Independent Living Index by HealthyLifetime Logo

HealthyLifetime has developed the revolutionary Independent Living Index® (ILI), based on ten critical and scientifically-based factors that help participants understand and deal with their unique constellation of issues to improve their independence, lower healthcare costs and increase their quality of life.

HealthyLifetime’s Independent Living Index Factors


Self-Rated Health

Not Smoking

Health-Related QoL

Positive Food Choices

Alcohol Use

Sleep Quantity/Quality

Social Engagement/Relationships

Independent Agency/Resiliency

IADL’s (Instrumental Activities of Daily Life)

The Independent Living Index in Action

HealthyLifetime uses the factors below to first understand each individual’s unique background story.

Physical Functioning

  • IADL’s (Instrumental Activities of Daily Life)
  • Walking, Reaching, Vision and Hearing
  • Spatial Orientation, Memory, Speech and Alertness


  • Nutrition
  • Smoking
  • Alcohol
  • Sleep
  • Exercise

Social Determinants

  • Socioeconomic Status
  • Education
  • Neighborhood and Physical Environment
  • Employment
  • Access to Health Care

Agency, Confidence, and Resiliency

  • Ownership of Their Condition and Situation
  • Goal Setting and Measurement
  • Problem-Solving
  • Communication Skills
  • Dealing with Challenges
  • Dealing with Change

Chronic Conditions

  • Treatment Management
  • Medication Management
  • Symptom Management
  • How to Talk with Healthcare Professionals
  • How to Effectively Work with Healthcare Professionals


  • Family
  • Friends
  • Social Network
  • Social Engagement


  • Depression
  • Anxiety
  • Stress

HealthyLifetime’s Strategies

Eliciting Narrative

Eliciting narrative involves drawing out the participant’s personal story of what is important to them and why, fostering empathic communication between the nurse and participant. It’s an integral part of our program, facilitating trust-building and mutual learning. Through this process, participants often discover new strengths and insights about themselves, empowering them to achieve their desired goals.

Guiding Insight and Behavior Pattern Recognition

Cognitive insight empowers individuals to recognize behaviors addressing their needs. With this awareness, they can consciously choose to maintain, replace, or adopt new behaviors. Through reflection and questioning, nurse health coaches assist participants in gaining clarity about their patterns and empower them to make conscious decisions to disrupt unhealthy behaviors, substitute healthier ones, or establish new ones.

Goal Setting

Goal setting is the process of identifying priorities important to the participant at a given point in time. But a goal without a plan is only wishful thinking. Our goal-setting process guides the participant from initial goal identification, clarification, specification, and commitment to a plan. Whether big or small, goals evolve as participants progress, often leading to broader changes. By learning these processes, participants gain clarity and conviction in setting and achieving their goals, even after the program ends.

Cognitive Restructuring

We all have ways of perceiving problems that may not align with the facts, which we call errors in thinking. For instance, ‘all or none’ thinking might lead a participant to believe they must be perfect in implementing their plans, or not do it at all. In such cases, the nurse coach helps the participant review the facts and provide feedback and reflection to foster a more accurate and balanced perspective. Participants may learn that trial and error is not failure but a necessary part of the learning process for overall success.

Encouraging Resilience and Sustainability

Throughout the program, the nurse coaches employ various techniques to guide participants towards resilience and sustainability. Resilience encompasses managing life’s challenges with attention, strength, practice and hope. It involves various facets such as thinking, reflecting, trying, learning, and recommitting. Sustainability addresses the underlying motivation for behavior change and the emerging identity of individuals committed to healthy behaviors. Resilience supports sustainability by offering strategies for success, while the enduring benefits of sustainable practices provide ongoing motivation for goal-directed behaviors.

Motivational Interviewing Communication

Our approach incorporates motivational interviewing (MI) skills to effectively respond to participants’ sustain talk or change talk as their narrative unfolds. This strategy complements our other techniques and remains central as the participant’s narrative develops.

HealthyLifetime Model

Driving Forces

Cognitive-Behavioral Factors that Promote Change

  • Change Talk
  • Resiliency
  • High Self-Efficacy, Personal Agency, Self-Esteem
  • Insight and Pattern Recognition
  • Sustainability Planning

Achievement of Goals and Improvement in Health and Long-Term Independence Capacity

Restraining Forces

Cognitive-Behavioral Factors that Make Change More Difficult

  • Sustain Talk
  • Hopelessness and Helplessness
  • Low Self-Efficacy, Personal Agency, Self-Esteem
  • Cognitive Errors
  • Chaotic Goal-Setting

The Independent Living Index’s Success

Visualize the transformation in the figure to the right, where the green area represents high-functioning individuals, and the red shading indicates those with poor functioning. Our intervention has consistently elevated the cohort’s profile [N=96], with sustained improvement evident even four months post-treatment. The proportion of individuals with poor functioning has notably declined from 30% to 5%, emphasizing our commitment to empowering individuals with the skills needed for lasting improvement.

Percent of Participants in ILI Score Ranges Bar Graph by HealthyLifetime

Estimated Cost Savings

In addition to the $16,000 to $20,000 annual savings per participant, the anticipated average savings in medical services per participant during the program, including unplanned clinic visits, ER visits, and hospitalizations and more, based on our research, is estimated to be $1,328.17. The cumulative savings for the entire cohort is projected to be $175,318 over a four-month period, encompassing two months before and two months after the program.

Control Medical Use Index RCT Bar Graph by HealthyLifetime

RCT: 50% in Medical Use Index in HL Group Only

Medical Use Index Cohort 2022 Bar Graph by HealthyLifetime

50% Reduction Replicated in Another Cohort Study