Exercise for older people
‘Clean your teeth standing on one leg’
What is your reaction when you see an older person - somebody over 65? Is it, ‘I hope I never get like that’, or ‘They are so boring’, or ‘Why would I want to work with them’? Or is it, ‘What a fantastic opportunity this group of people are.
It would be quite a challenge to work with them. What a great market!’ By paying little attention to older people the fitness sector is avoiding an area of work which is hugely rewarding and satisfying and reduces greatly the personal, social and health costs of old age as well as missing an enormous commercial opportunity. So here are three key questions for those of us who work as personal trainers and fitness instructors:
1. Why are older people important?
2. What can we offer them?
Why are older people important?
The reason is that there are a lot of us – by 2015 there will be 12.7 million people in the UK over the age of 65. We cost the NHS and social services, vast sums of money which are rising year on year. It will not be long before this financial burden will be unsustainable. We suffer from many preventable illnesses. We fall over and break our hips, we occupy hospital beds, we get less and less independent and many of us end up in care homes sitting in chairs, incontinent, unable to recognise our family and using up any inheritance we had hoped to pass on to our children!
At least that is what it is like if we are not physically active.
Yes, there are physiological changes which take place with age: aerobic capacity falls, muscle
bulk strength declines, balance, coordination and cognitive function fail progressively. There is a greater risk of heart attack, stroke, cancer, depression and musculoskeletal disease. The combination of physiological aging and illness result in failing health, decreased mobility, loss of social interaction and increasing dependence.
What can we offer them?
The good news is that it does not have to be like this!
The overwhelming evidence shows that exercise in older people has huge advantages. In general terms, older people who exercise maintain their independence, have good social activities, are much less likely to get dementia, visit their doctor infrequently, have fewer illnesses; and when they do get ill, recover faster than their sedentary friends. Furthermore, if they have a long-standing condition such as arthritis, the symptoms, and therefore their lives, are significantly improved by regular exercise.
But what sort of exercise are we talking about and how much? Firstly, older people must attend to the activities of daily living. Wherever possible they should be walking rather than using cars or buses, using stairs instead of lifts and escalators, doing the garden and house work frequently, making sure they don’t remain sitting down for more than 30 minutes at a time. In other words, taking and making every opportunity to move.
Secondly, we need to help them train all the components of fitness. That means 150 minutes of moderate intensity aerobic exercise or 75 minutes of high intensity every week;
two progressive strength training sessions a week of two sets of 15 reps for all the major muscle groups; regular flexibility and motor skills work (Start Active, Stay Active, 2011). I train my clients and patients to clean their teeth standing on one leg!
Of course this is a challenge both for the instructor and the client.
But those of us who work with this group of people experience on a daily basis that the research evidence is right. Huge gains in health, fitness, wellbeing and just the sheer energy and enthusiasm for living are achieved again and again.
How can we do it?
Here are a few key things to do when working with older people.
1Remember that their goals are different from younger people. We are not usually interested in a six-pack, sculptured pecs or a tight butt. They want to be able to live life to the full, have lots of energy, and do the things they want to.
2Develop excellent people skills out of courtesy and respect. The ability to listen and provide total undivided attention, as well as top rate customer care is expected.
3Think about the environment. Is it intimidating because everything shouts, fit, young, tanned and sexy?
Or does it say, ‘Hey, everyone is welcome here’?
4Provide opportunities and an inviting environment where we can socialise before and after our workout. How good are the coffee, tea, fruit juice and healthy snacks?
5Be willing to learn from us – we actually have a lot of life experience.
6 We often enjoy working in groups so classes for us are an attractive option.
Working with older people is challenging, rewarding and fun!
John worked as a hospital consultant in the NHS for 25 years before developing rheumatoid arthritis (RA) and having to retire in his mid-50’s on health grounds. While drugs kept the RA under reasonable control he discovered the huge benefits of exercise such that he and his wife successfully climbed Mount Kilimanjaro (5895m). He qualified as as PT and developed a practice working largely with older people and patients with longstanding disease. He writes and speaks widely. He has been the honorary chief medical officer of ukactive (FIA) and continues to undertake consultancy work in health and fitness. At 71 he has no intention of retiring. He trains 4 to 5 times a week including a weekly session with ‘a superb PT, half my age’.
All fitness ___by Dr John Searle