Tailoring our Programmes  to Suit an

Elderly Population- Exercise Considerations

 Lesley SimpsonHealth Promotion Manager

Nexus Community

• Who are Nexus Community?• What do we mean by “an elderly

population”?• What are the potential benefits of

being physically active for the older person?

• Putting the theory into practice. How the heck are we going to engage and motivate this population!

What is Nexus Community?

• An Industrial and Provident Society, a non profit distributing company where all surpluses must be returned to the services operated.

• Has been running leisure and sports facilities on behalf of local councils and other partnerships since 1997

• Employs approximately 3000 staff over Chiltern, South Bucks, Wycombe and West Oxfordshire District Council

Nexus Mission Statement

“To help to improve the quality of people lives”

Physical Activity Opportunities with

Nexus• Gym programmes• Main studio – body

conditioning, aerobics, body pump, mind and body, step, spinning

• Pilates• Aqua aerobics• 50+• Swimming• Racket sports• Tea dancing• Walking/home programme

Specialist sessions

- Phase III and IV cardiac rehab- Stroke rehab- Tai Chi for balance- Prevention of Falls- Counterweight – for those with a BMI > 30- Diabetes- Coping with pain- MEND- Aqua therapy- Injury rehab- IFI - Inclusive Fitness Initiative

The Team!

What do we mean by the

term

“Elderly Population”?

Defining who is an older person is arbitrary

WHO definition is:45 – 59 middle aged

60 – 74 elderly>75 old

?

“What do you expect at your

age?”• Aging is a natural process – we

all age but we all age differently• Individuals do not age at the

same rate• Disease, genetics, environment,

poverty, stress and inactivity influence the aging process

• We live in an ageist society

England is an aging society

1994 - 16% of the population over 65

2031 - 23% of the population over 65

(National Population Survey 2007)

England is an aging society

The life expectancy in Bucks:

•76.9 males•81.1 females(Bucks Community Health Profile 2007)

Hierarchy of physical function• Group one:

Healthy and physically fit

• Group two:Unhealthy independent and physically unfit

• Group three:Unhealthy dependant and physically unfit frail

(WHO 1997)

Potential Benefits of being Physically Active for the Older

Person• Reduced the risk of developing and controlling

when present CHD, stroke, weight, hypertension, certain types of cancer, diabetes type II

• Prevention of post menopausal osteoporosis and protection against osteoporotic fractures by reducing the risk of falls

• A reduction in the complications of immobility• A reduction in loneliness and isolation, along

with a reduction in depression, stress and anxiety

• Improvements in self worth and self esteem• Improvement in overall psychological well being(sourced BHF Physical Activity and Health 08)

Current levels of activity

Despite the evidence those over the age of 65 currently achieving the recommended levels of activity:

• 17% males• 13% females

(Health Survey of England)

“ If I had known I was going to live this long I would have taken better care of myself”

Mickey Mantle

Personal Qualities

The person who is giving physical activity advice is not only responsible for giving safe and effective recommendations but it is also their responsibility to educate, motivate, empower and inspire the older person.

A good role model is far more likely to encourage individuals to comply with their activity programme

Personal Qualities

• Keep up a smart, clean and professional appearance - a good physical appearance communicates a personal statement

• Constantly update your training- being outdated is potentially dangerous

Personal Qualities• Arrive early• Have everything prepared and be

resourceful • Be bright, enthusiastic and

motivating• Be kind, confident and positive• Learn names and be interested in

individuals• Aim for personal achievement,

praise and acknowledge

Be prepare

d!

Programming considerations

• Participants should be involved in planning and selecting their activity programme

• Acknowledge previous and personal experiences

• The activity should be tailor made considering past experiences, barriers, attitude, expectations

• Be non judgemental - listen• Consider sensible, specific, achievable

short and long goals• Assess progression or regression

Programming considerations

• Being active should be fun – games, the use of music, participate in events

• Try a selection of activities - one size does not fit all

• Include family and friends, create a support network

• Look for inspirational role models/ambassadors

• Encourage activity diaries, record benefits and achievements

Try a different activity?

Programming considerations

• Rewards!• Consider follow up

appointments and telephone support

• Time of activity, not too late or early

• Costs• Marketing• Supportive educational

material which is written in larger text and appropriate language

Rewards!

Tea and Cake

FacilitiesConsider:• Convenient for older

people• Car parking and public

transport• Access• Ventilation and lighting• Floor surfaces• Changing and toilet

facilities• Refreshments• Staff

Safety Considerations

• Risk stratification• Physical Activity

Questionnaire (PARQ)• Appropriate clothing and

footwear• Check that all the

equipment is clean, well maintained and safe to use

• Appropriately qualified staff

• Ensure that there is a sensible instructor to client ratio

Wear appropriate

clothing!

Advice for exercise sessions

• Always be in a good teaching position where you can see and be seen

• Speak in a clear, strong voice giving verbal as well as visual cues

• Ensure that your instructions are unhurried

• Constantly give alternatives and teaching points. Observe and correct

• Keep the exercises simple and cue well

Advice for the exercise session

• Consider the language that you use

• Demonstrate clearly and ensure that your technique is correct

• Emphasise alignment and balance at all times – starting and returning to a stable base

• Mirror the movements• Keep all movements slow and

controlled and encourage full range of movement

Emphasise balance!

“That which is used develops and that which is not used wastes away”

Hippocrates

Conclusion

• Activity is essential for older people not only so that they may enjoy good health but also that they may be involved fully in life

• Activity should be fun, enjoyable, appropriate and safe

• It is essential that the professional giving activity advice sets an example and present themselves as an educated, positive and motivating practitioner