Corporate Fitness and Active Aging

Senior Living: 5 Heart-Pumping Moves for Small Spaces

While some might feel restricted in their fitness options right now, many are becoming enlightened to a whole new means of exercising from the comfort and safety of their home. After all, necessity is the mother of invention and we are all learning to adapt. In addition, many are recognizing what a key role daily physical activity plays in their emotional and physical well-being. As stated here by the World Health Organization (WHO), “Now is a critical time to ensure we are moving more and sitting less to stay healthy.” All the reason why the Center for Disease Control (CDC) has listed exercise here as one of the key steps people can take to manage stress and cope with our current reality.

When you think of aerobic exercise in particular, what exercises come to mind? Walking, running, swimming are great ways for active older adults to increase their heartrate and get all the benefits of cardiovascular activity. But what if you can’t go outdoors, to the gym or access a pool? What can you do in limited space? It’s amazing how resourceful you can become for a highly effective workout when you put your mind to it. We are here to provide you with a 5-move aerobic workout that requires 100 square feet or less! As always, modify as needed for your personal comfort and always consult with your physician before beginning any exercise program.

Click image below for 5 heart pumping moves for your small space!

5 heart pumping moves

 

Topics: senior living senior fitness at home workout

Move More: Take a Break from Sitting

GettyImages-475200500Staying home is something we are all doing more of lately due to the COVID-19 epidemic. Spending more time at home has some benefits like increased family time, less driving, and especially lowering the risk of contracting COVID-19. Unfortunately, there are also hefty drawbacks to being homebound. As we spend more time inside, we are also sitting for longer and longer periods of time. Watching movies, reading books, or napping are all fun and enjoyable seated activities. Unfortunately, doing too much of these things can have disastrous results on our health. Taking breaks from sitting every 30 – 60 minutes will improve your safer-at-home experience by reducing risk of deadly blood clots, maintaining muscle and bone health, and using up energy that would otherwise be stored as fat.

  • First, sitting for extended periods of time negatively affects your body’s ability to circulate blood. When you spend too much time sitting, blood pools in the legs which can cause blood clots to form. This is known as a deep vein thrombosis (DVT). Some DVT’s are small enough to not cause any harm, but it is possible for the clot to dislodge and travel to the lungs. This can lead to a deadly pulmonary embolism. Older adults are at a higher risk for blood clots like this, especially in combination with a medical history of cancer, obesity, or recent lower body surgery. To combat the risk of DVT’s and pulmonary embolisms, take frequent breaks from sitting.
  • Second, being immobile causes your muscles to shrink. The saying “use it or lose it” is true in this case. When you regularly stay seated for too long, your body adapts. The body’s ability to adapt is a marvelous thing, but it can unfortunately lead to some very negative side effects in this case. Muscles are responsible for movement. If we don’t move or exercise, there is no reason for our bodies to hold on to muscle tissue. All of this applies to bone tissue as well. If your bones do not frequently bear your weight, they will lose density and strength. This can lead to a condition called osteoporosis. Fortunately, there is a simple remedy. Get up, move around, and use your bones and muscles!
  • Finally, you should take breaks from sitting because it will help you maintain a healthy weight and body composition. When we are resting in a seated or reclined position, our bodies are not using very much energy. Long periods of inactivity lead to excess storage of energy, which in this case will be body fat. If your body holds on to too much stored fat, this can increase your risk of diseases like hypertension, type II diabetes, and cancer. To properly manage the amount of fat your body stores, it’s incredibly important to use up the energy that you consume (calories). The human body naturally uses energy from food to maintain its complex systems, but physical activity is the best way to burn more calories. To fight off excess body fat and the risk of disease that comes with it, manage your energy intake and output!

Optimal circulation, lean mass maintenance, and a healthy bodyweight are all goals that we should aim for during the COVID-19 epidemic and beyond. As we reduce our risk of contracting the virus, we should also aim to reduce our risk of serious inactivity related diseases. One extremely effective way to do this is taking breaks from sitting. At least once per hour, stand up and walk around for at least 5 minutes. Use your muscles by completing a few basic exercises like marching, wall push-ups, or chair stands. All of this together will help you stay healthy and strong as you stay at home. If you find yourself sitting down for a long period of time, remember to take a break from sitting every 30 – 60 minutes.

