Currently, 40.1 million people are between the ages of 55 and 64, while 26.4 million people are between the ages of 65 and 72.1 In many ways, people have numerous choices for maintaining optimum health. Moreover, Spafinder’s 2015 Trends Report described the 10 top movements for the spa industry, many of which depict a large wellness component that is rapidly becoming mainstream in society. Referred to as a wellness revolution everything from aging to the cost of healthcare is driving these trends. People are living longer and require a high quality of living, no matter their age. These changes are also driving the entire beauty and fitness industry, forcing present spa owners and new business planners to study new concepts for the integration of a greater wellness module into their strategic plans.

CONCEPTS FOR HEALTHY COMMUNITIES
Entire communities are also integrating wellness and fitness centers into the neighborhood. For example, the Cliffs,2 communities that are nestled in the foothills of the Blue Ridge Mountains, spent millions of dollars to integrate an entire lifestyle of health and wellness, including golf courses, fitness centers, spas, hiking and bicycle trails, swimming, and places for social gatherings. These lifestyle concepts have expanded throughout many regions of the country.

GLOBAL WELLNESS
The 1948 preamble of the World Health Organization (WHO) states, “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” It is compelling to observe that 68 years ago, the WHO definition of wellness went beyond just the physical aspect of disease. There was an emphasis for a more positive state of being that collectively encompassed mental and social dimensions. This vision laid the groundwork for modern day thinking about total health and wellness. It is also important to remember that modern day lifestyle in the Western world has undergone multiple alterations, including a changing global environment, food modification and production, newer technologies, and increased stress factors. Internally, the West is also facing compromised immune systems that give rise to many diseases. Closer examination of these tendencies requires a more profound insight as to how wellness is defined.
Sanford Research Institute (SRI) published a report for the May 2010 Global Spa Summit, Spas and the Global Wellness Market: Synergies and Opportunities,3 that presented a comprehensive document on wellness and spa trends. This report states that wellness is multidimensional and holistic; that it changes over time and along a continuum; that it is individual, but is also influenced by the environment; and that it is a self-responsibility.

THE FUTURE IS NOW
Defined by the SRI as The Wellness Cluster, there are two approaches that give rise to a potential $1.9 trillion integrative global market: a conventional, medically-oriented approach and an integrated wellness approach. The following model is based on a continuum concept created by Dr. John W. Travis. It represents two treatment paradigms: Reactive and proactive.

Trends come and go, however, the concept of wellness is here to stay.

PREPARING THE STAFF
Spa services can undoubtedly serve a greater integrative approach for maintaining health, especially with an aging population that seeks out and places greater value on regular spa visits and services. Given the trends of a global market, and also the popularity of creating a more Zen environment (mind, body, and spirit approach), new spa designs require considerable planning with a multiplatform approach to services. This may include skin care, massage, body wraps, acupuncture, hair and scalp care, hands and feet therapies, meditation and quiet rooms, makeup bars, and the use of professional products.
Furthermore, the integration of oncology or health-challenged skin services may also be considered. Health professionals may provide services such as nutritional counseling, weight loss, cosmetic enhancements, and more. No longer a luxury, spa principles have shifted into an all-encompassing concept of wellness.

EDUCATION
Professionals must grasp a greater understanding of the health profile of their clients as well as become aware of the potential risks of chosen treatments performed for each. This knowledge beckons for more advanced scientific education to ensure consistencies of knowledge and treatment and the reduction of liabilities. Working within the scope of a practice, a key objective for spa professionals is to gain advanced education from experienced and credentialed educators in order to recognize, understand, and adapt skin and body care treatments to specific individual requirements.
There is also a growing international trend to offer more formal advanced education and certification to aestheticians, massage therapists, and palliative care personnel who wish to further their specialty. They may become a member of a patient support team in a hospital setting or an oncology treatment center. The globalization of these services has also reached out into other countries.

WHO ARE THE CLIENTS?
With increased age, there may be a progressive profile of variable health symptoms and issues. The natural aging process also increases in postmenopausal and clients that are 50 years or older. Biological cells, including those within the immune system, lose memory (communications) and also are affected by oxidative stress, mitochondria damage (DNA), shortened dendritic cells (such as melanocytes), and Langerhans (immune); cognitive skills may decline as well. Moreover, superimposed lifestyle factors, such as smoking, alcohol, poor dietary habits, medications, lack of exercise, and inflammatory diseases, can easily increase the biological aging process. So who are the clients and what are their potential risks? Older clients who are healthy or unhealthy; clients with hidden health issues; clients with inflammatory or degenerative diseases, such as arthritis and bone density loss; and those with autoimmune disorders, diabetes, lupus, cancer, heart conditions, or hormonal changes/conditions.
Certain clients, especially those with a systemic disease, may require specialized care from a medical team integrated with palliative caregivers. Working with health-challenged skin, requires an understanding of the sciences and medical theoretical aspects of the various types of diseases, including cancer, and the myriad of treatments addressing those concerns. Moreover, health challenges have a profound impact on the skin barrier function and immune response. Specially-trained skin care professionals can provide non-invasive and beneficial treatments designed specifically for cancer patients and survivors. The benefits of complementary therapies may help ease the symptoms, skin reactions, and stress resulting from radiation, chemotherapy, or other methods of disease management, improving the skin and reduction of stress. Moreover, there are specific guidelines for skin care formulations to address potential inflammatory reactions from conventional cancer treatments, including soothing and supporting the numerous changes within the skin barrier.

PROACTIVE WELLNESS OPPORTUNITIES FOR THE SPA
Following the philosophies of a spa, partner with conventional and/or medical establishments to deliver complementary and integrated-healing services. Offer oncology services, such as pre-and post-operative treatments and recovery phases and integrated spa, beauty, and wellness packages for companions traveling with medical patients. Professionals can also partner with medical establishments to conduct evidence-based research and repackage and develop new offerings to define and market the spa as a wellness necessity.
Professionals should also help clients understand and select the spa’s wellness offerings. Conduct an education event to inform attendees about a particular subject (such as aging and preventative care) and expound on the spa’s services. Spas should also position themselves as the center of integrated and/or holistic approaches to wellness. They can also deliver executive health services and manage the general wellness of the employees (such as stress reduction through chair massage or yoga). They can also offer executive retreats, health assessments, and life style education, including nutrition.

There are numerous opportunities for spa growth during the next few years. Traditional spa philosophies have been about healing, renewal, relaxation, and feeling well. Wellness is an important trend for the future of this industry; it all begins now through repackaging what is already offered. Furthermore, clearly defined concepts and pathways are required for education in professional schools, as well as in-house staff education. Wellness is a multidimensional, holistic concept that encompasses the physical, mental, emotional, spiritual, social, and environment.

References
1 Marketing Charts. (2015, April). So How Many Millennials Are There In The US, Anyway?
2 Cliffs Living. (n.d.).
3 Sanford Research Institute. (2010, May). Spas and the Global Wellness Market: Synergies and Opportunites.

Alexandra J. Zani is an international educator, researcher, and author with a background in cell biology and medical. Her passion for education resulted in receiving numerous advanced certifications, both in the United States and abroad. Zani earned an instructor license for aesthetics/cosmetology, is National Catholic Educational Society (NCEA) Nationally Certified, certified in Oncology Esthetics®, and the Pastiche Method® of Skin Analysis. She presents education for advanced aesthetic technology, including microcurrents, LED, and non-ablative laser. She is a specialist in the anti-aging sciences, including the effects of nutrition, lifestyle, and the mind/body connection.