How to Age Well: Mental Flexibility, Movement & a New Wellness Model of Aging

Welcome to the Living to 100 Club Podcast.

Here's our host, Dr. Joseph Casciani.

Hello and welcome. You're listening to the Living to 100 Club Podcast, where we explore the upsides of aging. I'm your host, Joe Casciani. In my programs, I talk with experts and thought leaders about how to stay positive, resilient, and purposeful. Because growing older isn't just about adding years, it's about making those years count. This podcast is part of my broader Living to 100 Network, which brings together 3 core pillars: these conversations, a growing collection of practical tools and learning resources, You can find these at livingto100.solutions and my Living to 100 Community, a space to connect, share insights, and support one another on our journey. You'll find this at livingto100.community. So let's get started with today's guest. In today's program, I speak with Angie Dorch, creator of Learning How to Age a research-informed arts-based training program designed to help older adults strengthen mental flexibility, physical awareness, and confidence as they age. And she explains how this blends principles from neuroplasticity research, movement and performing arts, and practical measurable exercises that can be adapted for different abilities and living situations. First, a little word about Angie. Angie is the content producer of Expressive Avenues Wellness on YouTube. She spent 2 years facilitating a psychosocial wellness practice with independently living older adults, producing a 45% Improvement in mental flexibility, physical perception, and kinesthetic awareness—key capabilities for living and aging autonomously. Angie holds an MFE—MFA, sorry—from the University of Louisville and brings decades of experience in education, directing, and media production. Angie, welcome to our program today. Hi, thanks for having me.

Pleasure. Oh, you're welcome.

I'm looking forward to our conversation. Let's begin with the why. Um, what problem were you trying to solve when you created How to Age?

Uh, I was working with my mom at the time. She was 70 and recently retired, and we realized that there was, um, there's a large, obviously a large group of people that are getting ready to retire and were getting ready to retire at the time, and that kind of missed out on this paradigm shift that happened between the illness model that we used to kind of operate from, which is, you know, give me a shot, give me a pill, to the wellness model. And there was this group of people, this cohort that was getting ready to retire, still very engaged and active, but really didn't have the tools that they, that they needed because they hadn't, they kind of missed the, the shift there. Sure. So, um, mom and I started working on putting together this program. She was from education. I was from education. Um, so we developed a program and, uh, it seemed to fit, uh, into that psychosocial wellness, um, niche. Um, that, uh, mental flexibility, physical perception, and kinesthetic awareness, or the dimensions of wellness that were not really that widely practiced or, or even encouraged really. I think it was probably because maybe there was no strong metric to judge it. So part of this program, putting this program together, was developing the exercises and the games from my background as a performer, but then also making sure that we could put those into a metric that could be assessed and calculated and kind of tested. So when I did that 2-year program, I assessed the, uh, participants every 10 weeks on the same things, and I kept pretty meticulous scores. And at the end of 2 years, as you said, I was very pleased to see the growth in their skill level of those particular aspects of wellness that seem to matter the most for aging adults and remaining autonomous.

So, so when you speak about mental flexibility, for example, what does that mean in everyday life?

Mental flexibility is concentration shifting, your ability to think about one thing, shift your concentration at will, do something else, and then shift it back at will to whatever it was you were doing. That ability is a process. It's a mental process that sometimes slows as we age. And so practicing that, putting yourself in a position to be able to practice that shifting really keeps that kind of fluid and active. Mental flexibility is not changing your mind or altering your opinion. A lot of people think they hear mental flexibility and they think, well, you just want, what do you want me to change my mind? And it's, it's much more of a functional process. Sure. Putting your attention on one thing, shifting it to something else, and then putting it back on the, the other thing and being able to do that at will is mental flexibility. Yeah. So important.

That's of course an important skill. But how does that, um, let's, how does that come into the picture for someone who's kind of navigating everyday life and activities? How do we need that? Where does it come into play?

