Corporate Fitness and Active Aging

Now that the less obvious tips have been addressed in part 1 of this series, let’s dive into some physical approaches that you can guide your parents through. There are so many exercises that can be practiced in the comfort of their own home to improve stabilization, gain independence, and build confidence. Our last, but certainly not least, tip:

Get your parents active! Talk with your parents about what they are currently doing to stay active, whether it’s a lifestyle activity, like gardening, or an intentional exercise such as strength training. It is important for your parents to stay active through all areas of wellness, but for now, let’s focus on the physical to keep your parents from falling. Here are some exercises that you can coach your parents through to help with fall prevention:

• One-Leg Stance: Stand  on one leg at a time for 20 seconds and then gradually increase the time as it becomes more comfortable. Start by holding on, and then try to balance with  your eyes closed or without holding on.
• Tandem Stance (Heel to Toe): Stand on your toes for a count of 5, and then rock back on your heels for a count of 5. When comfortable, progress to a count of 10. Repeat 5 to 10 times.
• Hip Circles: Stand with your feet shoulder-width apart and hands on your hips. Make a big circle to the left with your hips, and then to the right. Repeat 10 times.
• Abdominal Squeezes: Sit forward on a chair and sit up straight with shoulders back. Tighten your stomach for a count of 2 and relax. Repeat this 30 times, rest for 1 minute, and repeat 2 times.
• Sit-to-Stand: Start by sitting in a hard, upright chair (like a breakfast or dining room chair) with your feet hip-width apart, ankles right below your knees, and toes pointing straight forward. Reach your hands out in front of you or place your arms across your chest and stand up. Then return to a sitting position. Make sure that you sit slowly and do not “plop down” in the chair. If needed, you can use the arms of the chair but focus on using your lower-body strength to stand upright. Repeat 2 sets of 10 repetitions. 
• Tandem Walk: First, find a place where you can take forward steps with something next to you that can give touch support, like a countertop or the back of a couch. Start with your feet together with your side to the support surface. Standing tall, take forward heel-to-toe steps as if you were walking on a balance beam. Take 10 steps or walk until the end of your support surface, whichever comes first. Once you feel more comfortable with this, challenge yourself by walking heel-to-toe backward! Repeat 2 times.
• Balance Stance with Eyes Closed: Stand with your feet together and arms across the chest. Keeping a tall posture, close your eyes and hold this position for about 20 seconds. As this gets easier, progress by increasing the amount of time by 5-second intervals.

If these exercises are too much at once, just pick a few to get your parents started. Once they are comfortable with that, begin introducing more at an appropriate pace. If they need to rely on holding onto a handle or surface to try these exercises, especially in the beginning, that is perfectly fine. Their safety comes first, but remember: falls can be prevented! What are you doing to help prevent your loved ones from falling?

Have you noticed your parents sitting more and more? Throughout the aging process we tend to become less physically active, therefore decreasing our overall strength. This can lead to many health issues, including loss of balance and eventually falls. Falls in seniors are the number-one cause of fatal and nonfatal injuries. As we all know, the older we get, the harder it can be to recover from any type of injury, so let’s help mom and dad prevent what could potentially alter, or even take, their lives.

Prevention is the keyword. Take a look at these tips to see whether you can do anything for your parents before an accident occurs and you find yourself saying, “This could have been prevented.”

• Speak with your parents about their overall health. Discuss medications and their side effects, as well as health conditions that could cause falls, such as eye or ear disorders. Some medications alone can cause dizziness, while others may have negative interactions when combined, and visual and vestibular impairments and disorders can be large culprits when it comes to falls. It is also important to keep open communication about previous or current falls. This can be embarrassing for the parent, so it is important that they understand that it is not a burden to you, nor should it be an embarrassment to them. Do not take any fall lightly, because not all injuries are obvious or can even be seen without medical testing.

• Make an appointment or two. Encourage your parents to make an appointment with their doctor to discuss their overall health and risk of falls. If possible, ask to sit in on the appointment to help yourself better understand what you can do to motivate your parents to work on fall prevention.

