Corporate Fitness and Active Aging

Boost Your Workout with Motivating Music

NIFS | Group Fitness GroovePop in those earbuds and get moving. Exercise and music go hand-in-hand for many gym-goers. Listening to music is a great way to make your work out more enjoyable. There’s nothing like cranking up an upbeat, energetic, song that adds a little pep to your step. An excellent motivator, music helps you to keep up with the pace of your workout, and inspiring lyrics keep you moving. Those specific beats and lyrics can encourage you work harder and push you to complete your workout. Keeping up with the beat provided by music can prevent you from slacking and help you power through to reach your goals. 


Music can also be a good kind of distraction. It can help distract you from the so called “pain” or “burn” of the workout. The music can help to take your mind off the exercise that is being performed and might even challenge you to complete just “one more” repetition or finish that last mile! Those catchy tunes can make working out more bearable rather than it being quiet and listening to yourself breathe. Listening to music allows you focus more on your workout and definitely makes it a little more fun!

Have you ever had a song come on and instantly you feel your mood improve? Music can elevate your mood and get you excited about working out too. It can give you that extra boost to make you more energetic and it might even get you “in the zone.”  Music can drown out external distractions so you can concentrate on the exercise.  It also might push you to keep moving until the end of the song. Music can put you in a positive mindset providing motivation and making your workout more enjoyable.

Select songs with that perfect beat. Put together a playlist that will keep your muscles pumping and your body moving or check out some of the latest music apps specifically made to jazz up your workout. Or, skip the playlist and check out this list of 5 music apps that you can install for some motivating tunes. Just like your workout, remember to periodically change your playlist. This can make your workout be more challenging and less predictable. The more enjoyable your music is the easier your workout might just be. So, crank up that music (just not too loud) and start moving to the beat of your favorite tunes!

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Topics: workout music music motivation workout motivation playlist fitness goals

How One Resident Walked 100 Miles in One Month


NIFS | Senior Resident

An interview with Ida Lee of Wyndemere Senior Living, Wheaton, Illinois.

In June of 2018, residents at Wyndemere Senior Living in Wheaton, Illinois were challenged to participate in a fitness program called, Exercise Across America. For every mile exercised, residents received 100 miles on distance on a map, towards their favorite location. By month’s end, one resident had blown past the others by walking 109 miles (10,900 map-miles towards her Los Angeles, California destination). Ida Lee walked nearly four miles a day to achieve this goal and according to Ida, June was a “bad” month as she had additional commitments that took away from her exercise time. The closest runner-up accumulated 78 miles. 

Ida Lee, age 79, has always preferred walking for exercise. She began walking longer distances in January 2018, after realizing she had extra time in her day. She also discovered that the Health app in her iPhone would track both her steps and walking distance. Recalling an exercise program that her sister did a few years ago, Ida decided in February 2018, to make walking 10,000 steps her daily goal. 

What are the three biggest benefits you’ve seen since you started walking?

Answer:  It gives me a sense of accomplishment. Walking 10,000 steps takes at least one hour and 40 minutes so it keeps me busy. It also helps stabilize my weight because I have a healthy appetite.

Do you have any tricks or secrets that help you get you going on those rough days?

Answer:  If I am really busy I don’t worry if I don’t meet the goal.  On hot days, I walk early in the morning and late in the evening.  Also, keep your phone in your pocket or in a small purse with a shoulder strap.

What do you do in rainy weather or during the winter?

Answer:  In winter, if the sidewalks are too icy, I walk the halls in our large building. Outside, I wear layers of warm clothes in winter and a raincoat on rainy days. I usually have my two Cocker Spaniels as walking companions so an umbrella is too much bother.

What tips can you recommend to others to get the most out of a walking program?

Answer: Don’t try to walk 10,000 steps all at once. Take several short walks of 30 minutes or less.  I average 100 steps per minute.

What are the biggest challenges you have with trying to get a walk in every day?

Answer:  In January 2018, I began to suffer from episodes of vertigo that lasted from 20 minutes to several hours. Most of the time, I have been able to reach my walking goal on these days.  Days when I’ve scheduled too many sit down meetings are a challenge, also.  Weekends without plans often lead to a “couch potato” problem.

What keeps you motivated to keep on going? Why do you continue to do it?

