What does fulfillment mean for older adults, and how can this subjective experience be measured in a way that informs care? Also, which factors shape it, and how does it connect to overall well-being?
A new white paper from CenterWell, “Understanding Fulfillment for Older Adults: Definition and Impact,” (PDF) presents the results of a two-year research project that explored fulfillment and quality of life in older adults. Its findings include how fulfilled they feel now, how that varies demographically, and what psychological, emotional and life factors impact that feeling.
“Out of that work came this concept of fulfillment, which is this idea of greater context to life lived, a sense of happiness, contentment and other intangible life elements that exist as we age,” said Carly Woods, coauthor of the white paper and market research lead at Humana. “What drives it, and how can we help people feel more fulfilled and content?”
CenterWell Senior Primary Care—part of Humana—is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine. They also received bronze-level recognition in 2025 from the AMA Joy in Medicine® Health System Recognition Program.
Older adults face overlapping health and social issues. Those challenges, as met by resilience, purpose and meaning, drove Woods and her colleague, Joy Collins—director of market research at Humana—to identify a simple measure that could serve as a proxy for overall well-being. Fulfillment became that measure. Then, they defined what that means for older adults and created a model demonstrating how it might be used to identify how and where fulfillment is lacking, and interventions that address it.
“The white paper was developed with the intention of designing something consumer-back, or from the perspective of older adults themselves, what is important and meaningful to them,” said Collins.
A multiphase research effort was used for the white paper. The first phase, conducted in 2023, included experts in aging and health policy and a survey of 1,150 older adults, which was used to test draft fulfillment findings and establish a one-item fulfillment measure. The second, in 2025, surveyed a cross-section of 5,501 adults 62 or older to delve further into fulfillment items, subgroups and opportunities for interventions.
“The first study was to understand how seniors experience life, not necessarily related to health insurance or health care,” Woods said. “This year, we had a bigger audience, and the good news is that our model aligned and the things that were driving fulfillment in 2023 are very similar today.”
Factors that drove fulfillment among older adults were self-contentment, feeling comfortable with one’s place in life, free of regret, and satisfied with retirement. Financial and personal security, living situations and other elements were important, but were less impactful than attitudinal and emotional factors.
In other words, fulfillment is shaped even more by how older adults feel about their lives than by the conditions in which they live.
Fulfillment needs change with age
Some demographic factors cannot help but affect seniors’ sense of fulfillment. While 54% of older adults reported feeling fulfilled, that sense was notably lower among those with incomes below $50,000, dual-eligible Medicare and Medicaid beneficiaries, and those in fair or poor health.
Fulfillment initially dipped between 65 and 67 years old, a period that Collins and Woods note often corresponds with the first years of retirement. However, fulfillment generally rose for older adults in their 70s and 80s. These patterns suggest that targeted interventions may be key to helping people adjust to new routines, social roles and identities.
“Purpose, optimism and emotions impact physical health. If you’re feeling miserable and depressed, your physical health suffers, too,” said Rumki Banerjee, MD, a family physician who left private practice to join CenterWell Senior Primary Care, went on to recount her experience with a patient of almost 20 years.
“I have been seeing her since she was in her 60s and now she’s in her 80s, and I increasingly felt like she was depressed and lonely,” Dr. Banerjee said. After becoming involved in CenterWell’s social programs at their clinic in Richmond, Virginia, the patient found ways to connect and began to look forward to her time there, which Dr. Banerjee could see in her improved mood, confidence and sense of purpose.
“Sometimes she’ll be in the clinic with me and she’ll say, ‘Dr. B, it’s 11:30 and I have bingo in half an hour. Can you let me go?’” Dr. Banerjee said, laughing. “I can see that her life has changed. She’s more optimistic, she makes plans, she has a purpose and she is happier because of it.”
Purpose influences well-being
Another finding that was consistent across both phases was that purpose is a major driver. Respondents who were proud of their accomplishments and believed that life improved with age were more likely to report feeling fulfilled.
“In fact, some of our sickest individuals, from a chronic condition perspective, also have a positive outlook on life,” said Collins. “They live their life with no regrets and they’re grateful. That’s why this fulfillment work is so meaningful. It takes into account physical and mental health, which is important to us as a health care company but lets us see it from the seniors’ point of view.”
Whole-person care supports fulfillment
Dr. Banerjee shared the story of another long-time patient whose situation reflected the importance of whole-person care for fulfillment: A former truck driver whose physical health deteriorated as his emotional and social needs went unaddressed.
Despite years of clinical treatment, he struggled with uncontrolled diabetes, isolation and a lack of structure after leaving the workforce. He was adrift, disconnected and without a sense of identity or purpose now that his career had ended.
“He was not used to taking medicine while he worked because he didn’t want to drink water because then he had to make frequent stops on his route,” Dr. Banerjee explained. “He didn’t like to take insulin and now that he was retired, he was still reluctant. I told him, ‘Look, I’ve known you for many years now and we need to make a plan, because it is not possible for me to manage your diabetes all alone. But if you can work with me and my team, it’ll be an extraordinary change that you will be able to see.’”
A community health worker and a behavioral social worker helped reshape his routine and scheduled twice-weekly phone calls that drove a change. Within three months his A1c dropped to eight.
“That is a very good number, which he could not have done if the team of ancillary health staff were not helping me,” Dr. Banerjee added.
Provide compassionate care
A sense of fulfillment is central to well-being in older adulthood. Recognizing the emotional, social and psychological factors that shape seniors’ lives can help health systems intervene earlier, more precisely and more compassionately.
“As far as ways to help support patients, there will be other opportunities to keep the conversation going as we learn more and more,” Collins said. “Hopefully, we’ll be able to add even more context to the conversation when we think about how some people are more impacted than others.”