• Help your parents with a home safety checklist. This is as simple as checking your parents’ home for possible hazards that could cause a fall. For example, ditch the throw rug, remove electrical or phone cords from walkways, or add night lights in their bedroom, bathroom, and hallways. Refer to this CDC link for a comprehensive checklist.

• Discuss possible upgrades to existing amenities in their home. Oftentimes, the bathroom can be an easy place to take a tumble, so find out how you can help prevent these types of falls. Speak with your parents about raised toilets, grab bars, and shower or tub seats. Refer here for a more complete list of safety care product suggestions for the bathroom.

• Chat about whether their home is the best place for them. Is downsizing realistically a safer and more convenient environment? This can be a very hard and sensitive topic to discuss but could prevent issues down the road. Consider alternatives, such as smaller homes, condominiums, retirement communities, assisted living communities, etc. Making the decision may be difficult, but it is critical, and the change becomes much easier once they have adjusted. Check out this blog to read about the “Someday Syndrome” that keeps some seniors from making the move.

Stay tuned for part 2 of this series, where I give another important tip that can singlehandedly make a significant change in fall risks.  Check out our Balance Training Whitepaper for the importance of balance training for seniors.

Regular physical activity is essential for healthy aging!  There are two main questions that I am constantly being ask: how much exercise should I do? and how do I find the time to exercise?

The first question is easy to answer.  There are specific guidelines that seek to help older adults select types and amounts of exercises appropriate for their abilities. The key word is ability, please know your limitations and make sure you have your doctor’s consent.

Key Guidelines for Older Adults (65 years or older):

• Avoid inactivity. Some is better than none!
• Do at least 150 minutes (2hours and 30minutes) per week of moderate-intensity Aerobic Activity! These include walking, biking, rowing, nu-step, water aerobics, and even dancing. These could be performed in episodes of 10-15 minutes throughout the week.
• Do at least 2 days of muscle-strengthening activities. These include weight machines, hand-held weights, exercise bands, calisthenics, even digging in the garden.
• Do stretching and relaxation exercises as often as possible. Yoga and Tai Chi are excellent choices.
• Do Balance Exercises 3 or more days per week. These include backward walking, sideways walking, heel walking, toe walking, and standing from a sitting position.  Remember use support (wall or chair) until you feel more stable.  Tai chi also may help with balance and preventing falls.

The second question is always the most difficult because the number one excuse for not exercising is “LACK OF TIME”.  Even when one retires it seems that all the coupled activities and events leave little room for that important part of our day “EXERCISE”!  No matter how busy you are, someone even busier than you is finding time to exercise.  Here are some ways to squeeze in that time.

1. Wake up earlier or get to bed later. Sleep is definitely important but you can start your day an extra 30 minutes earlier or end your day an extra 30 minutes later.  You have the advantage of making your own time schedule, and you know whether you’re a morning or evening person.
2. Cut down on media.  Record how many hours of television you watch or how many hours you spend reading or on the computer.  Cut out some of that time and you will find you have an extra 10 to 30 minutes to exercise.  See Number #3!
3. Be an active TV watcher or active listener. Combine exercising with watching your favorite show! They have televisions in Fitness Centers! Books on tape are wonderful in enjoying the time you exercise.
4. Walk around! Getting from one place to another by walking there and back is a great way to incorporate exercise.   Consider your limitations (using a walker, cane, bad knees etc.) but find ways that promote movement.  The stairs, the hallways, standing and talking will burn calories and improve lung function. So take a walk to your retirement community fitness center.
5. Make it part of your routine.  You brush your teeth, you find time to eat, to socialize, to shower and even to catch up on your favorite television shows or good book.  Therefore, make exercise a part of your daily routine, once it becomes a habit it will be something that you don’t even think about you just do it. Before you know it you will be an active member of your senior living fitness program!
6. Mix socializing with exercising.  Find an exercise partner, a group to walk with outside or in the hallways, even attend exercise classes where there are others on a regular schedule.  Motivate someone to join you and have them motivate you.  
7. Schedule an appointment. You wouldn’t want to miss that doctor’s appointment because you may not get another one for over a month.  So why not set a standing appointment with an exercise buddy, a retirement fitness center personal trainer or your dog, and be accountable to exercise on a specific day and time.
8. Set a goal.  Whether it’s losing weight, gaining weight, standing taller, walking longer or even balancing better.  Exercise provides you those results!  Think about what motivates you to want to incorporate exercising and start working to achieve your goals!
9. Find an activity you love.  Not everyone wants to come to the community fitness center and not everyone enjoys attending classes.  Dancing, hiking, walking outside and even playing golf provides exercise.  Therefore, do what you love but make sure it keeps the body moving!
10. Say no.  The big one.  Look at your priorities and responsibilities.  Do you really have to involve yourself in everything on that list?  Can you start to say no to specific things that hinder your ability to find time to exercise? 

