Impact Feature Issue on Supporting Wellness for Adults with Intellectual and Developmental Disabilities
Modeling Health and Wellness in Minnesota:
Living Well Disability Services
According to DATA2010 (CDC, 2015), people with disabilities are more likely to have high blood pressure, be overweight, lack fitness activities and social- emotional support, use tobacco, and lack regular medical tests. The data reinforces the need for health and wellness activities for people with disabilities. Physical exercise, good nutrition, stress management and social support are important for everyone, including people with disabilities who may have a thinner margin of health.
Since 2008, Living Well Disability Services has worked to transform the delivery of services for people impacted by disabilities to one that models health and wellness. The goal is straightforward: to improve the overall quality of life for people with disabilities.
The 43-year-old private, nonprofit organization, founded as Dakota’s Children in West St. Paul, Minnesota, serves a broad spectrum of individuals in the region who have intellectual, developmental, and physical disabilities such as cerebral palsy, Down syndrome, multiple sclerosis, autism, and brain injury. These may be complicated by health issues related to aging, diabetes, anxiety, Alzheimer’s, and medical fragility.
The Living Well Disability Services menu system incorporates fresh and whole foods naturally lower in salt and fat, as prepared here by (left to right) Adam, Tim, Living Well Disability Services Advocate Devin, Jordan, and Jordan’s mom Julie.
The Wellness Program’s Beginning
Living Well began its health and wellness programming with individuals living in group home settings. The multi-faceted program started with the creation of a seasonally-based menu system for all Living Well Disability Services group homes. The menu system incorporates fresh and whole foods naturally lower in salt and fat. Nutritious meals are enhanced with produce from gardens planted at group homes by residents with the support of volunteer Master Gardeners. Access to local farmer’s markets and Crop Share programs was also researched and included in the process to implement the new healthy and nutritious menu system.
A holistic approach to wellness drove expansion of offerings to include individualized exercise programs, animal-assisted interactions, music therapy, and volunteerism. Exercise and diet are integral parts of targeted plans and support for weight loss, one of the key indicators of success for a focused wellness program. Therapeutic use of animals has shown that the presence of a pet can decrease heart rate and blood pressure significantly. Music therapy interventions are also designed to promote overall wellness through managing stress, alleviating pain, expressing feelings, enhancing memory, and improving communication.
For people with disabilities who choose to move toward greater independence, an intentional focus on volunteerism increases overall quality of life. Friendships and social skills gained through volunteerism help to increase natural and informal supports available.
With a desire to create a culture of wellness, employees play a critical role in the success of the wellness program. The organization reinforces healthy habits and behaviors, and recognizes employees for being wellness partners with people they support. A health and wellness coaching program pairing people served with employees, in conjunction with “Ways to Wellness” at Woodwinds Hospital, provides an opportunity for active partnerships. The 12-week partnership includes goal setting, attending wellness and nutrition training, and exercising together. Employees facilitate engagement, and the partners motivate and inspire each other to make healthy changes that last a lifetime.
Wellness services were expanded in 2014 to those receiving Home and Community Based Services (HCBS) wherever they live: in their own home or their family’s home. The program content and approach was modified to make it easy for a family to get started. For example, individuals and their family members attend nutrition and cooking classes to develop skills to implement a family-based wellness program. Comprehensive wellness kits include instructions and tools to help families integrate health and wellness activities into their daily routines.
The Impact of Wellness Programming
In 2014, doctors seeing people served by Living Well reported that 91% of the people they examined experience good to excellent health. Annual satisfaction surveys include responses from self-advocates who report improved physical health, regular engagement with people in the community, and a reduced sense of isolation and loneliness. Individuals have made progress in reducing their need for some medications, increasing their mobility and overall fitness, and reducing health-related crises.
Program success served as an inspiration when Dakota Communities changed its name to Living Well Disability Services, and developed a new mission and vision, in August, 2013. The wellness program results have been shared both locally and nationally. Living Well Disability Services is a founding partner of Altair, an Accountable Care Organization (ACO)-type collaborative with five other Minnesota nonprofit organizations serving people with intellectual and developmental disabilities. Based on program results, the members of Altair have selected the Living Well Disability Services health and wellness process as a best practice to be replicated across all member agencies.
Self-advocates served by Living Well report improved physical health, regular engagement with people in the community, and a reduced sense of isolation and loneliness.
Future Directions for the Program
Maximizing health for people with disabilities is a key determinant in the level of independence possible and the amount of support needed throughout their lives. In particular, improving overall wellness, including building social supports in the community, improves the likelihood of success for those who wish to increase their independence.
All elements of the health and wellness program are reviewed and renewed each year to incorporate best practices and new learnings. A complete revision of the healthy menu system was introduced in 2015, incorporating changes that streamline meal preparation and reduce cooking time. In addition, all recipes have been evaluated for affordability. Upcoming program additions will include mind/body wellness interventions designed specifically for people with intellectual and developmental disabilities. They’ll include activities that target sight, smell, touch, and sound, and promote a greater concept of self, increased environment awareness, and emotional well-being. Data will be collected to evaluate the effectiveness of these interventions on social, emotional, and physical health and wellness.
The Living Well Disability Services approach to wellness will continue to assist individuals with disabilities to express their aspirations, expand their options, develop non-paid relationships, and increase healthy choices in order to live as independently as possible and be engaged in the community.
Centers for Disease Control and Prevention (CDC). (2015). Healthy People 2010 Data.