Corporate Fitness and Active Aging

If you’ve ever worked with older adults you likely know about this love/hate relationship everyone has with any program labeled “Fall Prevention”. Residents are certainly interested in learning about how to prevent falls. They have a healthy fear of falling. But often times, they don’t want to move outside of their comfort zone to practice the things that will actually improve balance and fall prevention.

So what better way to face a fear than head on, right?

That’s what NIFS fitness managers did during Fall Prevention Week. With an average of 50 program participants at each site, there was certainly interest in the topic! Here are some tips for the basics of planning a robust Fall Prevention Week:

Get other departments involved

The week may have been okay without any other staff support, but I think you have a better investment from the community and from the residents when other departments get involved. The first department that comes to mind for this topic is Physical Therapy. Many PT departments were happy to work with NIFS staff in bringing presentations, device checks, and even home safety checks to residents. I think it goes without saying that partnering with Food & Beverage is always fun because who doesn’t like to have snacks? Fortunately, many of our communities also have a dietitian on-site and are able to take it one step further with an event centered on balancing nutrition along with balancing the body. The possibilities are really endless.

Have a mix of interactive and educational events

One of the most popular events across the board was the Fall Prevention Presentation with the Getting Up From a Fall Workshop. During this presentation, NIFS staff members discussed ways to avoid falls in the first place, but they also took the time to demonstrate how to safely fall and (where appropriate) how to get back up off the floor. Participants then had the option to work one-on-one with staff and learn how to safely get themselves onto the floor and back up into a chair without falling. Residents appreciated the chance to learn and then to try things themselves.

Follow up with participants

A key element to Fall Prevention Week is tracking who participated so we know who to reach out to afterwards. There’s always a “next step” available so it’s nice to be able to personalize that according to the needs of the specific participant. For some people, it’s a balance evaluation, for others it might be a 1-on-1 exercise prescription, and for others it’s simply going to be a class recommendation. No matter what the recommendation is, just following up with each individual makes the week more personal and gives them more buy-in to continue working on their own fall prevention skills.

As you might know, just the fear of falling can have significant and lasting impact on older adults or family members’ quality of life. In fact, the fear itself is a risk factor for falls. The good news is that falls can be prevented through balance-specific training and education, which is why NIFS has adopted a comprehensive balance-training method that goes far beyond simply offering balance-training group fitness classes.

It's Time for the Annual Balance Challenge

As part of our commitment to improving balance and reducing the risk of falls, we launched the annual Balance Challenge in 2013 and have been expanding on it ever since. Residents across the country will join us this month as we March into Better Balance with the 8th Annual Balance Challenge. This hallmark program has truly become a fan favorite, and NIFS staff at senior living communities across the country will be focusing on educating their members on fall prevention while providing special balance-training classes, programs, and events.

Participants will be encouraged to complete a Fullerton Advanced Balance Assessment as well as a pre and post self-evaluation survey relating to their perceived levels of balance and confidence. During the month of March, participants will have the opportunity to choose from a menu of programming that includes a balance fair, a fall-prevention presentation, a workshop on how to get up from a fall if one were to occur, small group discussions addressing the fears surrounding falls, a home safety check, and multiple modalities of balance training through group fitness classes, circuit courses, balance games, and more.

One strong advantage of hosting the Balance Challenge is that it shines a spotlight on the fall-prevention program offerings readily available all year long in the fitness center. NIFS staff members regularly collaborate with rehab and the healthcare team at the communities we serve to support resident transitions into and out of therapy. Residents appreciate the opportunity to continue building on the gains they made in rehab with the help of NIFS degreed and certified staff in the fitness center. This strong collaboration with rehab and robust service menu of programs is a great service model for supporting resident well-being year round, and the Balance Challenge serves as a reminder of everything that is available.

Results of Last Year’s Balance Challenge

Last year’s Balance Challenge resulted in many valuable accomplishments:

• Perceived balance: Across the communities, participants’ perception of their balance taken from their pre and post self-evaluations demonstrated a 12% increase in confidence.
• Fear of falls: Across the communities, participants’ fear of falling decreased by 18% as reported from their pre and post self-evaluations following the Balance Challenge.
• Total visits: There was an average increase of 11% in total resident participation to the fitness centers in March 2019 compared to March 2018.
• Group fitness visits: Group fitness classes saw an average increase of 17% participation in March 2019 compared to March 2018.
• Appointment volume: Resident engagement increased by 32% in the number of appointments conducted in March 2019 compared to March 2018.