Answer: I feel so good at the end of the day if I’ve reached my goal. When I add up my total miles for a month and I’ve reached or exceeded 100 miles, I really feel I’ve accomplished something.

Ida plans to continue walking 100 miles per month as long as her body allows. “I think my two artificial knees will last a long time, especially if I keep my weight under control” says Ida.  She hopes to walk a 5K in Waukesha, Wisconsin next year.  “The last time I tried it, I injured my hip because I hadn’t trained before the walk.” Even if Ida forgoes the 5K, she will still be keeping busy.  In addition to walking, each week she attends two chair yoga classes, two balance classes, and occasional aquatic exercise classes.  Wyndemere may have to rename that fitness program Exercise Around the World just to keep up with Ida.

Interested in offering wellness for your residents?  Click below to find out about our consulting services.

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Topics: senior living walking tips walking starting a walking program motivation active aging fitness routine

Whole Grains as Part of a Balanced Diet

NIFS | Whole Grains Whole grains have been advertised as being part of balanced diet for as long as I can remember. Specifically, bread and cereal companies are careful to emphasize their importance as a quality source for whole grains in their marketing messages. So, why are they so special and why are they essential for a balanced diet? I will get to that in a second, but first, let’s start with what is considered a “whole grain.”

The processing that a grain goes through is what determines whether or not it can be considered whole. When a grain is processed it is stripped of most of its outer shell and other nutrient dense components, leaving just the starchy inner layer that does not have  significant nutritional value other than acting as a carbohydrate.

The anatomy of a whole grain has three important components to it, which include the bran, the endosperm, and the germ. All of these different parts have unique health benefits to them and they all need to be present for the grain to be considered whole. The outer layer of the grain is the called the bran and it is chewy and fibrous. It contains a large amount of fiber and other nutrients such as antioxidants, iron, zinc, and B vitamins. The next part of the grain is the germ, which is the base for growth for each whole grain kernel. Antioxidants, healthy fats, and B vitamins can all be found inside the germ. The last part of the grain is the endosperm. The endosperm is the soft and chewy middle part of the grain that is left over after the germ and bran have been stripped away through the refining process. This only has a small amount of minerals and B vitamins and mainly acts as a source of carbohydrates.

Grains that have all three components (bran, germ, and endosperm) can be considered a whole grain. If it’s missing one or more components, then it is considered a refined grain. An easy example would be brown rice and white rice. Brown rice is a whole grain because it is still covered by the bran and has the germ intact, making it more fibrous and tougher to chew. White rice is a refined grain because it has had the bran and germ removed leaving just endosperm which is soft and easy to chew. 

Now that you know more about whole grains and how they are classified, let’s look at some of the health benefits of grains and why they are an essential part of a balanced diet. One of the major benefits of whole grains is their ability to reduce your chances of developing cardiovascular disease. The fiber in whole grains is essential for preventing cardiovascular disease, because fiber has been shown to lower triglycerides, cholesterol; it can also help regulate insulin levels. All of these different effects help to lower the chance of developing cardiovascular disease.

Whole grains can also be protective against type 2 diabetes; because whole grains are low on the Glycemic Index they do not cause your body to release a surge of insulin when eaten, rather they cause a steady release of insulin. The nutrients and fiber in the whole grains also help with insulin sensitivity which greatly help to reduce blood sugar spikes. 

Health Bonus: Whole grains can also help with digestive health. All of the fiber and other nutrients in grains can help with healthy bowel movements and reduce the chances of constipation.

With all of these health benefits and disease fighting properties, whole grains should become a staple in your diet. Start to reduce your intake of refined grains and start looking for grains that labeled as being whole, such as: whole wheat bread, brown rice, and quinoa. Your body will thank you!

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Topics: nutrition diet and nutrition whole grains balanced diet

Senior Living: Putting the Fun Back in Your Fitness Program

When planning exercise and physical activity programs for our active older adults, it’s sometimes easy to get lost in the nuts and bolts of programming, and as a result, we can forget to ask one important question about our programs.  “Are the residents having fun?”  We know how important fun and play is for all ages, but it’s especially crucial for senior living residents that commonly struggle with anxiety, loneliness, and depression.

Finding ways to create a fun environment is especially important when developing exercise programs because for most people exercising isn’t inherently a “fun” endeavor. This is even more the case for the average active aging resident who might have limited exposure to exercise, and when they think of exercise all they picture is what they see on reality TV shows. So, how can we can make our programming more enjoyable for all residents?

