Corporate Fitness and Active Aging

NIFS Pump it for Parkinson’s: A Special Event, 15 years in the making!

PI4P logo_final-01Over 15 years ago, I remember sitting down at the computer in my senior living client’s fitness center and Googling, “exercises for Parkinson’s disease”. I had a new resident move-in with Parkinson’s and though I’m a certified and degreed exercise physiologist, I wanted to make sure I understood how to support her needs. Her name was Carolyn and I still remember her smile.

I now work at the operational level for NIFS supporting dozens of senior living clients and team members across the country. I benefit from a bird’s eye view of hearing successes and challenges impacting our communities and what residents want in their fitness center. I was continuing to hear requests from clients and staff for Parkinson’s resources. Our clients wanting a quality, yet manageable program that stands up to their brand promise in helping residents live well, and from our staff feeling like there were missed opportunities to better engage these residents.

Our staff are degreed fitness professionals, but those credentials don’t tell the full story of who they are as people. They are intuitive and gifted in relationship building with their members. They shared stories of individuals with Parkinson’s trying an existing balance class and noticing they weren’t coming back. They shared stories of what they were witnessing in the emotional needs of these residents who can also experience fatigue and depression.

As a prospective or current resident with a diagnosis speaks to our clients or staff, we want them to feel confidently met with exercise options that they know are designed for their needs. This is where Bold Moves was born. We spent over a year researching, completing specialized certifications, and meeting with our team to learn not only how to better support the exercise needs of those with Parkinson’s, but in a way that we know is manageable in a senior living fitness environment. We know the equipment, spaces, personnel, and resources commonly in place and created safe and empowering programming with Bold Moves that our staff could apply across different client settings.

Many think they have classes and one-on-one services that residents with Parkinson’s can participate in already. This was our line of thinking too. But after implementing Bold Moves, the level of engagement by residents with Parkinson’s skyrocketed. In the first two months of the program, we saw a 96% increase in group fitness participation by these individuals having a dedicated class on the calendar uniquely designed for their training needs. We have also seen a 100%+ increase in completion of our one-on-one exercise prescription service. These residents are regularly engaging in their community’s fitness centers more and it’s amazing to see how far we’ve come since the days of that simple Google search looking for resources!

We were so pumped by these outcomes; we wanted to celebrate and share resources to help more communities support their residents. On World Parkinson’s Day, we are going BIG with Pump it for Parkinson’s. During this nationwide event on Tuesday, April 11, senior living providers will come together, utilize complimentary programming materials to host their NuStep step-a-thon, and receive expert resources from NIFS to continue supporting their residents with Parkinson’s. Don’t have a NuStep in your community? That’s OK. We can find opportunities utilizing the equipment you do have. It is estimated that one million people are living in the US with Parkinson’s and our goal is to come together and complete at least one million steps on the NuStep as we Pump it for Parkinson’s. In addition to the great Parkinson’s resources including instructional videos for your fitness staff and education from NIFS Registered Dietitian, your community will also have an opportunity to win a free NuStep T6 Cross Trainer in thanks to our partnership with NuStep! We are thankful for our industry partners with NuStep, ICAA and Wellzesta who are helping us spread the word about this event so more communities can join us. For more information and to register your community, visit our Pump it for Parkinson’s page here.

Learn More: Pump It for Parkinson's

Topics: fitness programs for seniors senior living communities senior living wellness programs Parkinson's Disease Bold Moves Pump It for Parkinson's

NIFS Announces Pump It for Parkinson's: A Senior Living Event

The National Institute for Fitness and Sport (NIFS) presents Pump It for Parkinson’s on World Parkinson’s Day, April 11, 2023. NIFS has partnered with NuStep inviting senior living communities across the country to take part in this event to raise awareness on the benefits of exercise for individuals with Parkinson’s. Pump It for Parkinson’s will be a day-long NuStep challenge for senior communities striving to achieve 30,000 steps on their NuStep.

Emily Davenport, NIFS Director of Fitness Center Management, said, “communities can rally their entire campus by bringing together their residents and employees to accomplish the goal!” NIFS will provide communities with a complimentary programming packet including tracking tools, promotional content, and educational resources they need to get their residents excited. The event’s goal is to accrue 1 million steps representing the 1 million people in the US living with Parkinson’s!

