Target Wellbeing
Physical Activity 2010
Contents
Current Physical Activity Standards and Guidance ...................................................................................................................................................... 3
Recent Projects and Research ..................................................................................................................................................................................... 5
Interventions................................................................................................................................................................................................................. 7
Examples of Training.................................................................................................................................................................................................... 9
Examples of Physical Activity Assessment Tools ....................................................................................................................................................... 12
This Physical Activity Scoping exercise was carried out in 2010 to find the most recent and relevant documents concerning physical activity-related
practice for older people in care homes. It should be noted that the information presented in this document, was correct at the time of development.
In addition the training courses and physical activity assessment tools detailed in this document have not been endorsed by Age UK West
Cumbria.
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Current Physical Activity Standards and Guidance
http://www.dh.gov.uk/prod_consum_dh/groups/dh_d
igitalassets/@dh/@en/documents/digitalasset/dh_
4067778.pdf
Care Homes for Older People- Health Care (8.8)
(Care Standards Act, 2000)
Opportunities must be provided for appropriate exercise and physical activity; Also, suitable
interventions are conducted for older people seen as at risk of falling.
Standard Eight: The promotions of Health and Active Life in Older Age
(The National Service Framework for Older People, 2001)
The health and well being of older people is supported through programmes of action led by the
NHS with support from councils.
Activities that can encourage a healthy active life for older people include:
• Older people having access on the basis of need, not age
• Health promotion activities of specific benefit to older people such as programmes for
increasing physical activity
• Wider initiatives involving a multi-sectoral approach to promoting health, independence and
well being in old age, such as exercise services.
3
http://www.rcgp.org.uk/pdf/ISS_SUMM01_02.pdf
http://www.who.int/dietphysicalactivity/pa/en/index.ht
ml
Physical Activity and Health Outcomes
(WHO, 2010)
At least 30 minutes of regular, moderate physical activity, five days a week, reduces the risk of
cardiovascular disease and diabetes, colon cancer and breast cancer. Muscle strengthening
and balance training can reduce falls and increase functional status among older adults. More
activity may be required for weight control.
http://www.who.int/dietphysicalactivity/factsheet_old
eradults/en/index.html
Recommendations for Older People
Types of physical activity suitable for older people can include, walking, swimming, stretching,
dancing, gardening, hiking, cycling or organised exercise sessions. However, there are various
vital considerations specific to the older people population in terms of physical activity
recommendations, for example:
•
•
•
•
Recommended intensity of aerobic activity should take into account the older persons
aerobic fitness.
Activities that maintain or increase flexibility are suggested as beneficial.
Balance workouts are promoted for older adults at risk of falling.
Older people that have medical problems or disabilities that may affect their ability to be
physically active should seek advice from a doctor.
http://www.wscsp.org/site/index.php?/news/activities
/seniors/physical_activity_and_older_people
New Guidelines on Older People and Physical Activity
(WASP, 2007)
These guidelines look at appropriate physical activity for the older person and how to translate
evidence on promoting physical activity into practice. Intervention provides assistance to those
planning programmes designed to promote physical activity with all older people.
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Contact: Rachel
Bardsley <[email protected]>
http://www.wscsp.org/site/index.php?/news/activities
/seniors/physical_activity_and_older_people
Active for Later Life Resource
(WASP, 2007)
Contact: Rachel
This helps people to produce physical activity programmes for older people of all abilities. It
Bardsley <[email protected]>
includes summaries of data and suggestions and policy. It also includes a series of working
papers, practical guidance documents and thoughts on physical activity prospects for older
adults.
http://www.nice.org.uk/niceMedia/documents/act4lif
e_older.pdf
Active For Life
(Nice, 2010)
This guide is aimed at people working with older people. It highlights various methods of
encouraging those over 50 to engage in physical activity to improve their health.
Exercise & Physical Activity: Everyday Guide from the National Institute on http://www.nia.nih.gov/healthinformation/publication
s/exerciseguide/
Aging.
