This 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?

How 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!

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.

#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.

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. 

This week more than 7,000 professionals working in senior housing and related businesses converged in New Orleans, LA, to share their passions, learn from each other, and return back to their communities inspired to continue doing great work for the older adults they serve. I was honored to be at the LeadingAge annual meeting both as an attendee and as an exhibitor.

Typically when I go to a conference, I learn in two categories:

• There's the "duh-why didn't I think of that...it's brilliant" way where I'm usually listening intently in a session, scribbling copious notes and the speaker says something that resonates deeply for me.
• And there's the "thinking about it later" way that usually comes up when I'm reflecting on the day, on the people I met, and the conversations I had.

Below are a few of my takeaways that, not surprisingly, fall into both of those categories.

#1: Status quo does not equal thriving

My first session of the conference was "Nature Meets Nurture: Designing a WELL Building". The content of the presentation was interesting; I had read some about the WELL Building Standard, and the session helped me get a better understanding of how the standard applies at a more practical level. What struck me during this session was when one of the speakers categorized the Standard as moving forward, moving beyond the status quo.

I realized that's true of so much work being done in senior living. Status quo is not the same thing as thriving. Moving forward, doing better, trying new things is not equal to doing what we've always done. Of course, this isn't just true for how we build communities; it's true in the areas where NIFS works as well, including building and executing on a life enrichment or fitness program strategy, and I have already started looking with fresh eyes at how we can help communities move past their status quo to build thriving living environments for their residents.

[Read More: 5 ways wellness consulting helps meet the mission of your community]

#2: There is no single solution

There is no one-size-fits-all solution that works in every community and the volume of providers stationed through the exhibit hall is proof. Even in our work with a family of communities all united under the same brand, our delivery of services is unique per location because the resident and client desires drive the strategy. The LeadingAge expo was a great reminder that communities deserve creative and flexible partners who are willing to adjust their models to meet unique needs.

The flip side of the creative partner coin is the open-minded senior living community.  If you strolled the expo thinking (or saying) you don't need X product/service because you already have it covered, see #1 above.  Maybe rethink that "we already do that notion" and give a second look to the information you gathered form the expo before you put it in the recycling bin.  There just might be a nugget in there to help your community make a move toward thriving.

 #3: Resident engagement is everyone's job

As I sat in the Redefining Resident Engagement session with Michelle Holleran and Tim Johnson, I was intrigued by the Holleran model for the four domains of engagement. (Grab the whitepaper here.) My early thoughts were all around how much the domains are the resonsibilty of a communitiy's life enrichment director.  [Full disclosure - that role is kind of a sweet spot for NIFS as we consult with and provide staffing solutions for communities in that role.]  However, the further we got into the session, the more I realized how deep the idea of engagement really runs. 

There are lots of ways to improve traditional activities in communities, and many of those opportunities rest squarely with your Life Enrichment staff doing their jobs differently.  Yet, beyond the prominent role your Life Enrichment department plays in facilitating opportunities for resident engagement, it is the entire community supporting those opportunities, connecting with residents, and communicating with each that is the foundation for engagement.  Residents also have to be present at a fundamental level.  We should not be simply filling an activities calendar and calling it done.  For strong engagement, we have to invite residents into their own life story and then step back to allow them to live it.  

If you attended the 2017 LeadingAge Annual Meeting and Expo, I'd love to hear your key take aways in the comments below.

When we first started talking about Balance Redefined inside our organization, our sole focus was on physical balance and the unique, wrap-around fall prevention programming we provide. But we knew that wasn't the stopping point for us. Because our work outside the fitness center serving as life enrichment directors for a variety of clients has demonstrated that living well extends way beyond an individual’s physical health, particularly for older adults.

We believe that wellness programming in your community should be diverse and built around the interest of your residents. The idea is to inspire residents to get involved and in order to do that, you have to know what makes the residents tick. You have to know what makes them want to get out of bed in the morning and what inspires them to invite their neighbors to join them. Filling the calendar is definitely more art than science; avoiding common pitfalls like order taking is tough. And ensuring there are very few sit-and-listen programs on the calendar requires discipline. But there are plenty of fun, engaging program ideas to go around.

[Related Content: Evaluate the quality of your wellness program]

Below are a few examples of programs created by our lifestyle staff that demonstrate our commitment to creating experiences to engage residents in balanced living.

How does your garden grow

Create a focus on gardening by using National Exercise in the Garden Day to host a balance class in/near the resident garden area. Emphasize the residents gardens by setting up a stand where residents to showcase/sell their produce to their neighbors. Provide a presentation from a master gardener with tips/benefits on organic gardening; it's possible you have residents who are trained as master gardeners who could provide this talk. Offer a series of short group fitness classes that are designed to prepare residents to be active in the community gardens. Host a themed garden party for happy hour.

Water, water everywhere

You might this theme would speak only to pool-based programming. Certainly, if your community has a pool, it should be a spotlight, but that's only one element in this robust program that deals with everything water. Start this programming with an event to teach residents about the importance of proper hydration; build a challenge encouraging them to drink enough water daily. Hold an aquatic ambassadors program to promote pool participation. Serve fresh seafood in your dining venues and showcase the origin and health benefits of the spotlighted menu items. Host a series of coffee talks with your a dietitian discussing the importance of fish in a balanced diet. Wrap the water themed programming up with a polar plunge, a luau, or a pool party.