“Whether this event is a community’s first program dedicated to supporting residents with Parkinson’s or a fun add-on to existing offerings, we want to provide resources as they continue to help residents fight back against Parkinson’s,” said Davenport. Participating communities will also receive a Parkinson’s fitness toolkit of resources and videos they can use in their fitness center. Communities that want to get involved need to register here.

“We’re pleased to partner with NIFS and support their event, Pump It for Parkinson’s. And we’re honored that participants will be using NuStep cross trainers throughout the day to demonstrate the importance of exercise for people with Parkinson’s," said NuStep Vice President of Marketing and Product Development, Tobey Thelen. As an added incentive, thanks to NuStep and NIFS, communities may be eligible to win a NuStep T6 Cross Trainer for participating in Pump It for Parkinson's.

Nearly 10 million individuals are living with Parkinson’s Disease worldwide and each year 90,000 Americans are diagnosed with this degenerative condition. Three years ago, NIFS embarked on developing a comprehensive fitness program to meet the unique needs of residents with Parkinson’s Disease for their senior living community clients. From this, Bold Moves programming specifically designed for residents with Parkinson’s was born.

NIFS would like to thank strategic partners, NuStep and Wellzesta, for supporting Pump It for Parkinson’s and their help in creating awareness of the unique fitness needs residents with Parkinson’s Disease have.

To find out more about Fitness Center Management by NIFS, call (317) 274-3432, email Emily Davenport.

NuStep is a leading manufacturer of recumbent cross-trainers used in healthcare, senior living, and fitness settings worldwide.

Communities can learn more about this complimentary program and register for the event by clicking the button below!

Learn More: Pump It for Parkinson's

Follow the event on our Facebook page: Pump It for Parkinson's

Topics: senior living communities senior living wellness programs senior lliving activities calendar senior living Parkinson's Disease Bold Moves Pump It for Parkinson's

Bold Moves – an inclusive class for residents with Parkinson’s

“What keeps NIFS from inviting folks with varying neurological conditions into our Bold Moves for Parkinson’s class since it is also a neurological disease??

BM photoThis is a great question because it is a priority for our clients (and for us) to make sure programs and services are as inclusive as possible. But in this situation, Bold Moves is specifically designed for those who have Parkinson’s Disease and here are a few considerations on why that is the case!

Did You Know...

  • ...Parkinson’s Disease is progressive and without a cure?
  • ...medications and surgical procedures are only to help minimize symptoms?
  • ...those same medications start to wear off and do not help as much as they did at the start of use?
  • ...exercise is prescribed just as much if not more than medication for symptom management?

NIFS Bold Moves group fitness class is exclusively available to residents with Parkinson’s because the training modalities they need to manage symptoms are unique. We followed the science to make sure we were bringing our clients and their residents an evidence-based program for their fitness center and while exercise is GREAT for anyone, that doesn’t mean ALL exercises are meant for everyone. Some training modalities that benefit those with Parkinson’s in Bold Moves may be contraindicated for individuals with other neurological conditions.

Our goal with Bold Moves is to provide a safe space that encourages the types of exercise that will assist those with Parkinson’s to ease symptoms of the disease. For example, large, big, (dare we say, bold 😉,) movements are encouraged for range of motion and fighting rigidity, but did you know we should not encourage cross over steps for these participants? Another example of a warmup we might include is for facial muscles due to the symptoms that limit muscle movement in the face which can lead to further problems with swallowing and talking. Yes, we will include fitness staples like cardiovascular exercise, full body strength, and flexibility exercises, but they will each be nuanced for the symptoms individuals experience with Parkinson’s. Furthermore, if a group setting isn’t enjoyable for a resident, they can receive an individualized Bold Moves fitness program utilizing the equipment in the fitness center or the pool!

While these exercise considerations are clear in the Bold Moves training NIFS team members receive, how they format their classes remains unique for their participants. We don’t take a cookie cutter approach across our communities in how we format a fitness class, plan an exercise challenge, or promote the next big splash in aquatics programming and Bold Moves is no exception. Our skilled staff learn from their residents at each community and create a program that meets participants where they are with Bold Moves classes looking different at every client site NIFS serves. We love seeing how our team applies their Bold Moves training to give the program its own unique flavor at every community!

