The World Health Organisation has pointed out that health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The process of aging and its effects on body and mind affect retirement plans at least as significantly as finances. This brief article explores some of the factors that affect seniors being and staying healthy as they approach and enter their retirement.

 Keywords: health maintenance, health promotion, illness prevention, healthy aging, happiness, age-appropriate exercise, diet, positive psychology, taoism, tai chi, yoga, qigong

If you ain’t got your health, you ain’t got nuttin’¹

Perfect health is not a constant

The World Health Organisation has pointed out that health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.² The process of aging and its effects on body and mind affect retirement plans at least as significantly as finances. Being and staying healthy is of increasing significance to seniors as they approach and enter their retirement.

Staying healthy, is not a fixed point. From a Taoist point of view, maintaining good health is a process, a constantly flowing stream. As individuals we may aim to always be in the best of health, but the sobering reality is we all feel ‘under the weather’ from time to time. Moreover, as we age our immune system tends to become less efficient and so we become more at risk of succumbing to something.³

If we socialise with others we may catch Upper Respiratory Infections - colds and coughs or worse still RSV, Flu or Covid.⁴ We may get upset stomachs (Dyspepsia or GERD⁵) from eating too much or too many rich foods; or perhaps we are unlucky, and we eat tainted food and thus are exposed to some of the most common food borne illnesses (E.coli, Salmonella, Lysteria).⁶

If we travel to other countries we run the risk of being exposed to a variety of novel pathogens, ones we have not built up an immunity to through exposure during childhood; and to vector borne illnesses e.g., Malaria, Dengue Fever, Zika; and water borne illnesses such as cholera. Given the changes in climate and our ability to travel relatively inexpensively, the risks of catching something are increasing even if we do not travel to an exotic location. However, we may still take steps to help us remain healthy.

Taking steps --- keeping balance and avoiding falls

Nowadays, and not just in Western privileged nations, people drive to work and often sit at a desk for a long time while there. This coupled with large periods of time sitting in front of the TV exacerbates the assault on our health.

According to the WHO, “Sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety.”⁷ In Australia, Victoria’s State Governments’ Department of Health has suggested “sitting is the new cancer”.⁸

Our long periods of inactivity from driving, sitting at work and in front of the TV also increases the risk of slip and fall accidents.⁹ Falls are the leading cause of fatal and nonfatal injuries in persons older than 65 years.¹⁰ The risk of falls and resulting serious injury increases with age. Injuries, such as hip fracture, and falls are risk factors for placement in a nursing home,¹¹ where the fall risk is nearly three times that of persons living in the community. An individual with a history of falls has a two to sixfold increased risk of a future fall. Falls without serious injury are nevertheless a harbinger of potentially life-threatening events. They are a red flag for both the individual concerned and the healthcare professionals caring for them.

The relationship between physical activity and health¹²

The health benefits of physical activity and exercise have been well documented. Extensive research shows a relationship between physical activity and not only reducing premature mortality but also the primary and secondary prevention of several chronic medical conditions. There are relationships between physical activity and health outcomes, and marked health benefits may be achieved with relatively minor volumes of physical activity.^13,14

Some of the well know benefits of movement

There are so many benefits to be gained from moving every day.^15,16 A lot has been written about how physical activity helps:

1. Increase blood flow and blood volume.
2. Cholesterol levels - lowers LDL- raises HDL.
3. Stimulate bone and muscle growth.
4. Weight management.
5. Lower risk of heart disease, stroke, and cancer.^17,18

A few other benefits

Enhances mood

Moving your body not only improves mood, but also helps combat anxiety and depression. Movement increases the production of endorphins, which both acts as a natural pain killer and also helps our mood.

One Polish Study strongly suggested exercise provides benefits both in healthy individuals as well as those with diagnosed emotional disorders, regardless of sex and age.¹⁹ Other studies suggest that routine exercise, while not necessarily preventing you from feeling acute stress, is helpful in maintaining a positive mood and preventing stress from accumulating in your body.²⁰

Improves lymphatic system²¹

Unlike the circulatory or respiratory systems, the lymphatic system does not have a “pump.” Instead, it relies on your motion to circulate lymph fluid around the body. Each time you move large muscles of the body, you help pump lymphatic fluid through your body, keeping your systems circulating. This enhances immune response and overall health.

