Needs Assessment Specialty: Older Adult Needs

The Model for Aging Well

When a person is doing well, there are fewer needs, real or imagined. But even those who are getting by just fine have worries, problems and areas of struggle that diminish their quality of life. It is said that strengths are merely one side of the quality of life coin. Turn the coin and you have a need. A coin is a good metaphor for the currency of quality of life. Helping older adults maintain the quality of their life and independence is likely to be less costly for society if we understand what makes them strong and work to provide programs and community supports that bolster and sustain their strengths. NRC analyzed data from almost 9,000 surveys of older adults, identifying strengths exhibited by them that correlated with aging well—high self-ratings of quality of life and health, the absence of falls or time spent in the hospital or care facilities. By identifying important strengths, service providers and other stakeholders are alerted to the qualities exemplified by older adults who are doing well so that those strengths can be nourished.

Using the NRC-developed, research-based Model for Aging Well, important strengths of older adults may be identified and explored, correlating various characteristics of older adults with their overall wellbeing and successful aging.

The model was developed over time building on NRC’s work with Boulder County (Colorado) where a “Framework to Build Strengths in Older Adults” was first developed.

Since the Boulder framework was developed, NRC has worked with Boulder County and the Denver Regional Council of Governments to refine the model through focus groups, literature reviews and analysis of diverse older adult survey data sets.

The current Model for Aging Well consists of 12 strengths which are grouped into three thematic categories: physical health, outlook on life and one’s connection to others and the community. In this model, possessing a greater number of strengths was related to higher self-ratings of quality of life and quality of health. Further, those with more strengths were more likely than those with the fewest strengths to be living in their community rather than being institutionalized.

The first category of strength, positive outlook on life, includes higher scores on mental health, self efficacy, feeling valued by the community and spirituality. The second category, physical health, includes physical activity, nutrition, assurance of adequate food, activities of daily living such as walking and bathing and instrumental activities of daily living such as use of telephone and organization of personal finances. The third strengths category is connection and it is composed of practical and social supports, engagement in life and hobbies.

Validity of the Strengths Model

NRC’s research has shown that older adults with a greater number of strengths experience fewer falls, hospitalizations or institutionalizations than those with fewer strengths and those with more strengths have reported a better quality of life. In our analysis, rates of hospitalization, institutionalization and falls were compared by possession of strengths. Those with the fewest strengths were at least twice as likely as those with the most strengths to have spent at least one day or more in the last year in a hospital, a nursing home or a rehabilitation facility or to have had at least one serious fall in the previous 12 months.

Adapting the Model for Aging Well to your Community

Older adult service providers and other stakeholders can find out the number of strengths in their community and how these strengths vary by population sub-groups (i.e. rural versus urban, white versus Latino, women versus men, etc.). This valuable information can help stakeholders better plan programs to target certain populations and engage the community in helping older adults age well.