Recently, NIFS interviewed several members at varying client locations to get their feedback on why they participate in this program and if it has helped them. The answer is a resounding yes! They are feeling the difference in how their body moves and feels after their sessions. They are paying attention more to the cues NIFS fitness staff provide them during class and remind themselves when they are out in the community. Most importantly, they are thankful someone has the understanding that they cannot control these movement symptoms and they have confidence that they are performing the best exercises unique to their needs as part of their symptom management.

Learn more about our program for residents with Parkinson's Disease by clicking below.

NIFS Bold Moves Program for Parkinson's

 

Topics: senior living wellness programs activities calendar senior living disease management Parkinson's Disease Bold Moves

How NIFS Became Experts in Parkinson’s Fitness Programming

Exercise continues to be one of the best tools to slow the progression and combat symptoms of Parkinson’s Disease and the need for senior living communities to have dedicated exercise programs for residents with Parkinson’s is increasing. According to the Parkinson’s Foundation, 60,000 Americans are diagnosed annually and 96% of those diagnosed are over the age of 50 leaving seniors looking for best-in-class amenities and services including fitness professionals who understand their condition and can help them safely maximize the benefits of exercise.

Executive directors and marketing directors in the senior living communities NIFS serves were asking us for a marketable program they could offer in their fitness centers to support both current and prospective residents with a Parkinson’s diagnosis. NIFS culminated our years of experience developing expert health and fitness programming, supporting residents with Parkinson’s, and immersing ourselves in the science and research to develop Bold Moves™ a Parkinson’s Program by NIFS.

While NIFS had the resources to develop such a program, it was no easy feat and as usual we relied on our expert staff to help us learn what works, what doesn’t, and what resources and education we needed to enhance our department. Our staffs’ passion and commitment to finding exercise solutions to support the needs of their residents is boundless and supporting those with Parkinson’s is no exception as they helped us develop Bold Moves to incorporate:

BM Offerings_graphic icons-1We were able to learn from the experiences of team members across the US and industry experts in the field of exercise and Parkinson’s to create a truly unique program for our residents. Best of all, it’s making an impact with how much residents are engaging in exercise generating a 96% increase in group fitness visits by participants and 92% of them rating Bold Moves as good to outstanding. These statistics are from residents already residing at these communities which indicates a dedicated Parkinson’s program supports these residents in moving more!

Today, NIFS team members complete a comprehensive 8-week training including a specialty certification in Parkinson’s & Exercise to effectively launch Bold Moves for our clients. We collaborate with community personnel to incorporate an interdisciplinary team approach to bridge resources and care where needed. Residents with PD have confidence in the credentials of their fitness staff and a program uniquely designed to meet them wherever they are in their fitness journey. In turn, NIFS senior living clients have a marketable service that helps them create distinction in their marketplace with 100% of participants rating Bold Moves as a great feature of a great community!

Here are a few questions to evaluate on how your community could take steps to support residents with Parkinson’s:

  • What are the credentials of my fitness staff to deliver effective and safe Parkinson’s fitness programs?
  • Do we have a class on the group fitness schedule that provides the training modalities, equipment and safety factors to support residents with Parkinson’s in a class setting?
  • For those who don’t like group exercise, how can we provide exercise options for them in the fitness center or pool that can help them manage symptoms?
  • What pathways to bridge resources are established with other disciplines in your community like physical, occupational or speech therapy, dietitians, or healthcare navigators?

    NIFS Bold Moves Program for Parkinson's
Topics: senior living wellness programs disease management Parkinson's Disease Bold Moves

Why Exercise is Important for those with Parkinson's Disease

Bold MovesWhat is Parkinson’s? It is neurodegenerative disorder that affects movement. An individual might start with a gradual tremor in one hand, but this disease can result in numerous symptoms at different levels of severity including stiffness, slowing of movement, and disturbances to his/ her sense of balance. It cannot be cured but medications are given to try to improve symptoms. Exercises can be prescribed to help improve strength, flexibility, and balance and adherence to a regular exercise program is one of the best treatments options in managing symptoms and empowering those with Parkinson’s to fight back against the disease!