I think what it teaches you is how important it is to be present and focused on whatever it is you are attempting to do, and to give that your full attention and focus. You know, we kind of, we, we kind of live in this world of multitasking, the myth of multitasking, which you We can't do, but everybody talks about that, right? Everybody wants to be able to multitask and there's so much information and so much stimulus coming in at us all the time. The ability to focus on what you're doing when you're doing it, not thinking about what you were doing before, not thinking about what you're gonna be doing after you're done. Excellent. But to be focused on this particular activity. Is really important. It's important for safety, for memory, to be able to lock those activities in your mind. So all the ability to do that, to direct your attention and direct your focus, just is very important for being intentional about what you're doing.

Yeah, it sounds like it's also the ability to manage interruptions and distractions wherever the distractions are coming from. Yes, that's exactly it. Task, it's easy to kind of forget or something else comes into play. Yeah, right. See that? Sure, sure.

It's like I've had several people say, they'll, they'll, they talk about this often, uh, they walk into a room and they forget why they walked in there. Yeah. Why was I even coming in here? So yeah, it's, it's being able to focus your attention and then shift it when you want to, not when it just kind of wanders off, not when you're distracted, but within your control to focus on whatever it is you're thinking about.

So you have exercises in, in your program that help, um, kind of develop some additional mental flexibility through practice, through different exercises. Yes.

Yeah, we've got a couple of exercises. In particular, my favorite, because it engages the whole group, is called Ball Toss. And it's based on a very basic exercise, but then we build up different levels and different layers. Kind of if you're familiar with STACC, the Scaffolding Theory of Aging and Cognition, it's that kind of— you're building up that scaffolding. So we build it up one layer at a time, one level at a time. Um, and then you— but you're required to achieve the objective, if you do, to put your mind on that objective of the game. And if you're going to achieve that objective, you must pay attention to this moment now, because the ball is coming at you. You're going to catch it, and then you're going to toss it, and then you're also listening, because we add on top of that memorize a verse from the group and one word per, per ball toss as the ball comes around the circle. And then there's a physical component to it that we add that you're doing as well. So that requires you to pay attention to the moment you're in if you're going to be successful at the game, which of course everybody wants to be successful at the game.

So No, go ahead. Sorry.

No, that's one, one of the things that I do. The other thing that I do, um, is improvisation, which is, uh, so it's so important for your mental flexibility and for your creativity. And it's also so fun. It's engaging. Um, and it, it really puts the emphasis on an external objective. Versus what am I doing, how do I feel, what do I think, who's looking at me, you know, get that self-consciousness out of the way. You put your focus on an outside objective and, um, then you can be creative.

And so an improv activity would look like what?

Uh, well, there are many that we do. Uh, the first one that I start with usually is is what I call a group add-on. First, one of the first things I do is set up some guidelines like no talking at first, because of course one of the first things people want to do when they get up and do an improvisation is to start explaining it rather than being engaged in the activity. So one of the first things is no talking, and then a person will get up and begin to engage in an activity, and when a member of the group sees an opportunity to add themselves in, in a way that makes sense, that is believable, then they can just go up and add themselves in. So the improvisation begins to expand out from there and becomes more and more specific, clearer, more clearly defined. Um, and then once they get past that Then you can introduce, you reintroduce the ability to talk and respond based on what's happening in the activity, not trying to explain it to everybody else what you're doing. It's hard to describe, but one of the participants said, oh, this is like charades. And I said, you know, it's not. It's actually not like charades at all because For the purposes of this program in particular, when you're doing an improvisation, your goal is to engage in this imaginary world. Your goal is not to communicate where you are or what you're doing, which is what charades is, obviously. It's, it's, let me explain to you what this is so you can guess it. This is exactly the opposite of that. This is how fully can you mentally, imaginatively, and creatively immerse yourself in this world. And that's the value of that for this program.

Yeah, yeah, I, I, I like that. I can see the advantage there where you're observing this first person and you're looking for some way to join or complement what he or she is doing, right? And how can you shift that kind of perspective from my usual mode to something different that fits in with this other person. I like that a lot. Yeah, that's good. Yeah. So, um, you have— how many lessons do you have in this training program?