Playing sports

We don’t always think about sports when it comes to senior living, but sports play is a great way to add fun into your current programming, and to provide your residents a chance to relieve past glories, or have an experience they’d never expected to have. The best part is that every sport can be modified to fit your residents and their abilities. This past spring we introduced Chair Volleyball to the residents at North Oaks, and it was an instant hit. They had so much fun, that they played for almost an hour and didn’t realize it. Most encouraging was that the majority of the group had never played volleyball in their lives, and now had a brand new experience they could return to for social interaction and movement. 

NIFS | seniors seated fitness

Adding a social aspect to group fitness classes

This is the simplest, cheapest, and easiest thing you can do today. Instead of just walking through the door, teaching, and leaving; strive to make your classes more interactive. This could be as simple as having participants count repetitions when lifting weights with you. Earlier in my career I started classes off by telling a silly joke, and it became a hit. From that point on, I allowed participants to provide the jokes every day. It was simple, a lot of fun, a great opportunity for important social interaction, and was something to look forward to before each class. 

[Read More: How One Community Got Focused on Brain Fitness]

Striking up random silliness

Here is where you have a tremendous opportunity to be creative and take advantage of the personalities of each residents.  It can be as simple as playing music with different themes in the fitness center, in a group classes, or having a day where the participants wear funny hats and dress in the same color. The potential ideas are limitless and can really help create an environment where the residents are active members of your programs and not just passive participants. 

 Obviously, what every person considers to be fun will be different, but that provides an incredible opportunity to try new things and think outside of the box. Finding ways to increase the “fun level” of your programming can sometimes be a challenge, but there are plenty of easy, lost cost ways to increase the value of programs for residents.  What are some ideas that you have tried in your facility to make your programs more fun? If you’re thinking about this for the first time,  it’s time to have some fun and get creative!

How we improved an already successful fitness program

Topics: senior fitness active aging adding fun to senior fitness improving senior fitness

Setting the Groundwork for Successfully Completing a Challenging Fitness Event

NIFS | Prepare today for success

Many thoughts come to mind when setting the groundwork for successfully participating in a sporting event, race or activity. Whether you are a recreational sports enthusiast or competing at a high level, everyone desires a successful event, and “success” means something different for each participant. When speaking to a recreational sports enthusiast, most will tell you that they are looking to maintain good health, have fun, and complete the event. On the other hand, the competitive athlete will define success only when they outperform others or themselves. Let’s take a look at some considerations for setting the groundwork for competing in a successful event.

[Read More: Preparing for your First Obstacle Race]

Planning – Planning your training weeks in advance before an event will pay off on the day of the event. It reduces stress and provides confidence that you prepared physically and mentally to complete the task. In addition to mapping out your training calendar, outline your goals for the event early in your training. Then, trust that the training sessions have prepared you to be successful in meeting your goals.

Organization – During the weeks prior to the event, it is important to do your homework. Create a check list with items needed for the event. Purchasing appropriate clothing and equipment early will give you time to test and exchange items if needed. Packing all the necessary items for the event a few days in advance will help eliminate stress on the day of the event.

Check the weather – If the event is outdoors, always keep in mind weather conditions for the day of the event. Pack additional clothing in advance or equipment options for unexpected weather changes.    

Visualize – It is helpful to visualize your plan of action during the event. What strategies are you going to use to meet your goals? When will it be the best time to push harder on the course or ease up? Focus on each aspect of the event. It is better to break it up in small parts as you transition from one mile to the next. Visualization prepares you mentally providing you with positive thoughts and images for a successful outcome.

Do not try anything new – It's not a good idea to try anything new on the day of the event. For example, don’t try new foods/drinks en route and don’t use new gear that hasn’t been road-tested. Stick to your plan. Your training sessions have prepared you for this day. Trying out new strategies does not prepare you for the risk of new unexpected challenges that can occur.

Expect the unexpected – It’s common for an event to stray from your plan; be adaptable and expect some variation of what you’ve outlined. A change in the course, unforeseen weather, or equipment breakdowns can occur causing disruptions in mental focus and attitude. Implement your plan B and stay the course! Do not let the unexpected defeat you.