Many communities offer balance training to their residents simply as a component of a group fitness class on the activities schedule. I’m here to tell you that is not enough! Residents need an opportunity for group classes solely dedicated to balance training, as well as balance assessments, equipment, and workouts in their community fitness centers.

Comprehensive balance training programming is often an early success when NIFS begins staffing a fitness center at retirement communities. We’ve been able to engage many residents in the fitness program who previously wouldn’t buy into other modes of physical activity, but they are chomping at the bit to participate in balance training opportunities that can decrease their risk of falls and improve their confidence. Doing so is sometimes a “gateway activity” to help residents recognize their abilities. After building that initial confidence, they experiment with a NuStep or a chair aerobics class. We’ve all got to start somewhere!

NIFS’ Balance Challenge Program

To promote existing balance training programs at our CCRCs, NIFS will hold its inaugural Balance Challenge in March. The Balance Challenge program encompasses different elements of our regularly offered balance training programs and services as well as a few new opportunities for residents. Participants will track their activity on a scorecard and will be required to participate in group classes, educational lectures, assessments, fitness center workouts, obstacle courses, and much more to complete the Challenge. The program is designed with activity options for residents of varying ability levels so it can be marketed to someone new to the fitness program looking to get into a routine, or for seasoned participants to further hone their skills.

All participants in the Challenge will complete a Fullerton Advanced Balance Scale test as well as a pre- and post-program survey in which they will rate their current balance skills and confidence levels. In future programs, we hope to see that our participants are maintaining or improving their balance abilities as well as their confidence levels through engaging in not only the month-long Challenge, but also throughout the year in regularly scheduled programs. (Consider the marketing advantages for a community with data of this nature to back up the effectiveness of your balance programs!)

Things to Consider When Starting a CCRC Balance Program

Here are a few key considerations when launching a comprehensive balance program for your residents:

• Who is qualified to lead these types of classes and services for your residents?
• How will you track the impact the program is having on your residents’ functional abilities and how will you utilize that information?
• How can you utilize resident volunteers to act as your balance champions to demonstrate exercises, provide testimonials, etc., on the effectiveness of the program? (Residents seeing their peers demonstrate exercises may help them get over any fears of participating.)
• How can you partner with your community therapy department in balance program offerings?

Whether your community already has a variety of balance training opportunities, or you are looking to launch some new initiatives, consider how a comprehensive program can help spark enthusiasm in your residents!

The number-one challenge that the aging population faces is balance because the number-one concern is falling!

In order to maintain balance, you must balance your day to include balance exercises! A wise person once said, “Practicing balance doesn’t make perfect; practicing balance makes permanent!” Therefore, include specific balance exercise daily, incorporate them into your exercise routine, provide a variety of balance exercises, and do different ones daily to challenge your stability.

Start with the three goals of achieving better balance:

Goal 1: Establish a Routine.

What’s the first thing you do when you get up in the morning? You usually head to the bathroom, take a shower, brush your teeth, and so on. It’s a consistent routine. So is practicing balance! Find the time, whether it 's before or after exercising, after breakfast, or before bed. Schedule in a few balance exercises and make it part of your routine.