In the program I have, there's like, there's a 10, a 10-week introductory, there's lessons for the introduction, um, it's twice a week, 5 for 5 weeks, uh, but then the whole program I've got 30 additional exercises. So I guess a total of 40 exercises. Um, and depending on where you are after you've done the introduction, then you go on to the rest of the, of the lesson. But you have to go through the introduction first because those introductory lessons do some important things like establish a common language with everybody. Um, establish certain, uh, physical parameters and ways that we're going to approach your physical perception with each other and in the world around you. Um, we give things because again, my background is from a performance standpoint. So I base things on the stage and make that give them the ability to develop that awareness that actors have on stage of where you are in relationship to other people in relation to the set. In relation to, uh, the audience. And that, uh, that exercise in blocking that I do with them goes directly to things like, um, well, we've all been familiar— we're all familiar with this. You park your car somewhere, but you can't remember where it is. Sure. Park your car, you go in, you do your whatever, then you come out and you think, now where did I park? So by kind of giving them the skills to view their world from that blocking perspective, then they can begin to root where they are, where their car is, where the building is in this, in this basic universal framework. So the first 10 weeks establish things like that, so that all of that is kind of set up and the basic exercises are learned. And then The following 11 through 30 lessons is a matter of practicing those skills, those, those basic skills.

Sure. Yeah, you know, I— we touched on the importance of, um, kind of metrics, the whole notion of measuring outcomes. And what's your, what's your thinking on that? I know you've done that already and you've seen some real benefits, but why why emphasize that, or why put the spotlight on metrics?

Well, I— we did that, um, because as I thought of, of developing this program further, um, and I wanted it to be something that anybody could take and kind of adopt and, and move into their life. And I knew that if, for instance, there were facilitators or program directors who are also going to be interested in that, having a metric that kind of proves the point, uh, is just, just gives it more validity. Sure. Gives the point validity and gives people, I think, confidence too, because many of us, myself included, even if I, even though I approach things from a very creative, um, perspective, it helps me to know that, oh yeah, always I can step back away from that creative end. And go, but if I were to analyze this analytically, if I'm going to put my left brain hat on, yeah, how does it, how does it stack up then? And it's nice to always see when the left brain kind of approach and the right brain kind of approach support each other.

Yeah, they're on the same channel, right? Yeah, I, I can see the advantage there because you're, I mean, you're, you're looking for adopt people to adopt your program, you need to show its credibility, and you need to take it from the abstract kind of idealistic to show, yes, we really do have some very concrete, real results. Yeah, that's— I agree, that's so important. So have you— can you share maybe a couple of early wins, people who have really improved or benefited from the program?

Um, yeah, I mean, um, there are many, um, anecdotal, um, instances that I have in my head from people that were in the program. Um, one man in particular in, in the group that I initially did this 2-year practice with actually skewed— 81 was the average age, which is actually older, uh, he was pretty high because I had 2 men who were in their 90s. One man in particular who was already mentally very sharp. He had been a copy editor, so he was linguistically very, very with it, very sharp. But he had some physical limitations. He had some paralysis in parts of his body, but nevertheless, he walked every day. And so when he came into the class, he was very interested in the physical things that he was going to be able to get out of it, not really anticipating there would be as much mental or linguistic growth for him. Um, but there was for him because I think the journal had a lot to do with that. When, as I introduced the journal, uh, which he of course loved. Now a lot of people kind of roll their eyes at the journal a little bit at first. But, um, but he really liked it, um, and then he could see the automatic growth between what he was able to accomplish physically. But when he put his mind and his body together, it was exponential, the growth. Yeah, that was exciting for him.

Yeah, yeah. So you start where they're at, but he happened to be a little further ahead of other people in a certain Right.

Well, and that's right. And that's one of the things that I also was important to me about the program was that it's, um, a lot of the exercises and games have a group goal, um, because it's very social, it's very, um, engaged camaraderie, that kind of thing, team building. But when I assess them, the assessments are always based on individual. So it's always, they're only assessing themselves. Against themselves, not against everybody else. Yeah. So I like that too. Yeah.

