Tailoring our Programmes to Suit an Elderly Population- Exercise Considerations Lesley Simpson Health 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 % of the population over % 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 prepared!

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

Facilities Consider: 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