Check out our Quick Read for Basics for Fall Prevention Programming for your residents.

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Topics: senior fitness improving senior fitness movement

Garnering Marketing Gold from Your Community Fitness Program

MMFC-3Our fitness management staff members have some of the best stories around on the impact their fitness programs are having on resident lives in the senior living communities we serve. They hear comments from residents or their family members, they see new faces in classes, and they track the data in programs and services that demonstrate solid engagement. Our staff takes great pride in these affirmations knowing that the work they are so passionately committed to is truly making a difference not just for residents but also for the culture of a community as a whole.

In 2020, NIFS is embarking on a new platform to more effectively bridge the gap from these stories garnered in community fitness centers directly to the marketing and sales teams. We have always partnered with clients on helping them in their marketing and sales messaging, but we are taking this to a new level in 2020 as more clients want to differentiate their communities during prospect tours and via social media in particular. Community fitness centers are becoming more commonplace in the industry. Communities know they need to have the physical space available. However, a truly comprehensive program can be a distinguishing element to showcase through the right storytelling about your resident successes.

How to Capture and Share Your Stories

Here are a few tips to help your community capture and share some of that marketing gold happening in your fitness center!

  1. It starts with the data. Having a strong foundation in your fitness program, where you are tracking total members, visits to the fitness center and classes, engagement in various services each month, etc., can help you identify the wins and program successes you want to spread the word about during prospect tours and social media postings. If you don’t have a solid foundation established to track this data with consistency, it’s difficult to substantiate the impact your program has with any bearing. Click here for more insight on the value of strong data.
  2. Capture the feedback. With a qualified fitness professional at the helm of your fitness program, you have someone who has a strong relationship with your residents, who is coaching them and guiding them in the fitness center, and who hears directly from your residents about the strides they are making in their fitness, balance, and overall well-being. Having a system in place to share resident success stories can be marketing gold to help your consumers identify how living in your community might positively impact their quality of life as well.
  3. Make it visual. On your website and social media channels, avoid use of stock art where possible. If prospects are following you socially, let them genuinely experience your community by seeing your spaces alive with vibrant activity week after week. They’ve likely seen your fitness center, pool, or aerobic studio during a tour, but you can help them truly feel what your residents experience through your images and videos or let your fitness manager go live for an even more engaging experience. Being able to see their friends and acquaintances thriving in a space they once toured can build a much stronger connection than stock art alone.

Let NIFS Help

The era of social media is changing how consumers shop from afar. Don’t miss out on creative opportunities to help your prospects experience your community week after week as they scroll through their Facebook feeds. If you have questions about how to effectively move forward with some of these components or how to have the right structure in place to do so, contact NIFS for more information on our fitness management or consulting services.

Find out more about NIFS Consulting Services >

Topics: senior fitness management data collection senior fitness success social media marketing in senior living senior wellness consulting

Liven Up Your Senior Living Community Fitness Center

Screen Shot 2019-05-07 at 2.34.17 PMPicture this: You are 78 years old touring a senior living community with the marketing and sales coordinator. They take you to the ground floor or basement of the building and they flip on the lights of the uninhabited fitness center. It has painted cinderblock walls, fluorescent lights, no windows, and a hodgepodge of equipment. It feels deserted and you wonder how active the community is.

You then tour a neighboring community and you see the fitness center on the main floor, with sleek and contemporary equipment, dedicated staff leading residents through a workout, light pouring in through the windows, and more residents passing by in the hallway just having left the bistro next door from an afternoon coffee talk.

These two environments paint highly different images of a community and the residents’ experience engaging in an active lifestyle. While the ground-floor space is quiet and functional for exercise, the main-floor fitness center conveys vibrancy and a sense of community. It is a space to inspire residents to be active and champion a healthy lifestyle. The purpose of my comparison is not to bash ground-floor fitness centers, however; we have developed highly successful fitness programs in this exact environment. But if you have the means to move your fitness center to a more central location, it’s something to consider.