Because improvement is, is looking at how you're doing better today than yesterday, not how you're doing better than the person to your right or the—

right. It shouldn't be. Yeah. Yeah. Yeah. It shouldn't be. Now, the being able to answer the question of, am I achieving the objective of the game? By saying, okay, you're either, it's either successful or it's not as a game. That I think is valid, but the assessment of you as an individual and your participation in that game is separate from whether or not the whole group was successful. Yes, of course.

Yeah, that's good. That's an important point. So, yeah, I love the program and the range of activities and cognitive measures, physical activities. What, What kind of setting does the program work best in?

Usually in an open setting, kind of an open studio. There, I mean, if you have an open area, I did a lot of this in our church basement, but there are most retirement living, independent living Communities and assisted living communities have an open space where they do exercises and that kind of stuff. It can be done if you live in a neighborhood. A lot of times there's an activity center where everybody goes, and there are some spaces there that can be rented, or you can use them if you're a resident of that community. So an open space, it should be, obviously have the safe part of it. You know, you don't want the carpet to be torn or things like that. You should have access to some fairly sturdy straight-back chairs, kind of just like the regular kind of chairs that you see in offices. Sure. They move around. They're light, but they're sturdy. They don't really have arms on them, most of them, because of the tendency, if there's an arm on a chair, is to use that to push. Yeah. And so one of the things that we do when we, when we work on the sitting to standing thing is to not be able to not do that, to use your abdominal muscles and your lower body to lift yourself up versus pushing up on the arms of the chairs. A lot of times people want to do that. So I always say it's best to have a straight back chair that's not got arms on it. And what level—

sorry, go ahead.

Yeah. No, I was just going to say, other than that, I love having open windows, you know, a lot of sun coming in. And I love having a high ceiling. Sure.

And what level of cognitive functioning is required? Will it work with some people with mild dementia? I'm guessing moderate to advanced, but at least mild. Yeah, I think so.

Yeah. The, I had a couple in this 2-year study, a man and his wife who came, and she had some dementia early on. And there were definitely some challenges for her when we did the ball toss exercise. As I said, we add layers to that and levels. And when we added in the memorized verse, one word at a time, as we're tossing the ball, go all around the circle, then everybody adds the word. Sometimes that was a challenge for her until I— I always let the verse come out of the group. I always encourage the group to decide what 10 or 12-word repetitious verse they want to engage in, right? So then she decided that she had one, so we did that verse, and then she had no problem at all. Yeah, no problem. So we kind of continue to do that, and then as we move on, we add 2, 3, 4 verses that then facilitator will call out when it's time to shift the verse, and the verse changes, but the game doesn't stop. That's the one of the goals, you know, that there's this shift that happens between what you're saying and then the next thing that you're going to say without the ball stopping, without the physical part stopping. Um, and that was, that continued to be a challenge for her a little bit, but a lot of times one word or two words was all she needed to trigger that next, that, that realization of what the, what was coming. Um, so, um, so I would say definitely there are benefits to, um, things like the ball toss. To people with dementia, early onset dementia. Now I would say as a facilitator, one of the things I always require though is if someone has some known dementia or some known physical problems that they have a caregiver with them that either participates in the program or is there in case. Sure. One of the things I'm getting ready to do with the program now, which I'm really looking forward to, is to take it from just for the aging population to an intergenerational kind of proposition, which is great because when you think about, for instance, people with early onset dementia, a lot of times they do have caregivers. A lot of times their caregivers are their children. Or their grandchildren or their neighbor. And so it's going to be great. It's going to be very interesting for me personally to see this program develop so that all of those people can work together instead of just separate out still people.

So yeah, yeah, I can see that's a real advantage because you don't need big groups to do this. You can do it with a couple people, right? Like the individual and maybe the caregiver.

