Aged to Perfection

At what age is exercise no longer important?

That’s a trick question—there is no age when exercise isn’t important.  Just because someone is elderly doesn’t mean they’re exempt from exercise!

It does mean the exercise needs to be modified to match ability level and possible injuries or conditions such as arthritis.  What qualifies as exercise also shifts as someone ages.  When someone is young, it may take a jog or run to get their heart rate up, whereas an elderly senior may increase their heart rate just by walking. The important thing is to increase the heart rate and to get the blood and oxygen flowing.

Sadly, many seniors lead highly sedentary lives.  All too often, the lazy boy recliner becomes the centre of seniors’ worlds. They settle into the recliner first thing in the morning and watch television for a significant part of the day. They nap in the chair…they may even sleep in the chair all night as a surprising number of seniors tend to do.

The most activity they get is a few steps to the washroom and back.  Even then, I’ve met many seniors who intentionally limit their fluid intake to reduce the number of washroom trips required!  Going to the washroom may be the only activity they’re getting, and even then they’re limiting that.

A senior who has become accustomed to such a sedentary lifestyle will need to reintroduce activity gradually. Compared to their currently sedentary day, it does not take much effort to suddenly double activity levels! Simply getting up and out of their chair becomes a form of activity that cannot be taken for granted.

If you’re visiting someone who tends to be overly sedentary, encourage as much movement and activity as possible. As a precaution, you might avoid suggesting “exercise”.  Calling it “exercise” may be a barrier to some elderly people. If they don’t have the same context as you do for prioritizing fitness and exercise, they may not be inclined to want to “exercise”.

Instead, integrate basic activity into your visit.  Suggest sitting at the kitchen table together for a bit. Ask them to show you around. Step outside into the backyard.  While it may not qualify as exercise for you, it is most definitely an increase in activity for them. Be mindful to not push too hard too quickly, but continually suggest more and more activity—and increasing lengths of time out of the lazy boy chair.

When you’re in the kitchen together, ask them to reach items out of the cupboard. Bending, stretching, reaching are all basic movements that are necessary to maintaining a range of motion.  Ask for help folding laundry and putting it away.  The “excuses” you use to call your loved one into another room, or get them up and out of their chair are only limited by your imagination.

Before you know it, you might start getting a little devious in the creative ways you encourage more activity during your visit. The better you can disguise the increased activity as anything other than exercise, the more successful you’ll be!

Do you know a senior who has suffered a serious fall? Likely you do, since approximately 30% of seniors who live in the community suffer a fall each year. The consequences of a fall can be quite serious—injury, hospitalization, even death from complications.

“Falling isn’t as much about slips and trips. It’s about the failure to recover. Slips and trips happen at all ages.” - Dr. George Fernie

Did you know that falls are the cause of 90% of all hip fractures, 50% of all injury-related hospitalizations in seniors, and the 5th leading cause of death in the elderly?! These numbers also double when a senior has dementia. So, it is extremely vital in keeping seniors strong and steady on their feet.

Why do seniors fall in the first place?

There are various external factors at play that contribute to slips and trips; such as:

• Loose carpets/rugs
• Poor lighting
• Unstable chairs
• Steep stairs
• Poor footwear (e.g. slippers)

While some falls can be attributed to tripping—such as tripping over floor mats, pets or curbs—other falls seem mysterious. The person will report that they just went down and we're not sure why. In many of those mysterious cases, the fall is due to internal factors such as:

• Visual and hearing deficits
• Vestibular dysfunction
• Cognitive impairment
• Neuropathy (abnormal sensory feedback)
• Low blood pressure
• Edema/swelling
• Pain and foot drop
• Weakness and tightness
• Decreased flexibility
• Slowed reflexes and balance disorder 

What can we do to prevent falls?

Get rid of all the external factors that cause slips and trips! Ensure that your living space has no loose carpets or rugs, the lighting is bright for increased visibility, all chairs are sturdy with armrests, everything needed is on the main floor (no stairs), and that proper footwear is worn in the house.

Improve balance and stability!

The number one key to fall prevention is staying active! Physical activity has shown to mitigate the deathly consequences of falls – just walking, gardening or housework is enough for an elderly loved one.

However, when your elderly loved one refuses to do regular exercise the best option is to increase their base of support. To remain balanced, there must be a stable base of support—the wider the base of support the more stable it becomes. The base of support is the invisible box that can be drawn around your feet when you are standing. Added to this is our centre of mass—which is approximately where our belly button is located.

When someone’s centre of mass is in the middle of their base of support, they are perfectly balanced. When their centre of mass begins to reach the outer edge of their base of support, they are more prone to falling.

“She says she wants to keep living in her home. We say it starts by keeping her on her feet.” - American Academy of Orthopedic Surgeons

For example, a ballerina narrows her base of support to be only one square inch when she is en pointe. Her balance is quite precarious because her base of support has been reduced. The only way that she remains upright is by perfectly hovering her centre of mass over her base of support.  She is constantly adjusting to ensure that her centre of mass doesn't sway too far aware from her base of support.

In the case of a frail senior, their feet may ache or have bunions, causing that person to only walk on the edges of their feet, which reduces their base of support and their balance. Instead of using the full surface of their foot, they have reduced their base of support more like a ballerina.  As well, the senior’s posture may be more forward-leaning, pushing the centre of mass to the outer edge of the base of support, causing instability. A senior will not likely be crouching down to touch the ground for support, the way a football player does.

The best way to create a strong base of support is to use a walker. The four wheels of the walker expand someone’s base and provide the necessary support. Much like a football player, a well-balanced senior using a walker is less likely to fall than a senior who is precariously balancing on sore feet. If their posture is forward-leaning then the walker extends the base of support ensuring that the centre of mass remains in the middle of the base of support.

Encourage the seniors in your life to carefully assess their centre of mass and base of support to ensure that they are as safely balanced as possible. Every fall that is prevented is a great success and ensures a longer and healthier life for that senior.