Moving the Fitness Center out of the Basement

Over the years, we have witnessed more and more clients bringing their fitness centers out of the basement or tucked-away spaces and positioning the fitness center as part of the central hub of activity alongside their dining venues and auditoriums. It isn’t just another room where people who like to exercise can go. It is in the forefront and inspires residents to go exercise!

This type of renovation can be easier said than done in finding the space, resources, and more to make this kind of transition happen. Even if you don’t have the resources at the moment to renovate or relocate your fitness center, there is plenty that communities can do to cultivate that inspiring and engaging environment. After all, we’ve seen some of the most beautiful, state-of-the-art fitness centers go underutilized without proper staffing support for residents.

Liven Up Your Fitness Space

Consider these three tips to liven up any fitness space.

  • Staffing, staffing, staffing! Of course I’m going to beat this drum, but we’ve watched underutilized fitness centers from 800 square feet to 2,500 square feet blossom into lively and inviting spaces simply by adding qualified fitness staffing who build relationships with the residents and offer quality programs and services. Give your fitness center a personal connection and draw for residents.
  • Give it a facelift: It’s always amazing what a coat of paint and fresh flooring can do for a space. If your space is lacking windows, make sure plenty of lighting is available and choose a light paint color.
  • Update the small supplies: Sometimes the small supplies of dumbbells, stability balls, ankle weights, and so on can overrun a space and make it feel cluttered without proper storage solutions. Consider how these items are housed and consider making small investments in storage options or replacing items. A dumbbell rack with uniform weights, for example, is much sleeker than mismatched styles and colors you’ve accumulated over time.

If you are looking to give your space an upgrade or interested in more information on qualified staffing to champion your fitness program, contact the experts at NIFS.

Find out more about a free consulting session with NIFS >

Topics: senior fitness senior living community senior living fitness center fitness center design equipment fitness center staffing improve your fitness center

Help Clients Overcome 3 Common Misconceptions About Exercise and Aging

It’s well known that being physically active, especially as we age, yields many physical benefits. Examples include decreasing risk factors for chronic diseases, and preserving many aspects of physiological functions, such as cardiovascular function, muscle strength and endurance, as well as balance and flexibility.

In addition to the many physical benefits that you can gain from regular exercise, there are also many psychological benefits. Some of the benefits associated with regular exercise consist of (but are not limited to) improved quality of life and cognitive functioning.

As a fitness instructor I am constantly hearing reasons why individuals feel as though it makes no sense for them to exercise. One example I have heard recently is “I’m 85 years old. What good could taking part in regular exercise do for me? I am too old for there to even be changes made to my strength or balance.” (Hint: This isn’t true!)

Following are three common “excuses” or misconceptions regarding regular exercise that I hear frequently from older adults, and how you can address these concerns.

GettyImages-929610028 (1)I’m Too Old

You might hear: I’m too old to start exercising; its too late to make a difference in my health; it isn’t safe; I don’t want to fall and break a hip; I’m going to get old anyway

To be honest, no one is ever “too old” to start a regular exercise regimen. Many older adults are not aware that regular physical activity has been shown to be beneficial to individuals of all ages, even those well into their 80s, 90s, or older. Besides, inactivity is often associated with the common signs of aging. Older adults often have a fear of falling, especially if they have experienced falls in the past. Thus, these individuals think they are safer or rather better off if they remain sedentary. However, what these older adults don’t realize is that regular exercise is going to help them build strength and stamina, prevent the loss of bone mass, and allow the individual to improve their balance.

How to address this: In addition to discussing how certain exercises are beneficial to oneself especially as we age, instructors should also go over ways to make exercises less scary and thus safer.

I’m Too Busy

You might hear: I’m too busy to exercise; I don’t have time

Many people of all ages don’t realize that exercise does not need to take place at any specific location or at any specific time. Really, exercise is one of those things that shouldn’t be made more complicated than it has to be, and can be made to fit into your daily schedule. Exercises can even be performed in smaller bouts of 10–15 minutes that are repeated a couple times throughout the day, or even simpler exercises that can be connected to certain parts of their routine. Older adults might find exercise to be easier once it is part of a routine.

