How To Create A Culture Of Activity In A Senior Living Community
By Eric Sartor, EP
FOX Optimal Living Exercise Physiologist
How does the health of our residents correlate with the health of the community?
Most people understand and agree that physical activity plays a pivotal role in their overall health and well-being. As an exercise physiologist with FOX, I share the belief that exercise and physical activity have a vast array of benefits: improving one’s physical, emotional, and cognitive state regardless of age.
Having worked in several senior living communities during the past five years, I have experienced how differently each community approaches exercise and wellness. Integrating exercise and physical activity into the framework of the community is not easy, but it has tremendous value, ranging from decreased falls and hospitalizations to simply happier residents.
Before we can understand how to establish a culture of activity, we must define an active community.
The American College of Sports Medicine recommends a minimum of 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week for people 65 years of age or older. There are two important factors to note: time and intensity. The appropriate type and dosage of exercise has the power to assist in the management and prevention of chronic diseases. Many people rely solely on medication to treat these conditions.
Simply put: Exercise is medicine.
“Exercise is Medicine” (EIM) is a campaign managed by the American College of Sports Medicine as an initiative for physicians and health care providers to incorporate exercise into treatment plans for their patients. EIM promotes the understanding of exercise prescription as a tool to prevent or manage chronic diseases.
An equally valuable concept to analyze is how the health of all residents directly correlates to the well-being and success of the community. When residents are active and healthy, the environment will feel positive and energized. Those residents will have the ability to maintain a higher level of function, allowing them to age in place longer and maintain as much independence as possible.
This requires exercise and activity to be woven into the fabric of day-to-day activities as well as into the mindset of the directors and staff of the building. Once a dynamic environment is established, new residents are integrated directly into the system and transition into a more active lifestyle. This article will touch on several ways to create a culture of wellness and why it is so important for every senior living community.
To get a more in-depth look at how length of stay impacts communities, take a look at this other piece of Fresh FOX Content.
EXERCISE CLASS
The words “exercise” and “wellness” are very broad terms that can be overused and misunderstood. Most communities will say that they provide exercise and/or wellness.
With FOX, our exercise physiologists are trained and certified to implement group exercise classes that range in frequency, intensity, type, and time.
Each class is designed specifically for various physical and cognitive abilities, implementing exercises that will have the greatest impact on participants’ functional wellness with a focus on progressive and intensive exercises. For some residents, the social interaction and cognitive stimulation they’ll receive is equally as valuable as the physical benefits.
In our FOX Optimal Living Program, we also encourage collaboration between the exercise physiologist and other FOX clinicians to implement the classes following treatment, ensuring that residents are safe and the right fit for the class before they are discharged from skilled therapy. In order for a resident to truly benefit from an exercise class, it must be appropriate and effective, and FOX has the framework to provide exactly that.
INCORPORATING EXERCISE INTO SEDENTARY ACTIVITIES
Having a sedentary lifestyle is a primary risk factor for many diseases, including cardiovascular disease, which is the leading cause of death in the United States.
The good news is that being sedentary is modifiable. As a fitness professional, my mind is always immersed in measuring functional outcomes and using evidence-based standards to prescribe exercise interventions for our patients.
However, it doesn’t have to be that complicated. The simplest and best way to prevent residents from being sedentary is to just start moving.
When beginning therapy and introducing wellness programming for new residents, it is imperative to encourage residents to independently move. This can be whether it’s moving with a walker or self-propelling a wheelchair.
In addition to basic mobility, many sedentary activities can be infused with a bit of movement to be more beneficial. Whether during card games, puzzles, art projects, or social gatherings, providing areas where residents can stand and participate in activities can elicit functional and meaningful improvement. Standing has significant benefits, including improved posture; increased circulation, strength, balance; and reduced risk of developing sores from consecutive lengths of sitting time.
There’s always time to start being active and no amount of movement is too little to be beneficial.
INCENTIVIZE PARTICIPATION
As health professionals, one of our ongoing challenges is maintaining the participation and motivation of our residents.
Adding catchy exercise class names to an activity calendar and expecting every resident to attend is futile. Many older adults did not grow up with organized exercise and it may be a completely new concept to them.
Finding ways to incentivize participation will help increase the amount of residents that attend classes, thus resulting in increased engagement and a healthier community.
