes, learn how they work and, as you might expect, create drugs that mimic their actions.

Fortunately, the head investigator wants to focus on healthy life patterns, as well. Most of the study subjects have not been smokers, heavy drinkers or obese. Yet, he also noted that even if you’re Jack La Lanne, you’ve got the perfect diet, you’re exercising for a really long time, you’re happy-go-lucky and incredibly nice and you’re thin, I would say that without the appropriate genetic variations, it’s still extremely difficult to get to 100. Well, sure, we knew that. It’s difficult to get to 90 or 80, as well.

Will You Live To Be 100?

These reports on living to 100 reminded me that I once had a bright idea for making a killing connecting wellness with reaching 100. Unfortunately, ethical considerations shelved my grand plan. No – I’m kidding – the plan was pure and noble, somewhat like life insurance. I even wrote an essay describing the plan – general terms.

It may be time, nearly a decade later, to take another run at testing the feasibility (and legality) of my initial scheme, published on December 29, 2001. If I wait a few more decades, it could be too late – I’ll already be 100 and thus too old to sign up.

In any event, it looks like the time has come to go for it, time to bring back my bright idea.

Here it is – let me know what you think. Perhaps this concept has even more appeal during the ongoing economic crisis. If the feedback from you is encouraging, I might announce a REAL wellness longevity program at NWC (National Wellness Conference) (www.nationalwellness.org) for those who want to associate with other centenarian-status seeking wellites. We can start our own club, and meet here at your website and annually at NWC. It will consist of a secret longevity reading program, special exercise regimens, an eternal diet pattern and much more. So far, none of this is all that special but I have not mentioned the best part yet. Here is the best part — why the “Don Ardell Live To Be 100” program will, if I go through with it, prove utterly amazing, incredibly attractive and a sure thing to sweep the nation into a frenzy for living long and well:

1. It will be guaranteed!

2. It will cost only $100 for life — which will be refunded if you don’t’ make it (provided you ask for your money back – personally)!

3. You will get a club T-shirt AND a lifetime subscription to the ARDELL WELLNESS REPORT. (I know – it’s free anyway, but never mind that.)

Other details will have to wait for a grand announcement.

Well, that’s all I have to say for now.

(Michael)

OK Don! Sign me up! 100 is such a nice round number, why not go for it? Thanks for your contribution to our conversation here. Your refreshingly blunt humor and relevance are always appreciated.

Early on in the wellness movement the nay-sayers were scoffing by saying that since we couldn’t guarantee greater longevity, there was not point in all of this effort to be healthy and well. We humans have always had trouble with this mortality thing (see Greek Mythology!). Now, with research like the work Buettner has looked at in The Blue Zones, that you mentioned, we may be finally silencing some of those old critics.

Remember the “Sixty Minutes” TV show that reported on the early version of the Blue Zones back in the 1980’s. That was the yogurt-eating Cossack stuff we all got quite enamored with. Well, I guess the data was flawed in that work, but Buettner’s summary of the current work being done by anthropologists, epidemiologists, and aging specialists around the world is quite solid. Genetics is overrated! Lifestyle again, rules supreme.

I think the promise of wellness that is there for we folks creeping into geezerhood is, and always has been, about the QUALITY of life. Sure, I’ll take a nice able-bodied lengthy stay here on the planet if I can get it. It is, however, somewhat determined by something the Chinese call “Joss” (something that combines luck, fortune, fate and karma). We can influence the probabilities. That’s it. Hey, but why play “Russian Roulette” with a revolver and put three or four bullets into the six chambers instead of just one? Reducing our risk factors makes sense, there’s a library of research behind that. However, Joss comes in to account for all of those unpredictable factors that make life, death and disability, very real.

We might call it EXISTENTIAL WELLNESS. Living life to the fullest, running (and winning!) Sprint Triathlons at 70 plus like you Don, or beginning to run again at age 60 (after a fifteen year hiatus) like I did last year, are just a couple of ways to maximize our precious existence. Existential wellness is all about our philosophy, our mindset, our view of ourselves and the world. It’s about embracing the adventure in life, and it’s about taking some glucosamine for those aging knees.

The current crop of “Boomer” will not go quietly into the night. They (we) are fueling the “Wellness Revolution” that Paul Pilzer talks about (http://thewellnessrevolution.paulzanepilzer.com/index.php). We are doing walking tours for vacations (link to walking the world), and looking for ways to stay well. As you and Jack Travis have always railed against the “Pill Fairy” mentality – that some medicine would magically keep us well – I’d add that our answers to healthy aging lie in our active bodies, our open minds, and our compassionate hearts. Let’s keep on being well!

Please add your comments to this conversation. Our next posts will reflect our Well Traveler theme as this blogger goes to Italy for a long-overdue vacation in search of La Dolce Vita and what we can bring back to our wellness lifestyles at home.

Wellness And Aging Well: Conversation With Donald Ardell

Don Ardell - Exuberance is part of REAL Wellness!