Train your brain

Help residents engage their brains in less traditional ways by launching language courses from a nearby partner university. Add 15-minute meditation sessions following the weekly balance class; consider spotlighting other brain fitness programming you may have onsite (i.e., Dakim(R)). Build a brain teaser program that runs riddles/cluse on your community's CCTV where residents are invited to various areas of the community to find the answers. Run a museum marathon where the month's outings focus on area museums and special tours are provided by the museum staff. Spotlight brain-boosting foods on your dining menus, and offer coffee talks focused on memory-related disorders as well as what services you provide in-house from your memory care center.

If these programs sound delightful but you're not sure you could get them going in your community, consider connecting with us for wellness consulting. You can put our years of experience in senior living communities across the US to work in your organization to build better programming that speaks to resident passions and that engages staff across your organization for a more collaborative approach.

Everyone is planning their holiday vacations and parties. As the manager of a fitness center, your job is about to get just a little tougher. This time of year it’s incredibly difficult to keep the attendance up in the fitness center. I think a lot of members think they can just “put it off” until January 1^st and that it’s not that big of a deal if they miss a few weeks of workouts. Unfortunately for those people, there can be major losses after just two weeks of skipping workouts. According to this article, it only takes two and a half to three weeks of inactivity to start seeing strength declines; and losses in cardiovascular fitness can happen even more rapidly.

So, in order to combat those declines in our Active Aging sites, we’ve created the Fitness Freeze program. The basic idea of the program is as follows:

Members earn a snowflake for each week where they exercise three or more times. This can include attending a group fitness class, working out in the fitness center, or exercising on their own somewhere else. At some sites, residents can earn a “bonus” snowflake by completing an assigned task such as a scavenger hunt, an express workout, or trying a new machine or exercise. As members earn their snowflakes, the manager will hang them up throughout the fitness center. The effect is thrilling. Each fitness center becomes a “snowy” wonderland as more and more residents earn their snowflakes.

It’s a fun, simple program that has proven extremely effective in our Active Aging sites. Last year was the first running of the Fitness Freeze program and it resulted in:

• 11% increase in the total visits from November to December 2014 compared to the same months in 2013.
• 8% increase in members gained from November to December 2014 compared to the same months in 2013.
• 26% increase in the number of appointments held from November to December 2014 compared to the same months in 2013.

Our team has set even higher goals for the 2015 Fitness Freeze and I can’t wait to see the results! How are you keeping your members motivated during the holidays?

It's not just about creative programming, how do you plan to take your program to the next level?

Download our eBook below for strategies to take your fitness center from vacant to vibrant!

Planning ahead is central to what we do.  It’s how we create successful initiatives like our March Into Better Balance Challenge, the 30 Day Squat Challenge, Club PED, National Senior Health and Fitness Day, Active Aging Week, Maintain Not Gain, and several other offerings. One of the ways that planning ahead helps us better serve our clients is with program evaluation.  We’ve written before about the importance of measuring the impact of activities in your wellness program.  In order to effectively evaluate what you’re offering, you have (1) know the programs you’re running, and (2) do the work to set up the program well.

Beyond program evaluation, there are a lot of factors our staff consider to pull off successful programs, and the one element that holds all of that programming together is our planning process.  In fact, our team is already hard at work filling out their 2016 program planning templates. The planning tool allows managers to look at several elements at once:

 1. Balance

Viewing the year-at-a-glance program plan is really helpful for our staff who are looking to provide a balanced programming strategy.  For example, staff can spread out their larger wellness initiatives and sprinkle smaller programs into parts of the year that are typically busier for members. They can also create a balance between types of programming such as fitness incentives, wellness programs, and educational pieces.

 2. Deadlines

Probably the most practical reason to plan ahead is to make sure all the prep work gets done in time. Many of the events and initiatives run by our managers involve other staff and departments. Planning ahead allows you to make sure you can get everything done on time. For example, let’s say you have a field day event planned. You’ll need to work backwards from the date of the event to be sure you have time to order supplies, advertise the event to your members, make arrangements for food and drinks, and plan what you’ll need for set-up. All of those details can take six to eight weeks or more to come together depending on how involved your program is. You can’t get started a week before and expect it to run smoothly.

 3. Community Collaboration

When we plan out the structure of our year ahead of time, it gives us a chance to take that plan to the other departments within the client – be it at a corporate site or in senior living – to allow for optimal collaboration.  And the possibilities for truly engaging programming is great. Our partners offer fantastic creativity to boost initiatives for better participation and for a more well-rounded approach.  Planning in this way also helps us avoid overlap with other key initiatives at the client so that the audience (employees or residents) isn’t confused, frustrated, or otherwise dis-incentivized to participate. 

What’s next?

If it’s true that failing to plan is planning to fail, then how do you go about building this plan?  Below are some tips and tricks to get you started.

Build programs with purpose

We’re not spending time and energy on programs for them to go unattended. And none of us really have time to slap spaghetti against the wall to see what sticks.  Instead, consider developing programs that have a purpose behind them.  It might be that you’re trying to tie into participation goals for the fitness center, or group exercise classes.  Then design the offering geared toward that goal. 

Establish annual campaigns

Members love a good tradition, and you can easily play into that nostalgia with fun programming that occurs annually. Competitions with bragging rights have worked well for us.

Look at untapped areas within your environment

In our corporate settings, sometimes the cafeteria or outdoor settings provide new spaces for creative programming.  In senior living communities, the pool may be a huge opportunity for social, intellectual, and/or physical programming. Grab our quick read on how to grow aquatics participation or click below.

Our creative staff have come up with creative ways for drawing in participation for programs in a variety of settings.  Check their success with the Fitness Freeze, Meditation, and NIFS150 programs. Subscribe to our blog to receive future posts about our successful programs.