Pain management

Physical activity has benefits for people with arthritis. However, many people with arthritis do not exercise, often because of joint or muscle pain, weakness, fatigue, or joint swelling. This can lead to loss of joint motion, stiffness, and muscle weakness and tightness. These problems can worsen fatigue and can cause joints to become unstable. There is a common misconception that exercise is deleterious to one's joints. However, it would appear that exercise has positive benefits for joint tissues in addition to its other health benefits.²² Physical activity can decrease pain and can enhance quality of life and is most beneficial if it is done on a regular basis.  Being physically active helps reduce inflammation, pain, and fatigue, and improves quality of sleep and mental health, which are all areas usually made worse from Rheumatoid Arthritis (RA). While being physically active is important for almost everyone, studies continue to show an even greater benefit for those with RA.²³

Walking and standing

A friend in her 90’s complained that she and her retirement home friends were falling. They collectively wondered ‘why we lose our legs first?’ A recent study²⁴ showed that legs can be strengthened with simple exercises done at home. Likewise, before turning to ‘waddling’, limping, canes, or walkers too soon, realize that aches, pains, niggles can often disappear with a little attention and targeted work. 

In a previous article, A Journey of A Thousand Steps,²⁵ I (BW) extolled the health benefits of walking. It is one of the primary ways of staying healthy. It helps keep our knees, hips, and ankles from seizing up.

However, implied in the ability to walk is that we can stand without falling over. There are many Western and Eastern exercises that help improve balance.²⁶ One simple exercise is Standing Like A Tree.²⁷ This self-healing exercise, one of the so-called ‘Medical Treasures’ of classical Qigong, in addition to being a simple but potent weapon in the fight against stress and stress related diseases also helps establish a stable base for all movement.

Dealing with physical and mental ‘decline’

Our mindset, our self-talk, our attitude is often our greatest obstacle to enjoying life to its fullest. There are simple, easy ways to improve our lives despite all variables. How we think about ourselves, or a situation affects everything. When I (GMF) first met my trainer²⁸ and commented that “at my age, I wanted to avoid ‘overworking”, she agreed, but reminded me that: “your muscles don’t know what age they are! They want to be worked.” This was pivotal information!  A friend of mine (GMF) recently quipped, “I’m supposed to have bad hearing, bad vision, and nothing to say. So, from now on, I’m practicing selective hearing, not paying attention and no filters on talking!”  I’ve (GMF) found that when angst, panic, dread, worry begin to creep up, my co-author’s (BW) trademark piece of advice: just “breath and smile” - becomes the best ‘medicine’. It provides me momentary relief and starts to become a way of improving the quality of the moment and the day. 

Acknowledging stress

Don’t think of the problem, think of the solution!

… there is always a solution.

Even a well-planned retirement presents challenges and events, often unforeseen, that were not planned and which present stressors that affect our health, happiness, and overall well-being. Moreover, in retirement there is may be a magnification of these stressors often within the context of the financial realities of reduced income in retirement.²⁹

Stressful situations and stressors are everywhere. The inner conflict between our understanding that we need to slow down and pursue a healthy lifestyle, set against the backdrop of the speeds and pressures of modern life, contributes in large part to both Situational Stress and Incipient Stress. We discussed these different types of stress in great detail in a recent publication.³⁰

Situational Stress is often beyond our control, and we simply have to react to it. In essence we find ourselves having to follow the advice of the Serenity Prayer³¹, we must accept the things in the situation we cannot change and focus moment by moment on regaining control of those things we can. Incipient stress is in large part of our own making. Moreover, we often are not even aware of it. It is carried around on our backs like invisible clothing. This stress is “… more insidious and more harmful in terms of (its) long-term biological consequences”.³²

Accentuate the positive?