(National Institute on Aging, 2009)
This guide highlights various different forms of exercise and physical activity. It also has many
suggestions to help older people be active in ways that suit their lifestyle, interests, health, and
budget and level of fitness. This guide shows that exercise is for everyone — people who are
healthy and those who live with an ongoing health problem or disability.
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http://www.health.gov.au/internet/main/publishing.ns
f/Content/phd-physical-rec-older-guidelines
Physical Activity
(Australian Government, Department of Health and Ageing, 2009)
These recommendations are relevant to older people across all stages of health and capacity.
They can also be applied to older people living at home or in residential care.
General advice when performing physical activities
•
•
•
•
•
View the physical activity as a fun social interaction with a partner, friends or family
members.
Drink water during and after physical exercise to prevent dehydration.
Do a short phase of warm up exercises/muscle stretching at the beginning and end of
the physical activity. This will help the body adjust to the demand of the exercise.
Include some outdoors physical activity (avoiding the warmest part of the day).
Use appropriate safety and protection equipment to reduce risk of injury during physical
activity eg. use supportive footwear for walking; helmet for bicycle riding.
This guidance also includes five recommendations for older people engaging in physical
activity:
•
•
•
•
•
Older people should do some form of physical activity, no matter what their age, weight,
health problems or abilities.
Older people should be active every day in as many ways as possible, doing a range of
physical activities that incorporate fitness, strength, balance and flexibility.
Older people should accumulate at least 30 minutes of moderate intensity physical
activity on most, preferably all, days.
Older people who have stopped physical activity, or who are starting a new physical
activity, should start at a level that is easily manageable and gradually build up the
recommended amount, type and frequency of activity.
Older people who continue to enjoy a lifetime of vigorous physical activity should carry
on doing so in a manner suited to their capability into later life, provided recommended
safety procedures and guidelines are adhered to.
http://www.active4life.me.uk/standards.htm
Active for Life Standards
Physical activities should meet the needs of the older person and allow them to make choices
about their life. Additionally, any type of physical activity for an older individual can be beneficial
for their health and wellbeing.
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Physical Activity and Public Health in Older Adults. Recommendation From http://circ.ahajournals.org/cgi/content/short/CIRCUL
the American College of Sports Medicine and the American Heart ATIONAHA.107.185650v1
Association
(American Heart Association, 2007)
This paper suggests types and levels of physical activity required to maintain and improve older
peoples’ health. A review of relevant findings shows the need to match level of aerobic
exercise to the older person’s aerobic fitness level. Recommendations include:
Exercises to preserve or increase flexibility
Balance exercises to prevent risk of falling
• An activity plan which details achievements and integrates preventative and therapeutic
suggestions
•
•
http://www.cdc.gov/nccdphp/sgr/pdf/olderad.pdf
Physical Activity and Health – Older Adults
(A Report of the Surgeon General, 1999)
If the older person has previously led a very inactive lifestyle, then when they commence with a
physical activity program they should begin with short intervals of moderate physical exercise
(5 – 10 minutes) and slowly build on this.
Additionally, older people should arrange an appointment with a doctor before undertaking any
physical activities.
http://heartdisease.about.com/gi/o.htm?zi=1/XJ&zTi
=1&sdn=heartdisease&cdn=health&tm=10&gps=34
(Health & Human Services, 2008)
5_325_1020_539&f=00&su=p284.9.336.ip_p726.8.3
These guidelines discuss the positive effects of exercise for the health of older people. It also 36.ip_&tt=2&bt=1&bts=0&zu=http%3A//www.health.
suggests that 150 minutes of exercise a week is achievable by most older people who are gov/paguidelines/guidelines/default.aspx
physically capable.
Physical Activity Guidelines for Americans
7
Recent Projects and Research
National Service Framework (2001)
A national service framework was set up by the government in 2001 to promote the wellbeing
of older people and set standards required to be met at a national level.
