Senior Health

Healthy Decisions, Healthy Actions

"Those who think they have no time for bodily exercise will sooner or later have to find time for illness."
-Edward Stanley

It is estimated that 70% of functional disabilities attributed to the aging process may actually result from our own unhealthy decisions and behaviors (smoking, obesity, sedentary lifestyle, etc.)¹ As professionals in health care who work with older people, we have the responsibility to use evidence-based information, whenever possible, to help improve lives by promoting healthy decisions that lead to healthy behaviors.

Americans place great value on independence. When our independence is threatened through functional loss, people, especially older adults, typically face a great deal of fear, anxiety, and suffering. Professionals serving older adults and their families need to focus health promotion efforts on maximizing independence and minimizing functional losses that often result from illness.

To help us in our quest, there are guidelines available to assist us in promoting health, reducing risk, and preventing disease. Two helpful resources are the U.S. Preventive Services Task Force (USPSTF) and Healthy People 2010. Evidence-based information has both of these organizations to recommend that professionals focus their efforts on the following health promotion, disease prevention and risk reduction areas:

Physical activity
Safety
Nutrition
Immunization
Tobacco use

Physical Activity

"Older people who exercised were found to improve performance on independent activities of daily living, increased lifespan, and quality of life. Improved longevity was correlated with avoidance of tobacco."²

Evidence indicates that insufficient activity leads to loss of function. Research focused on older adults suggests that inactivity leads to:

Functional loss and a significant number of deaths.³
Inactivity was associated with nearly $76.6 billion in direct medical costs in 2000.⁴

There is an abundance of information in both the popular press and professional journals that promote physical activity as key to well-being for people of all ages. Researchers recommend that older adults be assessed for "sedentary lifestyle" as a risk factor for many chronic and acute conditions and suggest that no other group would benefit more from increased physical activity.⁵ Recommendations include:

Aerobics (walking, walking upstairs)
Strength training (resistance, weights, muscle building)
Stretching (yoga, range of motion, stretch joints)

Encourage people to consult a health care professional before starting an exercise regimen to make sure the program is appropriate. Some of the simple ways we can encourage people to increase their activity levels include:

Educate people on the benefits of physical activity (improved oxygen to the brain, better balance, increased joint health, decreased pain in joints, decrease fall risk, increased quality of life)
Help people to understand that they may use their daily activities and routines as opportunities for exercise (chair exercise while TV watching, walking pet)
Encourage people to invite a "buddy" to exercise with them (more likely to engage in activities if done with another person)
Advise people to set goals and track their activity (realistic activity plan, obtain pedometer)
Write prescriptions for exercise (This is known to be effective)
Partner with older people to put together an exercise regime modified to their needs (tolerance level, remind to take pain meds prior to activity if needed)
Follow-up with people on their progress (walked extra 100 steps! Celebrate small victories)
Encourage and cheerlead their efforts (reward their good behavior, not intentions) motivate them to "keep up the good work" ⁶

Eveyln's Picks: Recommended Resources

Website: U.S. Preventive Services Task Force (USPSTF). The USPSTF is made up of an independent panel of private-sector experts organized by the U.S. Public Health Service. They review evidence of clinical effective prevention outcomes and recommend routine risk reduction services for integration into primary care plans.

Resources:

National Center for Chronic Disease Prevention and Health Promotion (1999). Chronic Diseases and Health Promotion. Center for Disease Control. Retrieved May, 2007
Kahana, E., Lawrence, R., Kahana, B., Kercher, K., Wisniewski, A. et al (2002). Longterm impact of preventive proactivity on quality of life of the old-old. Psychosomatic Medicine, 64(3), 382-394.
McGinnis, J. & Foege, W. (1993). Actual causes of death in the United States. Journal of the American Medical Association, 270 (18), 2202-2207.
National Center for Chronic Disease Prevention and Health Promotion (2004). Improving nutrition and increasing physical activity. Centers for Disease Control Retrieved January, 2005.
Miller, C.A. (2004). Nursing for Wellness in Older Adults: Theory and Practice. New York: Lippincott Williams & Wilkins, p.82.
Mauk, K. (2006). Gerontological Nursing: Competencies for Care. Boston: Jones and Bartlett Publishers.

GERO GEMS are a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, Gero Gems is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

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Last Reviewed: Dec 09, 2010

Evelyn L Fitzwater, DSN, RN
Associate Professor Emerita
Associate Director of the
College of Nursing
University of Cincinnati