Recently while I (BW) was lying awake in bed @ stupid o’clock³³ once again:

I glanced at various health related ads and reels on Facebook (FB) & Instagram (IG)

Many targeted the 50+ age group, emphasizing regaining something “lost.” -- what I refer to as Marcel Proust moments³⁴ -

1. Looking back at what was … rather than accepting what is, working with it and moving forward.
2. Even the ones emphasizing moving forward often contained elements of shaming and negativity.
3. It seems to me that it is a delicate balancing act - a paradox between:
4. Examining where we are in this moment and accepting it.
5. Acknowledging that to move forward, enjoy life more and live longer we may also need to make life (style) changes.
6. So, a question, to myself as much as anyone else, is how does one do this? As it is highly unlikely that it is pret a porter / one size fits all
7. I was made acutely aware of this in Thailand trying on clothes, where it is clear one size fits all should read, “One size fits small.”

Remember the reality is, and as painful as it may be, you are likely no longer in your physical prime! Pay attention to any diminished physical capability you are experiencing. If it is due to injury or illness or a particular action… is there something you might do to avoid or reverse the situation? If there isn’t then work within your capabilities, with the one caveat - do not use your restrictions not to try. If you decide you want to make changes in your life we make several detailed recommendations on how to approach changes in your Diet and Exercise in a recently published article.³⁵

You are only as old as you feel …?

Recently I (BW) had a discussion about indicators of health in seniors with my dear friend, Chris O’Gorman, who until recently used to be the general manager of several long-term care/ nursing homes in my local area. He suggested the health of older adults can be measured by how we each get out of bed. Through this discussion we came up with these 5 categories of health as defined by how we each exit our bed:

1. Leaping out of bed
2. Rolling out of bed
3. Taking a long time to allow the pain to subside before moving.
4. Having to be helped out of bed.
5. Being unable to get out of bed. 

While not being a clinical measure of good health, those of us who are no longer in our prime can identify with this rough guideline. In fact, we feel sure that many of us may experience several of these indicators at different times influenced by our exertions the day or two prior. As many readers may attest gardening and/or looking after young grandchildren can certainly affect how we feel the next morning.

How circle of friends affect health

Sometimes, in an effort to stay on top of health, our medical appointments can become our social lives. But it’s interactions with friends that can have a most profound impact on our health and outlook. What researchers of aging and gerontology have found is that most people are resilient. They find ways to create connections with others, which helps them cope in changing life situations such as: finding that one can rely on same age friends after loss;³⁶ finding new relationships with others after institutionalization;³⁷ and seeking new companionship through online dating.³⁸

Improving quality of life - things happen

The presumption in the sub-header is that one’s quality of life needs improving! Which probably is NOT true for many people. At the end of the day in retirement as in the rest of our lives, life is a series of chance events and choices.

1. If you are happy as you are now.
2. Accept this and stick to the path you are on.
3. IF you feel a need to make changes to your lifestyle to achieve specific goals
4. Make an age appropriate and realistic plan.
5. Start on that path until you feel the desire to change it.

Do not forget this moment is the only one you can guarantee, so ENJOY it!

¹Well-travelled saying originally attributed to jews living in the East end of London.

²https://academic.oup.com/phe/article/16/3/210/7232444

³https://medlineplus.gov/ency/article/004008.htm

Your immune system helps protect your body from foreign or harmful substances. Examples are bacteria, viruses, toxins, cancer cells, and blood or tissues from another person. The immune system makes cells and antibodies that destroy these harmful substances.
Aging changes and their effects on the immune system

As you grow older, your immune system does not work as well. The following immune system changes may occur:

1. The immune system becomes slower to respond. This increases your risk of getting sick. Flu shots or other vaccines may not work as well or protect you for as long as expected.
2. An autoimmune disorder may develop. This is a disease in which the immune system mistakenly attacks and damages or destroys healthy body tissues.
3. Your body may heal more slowly. There are fewer immune cells in the body to bring about healing.

The immune system's ability to detect and correct cell defects also declines. This can result in an increased risk of cancer.

⁴https://www.nfid.org/resource/how-to-tell-the-difference-between-flu-rsv-covid-19-and-the-common-cold/

⁵Dyspepsia is intermittent gnawing or aching epigastric pain that may improve with meals. GERD is heartburn and regurgitation.