According to the research on older people detailed in this framework, if a more physically
active lifestyle was adopted then life expectancy can be increased significantly even if the
person was previously inactive. More significantly increases can be seen in mobility and
independence and a general improvement to overall quality of life. Adapted exercise can be
used even for very frail older people to help improve strength, mobility and balance - and can
therefore reduce the risk of falling a major cause of fatalities among older people
American College of Sports Medicine and the American Heart Foundation.
(Nelson et al. 2007)
This research recommended different types of activity– each to be performed for certain
lengths of time, and so many times a week such as:
• Aerobic exercise – 20 minutes, 3 times a week
• Strength activities – twice a week
• Flexibility exercises – 10 minutes, twice a week
• Balance activities for falls prevention
An activity Plan should be drawn up for each individual to incorporate all these ideas.
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http://www.dh.gov.uk/prod_consum_dh/groups/dh_
digitalassets/@dh/@en/documents/digitalasset/dh
_4071283.pdf
http://circ.ahajournals.org/content/116/9/1094.full.pd
f
http://www.laterlifetraining.co.uk/wpcontent/uploads/2010/08/ExInjPrevScandJMedSciS
ports2003.pdf
Tailored Exercise Programmes
(Dinan & Skelton, 2000)
This study looked at different aspects of physical ability, such as functional capacity, strength,
balance, gait, postural hypotension, transfer and endurance. Tailored exercise programme
were conducted, showing significant improvement in older people. However, they did find that
activity had to take place continuously every week and once stopped functional capacity was
seen to deteriorate.
A key aspect for people in residential care is often Postural Hypotension, which can be caused
by long periods of standing or bed rest – to improve this, this study looked at a seated exercise
class which was carried out over a period of 24 weeks. The results showed that prevention of a
first fall and future falls can be influenced by community exercise opportunities, provided they
are accessible, quality assured and, where appropriate, multidisciplinary.
Older People- Physical Activity
(GLA, 2007)
The Review of Health Inequalities (2008) claimed that older people are not doing enough
Physical Activity to meet recommended guidelines.
For older people especially, increased physical activity is linked with a reduced risk of coronary
heart disease, hypertension, non-insulin dependent diabetes, colon cancer, depression and
anxiety. Higher levels physical activity increase bone mineral content, reduces the risk of
osteoporotic fractures, helps to maintain appropriate body weight, and increases longevity.
Being physically active could also improve older people’s quality of life as physical activity has
beneficial effects across several physical and psychological-health outcomes amongst elderly
populations.
Previous research highlights that lost fitness can be regained with regular physical activity,
even in extreme old age.
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http://westminstercitypartnership.org.uk/Partnership
s/Health%20and%20Wellbeing/JSNA%20%20Com
pleted%20Needs%20Assessments/JSNA%20%20Older%20People.pdf
Fit Body, Fit Mind
(Hertzog et al., 2009)
Regular physical exercise in older people helps their brain stay in better shape, therefore
increasing their mental health too. "Old minds are like old horses; you must exercise them if
you wish to keep them in working order."
Fit Body, Fit Mind. By: Hertzog, Christopher,
Kramer, Arthur F., Wilson, Robert S., Lindenberger,
Ulman, Scientific American Mind, 15552284,
Jul/Aug2009, Vol. 20, Issue 4
This study examines the relationship between physical activity in middle age, and the likelihood
of dementia. Those who had been more active earlier in their life were 52 percent less likely to
develop dementia.
In a study published in 2004, epidemiologist Jennifer Weuve of Harvard University and her
colleagues also investigated the association between physical activity and cognitive change
over a two-year period in 16,466 nurses who were 70+. Weuve's group found a significant
relationship between energy exhausted in physical activities and improved cognition, across a
large set of cognitive measures.
Physical Activities and Depression
(Blake et al., 2009)
Depression is a common occurrence in older people. Exercise has been proposed as an
alternative treatment to medication over recent years and such interventions are showing
promise. Physical exercise is an easy option to inhibit the progression of mobility limitation and
further disability may be slowed or even prevented in older adults. Research has also
suggested the possible psychological advantages of exercise training for older, non-depressed
people too. These include improvements in cognitive function, mood and general wellbeing.