In fact, I, I'm sorry. Okay. When I am facilitating this program, I, one of the things I put in the manual is the preferred ratio is a 1 to 10 because you want that intimate camaraderie kind of team building effect to happen with the group. There's also a lot of time. I'm going to say a lot of time. There's also 5, 10 minutes that we try to give to discussion and journaling. And that is much more easily done in a small group. Sure.

And you need some level of verbal ability too, I'm sure. If there's some stroke patients or aphasia coming into the picture, that's going to be really difficult. Maybe other activities, but not the verbal ones.

Right, right. We have some semantic fluency exercises that we do. That I think may or may not be as helpful. Sure, sure.

Yeah, yeah. I know when you and I spoke earlier, you mentioned kind of the role your mother played in your own shift from sickness model to the wellness model. And how does that— how did that come into play? We, you know, just share a little bit about what what you saw there.

Yeah, um, my mom was, um, 31 years old and she was diagnosed with type 1 diabetes. She had 3 small kids and she, she was always a pretty strong woman, but when she was diagnosed, this was the early '60s and there wasn't a lot of really groundbreaking stuff happening in diabetes was pretty much, this is the amount of insulin you're going to take. This is the amount of food you're going to eat. This is the amount of activity you have, and it's not going to change. And she immediately knew that that didn't feel right in her body. That was not how her body was responding because now we know with the endocrine system and the hormonal system and all that stuff, we know how sensitive those systems are. Every little nuance. So she kind of knew that instinctively, and she was very proactive. She followed her doctor's orders, of course, but she was also aware and stayed constantly aware, constantly engaged in the newest, the next newest thing. And so because she was so proactive about it, she ended up living pretty much a normal lifespan. She had— she dealt with diabetic diabetes, uh, for 51 years. She had none of the typical effects of type 1 diabetes, um, because I think she was so mentally curious and she was very physically active always. And she listened to her body. She could— she paid attention to how it felt, how certain things affected her. And how she could manage them. Um, and so I watched her. I grew up with that. Um, and I had a healthy respect, obviously, for doctors and for all the wonderful things that we've learned through medicine, but I had an equal respect for my own internal awareness of my body and what my body was trying to say. And how those two things many times matched, but sometimes didn't. And so, um, so that was kind of her effect on me. I kind of grew up in this wellness model long before this wellness model became kind of the buzzword.

So popular. Yeah. Yeah. I can see the way you'd have the respect for your mom that to taking responsibility for getting better and making the most of her condition. So that's a valuable lesson to learn, isn't it?

Yeah. Oh, it is. I, um, I, I didn't realize until many, many years later, as most people do, everything I needed to know my mom taught me. She lived it for me and she modeled it. And, um, yeah, she was wonderful.

Yeah. And has she continued to be your Kind of guiding light through this.

Uh, oh yes, yeah, she, she actually passed away 3 years ago. Uh, but, um, still, in, in fact, in, in the, um, in the manual, I dedicate the manual to her because it says, um, the dedication is, um, read this briefly. For my mom. Well, let me get to the page here. To my mom, Janice Deaton, who taught me how to get up when I got knocked down.

Yeah, so says a lot, doesn't it? Says a lot. Yeah, we all have that resilience. Some people feel like it's gone or burned off or blocked, but we all have it. That's right, we did. It's still there. Yeah, yeah. So, um, those values and that tenacity your mother had really kind of shaped a lot of this program and your— the way you interpreted her values and put it into this one. That's a beautiful story. Yeah, yeah. Can you give a maybe a couple of examples of activities an individual might put into practice on his own or her own?