How to address this: Fitness instructors should guide these older adults on how they can add simple exercises to their daily routines. One example could be practicing a single-legged stance while waiting for their morning coffee to brew.

It’s Too Boring

You might hear: Exercise is boring; exercise is not enjoyable

Most individuals today seem to dread working out and look at it as something that just needs to get done to check it off the to-do list. People often associate exercise with repetitive movements that may be viewed as boring. However, there are a lot of different ways for older adults to make fitness an enjoyable part of their everyday life.

For example, they could take up a sport (such as golf, hiking, or swimming), take a walk with a friend, play with grandchildren, work in the garden, or even take a group fitness class. The key is to at least keep the body in motion, because some movement versus no movement can still be beneficial to their health.

How to address this: Fitness instructors can easily inspire older adults to look at some alternatives that they haven’t considered before but would likely find enjoyable. Instructors can also add components to group fitness classes to make them seem more fun and enjoyable, and less like exercise.

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The next time you hear one of these excuses from an older fitness client, you’ll know how to encourage them to overcome the misconception and keep moving.

DOWNLOAD: Importance of Exercise for Seniors >

Topics: balance senior fitness group fitness exercise and aging why older adults don't exercise

Does Your Carpet Keep Tripping You? Work on Ankle Mobility!

GettyImages-185211535 (1) Ankle MobilityTell me if this has ever happened to you: You are fast asleep in your warm, comfy bed. In the middle of that perfect sleep, you suddenly hear the telephone ringing. So you open your eyes, sit up, and slide your feet into your slippers. At this point, you are in a rush because you are now thinking that it could be an emergency. You take a few steps as quickly as you can to get to the phone, which happens to be all the way across the room. Suddenly, the front of your slipper nicks the carpet and you feel yourself going down and fast.

You reach for something to grab but find nothing to get ahold of, so you throw out your hands to try to stop yourself from hitting the floor too hard. Now you’re lying on the carpet in pain because your hands and arms hurt as well as anywhere else you may have hit your body on the way down.

Why Does the Carpet Hate You?

You then remember how the carpet used to be your friend at a very young age. You recall how you used to love the carpet so deeply that you would fall asleep on it at times. As you got older, the friendship seemed to fizzle out. Over the last few years, it seems as though your old friend has it out for you because every time you come across it, it takes you down—and down hard!

Fear not. There could be a much simpler solution to this problem than avoiding all carpet everywhere. Maybe the problem has more to do with your ankle mobility.

Ankle Mobility Exercises

Following are a few examples of exercises that you can do to improve your ankle mobility.

  • Seated heel raises: Sit at the edge of a chair and place both feet on the ground with both knees at a 90-degree angle. While keeping your toes on the ground, raise your heels up for a count of 2 and down for a count of 2. Try doing 2 sets of 20 repetitions with both feet. You can challenge yourself by holding a weight or a heavy book on your knees for added resistance.
  • Seated toe raises: Sit at the edge of a chair and place both feet on the ground with both knees at a 90-degree angle. While your heels stay on the ground, raise your toes up for a count of 2 and down for a count of 2. Try doing 2 sets of 20 repetitions with both feet.
  • Seated ankle stretches: Sitting on a chair, raise one leg so that your foot is no longer in contact with the ground. Point your toes up and down. Try to do this stretch without kicking your leg up and down. Try doing 2 sets of 30 seconds with both feet.
  • Seated ankle circles: Sitting in a chair, raise one leg, lifting the foot from the ground. While your leg is raised, move your foot around in circles. Try to do it without moving the entire leg. You really want to focus on only moving the foot. Try doing 2 sets of 30 seconds in both directions with both feet.

Moving Forward

Click here to get more information and images of exercises that you can do to improve your foot or ankle mobility. And click here to learn a little more about mobility and stability.

Let us know how your next encounter with that dreadful carpet went by commenting below.

NIFS Fitness Management's programming can also help residents improve their balance with regular exercise.  Check out how Balance Redefined is changing residents lives!

