Corporate Fitness and Active Aging

As we grow older, we experience changes in cognitive processes, which is a normal part of aging. But in some cases these changes are severe enough to interfere with the performance of activities of daily living (ADLs), signaling the beginning stages of cognitive decline or possibly dementia. In most cases, age-related decline occurs roughly around the age of 50, and it is estimated that by 2025, 7.1 million older adults will succumb to Alzheimer’s disease.

However, there are actions that you can take to promote your cognitive health. Likewise, research has shown that lifestyle choices can help delay or possibly prevent cognitive decline. Yet it must be stated that not all risks for developing dementia can be modified, such as age and genetics. More importantly, if you happen to be a wellness professional or care provider, it will be imperative for you to identify whether the person in question lives independently, needs assistance, or depends on others, as this will affect the individual’s wellness program.

Three Principles for Creating a Wellness Program

To create your senior wellness program, it is essential to have a strong foundation to build upon. Here are three principles to build from:

• Identify possible barriers to your wellness program.
• Develop strategies to implement your program.   
• Consider the application of the strategies.

Case Study: Dan

Now let’s take this one step further and look at a hypothetical case.

Recently Dan has been experiencing a number of difficulties when it comes to his memory/recall. A few days ago, one of his friends noticed that Dan had difficulties following the flow of the conversations and had a tendency to forget what was said. Additionally, his son has been noticing over the past few months that Dan has been misplacing things and forgetting appointments. And on top of that, Dan has become aware of his recent lapses in memory. According to his neurologist, Dan is suffering from what is known as mild cognitive impairment (MCI).

With some background about Dan, we can begin the process of helping him navigate his barriers and begin to implement strategies that will best benefit him. With MCI, it is important to realize that Dan recognizes what is happening but needs help to navigate the MCI. Therefore, the following recommendations have been made for Dan which will require reevaluation every six months by his neurologist.  There is no cure for MCI—but these strategies to navigate challenges will help improve Dan's quality of life.

• Regular exercise: Research has shown that it may delay cognitive decline or slow the rate of decline.
• Social activities: Interacting with others creates a mutual benefit including offsetting potential isolation and depression brought on by individual struggles with MCI.
• Cognitive stimulation: Taking part in creative pursuits that include problem-solving and reasoning help the brain remain active in important ways.

Also, research has shown that factors that aid in overall health may indeed play a significant role in delaying dementia. These strategies include

• Staying physically active
• Losing excess weight
• Performing cognitively stimulating activities
• Being social
• Getting enough sleep
• Eating healthy

Avoiding Falls

One more factor to be aware of is falling, and among older adults it’s the number-one cause of head injuries, which can lead to language, emotion, and thinking impairments. Thankfully, there are actions that you can take to help decrease the chance of falling, including increasing lower-body strength and balance, adjusting medications, and evaluating fall hazards.

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All in all, it’s important to keep a positive attitude and embrace a culture of wellness. Through this perspective and these three principles, you are setting up yourself or those around you for success. More importantly, it will behoove you to continue researching cognitive decline to better equip yourself and those around you. Consider this information as only a summary, a beginning point for further development depending on your needs and goals.

During my morning commute a few months ago, I switched on the radio and caught the tail end of a brief NPR story about doctors not communicating to their patients when they are diagnosed with Alzheimer’s. Because I am surrounded by this disease in the workplace and have experienced it first-hand in my family, I was quick to become empathetic and my heart sank into my stomach. It just seemed so unfair and, well, wrong.

The next day, I decided to dig a little more deeply and find the article in writing. Maybe I missed some important details at the beginning of the story. Maybe the twist was that these patients were being diagnosed but simply forgot after they walked out of the doctor’s office doors, because, after all, they do have memory loss and dementia. Unfortunately, that was not the case.

According to this specific study, an alarmingly low number of patients with Alzheimer’s (only 45%) claimed that they were given this diagnosis by their doctor. When the study looked past the patient’s input, still only 53% of family members or caretakers reported being aware of the diagnosis. The reasoning behind this sits among a variety of excuses, ranging from the doctor having limited time in each appointment to the doctor simply feeling uncomfortable.

Is It Acceptable to Withhold the Diagnosis?

Are these legitimate excuses? Is it ethically acceptable to withhold information that is unknowingly being written down in your medical records just to save one or both parties from feeling uncomfortable? 

