Focusing on Midlife: An Oft-Neglected Stage
Start Date

September-October 2013

By: Joyce E. Brand, RN, M.S.

One of the hallmarks of the human experience is transition from one phase of life to another. While many programs focus on younger women, specifically those of childbearing age, Mount Carmel Health System, Columbus, Ohio, has created a resource to provide programming for women in the post-childbearing or "middle" years.

Launched in 2012, the Midlife Women's Health and Wellness Program is designed to serve women who are between 40 and 65, a group with stage-specific needs that are sometimes overlooked. According to the 2010 Census, more than 1.6 million women in Ohio are between the ages of 40 and 65, but Mount Carmel is the only health care system in central Ohio offering such diverse and expansive programming for this specific population.

At midlife, women are reaching many and varied important life milestones. Depending on her life choices, a woman may be raising a young family or sending her children off to college. She may be assuming caretaking duties for aging parents or a sick spouse. In fact, many women in this age group are taking on more roles than they did during their 20s and 30s, and their circumstances are creating a new set of physical and emotional complications that previous generations have not faced.

It is important to reach out to them, for today's midlife women are looking for resources, thus creating an opportunity for health care systems to expand their services and elevate visibility within their community.

The Mount Carmel Midlife Women's Health and Wellness Program provides a set of classes, workshops and seminars designed for women who are looking to get more from a stage of life that can be very gratifying and productive. Midlife women tend to be concerned about health, but wellness is another issue that drives their choices and purchasing within the health care industry. Wellness, however, can be a difficult concept to define, because its meaning varies across the population.


Mount Carmel is a leading provider of obstetrics and breast health services, thus it was a natural progression to create a program that would cater exclusively to women between the ages of 40 to 65. The idea to move forward with a specialized midlife program came after a consultant noticed significant experience among clinicians and administrators within the system with issues related to women in the middle years of life. Among the nursing staff at the system's women's centers, Mount Carmel identified Pam Mascari, CNP, RN, as a strong leader with extensive experience working with women transitioning through menopause. Mascari was a nursing care coordinator at the Women's Health Center and taught classes and created educational materials for women on midlife issues.

Mascari did an extensive literature search and consulted with various health leaders in the community and across the nation for more perspectives on what issues the new program should address. She structured the Midlife Women's Health and Wellness program to focus on the whole person, encompassing spiritual, social, emotional, environmental, physical, financial and mental health. The goal was to create a balanced set of classes, seminars and workshops tailored to stage-identified needs.

As a Catholic health care provider, Mount Carmel has been able to offer a holistic outlet for wellness programming because our mission promotes caring for the spiritual side of health as well as the physical. This focus is an important hallmark of the midlife program. While many classes are developed with traditional health needs in mind, there also are strong spiritual and emotional support offerings.

For example, Mount Carmel has been able to provide unique opportunities by embracing the quests that often begin at midlife — the search for a redefined identity, or a desire to reconnect with their faith. Numerous women have found the support and answers they are seeking through classes such as "What Matters Most in the Second Half of Life" or participating in walks through a local labyrinth.


The development of the Midlife Women's Health and Wellness Program has been a journey. The program has been operating for a little more than a year, with the number of participants increasing from 79 during the first quarter of programming to 192 during the winter 2013 quarter. We believe the tremendous growth in participation has been one of the most important signs of the program's success.

When the Midlife Women's Health and Wellness Program was created, there were no restrictions as to how it would be structured or what would be offered. This programming freedom, partnered with Mascari's passion, has allowed her to create classes and workshops that fit identified needs and to quickly make adjustments based on feedback from participants.

"The process of creating the Midlife Women's Program has been exciting, invigorating and very fulfilling," said Mascari. "It has provided an opportunity to develop a comprehensive program, encompassing mind-body-spirit, of women in this special time of their lives."

Because midlife women face varied challenges, we feel a responsibility to seek out the best resources and research-based information available to share with the women of our community at this important time in their lives.

"We hope this program will help women in midlife by empowering them to achieve a state of optimal well-being," Mascari said.

The program began with a $6,000 grant from the Mount Carmel Foundation, an Ohio 501 (c)(3) non-profit organization dedicated to funding the mission-driven health and education programs and services provided through the Mount Carmel Health System. We offered just under a dozen classes, but because our region is ethnically and socioeconomically diverse, we made sure to create a variety of offerings.

Also, in order to ensure classes fit the interests of the targeted age group, Mount Carmel conducts extensive and continual polling and surveying. After every event, participants are given opportunities to review the program and provide suggestions. The participants give feedback about the topic, instructor, environment and effectiveness of presentation which we use to help us refine our offerings. All this information goes into a database for analysis. We also use focus groups to identify topics for future class development, and Mascari also collects suggestions and input from community resources she has worked with during her time at the Women's Health Center. Once the class topics are set, Mascari works with the course instructor to develop the outline for the class.

The catalog of offerings has grown steadily, and now there are approximately three dozen Midlife Women's Health and Wellness Program activities and classes. By offering classes throughout our service area, the program has been able to develop a following and establish a positive reputation in the community.

Instructors represent a wide variety of backgrounds in the community. For example, a chef from the Columbus, Ohio, area teaches cooking classes; some of the physical and psychological health classes are taught by Mount Carmel physicians, and the program also brings in motivational speakers.

One of the most popular offerings has been the "Empowering Ourselves as Women" seminar, taught by Annette Franks, a motivational speaker and Gestalt psychotherapist. Attendance set a record for the program — 103 women — which focused on creating and maintaining balance, creating positive synergy, establishing productive rituals and psychological habits and learning how to integrate body and mind.

Now that the program has been running for a year, Mascari has been able to identify which classes are the most popular. Though no schedule has been exactly the same for each quarter, almost all of the exercise and meditation classes repeat.

The program also has hit an important financial milestone; it has made the transition from grant-funded to self-sustaining. The average cost of a class is approximately $30, but no woman is turned away because of her inability to pay. This is an important reflection of our system's values and mission. Mount Carmel is committed to supporting underserved populations within its communities. Instead of refusing service, we offer discounts and waive fees.


The outlook of women between the ages of 40 and 65 is ever-changing, and so is the Midlife Women's Health and Wellness Program. The program offerings have grown by leaps and bounds, along with the client base.

The new offerings bring in even more participants, and although the program is geared toward women between 40 and 65, we are also seeing women in their 20s and 70s attending. Plus, there have been a few men!

The Midlife Women's Health and Wellness Program has been a success, and its many facets have given Mount Carmel a more creative way to not only focus on a group with unique needs, but to demonstrate that we are a Catholic health care organization dedicated to wellness and treating the patient as a whole — at every stage of life.

JOYCE E. BRAND is service line administrator, Women's Health, Mount Carmel Health System, Columbus, Ohio.