Keep a good pace – Have a strategy in place based on your performance skills. Are you starting the event fast or slow? Are you going to remain at a steady pace throughout the course? Consider how weather conditions may affect your speed and performance. How will extreme hot or cold conditions or gusty winds effect your pace? Do you need to adjust your goals midway through the course? Consider all of these questions and more before race day.

Nutrition – It is not a good idea to try new foods on the day of the event. Many athletes are nervous on the day of the event and trying new foods can upset the stomach causing discomfort. Timing of nutrition during an event is especially important to consider for longer distances. Plan what types of food or drink you will pack for the event and when would be the best time on the course to ingest them, or will you rely on water or food stations provided on the course?

Following through with these considerations will set the groundwork for a successful event. Meeting your goals is satisfying and provides confidence for the next one!

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Topics: race tips sporting events fitness challenge training for a race training for a fitness event

What is Primal Living?

Primal living is about refocusing your way of life to be more in touch with the essential, natural aspects of life. Living a primal lifestyle means you focus on your well-being from a natural standpoint. There are multiple aspects of life that can be shifted to follow a more primal path.

NIFS | Raw Foods

DIET - A diet that follows a primal lifestyle is one that revolves around anything that occurs naturally, such as multiple types of meat, with those meats coming from animals that are raised in natural environments (i.e., grass fed, hormone-free). To go along with those meats, follow a mix of naturally grown sources, such as vegetables, fruits, nuts, and seeds can be dietary staples. As you add in these categories of food, try to reduce sources that are not natural to the human species, such as alcohol, dairy, sugar, and processed foods (i.e., boxed cereals, candy, chips/crackers). While it is important to eat the proper foods, it is also important to stay adequately hydrated. Aim to hydrate to the point where you do not feel thirsty at all throughout the day. Water should be the primary source of hydration.

EXERCISE - The human body is designed to handle physically straining activities. It will react to these stressors, and adapt accordingly. It is natural as a human being to push the body, so it’s important to make sure that you take time to exercise in various ways such as lifting weights, walking or jogging, swimming, cycling, and stretching. These dimensions of fitness will help you become physically well-rounded. Are you not into a regimented workout program? No worries! You can count any kind of playful activity as fitting for this lifestyle. That can be throwing the football around, riding a bike around town, or even a relaxing kayak on the lake.

SLEEP - With the added exercise, the body must sleep in order to recover. Aim for seven to eight hours of  sleep a night in order to restore the mind and body properly. Not all sleep is quality sleep, so make sure that when you do sleep, you limit distractions such as phones or televisions, and allow the body to fully immerse in sleep.

Try applying these three tips on your journey towards primal living. Start with one area and once that has been implemented, you can move on to the next for a well-rounded and healthy lifestyle.

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Topics: healthy eating sleep primal living exercise

New Ideas for Your Corporate Health Fair

NIFS | Health FairHealth Fairs have become a standard offering as part of corporate wellness programs and it’s common for our staff to coordinate these events. Because traditional health fairs have been around for so long, we place a lot of emphasis on being innovative when organizing experiences. Without a creative approach, you get the same old, boring fair with the same vendors, the same pamphlets, and the same cheap pedometers/stress balls/water bottles. Still, when you’re coordinating your seventh health fair, it’s tough to come up with something new. Ultimately, health Fairs are about education so here are a few ideas on how you can give your event a breath of fresh air.

Go Wild

It’s a known fact that people love their animals! So much so that many consider them part of the family. Studies show that pets can offer a sense of enjoyment, love and add companionship to a person’s life. You can see how pets go hand in hand (or paw) with health. Try working with your local pet adoption agencies to see if they are willing to bring a variety of pets for adoption. Employees will get to see/pet/love them in person and discuss the considerations of adoption. It may turn out to be a hot spot for your health fair, so plan head with ample space to draw a crowd and a bunch of smiles.

Get Your Hands Dirty

Sustainable farming is becoming an important part of our future and along with this, so is urban farming. Small gardens, bee hives and chicken coops are popping up all across the country in people’s backyards. Community gardens are also making a name for themselves so if you don’t have the space or you don't want the daily commitment, you can volunteer at a farm co-op. There’s so much to learn about sustainable living while enjoying time outside in the fresh air, getting your hands dirty. Research what urban garden contacts you have in your community to come offer information on this topic.