Goal 2: Think Before You Start.

Remember, all the exercises in the world will not do any good if you don’t follow these simple safety rules:

• Wear proper shoes. Your ankles and feet need good support. No sandals or fancy shoes!
• Utilize your strong muscles. Strengthen the muscles that support the body (especially the lower legs and ankles). So make sure your exercise routine includes strengthening these areas.
• A mirror is helpful. Look at yourself when you attempt to balance, check your posture, and note what your limitations (such as knee replacements or back issues) permit.
• Stand on good flooring. Do your exercises on stable and level ground. If one side is higher or more unsteady than the other, you will be the same.
• Use stable support. Make sure that there is a stable chair or counter available. As you practice, you will need an occasional support when you feel unsteady. The main goal is to prevent falling.
• Avoid fast movements and position changes. Slow down! Learn to turn and react with deliberate patience. Incorrect weight shifting is the number-one cause of falls. So when you go to move or turn, remember to be as cautious as possible. What’s the real hurry? Let your body catch up with your mind’s intent.

Goal 3: Practice Being Unsteady to Become Steadier.

Sounds silly, doesn’t it? Practicing exercises that force the body to feel unsteady actually helps the body become steadier. That being said, you should also continue to challenge the body. For example, if you’re capable of supporting yourself by raising both arms out and holding them for 10 seconds, next you can incorporate holding on with one hand and lifting one leg out to challenge yourself. Eventually and over time you can regain better balance.

Balance: simple right? I regularly work with a senior population that tells me, “My balance is lost” or “I don’t have balance.” They are under the impression that you either have balance or you don’t.

But your body’s ability to maintain your balance is much more complicated than having it or not. Your body, or your brain, processes multiple sensory and motor inputs to help you stay upright.

The Sensory Systems Involved in Balance

Your brain relies on sensory information from three systems in your body:

• Vestibular (inner ear): This is a system of channels in your inner ear that allows your brain to know your body’s position, relative to gravity, while your head is moving.
• Vision: This system works with your vestibular system to keep objects in focus by relaying to the brain the location of external objects in relation to the body.
• Somatosensory (nerves): This system is used by the brain to know the position of your center of gravity in relation to your base of support.

Your brain uses the information from your sensory systems with your motor system, which works to control the actions of your muscles to detect changes in your body position with respect to your base.

Balance Diminishes with Age

Your balance naturally diminishes as you age because your brain’s ability to receive and integrate sensory information is reduced. This is why it is important to start training your balance before you begin to notice any problems.

If the function of one or more of your sensory systems declines (say you lose your vision or develop a neurological condition that would affect your somatosensory system), your brain will have to rely more heavily on the other properly functioning systems for information.

What Can I Do to Work on My Balance?

Regular exercise (cardiovascular, strength, and flexibility training) is great for areas of your balance. But if you're looking to focus more specifically on balance, the easiest way is by adding or making simple changes to your current exercise program. You can do this by changing your base of support to make it smaller. The smaller or narrower your base is, the more difficult it is to maintain your balance.

Try adding in exercise stances such as these:

• A narrow stance: Stand with your feet together, side by side.
• Semi-tandem stance: Stand with your feet together and then take a big step forward with one foot. Your feet should be hip width apart with a step length between them.
• Tandem stance: Stand with your feet together and then place one foot in front of the other so you are standing heel to toe.

Other ways to manipulate your base of support include using a BOSU stability trainer, standing on a foam pad or wobble board, or using an exercise ball. These will provide an unstable surface for your base of support, making it even harder. You can also add exercises to the balance stances listed above to challenge your sensory inputs by turning your head side to side or looking up and down, closing your eyes, or reaching with one or both arms.

Balance isn’t just one thing; your brain is constantly working to process all kinds of information to keep you on your feet. But just like any other type of exercise, with some practice you can certainly do a lot to improve your balance.