Walk to reduce your loneliness and improve your well-being [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“Just before the pandemic, I walked 96 miles (154.5 km) in seven days on the West Highland Way in Scotland, though I was hardly alone in this endeavor. About 250 people start the walk each day, including the amazing group of primary women that I walked with, indicative of both the attraction of the trail and the popularity of this form of physical activity.

All types of people were walking. There were young people and old people, some fit and some not so obviously so. The walk was exhilarating and at the same time hard and very long. Much of the great feeling of satisfaction I had at the end of every day was the feeling of achievement at having physically and emotionally pushed my own limits.”

Paula Rochon is a geriatrician.

She shares her story and discusses her KevinMD article, “Reduce your loneliness, improve your well-being, and take the first step.”

This episode is sponsored by the Stanford Physician Leadership Certificate Program.

For the aspiring physician leader, leadership skills are one of the most important and influential traits that will elevate your overall success. 
 
Leadership impacts nearly every aspect of your career in a complex and diverse health care system. Including how you effectively communicate and influence those around you, how you respond to conflict and make important key decisions, how you develop your team, and even how you navigate social dynamics in your workplace. 
 
Stanford Medicine recognizes the need to foster physician leaders in health care. That is why they developed the physician leadership certificate program. This 6-month cohort-based program includes live virtual sessions, self-paced learning modules, professional coaching, a capstone project, and much more: Providing C-suite education for the non-C-suite physician leader.
 
They encourage all early career and aspiring physician leaders to apply. To find out more about the program or apply, visit physicianleadership.stanford.edu.

Did you enjoy today’s episode?

Rate and review the show so more audiences can find The Podcast by KevinMD.

Subscribe on your favorite podcast app to get notified when a new episode comes out.

Click here to earn 1.0 AMA PRA Category 1 CME for this episode.

Also available in Category 1 CME bundles.

Powered by CMEfy – a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Paula Rochon. She is a geriatrician, and her KevinMD article is titled “Reduce your loneliness, improve your well-being, and take the first step.” Paula, welcome to the show.

Paula Rochon: Thank you. Nice to be here.

Kevin Pho: We’ll get into the article in a little bit. First off, briefly share your story and journey to where you are today.

Paula Rochon: I’m a geriatrician and health services researcher, and I think I got interested in the whole area of aging probably in part related to my parents and grandparents. My grandparents lived really long and healthy lives; in fact, my grandfather lived to about 103. I realized that not everyone was living that same kind of way, and that really influenced me to go into geriatric medicine, to think about aging, and to think about how you could promote health and well-being with aging.

Over time, as a geriatrician, you see a lot of older people who are often women, and I became very aware of some of the unique needs of older women, how we ought to be thinking about them and often aren’t, and some of the inequities that they experience. So that led to me very recently founding a new research center called Women’s Age Lab, which is focusing on learning about older women: from a science perspective, figuring out how you put things into action, and how you talk about it so that we can raise awareness about some of these issues. So that’s my background.

Kevin Pho: So go into more detail on that. What are some of the specific challenges that older women face?

Paula Rochon: Challenges, I would say, potentially from a medical perspective, but they also have challenges that are perhaps unique from a social perspective. So for example, from a medical perspective, they tend to live longer than men. That’s a good sort of thing, but another piece is they experience more chronic conditions, and often not just a single chronic condition but multiple chronic conditions. So that’s something that we potentially have to think about how to deal with. It relates to medications: use of appropriate medications and how medications should be given to women. There are a lot of issues that come up there that I think we can do a lot better with.

There are also, I think, important social issues, and one of the ones that I think has become super important, and that we’re much more aware of now during the COVID era, has been the whole issue around loneliness. Older adults, especially women, experience loneliness. Women are more likely than men to live alone. They often outlive a spouse, and it’s sad that about 40 percent of those people that live alone are lonely. Loneliness impacts your health in a big way. People have said it’s like smoking a lot of cigarettes. So there are so many issues related to differences between older women and men that just haven’t had the attention that they need, and so we’re trying to make sure we look at that in everything we do.