Socialize

We know people are less social because of all the technology available drawing us away from community. There are some perks to the tech of course, but there is also a pretty big down side. People are losing touch, staying to themselves more, and not getting the health benefits of human contact. Ask some of your local social networking companies to attend your health fair. These groups host numerous get together's for people who may like to hike, attend events as a group, get coffee on the weekends, have discussions at book clubs, and even travel the world. Meetup is a website where you can find a variety of events in your area to join. This site gives you group options like food, music, dance, hobbies, family, photography and much more. There's something for everyone! Don’t under estimate how vital socializing can be for good health.

Hit The Road

Alternative transportation is a thriving business so why not put some options in front of your employees? In Denver, the buses and light rail welcome people’s bikes aboard as they head for their destination. We also have an automated bike sharing system where you can check out one of Denver B-cycles where they offer 700 bikes, at 82 of their bikes stations throughout the city. Just return your bike to the B-cycle station or the one closest to your destination when finished. I’m sure your city has some type of alternative transportation system, so do some research and see what you can offer about this topic at your next health fair.  

The most important take away is to keep your health fairs exciting and offer the most up-to-date information with a touch of something new and exciting. Don’t get pegged in to a corner on what type of vendors you can offer either, there’s a whole world of possibilities. Click below to access more creative program ideas from our staff.

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Topics: health fair fitness program corporate wellness programs corporate fitness programming

Senior Living: How to create a win when your programs and events flounder

Programs and events don't always turn out like we plan. Sometimes we misjudge interest, and sometimes we misjudge the timing or venue. In other cases, the program is well done, but we don't meet our goals because we didn't set the right target to begin with. We're managing close to 30 client fitness programs in senior living communities, so we're bound to miss the mark on a program here and there. What's important to me is that we learn from our missteps so that the next time we offer an initiative, it's a more complete program.

If you're looking for ways to continuously improve what you're offering to residents, check out our insights on a few programs below. For more on our process of goal setting and evaluating the programs we run, check out this blog.

Membership Drive Month

Membership Drive Flier

The Program and Goals:

Last April, Tim hosted a membership campaign to attract residents who were not members of the fitness center to join. Goals for the initiative were simple, as was the overall structure of the program. 

  • Gain five new members during April
  • Inspire each new member to attend at least one group fitness class during April

The fitness program at this client community is well-established with about 67% of the eligible residents already members of the fitness center. They regularly gain about five to six new members each month, so the focus of this program was a targeted outreach to long-standing residents who had not yet joined the fitness center. Tim believed that if he could get them in the door for orientation by lowering the barriers to joining AND inspire them to attend at least one group fitness class during the month they joined, those new members might be more active/engaged in the long run.

Tim set up "open orientations" for the month to create easier opportunities for non-members to attend. Despite issuing personal membership packet invitations to each of these residents, no one attended those orientation sessions, nor were any of the membership packets returned. While they did pick up five new members in the month, they all came from a pool of newer residents who had moved to the community recently. And of those five who joined, only one attended a class during April.

What we learned:

Sending invitations by community mail to non-members didn't generate a response, so future membership programs need to enlist a different outreach approach at this community. It is worth noting that we had a strong positive response to this very approach at a different client community. So if you operate multiple venues, you may need to adjust your approach per location.

2018 Winter Olympics

The Program and Goals: 

To capitalize on the winter games, Alyssa ran her own version of the Olympics for the residents in her Minnesota community. Her goals were tied directly back to fitness center membership and participation:

  • Increase the number of total visit to 1,500 in February 2018 (the previous year, February visits had reached 1,125)
  • Increase by 10% the number of members who reach the 5+ or 8+ visit per month categories
  • Gain three new members during February 2018

Alyssa was able to achieve the total visits goal (1,705 visits in February 2018) and the membership goal (5 new members gained in February 2018). But she didn't reach the goal focused on frequent visitors (5+ or 8+ visits per month).

What we learned:

While Alyssa was quite successful at using her Olympics program to get a lot of people to use the fitness center, many of the elements of the program did not promote repeat visits. Additionally, many of the events occurred outside of the fitness center. (Click here to read Alyssa's reflection on teaching the residents new skills during her Olympics program.)

She received positive survey feedback from participants.

