Session outline

1. Physical Activity and Health Training Course June 2003 Interventions and at risk groups -Older PeopleBetty HaralambousNational Ageing Research Institute

2. Session outline • Physical activity and the older person. • Benefits of physical activity for older people. • Level and types of activity in older people. • Interventions for older people.

3. Physical Activity - definition “…up to 60 minutes continuous, 3-5 times weekly, moderate to high intensity…” OR “…daily accumulation of 30 minutes of health promotion activities... requiring moderate exertion…. on most days” (incidental activity) (Active Australia campaign)

4. Physical activity and the older person - why target physical activity • Physical inactivity ranks second (to tobacco smoking) in burden of disease and disability from all causes in Australia (Mathers et al, 1999). • Increasing evidence base that some consequences of inactivity are reversible, even among older people. • Trends indicate that declining physical activity levels in Australia.

5. Physical activity and the older person • Older adults, both male and female, can benefit from regular physical activity. • Need not be strenuous to achieve benefits. • Can obtain significant health benefits with a moderate amount. • Older adults should consult a doctor before beginning a new physical activity program. Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

6. Benefits of physical activity for older people - literature review • Improved: • cardiovascular health • flexibility • strength • balance • general mobility • coordination • social benefits • psychological benefits • sleep pattern • Reduced falls • With consideration of: • specificity of training • co-morbidities • level of care

7. Benefits of physical activity for older people • Helps maintain ability to live independently • Reduces risk of falling and fracturing bones. • Helps maintain social contacts. • Reduces the risk of dying from coronary heart disease and of developing high blood pressure, colon cancer and diabetes. • Can help reduce blood pressure in some people. Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

8. Benefits of physical activity for older people • Helps people with chronic, disabling conditions improve their stamina and and muscle strength. • Reduces symptoms of anxiety and depression and fosters improvements in mood and feelings of wellbeing. • Helps maintain healthy bones, muscles and joints. Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

9. Benefits of physical activity for older people • Helps control joint swelling/pain associated with arthritis (some activities may aggravate arthritis, therefore people with arthritis should consult their doctor / physiotherapist before commencing a new program). • Helps maintain/improve functional abilities. • Can improve bowel motility and reduce problems of constipation. Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

10. Levels and types of activity in older people World Health Organisation Health-Fitness gradient Group I Physically fit, Healthy Group II Physically unfit, Unhealthy independent Group III Physically unfit frail, Unhealthy dependent Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

11. Interventions for older people Well for life Improving nutrition and physical activity for residents of aged care facilities March 2003 • Collaborative project/intervention between Dieticians Association of Australia (Victorian Branch) & NARI. • Funded by the Victorian Department of Human Services.

12. Interventions for older people - Well for life • Aim: to promote resident health through providing opportunities for physical activity and improving meal provision. • Currently being rolled out in one regional and one metropolitan region. • Project reviewed organisational culture • provided support resources for facilitating organisational change • critical for optimising outcomes for residents.

13. Interventions for older people - Well for life • Process: • Action research undertaken to identify and address issues that residential care staff raised in relation to nutrition and physical activity options for older people. • Resources were developed and trialed in 13 facilities. • Resources included: good practice checklists, help sheets.

14. Interventions for older people - Well for life • Good practice checklist: snapshot • Choice and variety in physical activity • Incidental activity is maximised • Environment of our facility promotes physical activity • Offer a range of outdoor activities • Physical activity discussed as part of care plan • All residents participate in physical activity daily • Residents are involved in developing activity program Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

15. Interventions for older people - Well for life • Help sheet no. 16 What constitute physical activity: snapshot • Chair bound older people: • gardening, lawn bowls • Frail older people: • walking to dining room for meals • formal exercise classes • showering and dressing as independently as possible • Intermediate health problems: • supervised hydrotherapy • group outings Source: Physical activitiy in aged care facilities - Dr Keith Hill, NARI, and the Well for Life Project Working Group

16. Interventions for older people - Well for life • Outcomes: • Promoting exercise improved function and reduced staff time in the long term - i.e. walking residents to meals rather than wheeling. • Incidental activity is maximised - i.e. independence at mealtimes encouraged through adjusting chairs and tables, minimal cutlery.

17. Interventions for older people - Other initiatives • Participation in physical activity research • Falls Prevention • Emergency Department Falls Prevention • Recent tai chi project • Vestibular rehabilitation • Pedometry and diabetes - use of pedometer in facilitating physical activity in older people with diabetes.

18. Further information www.nari.unimelb.edu.au