The importance of exercise in our daily lives has been discussed for many years. From increasing physical education programs in grammar schools in the 60s to the health club craze of the 90s, most of us know the importance of an exercise program to maintain general health and well-being. There is no age group that this is more important for than the geriatric population. "Even patients with chronic illnesses such as heart disease, high blood pressure, diabetes and arthritis can exercise safely" (American Academy of Family Physicians, 2003). Encouraging older adults to maintain a reasonable activity level is a job each of us should consider. Agility, flexibility, and strength may be just the key to preventing injury and debilitation in the future.
Developing an understanding of what types of exercise programs are available in your community setting is a place to begin. Whether the program is an exercise program for those with arthritic conditions or water aerobics exercise programs, many community centers are now offering a variety of programs for older adults. Exploring the options in your local area will give you the necessary information to help your patients begin the process of becoming active.
Dr. Adler in her article The Use of Tai Chi to Improve Health in Older Adults helps demonstrate the benefits associated with that particular exercise program. Encouraging your older patients to participate in an exercise program that suits their personal limitations is the message.
Programs such as that described by Dr. Adler offer the older adult many other benefits as well. It is easy for the elderly to become housebound and withdrawn from social circles. Any program that promotes activities outside of the home provides external stimulation and interaction. This is important to the mental well-being of the older adult.
An article from Women's Health in Primary Care (2000) advocates that there are four steps when working with the elderly to determine what type of exercise program makes the most sense. First, educate the patient about the importance of an activity level that can be achieved within the patient's own health parameters. Prescribing a daily jog to a patient who has symptomatic bilateral knee arthritis would not be successful.
Next, review what types of exercise the patient has participated in during his or her lifetime and which ones were personally fulfilling. Specifically look at the recent exercise routine so you can identify a good starting place for the current program. While a patient may have been active in the third or forth decade, that will have no impact on today. Once you know where the patient is today and understand what activities the patient might tend to like, you may then discuss an exercise program. For instance, a past routine of a weekly volleyball game with a group of friends might be the perfect program once again. Finding a local community center that has this type of program for older adults and encouraging the formation of a group of peers similar in age to try out the old sport again might be fun. An activity such as swimming or water walking is a great activity for someone with painful arthritic joints; however, it might be immediately discounted if the patient is afraid of the water. Once you know where the patient is coming from, decide on a graduated program that could work for your patient. Providing your patient with a list of local resources, whether it is community based or through a physical rehabilitation specialist, is important. Most older adults should be guided as they begin new physical activity.
Finally, following up with your patient to discuss any problems that might have been encountered in the exercise program and helping to make some adjustment is important. Showing interest and concern with the success of the exercise routine will help the patient continue to work toward a goal of increased activity. Increased activity and strength will provide the best promise for a longer life of independence.
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