  • 95% rated the program as excellent
  • 75% noted the program was extremely well organized
  • 85% said the program exceeded their expectations

In reality, the program itself was strong. But the goal focused on increasing frequent fitness center visits was probably the wrong aim. Future offerings like this that aren't specifically targeted to draw members into the fitness center will be created with different program goals in mind.

Want to find out more about how NIFS can provide this kind of smart, strategic programming to your residents? 

How Outsourcing fitness center management can work for your community

Topics: senior fitness senior fitness management fitness for seniors outsourcing fitness managment senior living fitness center

Staying Active While Traveling

Many people travel during the summer, whether on vacation or for work. One of the most difficult habits to maintain during these trips is exercise. Traveling can really disrupt your daily routine and your sleep schedule, which can make staying active seem like a chore. However, it is important to continue an exercise routine in order to stay healthy. Even a scaled down version of your traditional regimen may help you maintain during time away. Below are some tips for continuing an active lifestyle while you're on the road.

NIFS | Airport travle

Those who travel lightly will be happy to know that there are many exercises which require almost no equipment. The most obvious forms of aerobic exercise include walking and/or running. Walking up and down stairs is another great aerobic option when a staircase is available, near your hotel or even in the hotel itself. Body weight exercises are a great option for continuing a resistance exercise routine while traveling. Examples of these include; push-ups, sit-ups, lunges, and squats. Resistance bands are a great addition to any suitcase, because they allow for greater variety of exercises in a small, light package. Depending on where you stay, you may even find a tree branch that doubles as a pull-up bar on a walk!

Before you begin your travels look to see if the hotel where you’re staying offers an onsite gym so you can get a quick workout in before or at the end of your day. Or, consider if there are there any parks nearby that would offer a scenic walk or jog. If you're flying to your destination, walk through the airport (if time allows) and skip the moving floor. So even if you don’t get in a workout or you don’t have time when you arrive, you can at least feel good about the steps you did get in for the day.

Consistent physical activity is maintainable even when on the road. A big key to success is finding something that you enjoy enough to maintain despite disruptions in your normal routine. Do you hate the idea of a long walk or jog while traveling? Bring a jump-rope for a short cardio exercise that really gets your heart rate up. Don’t like push-ups or squats? Bring some resistance bands with you on your travels so you can perform a chest press, arm curls and a resisted hip extension. Hopefully, some of these ideas resonate with you and let you see that regular exercise is possible even when on the road.

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Topics: staying active while traveling workout bodyweight walking running

Senior Fitness: Don't be afraid to go back to the basics

In every fitness center setting it seems that the goal is to provide the most up-to-date, “trendy” group fitness classes and personal training. And while I agree that trying to offer something new and exciting is very important, I also think that sometimes we need to bring fitness back to the basics.

NIFS | seniors seated stretching

This is very important at a senior living setting. Many of our senior living communities support active living for several hundred people and providing fitness services appropriate for every fitness level can be challenging. It easy to cater to the “most active” group of participants. But we wanted to make sure we were reaching as many different residents as possible, so our fitness center staff challenged ourselves to take it back to the basics by providing a personalized group training that focused on the “bare bones” of exercise. And let me tell you, it has been some of the most rewarding work I’ve done to date! 

While I can’t deny that fitness professionals get a thrill out of providing a tough workout in a high intensity class and hearing “that was hard,” I can honestly say that providing an appropriate workout for those who need to take it back to the basics of fitness is also just as thrilling. Being able to coach a member to stand up from his chair independently when he hasn't been able to in a long time can make your heart swell with pride for his accomplishment. 

Now I’m taking that “back to basics” challenge to you dear reader. If you work in a senior fitness setting, take a look at your membership. Start identifying the needs of your members who struggle with standing, walking, overall balance, basic strength, and most importantly their confidence! One of the criteria we used when we started evaluating who might benefit most from “back to basics” programming was to begin with members who tend to get a little behind in class and do not reap the full the benefits. 

Once you build that member list, start reaching out individually to target specific fitness and functional living needs. Then watch how your overall participation numbers grow and how the increased confidence of some of your more frail residents helps them gain additional strength for every day needs. This experience has surprised me; I didn’t expect that getting back to the basics would be so rewarding and exciting, but it has been an absolute joy. Have a similar story to share? Respond the comments below.

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Topics: active aging senior group fitness classes group fitness for seniors exercise and aging resident fitness fitness for frail seniors