This study found that participants who were in the physical activity intervention
showed significant reductions in depression at the end of the intervention compared with the
older people in the control group. One investigation showed that participants who participated
in a higher intensity of progressive resistance training showed significantly higher rates of
improvement in depression compared with both the low-intensity progressive resistance and
the control.
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How effective are physical activity interventions for
alleviating depressive symptoms in older people? A
systematic review.Full Text Available Blake, H.;
Mo, P.; Malik, S.; Thomas, S.; Clinical
Rehabilitation, Vol 23(10), Oct, 2009. pp. 873-887
Interventions
Regional Target Wellbeing
Active Ageing Burnley – this aims to increase physical activity in the over 50’s using exercise
workshops.
Contact Information
Delivery Organisation / Lead:
Age Concern Lancashire
Key contact: Julie Duerden
Address: Burnley
United Kingdom
Website:http://www.targetwellbeing.org.uk/profile/a
ctive_aging_burnley
http://www.activecumbria.com/files/dance_cum
bria_brochure.pdf
Dance Cumbria
This project took place in Ulverston over 10 weeks and it assessed how dance could benefit
older people in terms of their mobility and quality of life.
Although this project was focused on people who suffer from Parkinson's disease the success
of this project highlights the benefits of such programmes and their potential use in care
settings.
The participants were asked to keep a personal diary and record their experiences of the
sessions. The entries were very positive.
‘Every session makes me feel energised and hopeful. I am aware that without this I would be
far more despondent and unmotivated’
Project evaluation reported an increase in ease of movement and improved mood.
Experiences of feeling marginalised and isolated were alleviated and participants were
generally more positive.
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Cultural Policy Unit, Cumbria County Council,
Arroyo Block, The Castle, Carlisle CA3 8UR
Tel: 01228 227306
Email: [email protected]
Contact: Juliet Jackson, [email protected]
Moving More Often (Kirklees)
Tel: 01484 234095
This is for frailer older people either in residential homes, community groups, luncheon clubs,
sheltered housing or sports centres in neighbourhood renewal areas which offer sessions for
older people. Community based workers are also trained to work with less active older people
in their own homes. This project found that a significant number of people are more active on a
regular basis as a result of this intervention.
Wandsworth Active Lifestyles 50+
This project is for older people aged 50+. It tries to increase participation in physical activities
such as community exercise classes, health walks and learn to swim courses. 84% of
participants found the programme beneficial.
http://www.idea.gov.uk/idk/core/page.do?pageId=93192
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Contact: Hayley Goodin,
[email protected]
Tel: 020 8871 6373
or Claudine Aherne
[email protected]
Tel: 020 8874 7883
Website: www.wandsworth.gov.uk/fit4life
Fit Together Norfolk
The project is aimed at older people aged 50+. Pharmacy staff were trained in the benefits of
physical activity, the opportunities within the area and the use of the Active Norfolk database.
Customers had access to promotions, club referral and volunteering opportunities. Health
check customers received direct suggestions in line with their condition. These activities
included cycling and dancing for health. Qualitative evaluation showed an improved level of
physical wellbeing in those who undertook the activities.
Contact: Martin Seymour,
[email protected]
Tel: 01603 257111
http://www.bhfactive.org.uk/downloads/Information_
sharing_booklet_FINAL.pdf
Get up and Go
Jackie Hanley
This is a chair based exercise guide produced in Oldham. The information provided allows
older people to carry on exercising at home once their classes have ended. The exercises
provided in the book aid older people with difficulties such as poor balance and poor functional
ability. To accompany the guide there is also a DVD with people demonstrating the different
exercises.