There are multiple benefits of exercise for those with Parkinson’s including:

  • increasing muscle strength, flexibility, and balance
  • improving well-being by reducing depression and anxiety
  • slowing down the disease and controlling symptoms
  • reducing pain and helping with emotional well-being
  • preventing falls by building strength and decreasing fatigue
  • improving sleep

The specificity of an exercise program for those with Parkinson’s is important to adequately manage symptoms and prevent fatigue.

  • Most people should try to reach a goal of 30-40 min per week of cardiovascular exercise such as walking, biking, and swimming.
  • As Parkinson’s can affect your posture, it is important to also add strength training and a stretch program to improve your core strength and overall range of motion.

There are different stages of the disease and medications will affect an individual suffering from Parkinson’s differently. Consulting with a qualified exercise physiologist who understands the unique needs of someone with Parkinson’s is important to ensure a safe and effective plan is being followed and tailored as needs change. An individual needs to be mindful of their movements, and at times, it can be overwhelming. A supportive exercise physiologist to observe, adjust and encourage participation can be a significant help! An individual with Parkinson’s needs to focus on walking heal to toe, taking large steps, swinging their arms, building core strength and upper back strength, and continue a quality stretch program. It is also best to continue sequential movements for brain health such as line dancing (crossing your feet and moving backwards might be a challenge) or boxing can also aid in brain health. Most importantly, find something you enjoy doing that contains all of these benefits, and make it apart of your lifestyle, ask your friends to join you!

See how NIFS wellness program, Bold Moves supports the physical, social and emotional needs of residents managing life with Parkinson's by clicking below!

NIFS Bold Moves Program for Parkinson's

Topics: senior living wellness programs Parkinson's Disease Bold Moves

Parkinson’s & Exercise: Enhancing Skills of NIFS Bold Moves Coaches

BM2We make no bones about it that our staff are the best in the business not only in their creativity but in their expert knowledge and appetite for continued learning. It takes this combination to make the most impact in reaching residents with engaging health and fitness programs in the senior living communities we serve. As NIFS was developing our Parkinson’s program, Bold Moves, we knew that equipping our staff with new certifications would not only boost their confidence, but the success of the program and we were right! Here’s some insight from three of our degreed fitness managers on how NIFS Bold Moves training aided them in elevating how they support the unique needs of their residents with Parkinson’s.

Becca G. – Bold Moves Coach in Indianapolis, Indiana

There was an abundant request at our community for a class for Parkinson’s Disease.  I researched some things on my own, but I felt like I needed more to effectively offer a class for PD.  The Bold Moves program helped me feel confident to lead class.  I feel like it gave more information about the disease, for example, how medication timing is imperative to consider when building an exercise program and encouraging participants to keep pushing. Prior to the Bold Moves training, I did not know to avoid cross over exercises, like the grapevine, or that PD causes impaired exercise-induced blood pressure levels.  After completion, I felt qualified to lead group classes and guide individuals in tailored exercise plans. Also, because of the education and training behind the program, the residents are ensured they are receiving safe, effective, and appropriate workouts from us.  I’m happy NIFS built the Bold Moves program with tools and resources to help us serve our residents with PD! It’s more than just the initial education, I have the sustained support and materials to manage the duration of this ongoing program.

Alyssa O. – Bold Moves Coach in Raleigh, NC

I feel the training was great because it educated us on the disease of Parkinson’s, the symptoms to be aware of, and walked us through several different exercises geared to manage those symptoms for maintenance or improvement in quality of life. It was very comprehensive in listing which exercises were better and why those exercises benefit this population of people.

They incorporated studies as well as example exercise programs for Parkinson’s that emphasized symptoms to look for when exercising this group of people. The training also guided intensity level and provided ways to structure the class so that it is conducted smoothly. The Bold Moves training was very helpful in my opinion!

