April 29 , 2018 /



There are five dimensions of human activity that are interrelated and interdependent. Those are the physical, mental, emotional, social and spiritual aspects of ourselves and our relationships with others. We tend to treat people along one dimension and focus our energy, time and resources on one major concern, possibly missing something important that could be revealed in a more comprehensive analysis and treatment response. While it’s easy to understand why a dominant and possibly negative characteristic captures our attention, it is difficult to be more inclusive and invite other variables into the equation.

For example, a patient goes to a doctor and the diagnosis is often targeted to a single cause. A familiar process starts with a complaint or an observation of a negative or unwelcome change. That is followed by a diagnosis which then gets a label. The 72nd edition of the PDR (Physicians’ Desk Reference regarding drugs, dosage and contraindications) is referred to frequently for treating some of these perplexing problems.  Next, and quite often, a regimen of drugs is prescribed along with other recommendations for possible changes in life style. Exercise and diet are among the more popular.  As people get older they often become more sedentary and eat whatever is appealing thus the recommendations.

What many people, both individuals and families, seem not to want to do is to talk about how they want to live out the last years of their lives, possibly because it’s too sensitive and most have a prevailing attitude that they will just deal with whatever comes when it comes. Postponing the conversation until it becomes necessary is certainly one choice but not necessarily the best one.


Many of the concerns about aging hover around the physical or mental decline as those are the most obvious and often most troublesome. From decreasing mobility and agility to various physical health problems to specific disease and disabilities, we see or experience these changes and they can be quite discouraging and even depressing. Physical symptoms that may start with decreased mobility and agility affect various dysfunctions within the systems of the body and often under the general category of loss – vascular, skeletal, neural, muscular, visual, auditory, digestive and vocal. Other losses also play an important role including the loss of one’s spouse or partner, losing a familiar home and accompanying surroundings, and the loss of friends.

In order to help keep people in their homes is one reason that “aging in place” is gaining so much traction.  There is also an economical concern in some instances because it can be less expensive to stay at home with care coming to the home instead of the person moving to where care is given elsewhere.

There are numerous activities that have the potential to delay physical and mental decline and exercise is one of these. Walking is often a preferred mode of physical movement that exercises mind, body and spirit. There are numerous others including yoga, tai chi, swimming, and even some modest participation in various sports such as golf and tennis. Social interactions and activities engaging with other people require thought, communication and the exchange of ideas and stories. All of these resources and more can be found in numerous places including senior centers, retirement communities, and from such organizations as AARP (American Association of Retired People) and health-related organizations that deal with specific issues.

The point of attending to all five dimensions of aging gratefully is to integrate, wherever possible, the physical, mental, emotional, social and spiritual activities. This broad-spectrum approach brings a variety of resources within reach of each person rather than concentrating on one or two issues that seem most difficult.


Physical – Moving the body deliberately with determination and purpose.

Mental – Exercising the brain, keeping thought processes nurtured & alive through a variety of activities that may include reading, playing games, being involved in programs that invite both physical and mental participation

Emotional – Expressing feelings, both positive and negative, having someone with whom to share some of the ups and downs of daily living.

Social – Interacting with others in varieties of settings, whether in planned activities with others or interacting with neighbors, friends and family on a regular basis.

Spiritual – Appreciating the natural, sacred and mystical world including art, music and a connection to nature that is meaningful and enjoyable.

As we move along life’s continuum toward the end, there is the inevitable realization that it will end. What we do not know is when or necessarily how it will end. What we can do is to do what we can that will help deal with whatever we encounter along the way until the end. That is why each of these dimensions merit our best effort and attention in the meantime.

We can be grateful for the days that we have wherein we can find ways to capitalize on these resources and bring them actively into our daily routines. This will help keep our minds, bodies and spirits engaged and thus working on our behalf to make positive contributions to our sense of well-being.

There are no guarantees for how long or how well we will live so the best practice, insofar as possible, seems to be to maintain good health, an active mind, interactions with others and to love what you’re doing.