⁶https://www.fda.gov/files/food/published/Most-Common-Foodborne-Illnesses-%28PDF%29.pdf

⁷https://www.who.int/news/item/04-04-2002-physical-inactivity-a-leading-cause-of-disease-and-disability-warns-who

⁸https://www.betterhealth.vic.gov.au/health/healthyliving/the-dangers-of-sitting

⁹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691853/

¹⁰https://www.aafp.org/pubs/afp/issues/2017/0815/p240.html#afp20170815p240-b1

¹¹https://www.aafp.org/pubs/afp/issues/2017/0815/p240.html#afp20170815p240-b4

¹²Warren B, McQueen-Fuentes G. Reintroducing Healthy Movement into Daily Life: Combating Stress, Disease and Ill Health. 2023.

¹³https://www.ingentaconnect.com/content/wk/hco/2017/00000032/00000005/art00010

¹⁴https://www.thehealthhub.com/benefits-of-moving-everyday/

¹⁵https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm

¹⁶https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811354/

¹⁷https://pubmed.ncbi.nlm.nih.gov/19306107/

¹⁸https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/

¹⁹https://europepmc.org/article/med/15518309

²⁰https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013452/

²¹The lymphatic system is found throughout your body, removing waste from every cell while helping to regulate the immune system. It produces, stores, and transports white blood cells along a complex network of vessels, ducts, lymph nodes, the spleen, the thymus, the adenoids, and the tonsils. 

²²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667877/

²³https://www.uptodate.com/contents/rheumatoid-arthritis-treatment-beyond-the-basics

²⁴Effects of the Mobility-Fit Physical Activity Program on Strength and Mobility in Older Adults in Assisted Living: A Feasibility Study. Int J Environ Res Public Health. 2022;19(9):5453.

²⁵http://medcraveonline.com/IJCAM/a-journey-of-a-thousand-steps-hellip-qigong-walks-for-health.html

²⁶https://www.hopkinsmedicine.org/health/wellness-and-prevention/fall-prevention-exercises

²⁷Standing Like A Tree

Research suggests standing for five minutes in this position has the same cardiovascular effect as walking for 20 minutes on a treadmill at a moderate pace

1. Stand with your legs hip width apart and your feet flat on the floor parallel to one another.
2. Bend your knees but do not let them extend beyond your toes.
3. Keep your shoulders relaxed and your spine straight but not rigid.
4. Imagine that your head is suspended from the sky by a silken thread, that
5. There is a small cushion of air between each vertebra and that your chin
6. Rests on a silken pillow – so that your eyes remain parallel to the floor.
7. Move your hips slightly backwards, as if sitting down on a high bar stool,
8. So that your shoulders are slightly forward of your hips.
9. Point your elbows away from your body with your palms facing towards your thighs.
10. Do not tighten your stomach muscles; rather keep the front of your body soft throughout.

²⁸Melissa Elsie of Happy Humans

²⁹https://www.ualberta.ca/folio/2024/03/financial-strain-is-bad-for-our-health-says-new-crc.html

³⁰http://medcraveonline.com/IJCAM/a-journey-of-a-thousand-steps-hellip-qigong-walks-for-health.html

³¹God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.

³²Gabor Mate refers to this as Chronic Daily Stress. He discusses ideas related to stress in detail in his excellent book Scattered Minds and When The Body Says No.

³³Stupid O’clock my friend Peter Spitzer and I used as shorthand to denote waking up in the very early morning usually to ponder a problem or write.

³⁴Proust’s most famous work,  A la recherche du temps perdu (often translated in English as In Search Of Lost Time) has led me to suggest that as we age we create Proust Moments, where we each try to recreate or recapture the past.

³⁵https://juniperpublishers.com/jcmah/pdf/JCMAH.MS.ID.555834.pdf

³⁶Harvey IS, Alexander K. Perceived social support and preventive health behavioral outcomes among older women. Journal of Cross-Cultural Gerontology. 2012;27(3):275–290.

³⁷Greenfield EA, Mauldin RL. Participation in community activities through naturally occurring retirement community (NORC) supportive service programs. Ageing and Society. 2017;37(10):1987–2011.

³⁸Wada M, Mortenson WB, Hurd Clarke L. Older adults' online dating profiles and successful aging. Canadian Journal on Aging. 2016;35(4):479–490.

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The authors declare that there are no conflicts of interest associated with this publication.

None.