Kevin Pho: So I’m a primary care physician, and I see a lot of older women in my clinic. You mentioned loneliness being one of the major issues that they face. So in my primary care practice, in the exam room, what are some of the things that I can do to address this?

Paula Rochon: I think one of the things that we don’t really do is we don’t ask about it. We don’t ask people about how they’re doing, or just simple things like who they are connecting with and what their social network is. So I think it’s important to start asking those questions, and once you have, then I think there are opportunities to find ways to potentially intervene.

People talk about the idea that it’s not just about prescribing medicines, which I’m sure everyone’s well aware of, but it’s also about what else there might be available. What are some of the programs that are available in the local area that they might be interested in? What are potential volunteer activities? What are some of the ways that people can be engaged and take advantage of the skills that they have? Which gets into what we’re going to talk about a bit later on: activities, the importance of activities that people can do themselves or with others, depending on their interests, like walking.

Kevin Pho: All right, let’s talk about your KevinMD article. It’s titled “Reduce your loneliness, improve your well-being, and take the first step.” Now, for those who get a chance to read your article, just walk my audience through it. Share the story.

Paula Rochon: Why I decided to write this article is really about walking and women, and it was something that I really started thinking about when I walked the West Highland Way. That’s almost 100 miles; I think it’s about 96 miles, but we did it in about seven days. You go from the north of Glasgow up to Fort William. It’s a beautiful walk, pretty hilly, and what I saw on the way is that there are a lot of people out there walking. There were people that were walking just for the day, just doing short trips. There were younger people, there were older people, there were people that were camping along the way, all sorts of things.

I realized that a simple activity like walking is just important, and that even though you might be starting out a walk like the one I was talking about alone, you met people along the way. You interacted with people. With people who were doing the whole distance, you’d see them one day at lunch, then you’d catch up and they’d be ahead of you, and then you’d see them again a bit later on. It was just a wonderful way to connect, to meet people, great physical activity, and just an opportunity to enjoy things and really take it in. That’s unlike when you just make the trip, which we did on the way back, in a van, where it just goes by in a flash and you don’t see anything. When you’re walking, you really just experience this whole thing.

So it was an absolutely beautiful walk, and I know Scotland is known for maybe not always having the greatest weather, but we had fabulous weather. So it’s just a wonderful way to experience it, and it made me think about walking and how that’s something that we maybe don’t value as much as we should, and it’s so important for health and well-being.

Kevin Pho: So tell us, how can we incorporate more of that into the advice that we give to older patients?

Paula Rochon: When we talk about older patients, one of the things you want to do is promote physical activity. That’s really good for health, for reducing chronic conditions, and that kind of thing, so that’s really important. But I think the piece that we don’t often appreciate is that it’s particularly important for women, older women. Women are less likely to be physically active than men, and that’s something that people may not really think about, but it’s something that really does happen quite universally.

Why might that be? Is it that physical activity is something that maybe women feel is expensive, and women don’t always have the same kind of financial resources? Maybe is it related to other kinds of responsibilities that they might have, and so they’re not able to go out? But I think when you think about that, it’s something that you can propose as something that’s really accessible and doable for people, especially now.

Kevin Pho: What about some of the evidence or studies that show the benefits of walking in older women?

Paula Rochon: One of the pieces that we talk about in the article, which I thought was really interesting, was a piece that was done as part of the Women’s Health Study, and it looked at the idea of counting steps. I think we’ve all heard about this number, this magical number that comes up in our mind: 10,000 steps is where we have to go. I think for most people, they think that’s a bit daunting. That’s far, that would take a long time to do, and so maybe people back off.

But one of the things that came out of this article, which I thought was really helpful, is that maybe you shouldn’t worry about the 10,000 steps. Maybe the idea was that just walking was a good thing, and they even pointed out that walking a lesser amount, I think the number was something like 4,400 steps, was also important, relative to people who walked lesser amounts, in terms of reducing major things like mortality.

