There is growing recognition that supporting the mental well-being of older adults requires more than just clinical care. Across community settings, efforts increasingly focus on reducing loneliness by creating opportunities for social connection. These include group classes, volunteer programs, and social prescribing initiatives that connect individuals with activities such as walking groups, art classes or volunteer activities. These approaches are valuable, and they can make a real difference.
Yet something feels incomplete.
In our recent qualitative study of a community-based health program serving older adults with chronic disease in under-resourced communities, we observed clear improvements in mental well-being. Participants described feeling more confident, more connected and more capable of making positive changes in their lives. What stood out, though, was how those changes happened.
Participants didn’t describe it as simply “getting together” or spending more time with others. They talked about feeling welcomed, valued, seen, and having a sense of purpose. They described learning from one another, supporting one another, and discovering that they still had something meaningful to contribute. These experiences supported notable improvements in mental well-being and set the program apart from other programs designed to support social connection.
This program—Community As Medicine (CAM), a registered trademark of Open Source Wellness—is a health coach–facilitated, group-based, lifestyle-medicine program designed to support whole-person health. It brings participants together to work on movement, nutrition, social connection, and stress reduction, but its impact comes from how those elements are delivered in a supportive, relational environment.
At first glance, CAM may look like other community-based programs seeking to reduce loneliness. What we began to understand through our study and reflection on participant experiences is that the outcomes were shaped not only by the content but even more so by the conditions created in the group.
‘Participants spoke at length about their initial experiences with health coaches: how warm and encouraging they were and how comfortable they made them feel.’
So, what does it take to create those conditions?
While there isn’t a formula, clear patterns emerged, suggesting that these elements, when intentionally designed, can help us rethink how programs for older adults are created and facilitated.
- Start with the mindset: “You matter”
This may be the most important, yet most overlooked, starting point. Many older adults enter these programs carrying internalized beliefs about aging: that they are less capable, not relevant, or somehow “past” their prime. These beliefs don’t always show up directly, but they shape expectations and behavior.
Programs that focus primarily on what needs improvement—such as diet and physical activity—can unintentionally reinforce those beliefs.
What we saw instead was the power of a different perspective, one that assumes from the outset that every participant matters, has value, and contributes to the group. This isn’t something the group facilitator says, it’s something people feel. It is a mindset that shows up in how people are welcomed, seen, listened to, and acknowledged. It subtly shifts the dynamic in the room away from fixing and toward valuing what each individual brings.
2. Model the culture you want to create
Participants do not automatically know how to engage in ways that foster trust, support and openness, especially if they have experienced isolation or marginalization. Early in a program, they often look to the group facilitator for cues.
In discussing the impact of CAM, participants spoke at length about their initial experiences with health coaches: how warm and encouraging they were and how comfortable they made them feel. As they expanded their reflections to describe their experience across the 12-week CAM program, participants talked less about the coach and more about one another. That shift reflects what was modeled.
Facilitators created a space grounded in curiosity, inclusion and non-judgment, modeling in real time what it looks like to listen, encourage and share. Participants discussed how, over time, they began to show up for one another in the same way. What began as a room full of individuals became a community—one where people noticed each other, checked in, and were genuinely invested in one another’s progress, as well as their own.
3. Make space for reciprocal support
One of the clearest insights from our study is that participants grew not only by receiving support but also by offering it.
This calls for a subtle but important shift in facilitation. Many programs are carefully designed, tightly structured, and facilitator-driven and led. There is a natural tendency to lead, guide and deliver, e.g., to be the expert. Yet something shifts when facilitators step back just enough for participants to step forward to share from their lived experience.
That sense of contribution—of being able to help someone else and having a purpose—appears to play a meaningful role in building confidence and well-being.
In CAM, participants are invited to share how they apply what they have learned in the group sessions. They learn from sharing their experience of the program and actions they’re taking to improve their health. Participants begin to see themselves in one another. Over time, the coach facilitator makes themself less central, and the group itself becomes a source of insight, accountability, and encouragement.
In this process, a deeper shift begins to take hold: people start to feel as if they are part of a community where they are valued. One participant captured it this way: “I needed to feel needed.”
That sense of contribution—of being able to help someone else, and having a purpose—appears to play a meaningful role in building confidence and well-being. It relates to what is increasingly highlighted as foundational to lifestyle medicine: the importance of meaning and purpose to sustaining well-being. By encouraging others to improve their health and receiving encouragement in return, participants begin to see themselves differently: as capable, valued and needed.
This idea goes beyond community programs. In her book “Multipliers: How the Best Leaders Make Everyone Smarter,” Liz Wiseman describes the most effective leaders as those who create the conditions for others to contribute and grow, bringing out the best in people. We see that same dynamic in the CAM groups. The role of the facilitator becomes less about directing the experience and more about unlocking the potential already present in the group.
Together, these insights suggest a shift in how we think about supporting older adults’ mental well-being. It’s less about creating opportunities to connect and more about shaping environments where people feel valued, capable and able to contribute. For organizations investing in social connection, from healthcare systems to community-based settings such as YMCAs, this raises an important consideration:
What do people actually experience when they walk into these spaces?
When the right conditions are in place—when people feel they matter, when supportive behaviors are modeled, and when there is space to contribute—community takes on a different quality. It becomes a place where older adults reconnect not only with others, but with who they are, and with the value of what they have to contribute.
Sally Duplantier, MS, is a gerontologist, researcher and doctoral student in Global Public Health Leadership at Indiana University and serves as a research and gerontology advisor to Open Source Wellness. Michaela Hayes, MHSA, CFRE, GPC, is a public health professional and gerontologist, and is director of development at Open Source Wellness. Elizabeth Markle, PhD, is a licensed psychologist, speaker, writer, researcher and executive director and co-founder of Open Source Wellness.
Photo caption: Community As Medicine participants engaged in joyful movement.
Photo credit: Courtesy Open Source Wellness.
