These Annual Checkups Help Seniors Not Only Survive But Thrive
Bea Lipsky shuffled into her wellness coachās office one morning this fall and parked her walker by the wall. Lipsky, 89, had had a trying year, enduring a hernia operation and two emergency room visits for heart problems. Sheās losing her hearing, and recently gave up her dream of riding in a hot air balloon for her 90th birthday.
That day, though, she was filled with pride: She told her coach sheād achieved her goals for the year, including attending her grandsonās wedding in China.
Lipsky spent two months training, doing leg curls and riding a stationary bicycle, to build up the strength to make it through a 10-day trip to China, accompanied by an aide. āIt was absolutely divine,ā she told coach Susan Flashner-Fineman, who works at the Orchard Cove retirement community in Canton, Mass., where Lipsky has lived for the past four years.
Lipskyās check-ins with Flashner-Fineman are part of a wellĀness coaching program, Vitalize 360, that Orchard Cove startĀed eight years ago in collaboration with the Kendal nonprofit senior living organization in Pennsylvania.
When seniors arrive at Orchard Cove, a coach measures their health and wellness in an hourlong, one-on-one session, assessing common problems for seniors, like loneliness, pain and distress. The coach also asks about seĀniorsā families, friendships, and spiritual life. Then the seĀniors meet with their coach every year before their physical checkup with a doctor, to talk about what matters most to them. The coaches, who come from a variety of backgrounds, including fitness, social work and chaplaincy, help seniors set goals for the year ā which could be physical, social, inĀtellectual or spiritual. These goals become the focus for the seniorās medical team, and the seniors follow up with their coaches every three months to stay on track.
Wellness coaching aims to rethink how we treat aging, said Aline Russotto, Orchard Coveās executive director. āWe used to be at our very best when somebody was in crisis,ā she said.
But Orchard Cove staff think they can help residents live healthier and happier lives by shifting the focus away from āfixing whatās broken,ā said Russotto, to āliving your best day every single day until the end.ā
Dr. Atul Gawande, author of “Being Mortal” and an expert on end-of-life care, calls the Vitalize 360 approach ātransforĀmative.ā It recognizes that āeven as you may have health isĀsues and frailty and the difficulties that can come with aging … people have lives worth living. And in fact have a lot more life worth living,ā he said.

When young people become disĀabled, others often help them find ways to contribute to the world, he noted, but that is much less true for older people.
āI see it as the kind of thing that youād like to see go populationĀwide,ā Gawande said. āYouād like to make it routine.ā
Since the program started at Orchard Cove, fitness parĀticipation ā the proportion of residents who exercise at least three times a week ā has more than doubled, from 30 to 77 percent, and one study found participants felt significantĀly less depressed than a control group, with a notable jump in the number who said they felt ādelighted with life.ā
The program itself has spread to 35 communities in 12 states, reaching more than 2,600 older adults in independent or asĀsisted living. Since existing staff can be retrained to serve as coaches, the program isnāt costly, though there is an annual fee for training and data-tracking software.
Flashner-Fineman, who spent a decade as Orchard Coveās fitness director, travĀels to new sites several times a year to run a three-day trainĀing to teach new coaches the skills theyāll need to work with patients and run standardized assessments. She and her colĀleagues also train health professionals, leadership and other staff on how to orient their care around seniorsā goals.
At Orchard Cove, where the average age is almost 90, Flashner-Fineman coaches a wide range of seniors, includĀing younger, healthy residents, like 74-year-old Janet DonĀnoe, a retired consultant.
In a recent visit, an energetic DonĀnoe announced āgreat progressā on her fitness goals. She now gets up at 5 a.m. on Tuesdays to drive off-campus for nearly two hours of aqua āboot campā and weight training. FlashĀner-Fineman asked if Donnoe, who moved there recently, is making time to meet her neighbors, too.
Programs like this have emerged because seniors are living longer and defying predictions of cognitive and functional decline, said John Morris, a researcher at the Institute for AgĀing Research at Hebrew SeniorLife, which operates Orchard Cove. Morris designed the assessment tool that Vitalize 360 uses and is helping retirement communities track particiĀpantsā wellness.
Esther Adler, a 93-year-old poet, writer and former HeĀbrew school teacher, moved to Orchard Cove in 2012, a few years after her husband died. She set a goal to ābe a proĀductive personā but didnāt know exactly how.
After learnĀing about her background in an extensive intake interview, staff invited her to start teaching Hebrew to patients on the skilled nursing floor. Adler discovered their memories were too short for language lessons, and started teaching Bible lesĀsons and prayers instead ā a practice she has continued for three years.
Adler, who also finds purpose in writing poetry and helpĀing neighbors through hospice, has proved resilient amid physical setbacks: She broke her pelvis last year when she tripped in the lobby of a hotel room in Poland, the night beĀfore the premiere of a documentary about her life.
āThey thought I would never walk,ā Adler said. āHere I am, Iām walking.ā
Lipsky, despite her successful trip to China, confessed she feels āhesitantā about the year ahead. āIām not as active as Iād like to be,ā she said. As she spoke, her right hand started shaking ā a new symptom she hadnāt yet told her doctor about.
But Lipsky lit up talking about achieving another goal, finding a new way to cope with loss. She sat with her granddaughter two weeks before and diĀaled up a medium on Skype to try to communicate with her husband, Sidney, who died three years earlier.
āShe breathed in our enĀergy ā on the computer!ā Lipsky said. āIt was eerie. We felt like he was there.ā
She said it helped the family grieve and brought her happiness. Since the experience, she said, āour lives havenāt been the same.ā
In the year ahead, she plans to attend another wedding, this time in Canada, and continue āfinding unexpected things that bring me joy.ā