Don Ardell is truly one of the founders of the wellness movement that we can identify as getting in gear in the late 1970’s. His foundational book “High-Level Wellness: An Alternative to Doctors, Drugs and Disease” was ground-breaking and he has since contributed more wisdom through authoring numerous books, being a true ambassador for wellness worldwide, and importantly reminding us that “Wellness is too important to be presented grimly!” One of his latest books looks at the very topic we’ve been exploring on this blog – Aging and doing it Well! Aging Beyond Belief: 69 Tips for REAL Wellness http://www.wholeperson.com/x-selfhelp/aging.html
In it, Don shows us how to “Age under the influence – of a wellness lifestyle.”

Don sent the message below to me just before he took off for the ITU Sprint Triathlon World Championships in Budapest, Hungary. There Don took his Fourth World Champion Medal in his 70-74 age group! http://pressbox.teamusa.org/Pages/TRIATHLON–U-S–Triathletes-Capture-Seven-Titles–21-Medals-at-Worlds.aspx
So! The man knows a thing or two about aging well!
Here’s his thoughts, spread over a couple of posts, and later, my reply.

(Don)

You asked me to keep the chatter going on this aging thread, so I’ll offer a commentary on a recent book about places (besides Stevens Point, WI) where high percentages of people enjoy remarkably long, high quality lives. Someone named Dan Buettner, an explorer with National Geographic who has traveled widely studying longevity, wrote about what he calls “Blue Zones.” In his new book, “The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest” (http://www.bluezones.com) , he addresses some of the themes mentioned by you and Sandy. Since I expect you both to be the first centenarians to be speakers at the NWC, you might find his comments on such folks of interest.

Mr. Buettner is not the first and won’t be the last to visit, observe, analyze and report on health habits of centenarians in remote, little understood places off the beaten paths we associate with civilization. In a recent interview on ABC News with the always annoying Diane Sawyer, Buettner condensed his newest aging discoveries into a short but interesting interview segment. Here is the bottom line, based on the qualities he reported to Ms. Sawyer: Centenarians (at least those in Icaria, a lovely Greek Island) have positive attitudes, a sensible diet and look after themselves. Surprise! In Icaria, they also have a special fondness for a local honey and a certain tea. They love walking and they eat a lot of nuts – and veggies, too. They soak in hot springs and hang out mostly with other thin, fit and upbeat people. like themselves.

Nothing was said about religiosity, yogurt or alcohol (though there might be something about such things in the book). The author claims genetics account for only 20 percent of longevity, at least in Icaria. (University of Georgia gerontologist Leonard Poon, in an essay on centenarians, claims 30 percent is due to heredity – see How to Live Beyond 100, World Future Society, November-December 2008 Vol. 42, No. 6.) Whether 20 or 30 percent, the largest factor by far, all agree, is lifestyle.

Let’s personalize this aging business – particularly the centenarian issue. What age might YOU attain before the final curtain call? On a scale of 1 to 10 (ten being quite confident of reaching the fabled mark), where would you put your prospects of living to 100 years or more?

Your chances are probably better than you think.

There are about 50,000 American centenarians around now. Any idea how many there were a century ago? Nearly none! What about the NEXT century at this time? What numbers can we expect by that time, assuming no epochal catastrophes? Who knows? Who could venture a credible guess? However – this may surprise you: Some experts predict there will be 800,000 to one million American centenarians by 2050! That’s a mere 40 years from now. (I can relate – I’ll be 112.)

Credit for longevity advances is attributed to better sanitation, control of air and water borne diseases and other environmental measures, including an improved food supply and greater safety. There are still product recalls, but it’s not The Jungle that Upton Sinclair would write about. Three other factors also come into play — lifestyle habits, economic safety nets and medical advances. The former affects the quality of added years, the latter, the number of them.

Unfortunately, medical advances can keep you alive at the margins too long. Only a few have occasion to make the ultimate decision as to when enough is enough. Your chances of being able to say when are somewhat better (but still difficult) if you live in a right-to-die jurisdiction, like Oregon or the Netherlands. Do you really want to make it to 100 if it entails an extended period of years immobilized with the personality of a Fox News commentator?

Before yearning too much about longevity, you might want to do more to make the most of the time straight ahead. Recall the line by Susan Ertz in Anger in the Sky (1943): “Millions long for immortality who do not know what to do with themselves on a rainy Sunday afternoon.”

A study that includes around 1500 centenarians has been underway for ten years in the US.. The research consists of interviews looking for insights that can help others live long and well. The subjects provide DNA samples, take psychological tests and encourage relatives to talk with researchers about their lives. The centenarians agree to donate their brains for medical research. (A request that hopefully won’t remind the old folks of the organ donor skit in the Monty Python movie The Meaning of Life.)

Among the preliminary findings from this study are that centenarians enjoy good health, are gregarious, optimistic, happy and skilled at managing stress. What’s more, they seem to get along well with people, have clear thought patterns and an excellent sense of humor. For example, one lady was asked for the identity of nephews or nieces (for interview purposes) who have consistently taken an interest in her affairs? The woman replied, “Well, they’re all interested in my affairs.”

The study leaders note that most subjects are healthier than they originally expected. Most avoided the devastating diseases of old age until their last months or so (compression of senescence). While the researchers are not sure what to make of it, another finding is that five times as many women make it to 100 as men, and the women, unlike the men, prefer the single life.

Don will expound further and I’ll muster a reply in our next post. Stay tuned, and join in on the conversation with your comments!