The data tells a story, and clearly the residents increase their participation in fitness program offerings when there is an emphasis on comprehensive fall-prevention programming. They truly turn out to learn, train, and experience these offerings.

NIFS partners with premier senior living providers across the US to bring their residents best-in-class fitness and wellness programming. The NIFS Balance Challenge is a great example of how our qualified fitness professionals have the skills and resources to support resident well-being while increasing education about fall prevention and increasing overall participation in the fitness program. Click here to learn more about resident successes from participating in NIFS fall-prevention programming. Looking to get started with some balance training exercises? Click here for inspiration!

Check out NIFS Premier Fall Prevention Program: Balance Redefined, our comprehensive approach to fall prevention programming.

Training yourself to do something that feels unnatural is never easy, but it’s also never too late to learn an important skill. Balance is a focal point with our Active Aging population and something our residents are concerned with on a daily basis. Whether it be through designing exercise prescriptions to improve an individual’s balance, leading an educational presentation on aspects of balance, or leading a balance group fitness class, there are countless ways that we as professionals can attempt to help improve someone’s balance.

We recognize the importance of balance because the longer someone can maintain this skill, the longer they are able to remain independent. However, with all of this time, energy, and work dedicated to balance, I notice the same issue coming up consistently: residents are constantly looking down at their feet while they move.

The Lesson: Eyes Up!

When I moved to Virginia six years ago, I was finally in a place to fulfill a lifetime goal of mine: to own a motorcycle. I had no experience riding, I didn’t grow up around bikes, but I just was always fascinated by them and determined to learn to ride one. I am a cautious person, so before I did anything else, I participated in a Motorcycle Safety Foundation® Basic Rider course at a nearby community college. I learned many things during that course, but one lesson that has always stuck with me is instead of focusing on the road directly in front of your wheel, you should be looking down the road and keeping your eyes up. When you keep your eyes up and your focus ahead of you, you give yourself a valuable tool: time.

This is a lesson I work hard to get my residents to understand. When we walk, looking down at our feet gives us a sense of security that we know exactly where our foot is going to be and what our foot is going to land on, but it comes at a price. When our gaze is down at our feet, we can’t see what’s coming. We give ourselves very little time to identify a trip hazard in our path or to plan a route to avoid uneven or unstable surfaces. Much like riding a motorcycle, when you keep your eyes lifted, you give yourself more time to determine your best route because your brain has more time to process what you are seeing and plan accordingly.

Prepare for Balance Challenges

When we know that there are consequences to our actions, we often are very careful with those actions because we know what might result if we are careless. This awareness and concern has had the unfortunate effect of teaching us that we should fear falling and avoid it at all costs, so we look down at our feet. But just like riding a motorcycle, keeping your eyes up and looking well out in front of you may help you avoid obstacles, prepare for any balance challenges, and be safe through fall prevention.

Interested in learning more about NIFS effective balance programming?  NIFS premier fall prevention programming can help set your community apart from the rest. 

Falls are a big concern for senior living communities. Given the well-known statistics from the Centers for Disease Control and Prevention, it's easy to see why. The National Council On Aging provides compelling numbers as well. This is why we work so hard with our clients to establish robust, evidence-based, year-round programming that focuses on improving resident's balance and strength, as well as their self-confidence.  

One of the key elements for successful balance programming is drawing in as many residents as possible; we've found that the best way to accomplish this is through varied programming. It's not enough to simply put a balance class on the calendar. Communities have to take it one step further and offer other ways to interact.

NIFS Balance Redefined^TM programming offers everything from fitness testing to classes that teach participants how to safely get up from a fall. We've spent years evolving these services as we responded to resident suggestions and evaluated our program data.  Below are stories from residents whose lives have been positively impacted by the work our staff do.

Ms. Weigle

Despite losing her husband just a few days after they moved into the community, Ms. Weigle made a conscious choice to take that difficult first step out of their apartment to meet new neighbors, and within a few weeks someone invited her to try the Balance Class offered by the NIFS fitness center manager. She has been a faithful participant (and ambassador!) ever since and has expanded her lifestyle to include additional activities such as swimming, walking groups, gardening, and studying Spanish. 

Ms. Weigle takes her regular exercise so seriously that she’s told her family not to call in the morning on Mondays, Wednesdays and Fridays because she will be in the pool. When asked, she’s proud to share that through repeat balance testing with the NIFS manager, she is seeing her scores improve.  At 87 years old, she thinks becoming steadier on her feet has helped her in other areas of her health. In fact, in a recent doctor’s visit, she was praised by her doctor for exceptional blood pressure, and she was pleased to share that ankle pain which had long bothered her was no longer a problem. 