 Charles B. – Bold Moves Coach in Atlanta, GA

As someone with a background in physical therapy, I already had some prior training and education for working with residents with Parkinson’s. However, Bold Moves training did give me a new list of Do’s and Don’ts for working with this population (avoiding grapevines and other advanced balance exercises while needing to implement exaggerated movements and elevate heart rates). The training also gave us the idea to install balance bars all along the back wall of our aerobics room, which has made our training much safer and accessible. I have 2 residents in wheelchairs and 3 in walkers who can perform standing exercises thanks to having these bars installed!

We are proud of our staff and their continued commitment to finding exercise solutions that work for all residents! For more information on NIFS Fitness Management services and our expert staff, contact Emily Davenport!

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Topics: senior group fitness classes senior living wellness programs activities calendar senior living Parkinson's Disease Bold Moves

Sit-to-Stand is the new go-to move for senior living residents

07.2021_sit to stand_CHPK 2This summer, eight different NIFS fitness managers lead their residents through the Sit-to-Stand Challenge. Residents were asked to set a goal each day and complete a certain number of sit-to-stand exercises. They could group them all together or break them up throughout the day. The program was received with much enthusiasm as residents completed an average of 367 sit-to-stands per person during the month!

So, why build a program based all around one exercise? For one, it gives everyone an attainable goal. Someone might say no to something where they are asked to do 10 exercises at a time even if it’s just three days a week, but everyone has time to just do one exercise per day, right? But why the sit-to-stand? Check out these benefits:

Maintain Independence

The seemingly simple movement of getting up out of a chair is something many of us take for granted. Have you ever counted how many times you stand up throughout the day? My guess is that it’s a lot. Giving older adults the continued confidence that they can get out of a chair with no help is huge for maintaining independence and comfortable living.

Fall Prevention

When older adults are looking to maintain independence, their main concern is often fall prevention. Many times when people thing about fall prevention, they think of balance-specific exercises like a single-leg balance or a tandem walk. What’s sometimes missed is the strength and coordination aspect of balance training. The sit-to-stand is a great lower-body exercise because it incorporates most of the big muscle groups in the legs and hips. Strengthening those muscles helps maintain stability and therefore prevents falls.

“Prehab” and Injury Prevention

Another major benefit of strengthening leg muscles is the support those muscles then give to joints in the hips, knees, and ankles. If someone is thinking about a knee or hip replacement, one of the things that a surgeon might suggest is to do some “prehab” or basically to strengthen the area around the joint before surgery so that recover will be easier and rehab will be more familiar. Think of it as giving yourself a head start on recovery. Who doesn’t want that?

Just about every piece of feedback on the Sit-to-Stand Challenge sent by participants was about how much stronger they feel after just one month and about how they want to continue doing the sit-to-stands in their normal exercise routine.

Check out what our participants are saying about the impact this simple challenge had on their strength and their confidence:

“About one quarter of the way through the challenge, I found it so easy to get up out of a chair. I was amazed at how easy it was getting up. I will be keeping it up from now on, but with 8-10 per day rather than 40 per day. Good program!” –Virsile, Chelsea, MI

“LOVED the sit-to-stand challenge along with all the other motivational activities.” –Jennie, Palm City, FL

“Probably many of us hadn't realized how much more sitting we were doing during COVID quarantine. I can tell I am stronger all over, not just lower body, from the continuous reminders to stay active and fit.” -Nancy, Indianapolis, IN

If you could choose one exercise to focus on perfecting over the course of a month, what would it be?

Get Our Guide to Successful Fitness Programs

Topics: senior living senior living wellness programs sit to stand

Senior Living: 3 Tips for Better Vocational Wellness

GettyImages-172429286How can older adults improve their wellbeing, grow closer to others, and enhance the community in which they live? Practicing vocational wellness is a great way to accomplish these important feats.

Vocational wellness is a part of our lives and wellbeing that makes the most of our individual strengths, talents, skills, and experiences. When we are vocationally well, these unique characteristics are intentionally used in contribution to our community and larger society.

Here’s what the International Council on Active Aging has to say about vocational wellness: “Work that utilizes a person’s skills while providing personal satisfaction is valuable for society as well as the individual. Participating in the paid and unpaid workforce means maintaining or improving skills, and helping others. Older adults contribute to society as experienced professionals, caregiver, mentors, teachers and volunteers. Leisure-time vocations in the arts and through hobbies maintain vocational skills.”