There are many ways to incentivize participation. My current community uses credits that are given to participants after exercise class, as well as events coordinated by the activity staff. At the end of the month, an auction is held where the residents can use their credits to buy items such as hand lotion, door decorations, snacks, and more. Most residents take this very seriously and will attend as many classes and events as possible to get more credits for the next auction.
Another way to incentivize participation is to publicly recognize residents for their efforts. Once a quarter, we choose a “resident spotlight” from our assisted living and memory care communities. An award is presented to a resident whom exhibits the most effort and determination in wellness classes.
Family engagement also has a lot of influence on participation. Inviting family members to attend exercise classes and therapy sessions or giving weekly updates on participation will encourage many residents to stay accountable and devote extra effort toward attending classes or activities.
Even simple gestures, such as giving a patient a FOX-branded walker bag or T-shirt makes them proud to be associated with FOX and gets other residents interested in where and how to get engaged. Not every resident is motivated the same way, so it is essential to incentivize participation in various ways to encourage involvement amongst the entire community.
PUT THE ‘FUN’ IN FUNCTIONAL
An integral part of creating a successful wellness continuum is to make it fun and social.
Older adults do not tend to actively seek out opportunities to participate in exercise classes. If presented properly, many residents won’t view it as “exercise,” but simply as a social event.
That is the magic.
If we can get our residents to shift their mindsets away from what they think they know about traditional therapy to focus on what they enjoy doing, it not only becomes more gratifying for them but the likelihood that they continue to participate and improve is much higher.
For many people, regardless of age, the gym is an intimidating place. As stated earlier in the article, many older adults whom we work with did not have access to fitness centers growing up. Using fitness equipment can be overwhelming.
As clinicians and EPs, utilizing communities as the “gym” can restore comfort and add an element of functionality. Creating a transfer circuit in their room, navigating the hallways and elevators, managing steps or walking outside, opening doors, and getting on the bus for trips can reestablish confidence and independence in our residents. This will help them gain the ability to enjoy activities that they may have never have expected to do again.
MAKE EXERCISE AND ACTIVITY EXPECTED, NOT OPTIONAL
Part of establishing a culture of activity lies in the mindset of not only the therapy team and the residents but the entire staff of the building. Training care staff to understand the benefits of exercise and how it translates to easier and safer care can elicit the encouragement of an entire team to assist in increasing the participation of residents.
In communities partnered with our FOX Optimal Living Program, upon move-in, residents are assessed and designated a tier based on criteria from their physical and cognitive assessment . Each tier is associated with specific classes that are geared toward their strengths and weaknesses, providing them with the most appropriate interventions to address their needs and achieve an optimal level of function.
Rather than just having residents pick and choose which classes to attend, we assign them specific classes that are suitably matched and will ensure success. If a resident wants to attend a higher-level class but is unable due to safety concerns, we use it as motivation for them to improve in their functional outcome measures to reach the next tier.
Creating these tiers and wellness system instills a more linear track of exercise for the residents. As they begin to understand the philosophy and more residents get involved, it has a snowball effect in provoking the attention of other residents. This results in increased participation, accountability, and ultimately a more active environment.
PREVENT LEARNING DEPENDENCY
Within the first few days after a resident moves into a senior living community, establishing an accurate baseline can be pivotal in the success or failure of that resident.
FOX ensures that each new resident is immediately and appropriately assessed by an exercise physiologist to determine their ability to transfer, ambulate, and assist in activities of daily living.
Thereafter, every 90 days the resident is reassessed to track improvement or decline and be provided with immediate intervention through therapy, upon physician referral, or other services.
The exercise physiologist can communicate their findings to the interdisciplinary team and coordinate the most effective care for the patient with the least amount of assistance needed. In this way, we can foster a sense of independence while maintaining safety.
Without the proper communication between therapy and care staff, residents tend to receive excessive assistance with activities of daily living, ultimately resulting in increased dependence and functional decline over time. It can be a very slippery slope. Encouraging every resident to maintain or improve their independence is imperative, allowing the community to thrive in activity rather than dwell in dependency.
Creating a culture of wellness takes time and commitment through a partnership between FOX and a senior living community, but once it is established, the results are incredibly impactful. When residents begin to believe in FOX’s philosophy of wellness and disregard the stigma of exercise as a negative experience, the community gains new life and positive energy. The culture of wellness becomes contagious and the community flourishes.