[Read more:  Ms. Weigle's full story]

Mrs. Chapin

When Mrs. Chapin moved to her community about ten years ago, she wasn’t new to exercise. With a COPD diagnosis almost 20 years ago, she started swimming laps, and even though she hated to exercise, she kept at it because she knew it was crucial to helping her stay well with a chronic disease. But when she and her husband moved into their community, she took a break from regular exercise to engage in so many of the other opportunities provided. 

She watched her husband’s health gradually decline, so she nudged him to join her for a Balance class, and they were regulars up until his passing last year. Through that loss, Mrs. Chapin felt the support of the members in her class, and was able to keep attending regularly. The social support in NIFS balance programming has been a significant and  positive as she draws her social network from that group. Mrs. Chapin’s annual senior fitness evaluation confirms she’s on the right track with maintaining her balance, but more important than the numbers is how Mrs. Chapin feels. She told us that at 88 years old, she feels steadier than ever and she’s thrilled to still be sewing quilts and clothes, as well as painting, and serving on several resident committees all of which wouldn’t be possible if she wasn’t in good shape. 

Mr. Sadler

Mr. Sadler never used to exercise.  But when he moved to his community in 2009, his decision to start taking group fitness classes and using the pool proved valuable to overcome health challenges that were just around the corner. After a knee replacement surgery didn’t go as expected, he had to have the surgery reversed and replaced the joint with surgical concrete.  Not only did that “fix” leave him unable to walk, he lost significant healthy muscle tissue as well. Following his release from physical therapy, Mr. Sadler was only mobile by scooter or wheelchair and he stopped attending an annual family beach vacation.

He knew his only hope to return to more independence, and maybe to enjoying that annual family vacation again was to get back to a regular exercise routine. After working closely with the NIFS team at his community, he was able to regain significant strength and balance through careful water training. Eventually, he got back to land-based exercise as well and at 87 years old, he has resumed driving and walks confidently with a walker. In 2015, he joined his family again at the beach for their annual vacation. 

[Read more: Mr. Sadler's full story]

Mrs. Boelter

Mrs. Boelter was physical active as a regular water aerobics participant before she moved into her community in 2013.  She was also an avid walker and all of that has continued with the help of the NIFS staff at her community. As her Parkinson’s disease progresses, she feels the importance of maintaining her activity level even more and shared that through regular personal training with the NIFS manager, she has more energy throughout the day. But most noticeably, she is more able to get moving in the morning compared to her previous routine.

Mrs. Boelter noted that although she’s had a number of falls over the past 20 years since she was diagnosed with Parkinson’s disease, she’s had no major falls since she started working with the NIFS staff on her balance. She tells everyone at the community about the benefits of the classes and personal training; she’s a living testament to being able to maintain her independence with regular balance training offered at her community.

Mrs. Moore

Mrs. Moore has been active in the fitness center and with the NIFS staff at her community since she moved in 2004. More recently however, she participated in the NIFS Balance Challenge at the suggestion of the NIFS manager. Through a series of evaluations, education, and fun games, residents engaged in the Balance Challenge understand how to improve their balance as well as how to avoid and manage falls. 

New information on managing falls proved to be very timely for Mrs. Moore when she sustained a fall outside of the clubhouse. After she got her bearings, she was able to use skills she had learned from the NIFS manager during the Challenge to get up on her own without injury. She shared she’s been able to use what she learned through the program to stay active with gardening and to keep up with her grandkids too. She has also become an ambassador for all services connected with balance training at her community. 

[Read more: Mrs. Moore's full story]

It's really common for communities to have missed opportunities when it comes to providing comprehensive fall prevention programming. We can help you spot and fill those gaps to provide exactly what your residents need to feel steadier and confident on their feet. Click below for more information about a free consulting session with NIFS to jump start balance training at your community.

In my last post about our launch of Balance Redefined, I wrote about the importance of building a group fitness calendar that includes stand-alone balance classes. Now I want to address how your community can move beyond the classes on the calendar to build a wrap-around fall prevention program.

