One Size Doesn’t Fit All: Creating a New Wellness Model Specifically for Older Adults

In an article that earned a 2019 bronze Mather LifeWays Innovative Research on Aging Award, researcher Matthew Fullen, PhD, proposed a multidimensional wellness framework to guide practice and research with older adults.

Driven by the question “What does it mean to age well later in life?,” Fullen reviewed the literature for peer-reviewed articles on wellness among older adults. This included research studies, conceptual articles, and literature reviews published between 2005 and 2017. Only 15% of the publications were rooted in a multidimensional wellness model, which was defined as four or more dimensions. Of this small subset, 55% used an existing wellness model; however, these models had not been tested to ensure their usefulness for older adults. A smaller proportion of the articles, 33%, discussed or developed a new wellness model. The remaining publications (13%) didn’t specify a wellness framework.

In light of the need for a wellness model for older adults, Fullen utilized research findings and his practice experience to develop an eight-dimensional wellness framework specific to older adults:

  • Developmental wellness, a domain not included in current wellness models, is characterized by hopeful and realistic perceptions of aging.
  • Cognitive wellness emphasizes engagement in learning and confidence in one’s ability to participate in activities that promote brain health.
  • Physical wellness encompasses one’s perception of being physically healthy. This includes diet and exercise behaviors and caring for health.
  • Emotional wellness is characterized by an ability to be hopeful about the future and to exhibit resilience when challenges arise.
  • Spiritual wellness incorporates a sense of meaning in life, as well as engagement in spiritual or religious activities.
  • Relational wellness includes the perception of having meaningful relationships.
  • Vocational wellness is defined by a sense of meaning and purpose based in life pursuits.
  • Contextual wellness is shaped by perceptions of adequate financial resources, safe and cohesive neighborhoods, and satisfaction with the overall physical environment and community.

Importantly, the research-backed framework is holistic and specific to older adults’ unique wellness needs. While additional research is needed to statistically validate the framework, the eight dimensions provide a starting point to conceptualize and promote wellness among older adults.


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Fullen MC. Defining wellness in older adulthood: Toward a comprehensive framework. Journal of Counseling & Development (2019);97(1):62-74.


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