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Introduction
Most of us are now aware of the vast
number of benefits that regular physical exercise can bring to our
lives. Regular physical exercise not only reduces your risk of heart
attack and stroke, but it also keeps your weight in check and your
mood in balance.
However, few of us realize the important health benefits that
exercise can bring to us when we reach our senior years. Maintaining
proper fitness during the senior years is vital to maintaining
strength, flexibility, and overall health – and it can be lots of
fun too!
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following text comes from nursinghome.org
In today's media, exercise has been
highly touted as an effective way to improve one's physical health.
While fitness has been promoted mostly to the young, research has
indicated that the elderly can also reap many benefits from an
exercise program. Many nursing facilities have developed creative
health and fitness programs to improve their residents' physical and
emotional health.
Too often, physical frailty is seen
as a fact of life for nursing home residents, with many unable to do
even the simplest tasks of daily living. Body weakness can also
contribute to accidents in the nursing home, with falls being a
prime example. As researcher William Evans of Penn State University
notes, "Many elderly are institutionalized not because of any
disease or cognitive impairment, but because of muscle weakness.
Their minds might be quite nimble, but their bodies are
diminished." Exercise programs are being used to make these
residents' bodies stronger and more flexible, helping to facilitate
their independence.
Exercise is a prime example of
preventative care, helping residents become better equipped to fight
disease and infirmity. Indeed, because of their many health
challenges, it is the elderly who can benefit the most from fitness
programs. Even 2000 years ago, the Father of Medicine Hippocrates
understood the necessity for keeping the body active and in shape
throughout one's life. He observed:
All parts of the body which have a
function, if used in moderation, and exercised in labours to which
each is accustomed, become thereby healthy and well-developed, and
age slowly; but if unused and left idle, they become liable to
disease, defective in growth and age quickly. This is especially so
with joints and ligaments if one does not use them.
Today's Elderly: Physically Unfit
Many elderly enter today's nursing
homes in dire physical condition. The National Institute on Aging
has recently released some revealing statistics about those elderly
who are beyond the age of 75: 40 percent cannot walk two blocks,
32 percent cannot climb ten steps; 22 percent cannot lift ten
pounds; 7 percent cannot walk across a small room; and 50 percent of
older people who fracture hips never walk independently again and
many die from complications. These statistics should ring a
resounding alarm throughout the long term care community that
effective fitness programs are desperately needed by residents to
improve their physical health.
Misconceptions about Exercise and
the Elderly
With advancing age comes an
expectation of increasing frailty and a dependence upon others for
the tasks of daily living. While it is true that physical
debilitation is a natural part of the aging process, this
debilitation can be minimized through the use of an effective health
and fitness program. Common misconceptions about the elderly and
fitness can include the following:
- Frail older adults are unable to
exercise.
- It is unwise and unsafe for the
frail elderly to begin an exercise program.
- Frail elderly gain few benefits
from exercise.
- It is too difficult for most
nursing homes to set up exercise programs for the frail elderly.
Many research studies have proven
that even frail elderly can derive many physical and psychological
benefits from well-developed fitness programs. In the future,
exercise programs will play an increasingly prominent role in
nursing facilities, helping curtail the debilitation that is now
seen as a common reality for the elderly.
One of the mostly startling
discoveries supporting this view of wellness came from a study by
researchers at Harvard Medical School, published in the June 23,
1994 edition of The New England Journal of Medicine.
Researchers tested the hypothesis that physical frailty is partially
caused by skeletal-muscle disuse and should therefore be reduced
through exercise interventions.
The study involved 100 nursing home
residents, including persons with arthritis, lung disease, and
dementia. One group of residents, the control group, participated in
normal nursing home activities, while the other group participated
in resistance training three times a week, using exercise machines
to strengthen their thighs and knees.
After a ten-week period, the
residents who underwent resistance training increased their muscle
strength by 113 percent, increased their walking speed by 12
percent, and increased their ability to climb stairs by 28 percent.