In truth, if you want to cultivate a robust balance program, you'll have to get more people than just your fitness center manager to the table. Here's how we make that happen for our clients:

[Related Content: How NIFS fitness managers spend their time]

• Partnerships: Therapy, home health and nursing staff are invited to observe a balance class to aid in resident referrals for those who could benefit. Many of the therapy teams we partner with will provide patients with a handout of exercises to continue upon discharge from their services with additional instructions to participate in the balance class. Our staff are involved in the discharge plan and participate in a hand off of a resident from their therapy regimen to a preventive program in the fitness center.
• Assessments: Using the Fullerton Advance Balance Test protocols in conjunction with the Senior Fitness Test, we assess how a resident’s vestibular, somatosensory, and/or visual senses impact their balance. Based on the results, we prescribe specific exercises to improve specific areas of weakness. We believe strongly that working with residents to identify the underlying cause of a balance deficiency opens the door to further educating and empowering the individual on a path to improved well-being both emotionally and physically.
• Education: Empowering residents through education and resources on fall prevention is key to improving confidence and helping residents identify the services best suited to their needs. NIFS offers an array of educational programs ranging from fall prevention lectures partnered with the therapy department, to seminars on coaching residents how to fall safely or get up from the ground, as well as signs/symptoms to look for with concussions and the long-term impact one can have on a senior’s stability.
• Balance Fairs: Think Health Fair with a creative twist to showcase everything balance and fall prevention related! This collaborative effort taps into internal and external partners to communicate services and resources for residents. Examples of vendors for the fair include an assistive device tune-up clinic from rehab, a balance assessments from the fitness staff, a "balance your plate" booth from dining services, a local podiatry practice educating on proper footwear, the community pharmacist speaking about medication side effects, internal clinic/health services offering blood pressure screenings, a local chiropractor providing posture checks, and more.

This may be a unique approach for your community, and if you don't have adequate fitness staff in place, it could seem like a heavy lift. If you need to rally your staff around the concept, forward on this blog to start the conversation, or download our quick read on the importance of balance training. With services ranging from fun balance circuits to balance sessions using the Wii Fit or Biodex Balance System to aquatic balance programs, prospects will quickly see how much more your community offers.

Based on the consulting work I've done with communities across the US, this is a comprehensive, prevention-based approach that helps our clients stand out from their competition. If you want to find out more about how to bring NIFS and Balance Redefined to your residents, connect with us.

Study Shows What Causes Senior Falls

A 2014 observational study determined how and why falls occur in the aging population by actually videotaping falls in two long-term-care facilities between 2007 and 2010. The video cameras were placed in the common areas such as the dining rooms, hallways, and lounges. When a fall occurred it was reviewed with a focus on the actual cause of imbalance and the activity at the time of falling. The study captured 227 falls from 130 individuals. The researchers concluded that the most common cause of falls (41 percent) was incorrect weight shifting: basically, how an individual moves or transfers from one position to another.

Specifically, researchers noted that the majority of falls they recorded occurred in a position change from standing to walking. You see, staying balanced is about more than maintaining steady footing when in motion. The results of this study show that how we start moving can be much more crucial to staying in balance.

Weight-Shifting Exercises are Key to Fall Prevention

If the researchers are right, then we need to make sure our senior living fitness programs incorporate weight-shifting exercises for participants. Not only do these activities teach residents about how to understand their center of gravity, but they also help with coordination and provide opportunities for modest strength and endurance gains in the lower body muscles. When taught carefully, implementing weight-shifting exercise into a balance program can provide intentional focus on more precise movement which helps overall motor control.

Ideally, your community's fitness program is run by a qualified fitness professional who can provide a range of fitness services for seniors including customized exercises in group and individual settings for each resident's needs.

Fitness professionals can administer balance-training and weight-shifting exercises through one-on-one personal training sessions, group exercise classes, or with simple recommendations of exercises for a resident to include in her typical morning stretches. Trained staff can also provide field testing to help residents understand how they score on balance and other fitness tests so that they can work toward improvement with their tailored exercise regimen.

In case you don't have qualified staff on board, here are some examples of simple weight-shifting exercises for active older adults that can be taught by anyone in your community:

• Side Sways: While seated in a chair or standing, place the feet slightly wider than hip width apart. Leading with the upper body, lean the body gently to the right while keeping both feet in contact with the floor. Repeat 10 to 15 times in both directions. Watch a demo of the exercise.
• Forward Steps: Standing with the feet together near a chair back or counter top to hold onto, take an exaggerated step forward with the right foot. Then take the necessary amount of steps to recover to a normal standing position. Repeat 8 to 10 times and then perform on the left leg. Watch a demo of the exercise.

For more great content like this, download our whitepaper on balance and subscribe to our blog:

All too often, older adults don’t realize their balance is not what it used to be until after they experience a fall. Unfortunately, falls are dangerous; many of them result in significant injury in the short run. Lasting fear of falling can also negatively impact an individual’s quality of life in the long run. Because falls can be prevented with a proactive approach to balance training, we have embarked on a comprehensive fall-prevention model.