Oldham Community Leisure Limited
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Tel: 0161 621 7135
Email: [email protected]
Examples of Training
National Association for Providers of Activities for Older People- In
House Training (Groups £850, Individuals £90 discount for members)
NAPA offers a variety of courses specific to each setting. The areas involved include;
• The Whole Home Approach
• A managers guide to improving activity provision
• Making the most of mealtimes
• Activities for people with dementia
• Effective care planning for activities
• Risk Assessment and Benefits around activities
• Red cross hand massage and manicure and Red cross neck and shoulder massage
NAPA Training Days (Members £60, Non Members £90)
(NAPA: 2010)
A day of training activities including presentations and workshops. The day allows for
workers to network and discuss issues with people experiencing similar problems. Training
opportunities are available all over the country and venues can be requested.
Distance Learning Course (£300)
NCFE Intermediate Certificate in Provision of Activities in a Care Setting. This course aims
to increase peoples knowledge and skills in planning, conducting and evaluating activities
resulting in enhanced quality of care in care settings and transferable skills. Individuals
work through learning materials and complete activities and tutor-marked assessments.
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Contact NAPA
National Association for Providers of Activities for
Older People, Bondway Commercial Centre, Unit
5.12, 5th Floor, 71 Bondway, London, SW8 1SQ
Telephone: 020 7078 9375
Fax: 020 7735 9634
Email: [email protected]
Website: http://www.napaactivities.co.uk/default.asp?contentID=514
Exercise for Older People- Training Pack (£50)
(NAPA Publications)
See previous page
This pack allows trainer to adequately train their staff on how to safely conduct seated
exercise and movement to music with frailer older people.
BHF National Centre for Physical Activity and
Health
Active Aging Seminars
(BHF National Centre: 2010)
The BHF National Centre for Physical Activity and Health (BHFNC) and the National
Coalition on Active Ageing (NCAA) host these. This is designed for those working in national
organisations and agencies trying to enhance health and wellbeing of older people, for
example fitness instructors and exercise specialists.
School of Sport and Exercise Sciences
Loughborough University
Loughborough
Leicestershire
LE11 3TU
T: 01509 223267
F: 01509 223972
email: [email protected]
Website: http://www.bhfactive.org.uk/olderadults/training.html
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June Brammar, Project Co-ordinator email:
[email protected]
Active in Age (Beth Johnson Foundation)
Gentle Exercise Training Programme for Older Adults. This course is for volunteers, care
workers and others with an interest in the care/ health of older adults.
This course discusses various issues and provides demonstrations, participation and practice
of the material. The main areas that are covered include:
•
•
•
•
•
Why target older adults to do physical activity
What we mean by older adults and how do we see this group in relation to exercise
Benefits of physical activity for this age group
The changes to body in relation to the ageing process and how physical activity can help
to offset, reduce and prevent the health issues associated with ageing
Practical applications of the underpinning knowledge
National Cascade Training Programme
Fit as a Fiddle is a programme that delivers specific programmes to support physical activity
such as:
•
•
•
•
•
Older men
Older people in community and faith settings
Older people who are isolated or house-bound
Organisations running sheltered accommodation for older people
Care and residential homes
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Jo Swinswood, Project Administrator email:
[email protected]
Beth Johnson Foundation
Tel: 01782 844036
Website:http://www.bjf.org.uk/Libraries/Local/919/
Docs/Health%20and%20Advocacy/Activ
einAge.pdf
Website: http://www.ageuk.org.uk/healthwellbeing/fit-as-a-fiddle/national-programme/national-cascade-training-programme-/
http://www.bhfactive.org.uk/olderadults/currentprojects.html#guidelines
Senior Peer Mentor Physical Activity Programme
This programme aims is to increase opportunities and motivation for older adults
The objectives of the programme are: •
•
•
•
To train Senior Peer Mentors to include the promotion of physical activity in their work.
To provide training and support for Senior Peer Mentor trainers/co-ordinators.
To develop a national network of training partnerships.