Sure, it feels terrible to look someone in the eye and tell them devastating news, but when a person is relying on someone, their doctor in this case, to keep them informed, the doctor needs to take responsibility here. Withholding this information puts the patient at risk of harming himself, as well as those around him. What if those around a person with Alzheimer’s believe these forgetful moments are merely part of a normal aging process? Maybe one day the person with Alzheimer’s cannot recall a street name, which may seem normal, but what if the following week(s) lead to such scenarios:

The person with Alzheimer’s…

• Goes for a walk or bicycle ride without telling anyone and gets lost.
• Accidentally leaves the gas burner on all day while home alone.
• Needs help but forgets how to dial the phone.
• Leaves the water running in the bathtub, does not realize it, and goes to bed.
• Gets in a pool alone and forgets how to use their legs, loses footing, and goes under.

Some of these examples may seem extreme, but they are actually scenarios that either myself or someone I know has personally witnessed. So many dangerous situations can be avoided if family or close friends are aware of the diagnosis. And though there is no cure, doctors are finding medications that can help slow down the disease process, and researchers are finding more and more ways for people with Alzheimer’s to gain a better quality of life through means such as music, aquatics, memory care, and more.

I often see family members or caretakers get frustrated, and even angry, with people who are forgetful. When we are able to have a medical diagnosis, can realize that it is truly a disease and out of the person’s control, and can view the whole picture, we are opening a door to having more compassion and understanding for the situation a person with Alzheimer’s is facing. 

Most senior living communities have a variety of group fitness classes on their calendars focused on balance, muscular strength, flexibility, and cardiovascular health, and the clients we work with are no different. But we’ve landed on a program tied in with our group fitness classes for seniors that has become wildly popular with the residents. It turns out, it’s been a great way to draw more participants into the exercise program, too.

The Popularity of Brain Activities

At one of our client’s communities we have many of the typical activities to stimulate the mind: card games, lectures, forums, resident committees, etc. And at one point we offered a “Memory” workshop series. This was so popular that we added a word of the day and the TriBond® game to our daily information board in the fitness center, along with including puzzles in our newsletter.

Over time, we noticed that more and more people started coming to the fitness center to learn the word of the day, to get the TriBond® puzzle, and to ask questions about the puzzle in the newsletter. It was obvious that our residents were craving ways to challenge their minds, and we were eager to respond in ways that would help them keep their minds strong or increase their abilities.

So we added a brain fitness class to our group fitness schedule, and that class is thriving each week! In the weekly offering, our residents have a wonderful time challenging their minds. They learn new games like Sudoku, and play old games like Memory™. They also engage in history trivia questions and challenges. One of our residents recently named all 44 presidents, in order, off the top of her head!

How to Start Brain Fitness Classes at Your CCRC

We’ve started offering this type of class at our other senior living client sites with similar popularity. Here’s some advice on how you can get it started in your community:

• Hold an event such as a brain fitness fair for your residents to see how fun and important it is to continue to work on the mind.
• During the event, pay attention to what the residents like and don’t like. This will help you build a class structure that works for them.
• Do not always make the class what they like. In order to strengthen the mind we need to challenge it. Typically the things that we do not like are the things that we find challenging.
• Begin putting puzzles in your weekly or monthly newsletters.
• ADVERTISE EVERYWHERE!

Brain Class Structure

For the structure of the class, consider the following ideas:

• Begin with a task that can be done while waiting for everyone to come in and sign in. (Example: Write your name with your non-dominant hand or with both hands at the same time.)
• Have classical music playing in the background. Some studies show this increases the brainwaves that stimulate thought process.
• Come prepared with four to five activities. Make it a variety of word games, long-term memory/short term memory, and deductive reasoning. Here are some sites that might provide some ideas: MazestoPrint.com, Activityconnection.com, BrainBashers.com, and ThinkablePuzzles.com.
• Leave time for discussion in small groups and then time with you for answers.
• Have the answers for all activities to share with the participants. (The residents will be angry if you don’t!)
• If you do not finish all activities, consider giving “homework.”

Learn more about physical exercises that help improve cognition here.

Let us know how your brain fitness program works in your setting! We’d love to keep sharing these kinds of ideas to improve the health of the residents we work with.