Yeah. Well, there are a couple that are individual practices. A moving meditation, it's a 12-step combination that you do in 4 different directions 8 times. So you make a complete circle, 360. That's one exercise. We do a stair-stepping exercise, which is to help to develop a kinesthetic awareness of your body and your body's positioning in relation to your own. Sure. Health. And also to the environment, which is the physical perception part of it. So those are practiced individually. Then as a group, if you have a group already in existence, the ball toss exercise is the first one I would start with. Sure. Because it's so on its face, it is so— such a simple— it's simplistic. How about that? It's simplistic but not simple. Does that make sense? Yeah, of course. Yeah, yeah. So it's, uh, you start with a very basic tossing and catching, and then as soon as that gets— you have success, and that means that the ball goes around and stays in play, it doesn't fall, okay, uh, you add a physical component. Add what? You add a physical component, bending and straightening the knees. Okay, okay. Then you add, um, a steady beat, which you can set up on your phone on an app, or somebody can count, can do that if you have a facilitator. Um, then you add the verbal component, which is the verse, and then you're still keeping the ball in play while you're doing all this stuff. So you see, you start adding layers and layers and layers. And I love that exercise because, again, as a group, the answer to, am I achieving the objective, is right in front of you. You either are, the ball is still in play, you're not. Yeah. And, and that's great. I love that it's that kind of feedback, immediate.

Yeah, sure. So, and again, we're seeing our own performance. We're not comparing ourself to anyone else because they're— Right. Oh yeah.

Yeah. Absolutely. Yeah. In fact, I have that, um, often people will say they start out, uh, we'll talk about it. We'll, we'll do a little bit of the exercise, then we'll stop and then I'll ask questions and they'll kind of give responses. Mm-hmm. And many times people will start out saying, well, the ball was coming at me too fast, or the ball was too high. And so then I'll say, okay, So stop. So what did you learn from that? Not, you need to do something, you need to slow down. What do I, what am I learning from that? How could that affect the way I toss the ball or the way I catch the ball? And that will always result in more personal responsibility. But again, that comes a lot of times out of the discussion that follows.

So, yeah, no, that's great. It is that personal response because we can always kind of point our finger at other people for—

I would have caught it if, if you hadn't tossed the ball too hard. I would have caught it.

Yeah. Yeah. You know, so, but that touches on the importance of communication too. And right. Kind of.

And that's a mind shift in a way. Yeah. Shifting your perspective on responsibility versus fault.

Yeah. Oh, great program. Great program. Where can our listeners learn more about your work and what should they start with? Where should they go?

Well, if they're on YouTube, Expressive Avenues Wellness is the YouTube channel. That's educational channel. I have lessons that are there for under 10 minutes at least. Many, many of them are under 5 minutes. So, and anybody can access those by going on YouTube. And then the manual and the journal are all available on Amazon. And again, you can just put into the search box Expressive Avenues Wellness, and I'm sure this— it will take you to the page for that. So sure, sure. And then there's also— you can contact me, angie@learntoage.org. And that's also a good way if you are interested in getting more details about the program, if you have questions about the program, or if you want some training, if you're a facilitator and you want to be trained in the program more specifically. So, okay.

And your contact again was angie@learn2age.org? Correct. Okay, great. Thanks. So, one final question. What, when you think about aging well, what do you hope people will start believing and stop believing?

Um, I hope people will begin to accept what I think most people secretly hope, which is that they, they live all of their life as engaged and as optimistically participating as much as possible, and that that there's a way to do that, um, and you can find that way, you practice that way that works for you, um, and that, that will serve you well. Yeah, yeah.

Stay engaged, stay connected.

Yeah, keep on moving and follow your mental curiosity.

Follow that. Yeah, yeah. Yeah, the curiosity is so important that we don't just follow. We need to ask why, what's that all about. Sure. Right. That's great. That's great. Well, thanks. Thanks, Andy, so much. Our time has really flown by, but I appreciate you sharing your insights and expertise. And to our audience, thanks for spending part of your time with us today. If you'd like to continue exploring the upsides of aging, here 3 easy ways to stay connected. Visit my livingto100.club for my library of podcasts, blogs, and other articles. You can visit my community at livingto100.community to access live events, expert discussions, and a private forum. And lastly, my card deck series, where I've also created programs similar to what Angie has described, um, my Better, Longer, and Happier Kardec series. And you'll find all these at livingto100.solutions. So thanks again for listening. Until next time, stay positive, stay inspired, and keep thriving.