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Topics: senior fitness injury prevention mobility exercises stability

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

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

What's Missing From Your Resident Fitness Program and How To Fix It

NIFS | Senior Group Fitness

I hear from a lot of leadership in senior living communities who know that there's more that could be done with their resident exercise program, but they aren't sure how to get their staff to ramp things up. If you find yourself in this situation, check out the list below for common challenges and opportunities to do better for your residents.

Our participation is lower than it should be.

There are a few reasons that participation in your fitness program might run lower than it should.  The first thing to determine is whether you have reliable data about who is participating. When we  start working with a community, we often learn that they may have total (or estimated) counts for group fitness class participation and that's the end of their program data.  

  • Start by tracking participation per resident. You'll have more reliable information about who is participating, how frequently they attend, and what they participate in. You'll also gain knowledge about who isn't coming to the fitness center and/or classes.
  • If your staff can deliver on individual services for residents, add fitness and balance testing along with exercise prescriptions to provide residents who aren't participating with the support they need to feel safe and inspired to begin an exercise program.

[Read More: 4 Strategies to Engage More Residents in Your Exercise Program]

Our group fitness class calendar needs a do-over.

It's common for the group fitness class calendar to get set on autopilot without critical evaluation of what needs to be updated.

  • Start by using the participation data to figure out which classes really deserve a spot on your calendar.
  • The balance classes our staff teach in our client communities are by far the most popular format. If you don't have dedicated balance training classes on the calendar, add them now. It's not enough to have balance training mixed in with a strength class or another blended format.
  • Carefully consider class descriptions; how you word group fitness opportunities for residents can make a big difference in what resonates with a previously inactive audience.

We need to be offering more fun programs.

Creating fun and inspiring programs to invite more participation in the fitness center is one of the best parts of the job! It's really central to how our staff are supporting residents in the client fitness centers we manage. Consider that engaging programs should be more than just fun; they should be built strategically to meet a specific goal. For example, NIFS Fitness Freeze program was a solid solution to combat the traditional fitness center visit decline we see in December each year. Or, think more holistically about Active Aging Week and use National Senior Health and Fitness Day to offer non-traditional options for physical activity.

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If you're committed to keeping your fitness staff in house, then they need some support to start improving what they're offering your residents. Our eBook on how to turn your fitness center from vacant to vibrant is a great next step.

Take your fitness center from vacant to vibrant >

Topics: senior wellness programs senior fitness group fitness for seniors fitness for seniors

A Warning About Wellness Data in Senior Living & How We Can Do Better

NIFS | senior living wellness Special thanks to Sara Kyle as a co-author for this piece.  You can read more about her experience in senior living here.

Over the last several months, the senior living industry has seen more published data on wellness offerings. A few examples include this report from Senior Housing News (SHN), and the 2017 ICAA/Promatura Wellness Benchmarks report. I'm thrilled that organizations are taking a stronger and more consistent approach to measuring the impact of wellness for older adults in senior living. We can all benefit by being more informed; but I want to suggest a few cautionary notes about the data. 

As you read the reports, articles, and posts, it's easy to get swept up in the headlines and colorful images. Instant validation seems logical when the numbers back up our own experiences. But just beneath those captivating soundbites are sample size issues, a lack of consistent definition of terms and problematic comparisons between a study population and real world groups. We've seen these research challenges for years in corporate wellness (check out this blog for a consistent digest of how the corporate wellness industry has routinely gotten it wrong). I'd hate to see senior living go down that same path.  

Here are a few examples from the above noted reports that spark additional questions when you dig a little more deeply into the numbers:

Who makes up the sample and how many of them are there?

In the SHN report, authors note that 308 adults age 65 and older were polled using a Google survey. We lack key information about these 308 respondents. For example, we don't know if those surveyed are employed, if they're community-dwelling, if they have health issues, if they're living with government assistance, what their faith background is, etc. And while 308 respondents seems like a significant contribution, it may/may not be enough to declare data from that sample to be statistically significant. These missing elements don't mean the survey findings are unimportant, but it does mean we need to take a measured approach to digesting what's offered.

We also need to ensure that study limitations (like sample size) are included in the write up because those limitations impact how we process the information for validity, reliability, and transferability into other populations. Limitations don't necessarily render the research incorrect or useless, but they do provide important context for the findings as well as how we might move forward to study a similar topic.