I think one of the messages that comes out from that, and from research that’s out there, is the idea of thinking about walking as something that people can do as they’re able to do it, and that different amounts of walking are certainly beneficial. You shouldn’t be worried about thinking that you have to go huge distances, you know? Those small amounts are really important. So I thought that was really important, plus just bringing home the fact that women are less likely to do that, or to be physically active, than men. So you want to think about how you could encourage women in particular to think about activities like walking.

Kevin Pho: So let’s say you’re in the exam room with an older woman, and there are so many issues that you need to get through within a constrained amount of time, yet you still want to encourage walking because of the benefits that you cite. Now, what are some high-yield ways where physicians like us can encourage walking when there are so many other things that we need to handle during a 15- to 20-minute office visit?

Paula Rochon: You’re right, those visits are really short, and in geriatric medicine we often have the luxury of more time because these issues are really important. But I think what you do want to do is ask people about their physical activity, and especially for women, take advantage of asking a few more questions about that, knowing that they may be less likely to be active. You might want to just briefly ask them, “Are you walking?” And if not, what might some of the barriers be? Is it that they don’t feel comfortable doing it? Would it be helpful for them to perhaps meet with a group, to walk with a friend, to build it into part of a routine that they might have as part of their day? Maybe they’re going off toward a coffee shop; they could take the opportunity to walk there.

So I think it might be about, first, in your very brief period of time, taking the opportunity to ask about it, and if they’re not doing it, thinking about what some of the barriers might be and what some of the simple things are that might entice people to start thinking about walking. As I’ve said, it might be having a bit of a destination to go to, building it into part of their daily routine, taking it as an opportunity to connect with family and friends, or maybe joining walking groups. Sometimes cities even have walking tours that are really interesting to go on. So maybe it’s about just proposing a bunch of different opportunities that people might want to think about pursuing.

Kevin Pho: Now, what about those who have conditions that may preclude them from walking, if they have rheumatologic disease, if they have osteoarthritis? What are some other ways that we can promote physical activity for those for whom it’s a little bit more difficult to walk?

Paula Rochon: Well, I think you’re right. Walking is something that not everyone can do, and that’s something that we have to think about and recognize. But it’s not always just about the walking; it’s also the idea of getting out and being able to interact. So for people that are not necessarily able to walk on their own, maybe it’s the opportunities to be out among other people and to socialize, because one of the other benefits of walking is that you do get those social connections. If you’re going out on a regular basis, for example, you’re often passing people along the way, people stop to talk, or you’re with a friend and you’re talking.

You know, during COVID it was so important to be outdoors, and walking, I think, was getting more popular as a way that you could safely meet with family and friends without necessarily worrying the same way about transmission of infection. In similar ways, for people who cannot walk, I think we want to find some of those opportunities for them to get the advantage of those social connections, which are also really important.

Kevin Pho: We’re talking to Paula Rochon. She’s a geriatrician. Her KevinMD article is titled “Reduce your loneliness, improve your well-being, and take the first step.” Paula, what are some of your take-home messages that you want to leave with the KevinMD audience?

Paula Rochon: I guess one of the things that I think you want to talk about, from a broad perspective, and this goes back to my interest in aging and women, is that aging is something that impacts all of us. People often think of aging as something that’s happening over there, but it’s something that we all need to think about, and I think we all need to think about what we want to do to promote our health and well-being, and that of those around us. We’re about to be in a society where we’re a super-aged society, where more than 20 percent of our population is going to be in that older age group. So this is important.

I’ve often been asked, as a geriatrician and researcher, “What can you do to stay well, to age well over time?” I think people are looking: Is there a fountain of youth? Is there some pill that I could take that would make a difference? I don’t think there is. You could wait for it, but I don’t think there is. In the meantime, I think there are things that people can do, and I think walking is one of those. It’s accessible for most people, not all, but it’s accessible, and it’s something that is very beneficial in terms of improving your health in general and your sense of social connections, and therefore well-being, in terms of reducing loneliness. It’s something that’s particularly important to think about for women, who are less likely to be doing activities like that than men.

Kevin Pho: Paula, thank you so much for sharing your time and insight. Thanks again for being on the show.

Paula Rochon: Thank you.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes