by Nanci S. Guest MSc, CSCS
Most older people say that their first goal as they age is to remain independent. Independent living depends on being able to do the things they want to do when they want to do them. It also implies not having to ask for, or receive help from someone else. Broken down into skill components, being independent means that they need to be able to reach, bend, lift, carry, and move around. easily. It also means having the cognitive skills such as planning, insight, judgment and memory that are necessary to live safely.
Physical activity is one of the most important things an older person can do to maintain their mental health and quality of life. The more fit and active they are, the less help they will need from relatives and/or health care workers. What we call the Instrumental Activities of Daily Living ( IADL) such as driving, shopping, housework and walking all become easier when fitness levels are maintained or recovered.
As people age, body systems effectiveness tends to decline. This means the functioning of the excretory system, immune system, reflexes, and others are not what they were. Exercise is one of the non pharmacological interventions that is most useful in helping to maintain this functioning, and even to some extent restoring it.
Many of the diseases and limitations that arise for many people as they age are affected by activity and fitness level. What have been thought to be simply part of the aging process, are now seen to be, in part, at least, to be the result of lack of activity level and fitness. With exercise, some of these conditions can be reversed and for some the effects can be modified. Scientists have proven that activity reduces the risk of heart disease, falls, high blood pressure, adult onset diabetes, osteoporosis, stroke, and colon cancer. Exercise can positively affect such things as sleep disturbance and depression.
Of the above, stroke and falls are two of the highest predictors of admission to nursing homes. When talking about maintaining their independence, one of the factors older people often bring up is the desire to live in their own homes as long as possible. Thus, exercise will help them achieve this goal.
Research has shown that exercise and physical activity is effective for even the very old—people in their late eighties and nineties. Studies have shown that this group too can improve muscle mass, strength, and endurance under guided exercise programmes appropriate to their current health level. These programmes include both cardio and weight training.
The key to all of this is an understanding of what physical activity and exercise mean, or what it does not. It does not have to mean going to the gym five days a week, or having a lot of equipment. It means to find activities that an older person enjoys or enjoyed, and start doing them again, or increasing them. It means building something into their day. If there is a structured activity, make sure it starts slowly, and set low goals to insure success and continuation of the programme. Exercise can be simply walking to the mailbox or up and down the halls of an assisted living facility. It can mean taking one flight of stairs, rather than the elevator. For people who wish to have more structured programmes, more and more seniors centres have active exercise and aquatic programmes.
For someone who has a serious medical condition, it is important to work with the physician, and obtain advice from experts. Approach health organizations such as The Osteoporosis Society, Heart and Stroke Foundation, and Arthritis Society to help choose programs. Often the support groups they have for people with these diseases have an exercise component.
When family members visit an older person, they can be the inspiration and coach. A visit can incorporate a walk or simple exercises instead of just sitting and talking. Walk the dog together, or push the grand children’s stroller. In a nursing home, it might mean joining in activities, or going down to the lounge together, rather than staying in a resident’s room. Remember, a lot of older people were not brought up to think about exercising into their old age. They have the same prejudices and limiting beliefs about aging and older people that most of our society has; these ideas can be an impediment to changing behaviour.
For many older people, there is also an underlying depression or hopelessness, that can influence their willingness to exercise. They may think that their life is over, that it is too late, etc. You may hear statements such as “what’s the use at my age.?” Exercise will help this, but the attitude is also what may impact on their being able to start or maintain exercise. It also may take a while for them to see the benefits.
Nanci S. Guest, M.Sc (Nutrition), C.S.C.S., owns Power Play: Nutrition, Fitness, Performance in Vancouver, B.C. Since 1995 she has provided the general public (including older adults), and athletes of all levels with nutritional counseling, personal training, athletic strength and conditioning, and information seminars. She teaches sports nutrition at the University of British Columbia and the University College of the Fraser Valley. Contact Nanci at www.powerplayweb.com.