One great joy in life is serving others or meeting needs in a way that only we can. Neighbors, friends, and family benefit from our vocational wellness. In community, this may look like teaching, leading groups, practicing creativity, or taking the time to volunteer. When we share ourselves vocationally, the impact can be surprising.

Here are 3 tips for improving your vocational wellness:

  • Learn about vocational wellness and meditate on what it could look like in your life. By reading this blog, you’re on the right track. You may also talk with your friends and neighbors about what they do for vocational wellness.
  • Seek out opportunities to participate in activities, clubs, committees, or special events that interest you. If on first look nothing interests you, don’t let that stop you! Get in touch with people who can help you start something new and exciting. Your skills and experiences are valuable!
  • Do what you like to do in a way that benefits yourself and others. Beyond being used for your own enjoyment, your vocational talents can be used for the greater good. If you are a creator, create something beautiful for others to see. If you are a leader, lead others to a healthier life. If you are a teacher, teach your friends something new.

These steps should get you well on your way to a higher level of vocational wellness. When vocational wellness is overlooked, everyone is being short changed. Make the most of your unique life qualities by getting started today!

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Topics: senior wellness senior wellness programs senior living wellness programs vocational wellness

Knowing what makes your residents tick could improve programs

Your community is, or should be built on resident satisfaction. Your residents are your priority, but they are also your revenue. Without them, your community increases the chances of failing. It’s important to understand this when building programming at your senior living community.

Every community is different. Every resident has a specific want or need. Our job as Wellness Managers is to hone in on what those needs and wants are and to address them. How do you do this? Here are five ways to assess your wellness programs so they are continuously successful and you are meeting the demands of your residents.

NIFS | A closer look

#1 - Get to know your resident population

It takes some time to understand what your residents really enjoy. It’s also important to note that not all residents are the same. Where some may enjoy the social interaction and class environment, others enjoy solitary fitness or wellness programs. It’s important to identify these differences and make sure that wellness programs have variety and cover many different personalities and preferences.

#2 - Listen to ALL resident feedback and take action

This can be tough, but is necessary to grow and develop a program that residents enjoy. If a resident comes to you and says, “I don’t think this program is successful and this is why…,” it’s important to take a deep breath, and LISTEN. As hard as it may be to sit back as it feel like someone is tearing your hard work into shreds, they are providing valuable information to improve your programming. Be open to the positive and negative feedback so you can make the necessary changes for improvement.

#3 - Evaluate your wellness programs

Evaluating wellness programs is the key to success. There are many different ways to do this. The best way is to keep track of your data and evaluate it. How many residents participated in your event/program/specialty classes? Did it show an increase in overall participation for the month in which you ran the program? Did you make a survey and distribute it to residents that participated? These are all valuable ways of gathering information to see if wellness programs are a hit or a miss.

#4 - Make sure programs are evolving over time

Your programs should evolve with your residents. If you have been running the same wellness programs for five years and haven’t changed them at all, it becomes routine, less exciting for some, and participation may decrease. Give residents something new and fun to enjoy. I am not telling you to completely re-invent the wheel, but to simply add/take away/replace some aspect of your program to make it more enticing and fresh. You’ll be amazed by what small and simple modifications can do for the community and programs.

#5 - Ask for help

It’s okay to ask community leaders, colleagues and staff members for information and help to reignite or invent a completely new program. Team work is one of the best ways for a community to put on a great event. Don’t be afraid to ask for help throughout your planning.

Being proactive in assessing fitness and wellness programs will not only keep you informed about the impact you are making for your community, it will also show that you genuinely care about the goals you are trying to achieve. Your community will recognize that not only are you putting in the effort to make a program, but you are also putting in the groundwork to make that program successful, enjoyable, and have a positive impact for residents.

Click below to learn more about partnering with NIFS to manage your senior living community fitness center.

Partner with NIFS to improve your senior living community

Topics: active aging senior fitness management resident wellness programs program evaluation nifs fitness managment senior living wellness programs programming resident engagement improving senior fitness

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