The U.S. population is projected to turn itself upside down by the year 2035, with people over the age of 65 outnumbering children for the first time in history (United States Census Bureau, 2018). Statistics also indicate that 77% of seniors will be entering their golden years with at least two chronic health conditions, putting them at risk for premature mortality and a diminished quality of life (National Council on Aging, 2018).
Health coaches can be a positive force in the lives of older adults by using strength-based coaching (SBC) to help them adopt health promoting behaviors and thrive well into later life. SBC focuses on accentuating the positive in a client’s life and sees individuals as whole, resourceful and naturally endowed with unique strengths and abilities. It has been shown to generate optimism, expansive thinking and positive emotions (Matthews et al., 2019).
I used this approach with an 85-year-old client, Doris, who came to me for help with a weight-loss goal. While her previous efforts were anchored in deprivation, leading to a history of relapse, infusing this journey with hope, autonomy and appreciation for her valuable life experiences led to transformative results. Here is a look at our process.
Generating Hope With a Well-life Vision
Doris suffers from painful peripheral neuropathy and is legally blind in one eye due to macular degeneration. Even so, during her initial consultation she shared, “I don’t think of myself as being 85. I feel 65 and enjoy staying busy around my house, printing out recipes, cooking and going out with friends.”
While addressing Doris’ health considerations was important, I wanted her first steps to harness the positive energy of that personal statement. Using open-ended questions, I encouraged Doris to explore the attributes she wanted to bring into her life, which generated life-affirming words such as energy, happiness, enjoyment, friends, family and accomplishment. These values became the foundation for creating a well-life vision to guide her journey.
Coaching tip: Ask questions that incrementally expand your client’s vision for his or her life. “What are some words to describe how you would like to feel every day?” “What would a perfect day look like to you?” “What is your well-life vision for the future?”
Strengthening Adherence With Autonomous Choice
Personal autonomy, or the ability to make self-directed choices, has been linked to perceived quality of life in seniors (Matsui and Capezuti, 2008). It also supports long-term adherence to new behaviors. Doris had many well-meaning people in her life offering “expert” advice. Family members wanted her to return to her water fitness class because it was a safe environment for exercise. However, Doris wanted to start walking around her neighborhood. “It’s more convenient and walking in the cooler mornings reminds me of growing up with the four seasons.”
I knew supporting Doris’ choice would increase her chances of success, so I asked how she planned to do this safely. She said she would use her walker, wear a pair of supportive walking shoes, and begin by walking back and forth in front of her house. Five months later, Doris now walks 45 minutes around her block each morning and boasts confidently, “I haven’t missed a day except when it has rained!”
Coaching tip: Brainstorm action steps with your client to support his or her autonomy. Discuss the pros and cons of each. Then ask, “What do you think you will do?”
Overcoming Challenges with Appreciative Inquiry
Appreciative inquiry (AI) is a way to help seniors move beyond their problems by magnifying the “best” in their life and helping them imagine and expand their possibilities (Moore, Jackson and Tschannen-Moran, 2016). The holidays had been a stumbling block for Doris since her husband passed away. During this time, I used AI to prompt her to share stories of laughter, love and togetherness. “Appreciating” or “growing” the good feelings in her life precipitated a range of positive emotions that we used to dream beyond the holidays. “I want to continue to enjoy going to church, playing dominoes with friends and spending Thursdays with my daughter. I plan to be halfway toward my goal by Valentine’s Day!” When that day arrived, Doris was enjoying a big victory instead of a box of chocolates.
Coaching tip: Asking questions such as, “Tell me a story about a time when you felt particularly healthy and happy. What did that feel like?” stirs positive emotions that can be mined for taking action.
Doris continues to be committed to her goal of healthy weight loss and says life feels full and meaningful. “I feel so accomplished and good about myself, knowing that I am doing what I said I wanted to do.” Health coaches can illuminate a positive path forward for senior clients by emphasizing possibilities over problems. Taking a strength-based coaching approach will ensure their golden years shine brighter than ever.
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Matsui, M. and Capezuti, E. (2008). Perceived autonomy and self-care resources among senior center users. Geriatric Nursing, 29, 2, 141147.
Matthews, J.A., Bryant, C.X., Skinner, J.S. and Green, D.J. (Eds.). (2019). The Professional’s Guide to Health and Wellness Coaching: Empower Transformation Through Lifestyle Behavior Change. San Diego, Calif.: American Council on Exercise.
Moore, M., Jackson, E., and Tschannen-Moran, B. (2016). Coaching Psychology Manual (2nd ed.). Philadelphia, Pa.: Wolters Kluwer.
National Council on Aging (2018) Health aging facts.
United States Census Bureau (2018). Older people projected to outnumber children for the first time in U.S. history.