Keiro’s Eight Dimensions of Wellbeing

The Eight Dimensions of Wellbeing is rooted in Japanese American and Japanese values and traditions. It is a holistic framework that envisions the spectrum of issues and challenges that older adults face as they age so that individuals are seen not only through a lens of physical health. Each of the eight dimensions describes a set of issues and potential needs for support and intervention. They are closely interconnected, and across the dimensions is critically important to quality of life as older adults transition through life stages.

PHYSICAL: This dimension is primarily focused on the physical health of an older adult from mobility to living with chronic illness. It involves access to quality medical care, how to address multiple health conditions and challenges, and coordination of pharmacological interventions. Food safety, nutrition and hydration, exercise, and appropriate and timely immunization are other aspects of physical dimension that can enhance or decrease life expectancy.

OCCUPATIONAL: This dimension focuses on engagement in meaningful pursuits so that an older adult feels purposeful, valued, and fulfilled. It might be related to finding appropriate work experiences, volunteer opportunities, or civic engagement that draw on older adults’ skills, talents, and experience. It also involves keeping the mind and body alert and engaged, disciplined, and active, according to one’s capabilities.

FINANCIAL: Because Japanese Americans and Japanese older adults live longer than the average American, having adequate financial resources and support systems are important. Financial planning and financial support, including retirement resources, health and long-term care insurance, and estate planning can help, but many face restricted, diminishing or inadequate resources as they age. Family and community can be resources but asking for help is often self-limiting, because of perceived cultural norms and not wanting to be a burden.

INTELLECTUAL: Cultivating creativity, lifelong learning, and intellectual stimulation aids in sustaining mental capacity in older adults. However, this dimension is a continuum and declining memory and mental agility are a natural part of the aging process. Coping with memory loss or adapting to changes in mental capacity are amongst the most challenging issues for older adults and their caregivers. Dementia, Alzheimer’s, and other cognitive issues are increasing in a growing older adult population.

EMOTIONAL: Aging is an emotional experience. We aim to address issues related to expressing levels of dependency, managing loss and grief, and transitioning between life stages. These require one to articulate wants and needs to maintain a strong quality of life in new ways as dependency on caregivers, including family members, grows.

SOCIAL: Isolation is one of the most under recognized issues facing older adults. This dimension involves promoting connections with family, friends, and neighbors as well as the challenges of building and rebuilding strong social support systems that address loneliness and seclusion. Reaching those that are cut off from regular social interactions is an extremely challenging issue and it becomes a vicious cycle if left unchecked. Expanding community programs that connect older adults, keeping them engaged in community activities is a priority.

SPIRITUAL: Beliefs and values are inner rudders to help as one navigates life decisions and life changes. They are especially important as one ages and faces end of life and loss. This dimension of Genki Living acknowledges the importance of sustaining older adults’ daily, weekly, or regular spiritual or religious practice. Spiritual practice can promote peace and equilibrium and can alleviate fear and anxiety about death, meaning, and connection. Unfortunately, the spiritual dimension is often under-recognized for its role in promoting health, inner peace, resilience, and social communities. Access to resources, centers, and support are critical.