While rehabilitation might be a good starting point for residents with severe balance impairments, our fitness center managers take several steps to play an active role in providing balance training long before residents experience a decline in quality of life. 

Transitions with Therapy

A referral service can work two ways. For example, when a resident graduates from therapy services, NIFS fitness staff ensure they are continuing with their balance exercises in the fitness center. This helps residents remain independent while enjoying the lasting effects of their achievements from working with physical therapy. Similarly, when our staff members identify a resident who could benefit from working with therapy, they refer that resident to therapy services on campus to create a seamless transition of care. Read this blog to find out more about how our staff supports a positive fitness center–therapy relationship.

Individual Services in the Fitness Center

Residents with less-significant balance issues benefit from working with our staff to receive an individual exercise program that addresses their unique balance needs. In addition, our staff provides assessments of the residents’ balance abilities, which can be used to more appropriately prescribe exercises and to demonstrate noted improvements over time.

Group Fitness Classes

Most communities offer a group exercise program, but many schedules still lack classes that are dedicated to balance training. While many class formats incorporate balance training, we believe it is essential to offer dedicated balance classes to meet residents’ needs.

Unique Programming

Sometimes individual services in the fitness center get buried among all the activity opportunities at a community, and the group fitness classes as a recurrent series of events don’t always command a fresh look from your residents. That’s why we believe that specialty programming is a significant element in a comprehensive fall-prevention strategy for your senior living community. NIFS Balance Challenge is a great example of such programming.

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The need for effective balance training opportunities for older adults will continue to rise as the large baby boomer population enters retirement. Current residents and prospective residents will appreciate this comprehensive approach in addressing balance issues through therapy services as well as through robust programming options in the fitness center.

Want to find out more about how we provide our clients with well-rounded fall prevention/balance-training programming?

Click below to download our whitepaper.

March is Balance and Fall Prevention Month for the National Institute for Fitness and Sports (NIFS) Active Aging sites. Although this is an important component of exercise for all age groups year round, NIFS spotlights balance and fall prevention for a month-long program and showcases the various challenges and solutions to balance issues, as well as how to stay ahead of the balance curve.

Our senior living communities provide educational presentations and handouts for residents to help with fall prevention. One such handout is a home safety checklist to ensure that your surroundings are as fall-proof as possible. The Home Safety Checklist can be a great resource to make safe changes around your home by doing things like making sure small rugs and runners are slip resistant, providing good lighting—especially in hallways, passageways between rooms, and other heavy-traffic areas—and keeping exits and passageways clear. These are just a few of the suggestions. What else has worked for you?

How to Prevent Injuries When Falling

The objective of NIFS Balance Challenge is to prevent falls, but let’s say you suddenly find yourself falling. Remembering these tips and safely practicing how to fall can be the difference between a bruise and a broken bone:

• Never try to prevent the fall itself. Instead, stay relaxed to prevent further injury.
• Bend your knees, or crouch, during a fall.
• Turn/twist your body so you can fall onto the outside of your lower leg first. If you cannot twist your body, NEVER try to catch yourself with your hands as it can break your wrists.
• Instead, smack the ground with your hand(s) to lessen the impact of the fall.
• Roll onto your backside to allow the muscles to dissipate energy and lower the impact force.

Fear is often the biggest obstacle when it comes to falling. Having a game plan and practicing the correct falling form can train your body how to safely fall and maximize injury prevention.

[Read More: How one resident's fall inspired a whole community]

What's Next After You Fall

• After a fall, you are probably feeling shaken up and scared. Take a moment to make sure you are alright and that nothing is broken. Wiggle your fingers and toes and then begin to feel other parts of your body as you regain your bearings. If you are feeling okay, remember these helpful tips for safely getting up from a fall:
• Roll over naturally to your side so your stronger arm is facing up.
• Place your inside arm on the ground at chest level and place your outside palm on the ground to lift your upper body.
• With both hands flat on the ground, lift your hips from the ground so that you are on all fours.
• Crawl to the nearest, most steady piece of furniture (such as a chair, couch, or countertop).
• Place both hands on the furniture and use your stronger leg by placing your foot flat on the ground in front of your body. 
• Pull yourself up slowly; sit, if possible.
• Do not let anyone lift you unless they are trained to do so.
• Use your pendant or make noise for help if you cannot get yourself up.

These are just a few of the topics that the professionals at NIFS present at senior living communities across the country. This education folds in well with weekly balance classes and individualized balance exercises that are available year round for seniors. 

Download our whitepaper to see how we have evolved our programming in community fitness centers.  Residents need more than a simple balance class, do more for your residents.  Click below to get started.