How we change as we age and how we age as we change have their own rhythms and seasons, not always so predictable as one might prefer at times. Perhaps one of the most significant findings was that which was reported in the Harvard longitudinal study of happiness. The main conclusion is that “warmth of relationships throughout life have the greatest positive impact.


“Good genes are nice but joy is better!”

For 75 years, researchers at Harvard have been examining this question, following 268 men who entered college in the late 1930s through war, career, marriage and divorce, parenthood and grandparenthood, and old age.

What allows people to work, and love, as they grow old? By the time the Grant Study men had entered retirement, George Vaillant, who had then been following them for a quarter century, had identified seven major factors that predict healthy aging, both physically and psychologically.

Employing mature adaptations was one. The others were education, stable marriage, not smoking, not abusing alcohol, some exercise, and healthy weight. Of the 106 Harvard men who had five or six of these factors in their favor at age 50, half ended up at 80 as what Vaillant called “happy-well” and only 7.5 percent as “sad-sick.” Meanwhile, of the men who had three or fewer of the health factors at age 50, none ended up “happy-well” at 80. Even if they had been in adequate physical shape at 50, the men who had three or fewer protective factors were three times as likely to be dead at 80 as those with four or more factors.

What factors don’t matter? Vaillant identified some surprises. Cholesterol levels at age 50 have nothing to do with health in old age. While social ease correlates highly with good psychosocial adjustment in college and early adulthood, its significance diminishes over time. The predictive importance of childhood temperament also diminishes over time: shy, anxious kids tend to do poorly in young adulthood, but by age 70, are just as likely as the outgoing kids to be “happy-well.” Vaillant sums up: “If you follow lives long enough, the risk factors for healthy life adjustment change. There is an age to watch your cholesterol and an age to ignore it.”

The study has yielded some additional subtle surprises. Regular exercise in college predicted late-life mental health better than it did physical health. And depression turned out to be a major drain on physical health: of the men who were diagnosed with depression by age 50, more than 70 percent had died or were chronically ill by 63. More broadly, pessimists seemed to suffer physically in comparison with optimists, perhaps because they’re less likely to connect with others or care for themselves.

More than 80 percent of the Grant Study men served in World War II, a fact that allowed Vaillant to study the effect of combat. The men who survived heavy fighting developed more chronic physical illnesses and died sooner than those who saw little or no combat, he found. And “severity of trauma is the best predictor of who is likely to develop PTSD.” (This may sound obvious, but it countered the claim that post-traumatic stress disorder was just the manifestation of preexisting troubles.) He also found that personality traits assigned by the psychiatrists in the initial interviews largely predicted who would become Democrats (descriptions included “sensitive,” “cultural,” and “introspective”) and Republicans (“pragmatic” and “organized”).

According to Robert Waldinger, director of the Harvard Study of Adult Development, one thing surpasses all the rest in terms of importance:

“The clearest message that we get from this 75-year study is this: Good relationships keep us happier and healthier. Period.”  Not how much is in your 401(k). Not how many conferences you spoke at–or keynoted. Not how many blog posts you wrote or how many followers you had or how many tech companies you worked for or how much power you wielded there or how much you vested at each.

No, the biggest predictor of your happiness and fulfillment overall in life is, basically, love.



Comments (2)

  1. It’s interesting that you mention the “five areas” that need to be well-integrated for healthy aging… Ayurveda (Indian system of medicine) talks about the five elements (air, water etc) and their effect on the five senses, and we get twenty-five possibilities… all influencing the “five areas” – fascinating stuff – and thanks for highlighting Joy and Love… the health elixirs… 🙂

    1. Kumud,
      Thanks for the connections. It may be that all the different systems are really after the same kinds of things, yes? Seems that our joy/happiness comes from being well-integrated not only with ourselves but with one another as well. Sorry to have been missing SC of late. Have been out of pocket for different reasons, hopefully back on track soon.

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