To further develop the skills of Senior Peer Mentor Physical Activity Motivators
The Senior Peer Mentor Physical Activity Motivator programme is made up of training
courses, with supporting materials and a national network of projects that can be used to
support local health promotion agendas focusing on older people.
Contact: Ann Grant, [email protected]
Tel: 028 90245729 or 028 43778781
The Actively Older Project (Northern Ireland)
This project addressed the obstacles to participation in physical activity for older people and
supported the production of secure and enjoyable programmes. The project provides:
training sessions; Activity leadership training; Networking events to share
good practice, and Good practice guides. This project has trained 66 leaders in inclusive
games, dance and chair based exercises.
http://www.bhfactive.org.uk/downloads/Information
sharing_booklet_FINAL.pdf
http://www.asaging.org/CDC/module6/home.cfm
Live Well, Live Long: Steps to Better Health Series, 2005
This programme has five phases and can be used in accordance with older people’s specific
needs/capabilities. This guide facilitates providers to successfully promote physical activity
and exercise among older people.
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Examples of Physical Activity Assessment
http://bjsm.bmj.com/content/43/1/5.extract
Assertive Screening
(Campbell, 2009)
This highlights and facilitates management of chronic health conditions and
functional limitations. This is a pre- exercise medical assessment in order for
older people to be able to safely participate in suitable physical activities in
relation to their abilities, even if they are very frail.
http://www.dapa-toolkit.mrc.ac.uk/physical-activityassessment/sedentary-behaviours/index.html
Physical activity assessment – Sedentary behaviours
If the individual has the mental capacity then the following self-report
assessments may be used to determine their level of physical activity. Two
examples are:
Self-Assessed Physical Activity Checklist (SAPAC) - this tool has been
psychometrically tested and uses a long list of prompts.
Previous Day Physical Activity Recall (PDPAR) - designed to assess
physical activity and sedentary behaviours.
CHAMPS Physical Activity Questionnaire for Older Adults
(Community Healthy Activities Model Program for Seniors, 2004)
The body weight of the individual being assessed is required along with a
questionnaire. Obtaining information about activities participated in over the
last 4 weeks. A modified version of the questionnaire is available for those
with vision impairment and also personal and telephone interviews are
available.
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http://sbs.ucsf.edu/iha/champs/resources/qxn/
CHAMPS: Community Healthy Activities Model Program for
Seniors
http://sbs.ucsf.edu/iha/champs
University of California, San Francisco (UCSF)
Institute for Health & Aging - http://sbs.ucsf.edu/iha
3333 California Street, Suite 340
San Francisco, CA 94143-0646
Telephone: (415) 502-5200 ◊ Fax: 415-502-5208
Email: [email protected]
http://www.surveymonkey.com/
?cmpid=us:ps:google&gclid=CJasyNyf558CFZdi4wodkWRXGw
Survey Monkey
This facilitates the quality of life surveys
The answers to the questions can be inputted "live" with the person with
dementia as survey monkey is a web based tool; alternatively if Dementia
Advisors are mobile the surveys can be completed on a hard copy and the
data inputted at a later stage.
Survey monkey is free to use for basic surveys but we pay an annual
subscription that provides access to further analysis. The link to the website
provides all the information about setting up surveys, analysis, etc.
http://www.easyforyou.info/downloads/EASYScreeningToolHardC
opyFINAL040308.pdf
Exercise and Screening for You (EASY)
This assessment measure allows care staff to choose an appropriate activity
programme suitable for an older individual whilst maximising full benefit from
possible health problems for them. It is a six question survey, followed by
recommendations depending upon the score of the older person.
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Age UK West Cumbria
Old Customs House
West Strand
Whitehaven
Cumbria
CA28 7LR
Head Office: 01946 66669
Client Helpline: 08443 843 843
Fax: 01946 591182
Email: [email protected]
Website: http://www.ageuk.org.uk/westcumbria/
Registered Charity No: 1122049
This document can also be provided in other formats.
Telephone 08443 843 843
Age UK West Cumbria welcomes Diversity in our workforce
and our services.
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