Four residents who had needed walkers to walk around the facility
became able to walk with a cane. As Maria Fiatrone, MD, head
researcher for the study, comments, "In other countries, older
people are out there riding bikes and climbing stairs. But in this
country people are keeling over out of sendentariness. It's
inactivity, not exercise, that's killing us."
OBRA Mandates and Exercise
Programs
Following OBRA regulations (Nursing
homes are regulated by the federal government under the Omnibus
Reconciliation Act of 1987 (OBRA), 42 U.S.C. § 1395 - 1396 [1999]),
facilities are mandated to assess the functional potential of
residents, rather than focus on their disease conditions. Residents
are to be assessed on an individual basis, and given interventions
that maximize their remaining functional abilities.
This new way of thinking has caused
nursing home caregivers to go beyond the myths and biases of
exercise for the elderly. The restorative emphasis encourages staff
to minimize resident dependence and maximize their functional
abilities. Health and fitness programs are increasingly recognized
as vital ingredients in satisfying the mandates of OBRA, in
restoring functional ability, and in ultimately improving residents'
quality of life.
Physiological
and Functional Benefits of Exercise for the Elderly
Both research studies and the
experiences of the elderly have shown that exercise produces many
significant physiological benefits. Functional decline in the
elderly is often the result of a sedentary lifestyle, rather than
the effects of the normal aging process. According to the Office
of Aging, U.S. Department of Health and Human Services, fitness
programs can be effectively used to achieve the following resident
goals:
- lessen the degree of disability
for seniors
- increase muscular strength and
endurance which deteriorates through inactivity
- improve a resident's joint
flexibility and range of motion by keeping them loose and
flexible
- strengthen bone mass which is
weakened in the later stage by osteoporosis
- improve respiratory ability and
efficiency
- relieve some of the painful
symptoms of arthritis
- improve circulation and reduce
high blood pressure
There are other physical benefits
which have been documented in the research. Exercise has been shown
to reduce the incidence of pressure sores and level of incontinence
in residents. Regular physical activity can also help alleviate some
of the digestive and bowel function problems that are common among
the elderly.
Resistance training has increased
strength in residents' knees and ankles, which can help prevent
falls and reduce facility liability. Exercise helps improve the
autonomic nervous system's ability to tolerate stress. It encourages
healthy appetites in residents, contributing to their nutritional
well-being.
Moderate exercise training has also
been associated with a 20 percent increase in serum immunoglobulins,
which enhances the immune system. This change is very important to
the elderly, since susceptibility to illnesses greatly increases
with age. A recent study by the University of Connecticut has shown
that exercise can also help those individuals who suffer from
sleeping difficulties.
Participating in exercise programs,
residents have been able to more easily complete their activities of
daily living, such as being able to eat a meal or walk to the
washroom. Residents have increased energy, enabling them to become
more active and better enjoy their lives. These benefits illustrate
the necessity of nursing facilities to invest the time and resources
needed to develop a quality health and fitness program.
Psychological Benefits of Exercise
for the Elderly
Exercise programs help nursing home
residents to maintain a sense of autonomy over their aging bodies.
Instead of feeling like victims to the aging process, they can take
control and make progressive steps towards improving their physical
health. This increased sense of independence also helps to foster
their self-esteem.
Cognitive abilities can also be
enhanced through fitness. Improving a resident's circulation
increases the amount of oxygen brought to the brain, enhancing a
resident's mental alertness. As reported in the July 30, 1993
edition of the Brown University Long Term Care Quality Letter,
researchers discovered that non-strenuous physical exercise can help
older nursing home residents to improve their memory retrieval and
visual-motor performance.
Psychological challenges such as
frustration, loneliness, and hopelessness are important ones to
address through programming interventions. Exercise has been shown
to alleviate these problems by channeling residents' energies into
healthy and productive activity. Participating in a health and
fitness group helps to promote socialization and contributes to a
feeling of togetherness.
One recent study of older adults
found that anxiety was reduced and tension was relieved as a result
of exercise. Those elderly who trained the hardest and had the
greatest improvements in fitness experienced favorable changes in
body image, mood, and attitudes. In increasing the delivery of
oxygen to the brain, exercise has also been effective in combating
resident depression.
The previous text is from nursinghome.org
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