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Dimensions of Wellness – Part 1: A Holistic Approach

If you are asked to describe “wellness” what would you say? Would you focus on aspects of physical health such as diet and exercise, or consider body, mind and spirit? Would you relate wellness to younger people and consider older adults as “unwell” based primarily on age?

The answers are not as simple as “yes” or “no” because more than just biology influences overall well-being. Wellness as a state of health involves many dimensions that make up the whole person. In addition to the six dimensions, some people believe environment and financial are other wellness factors.

The Six Dimensions of Wellness

  1. Emotionalfeelings, managing stress, transitioning
  2. Intellectualstimulating mind and mental capacity
  3. Occupationalcontributing, using skills/abilities
  4. Physicaltaking action to maintain health
  5. Socialconnecting and interacting
  6. Spiritualseeking spiritual centered beliefs1

Knowing that 79% of health education is focused on the physical aspects,2 many a well-intended person may inadvertently focus on biological parameters to gauge the well-being of older adults and overlook the holistic approach. It is true that older adults are likely to experience at least one or more chronic illnesses, but on a health-illness continuum, older people remain capable of an optimal state of wellness at some level. At any age, lifestyle choices and personal responsibility for wellness decisions influence the quality of our lives. Using anything less than a holistic approach increases vulnerability for harm due to the potential for missed diagnoses. It also limits options for optimizing health and wellness.

Dr. Bill Hettler, a graduate of the College of Medicine, is credited with developing an interdependent, holistic or whole-person wellness model as an approach to healthy living for people of all ages. His holistic approach is particularly important for older adults to understand. The Six Dimensions of Wellness Model emphasizes that teaching people how to live and influencing healthy life choices would have much greater impact on survival than anything physicians are likely to accomplish.

Professionals who take a holistic or wellness approach may face barriers when working with older adults. The following are a few potential barriers and suggested actions.

Barriers to Promoting Wellness

  • Older adults may doubt their ability to improve health/function.
  • “Basic survival” needs and multiple health problems take precedence.
  • Health care environments focus on treatment of disease vs. prevention and wellness.
  • Providers often doubt older adults capability to act on recommendations.3

Suggested Actions to Promote Wellness

  • Perform holistic assessment.
  • Challenge ageist attitude (own and others).
  • Direct outcomes to improve health, function, and quality of life.
  • Teach older adults about self-care (or teach their caregivers).
  • Promote wellness for caregivers and others providing care for older people.4

Evidence confirms that the interaction of all dimensions contributes to overall wellness more so than any single aspect of well-being in older adults.5 When professionals perceive older adults through a paradigm of whole-person wellness versus illness; there is increased opportunity to focus on their strengths and capabilities, rather than on deficits and decline that support a negative stereotype of aging.

The following questions may serve to guide professionals in applying the wellness model.

  • Does this approach help older adults achieve their full potential?
  • Do you recognize and address the whole person (multi-dimensional wellness)?
  • Does your approach affirm older adult’s positive qualities and strengths?6

Evelyn’s Pick – Recommended Resource

The National Wellness Institute – They serve professionals and organizations that promote optimal health and wellness in individuals and communities.


  1. Hettler, B. The Six Dimensions of Wellness.
  2. Hawks, S., Smith, T., Thomas, H. et al (2008) The forgotten dimensions in health education Research. Health Education Research, 4(23): 319 – 324.
  3. Miller, C. (2004). Aging for Wellness in Older Adults: Theory and Practice. 4th Ed. Philadelphia: Lippincott, Williams, Wilkins.
  4. Ibid.
  5. Neville, S., Keeling, S., & Milligan 2005). Independence and well-being in later life: Three New Zealand Studies. Nursing Practice in New Zealand.21(1) 14-23.
  6. National Wellness Institute, Applying Wellness.

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

For more information:

Go to the Senior Health health topic.