What do we mean by engagement?

It's common to see terms like engagement and participation when reviewing data related to wellness in senior living, but those terms often aren't clearly defined. In one case, I found (after some digging and discussion with the publishing organization) that participation was defined as residents choosing at least one activity per month. When NIFS staff report to communities about participation rates in the fitness program, we're providing data on resident who visit 1x, 5x, and 8x per month. It's easy to see how a lack of standard definition for participation could skew a comparison between the two different data sets. 

You might think participation is fairly cut and dry. And I suppose if our single focus is measuring the number of behinds in the seats, then participation is clear. But, we also know that headcounts don't always mean the individuals are involved in the activity. I would argue that sleeping through a stretching class requires a very generous view of participation to assume that the resident received the intended benefit from the class. And that's where engagement comes in; it's definitely a moving target. It's highly subjective and very individual. But the individual who is engaged in the stretching class is moving his body, making eye contact with the instructor, and is responsive to feedback or changes in the activity. While some people use engagement and participation synonymously, they are not the same thing. 

Is selection-bias an issue?

It might be. Here are a few ways I saw it play out in the two reports I've mentioned:

  • The ICAA notes that 89% of older adults living in Life Plan communities who are tracked through their bench marking tool, self-rate their health as good or excellent while only 68% of age-matched older adults who are non-community dwelling, rate themselves the same. That's a huge boon for housing operators, but this data suffers from a self-selection bias where a variety of factors well beyond the community's control may contribute to the higher scores for residents and the lower scores for non-residents.
  • The SHN report profiles a fall prevention program where the program operators note the baseline data showed that 38% of residents in the community had suffered one or more falls.  One year following the implementation of their initiative targeted at reducing falls, they noted that the incidence rate had gone down 10%. What wasn't noted in the report was a listing of potential reasons for the decreased rate of falls that are completely unrelated to the initiative such as variations in the pre and post-sample, and the increased likelihood for residents to not report falls (particularly when they know they're being watched for falls). The program providers indicate that they've saved the community $500,000 with this fall prevention initiative, but that savings would indicate that we can assign value to that which we prevented. I'm not aware of a concrete way to value prevention; it's one of the great shortcomings of preventive health strategies.

How can we do better?

While there are some holes in the data that has been coming out on wellness in senior living, I think the research should continue, and below are a few areas where we could all improve the quality of what we're releasing for the greater benefit of the residents we're serving.

  1. Let's ’s get industry clarity about how we define wellness because right now we see it as the “wellness gym”, the “wellness nurse”, the “wellness staff” who are really fitness center staff, the “resident wellness committee” who plans activities that may or may not be tied to purposeful living. Gaining a more clear and shared definition of what we mean when we say resident wellness gets us all started on the same page. 
  2. Let’s get clarity about how we define engagement and participation. To me, defining participation as 1x per month to seems kind of low, but if we’re going to agree to that baseline, then at least it's a starting point.
  3. Let's find value beyond hard numbers. The ICAA does a great job of profiling and recognizing fantastic programming provided by 3rd party providers as well as directly by housing operators. There are similarly interesting initiatives throughout the SHN report.  Continuing to share meaningful lifestyle offerings is a win for everyone.
  4. Let’s use data where it’s significant and less subjective. For example, one of the programs outlined in the SHN report showed where one operator demonstrated a 50% improvement on average for residents who did baseline fitness testing and repeat testing. In-between their testing periods, participants engaged in exercise prescribed for them by a trained fitness professional. This isn't a complicated initiative, our staff offer something similar in our client communities, and the data is hard to dispute.

When you're paying to download a report that promises reliable numbers, and meaningful information, it's okay to ask questions about what's being offered and whether it will translate to your environment. It's also okay to question the study design to better understand definitions inherent to the outcomes. 

We have a long way to go as an industry to tighten up research so that our evidence-based practices are better. Do you have other areas in senior living research or in wellness specifically where you think we can all do a little better? Comment below to keep the discussion going. 

Topics: senior fitness senior living community senior living wellness programs wellness for seniors older adult wellness