Senior Living Executive | May/June 2022 by Paul E Griffin III
Physical fitness is a primary component of successful aging: Older adults who maintain mobility, strength, and a healthy weight can prevent or delay many health conditions and be prepared for what life brings their way.
And it's much better—and easier - to maintain health in the first place than try to regain it after the fact.
Health-conscious senior living prospects are looking for communities that offer strong wellness programs to help them stay fit. Even residents who don’t like exercise can be motivated to participate if they’re given the right encouragement. To meet those needs, prevention-focused wellness programs can be delivered in a variety of ways through innovative, holistic, and science-based approaches
Making fitness fun
One of the best ways to appeal to active residents and encourage sedentary ones is to make fitness fun. SRG Senior Living takes that idea to heart with its Zest initiative. Zest programming is based on health science and hard data but is designed to be joyful.
Activities are planned around the interests of residents, with fun twists added to keep it fresh.
For example, SRG survey data showed that the top resident interest across all communities was collecting and listening to vinyl records. Directors turned that interest into Zest programming by instituting a monthly “Vinyl Variety Hour,” Each community was given a vintage record player. On the second Thursday of every month, residents are invited to bring their records, socialize, and dance.
The get-togethers are a way to add health-boosting social and physical elements to an activity that resident already enjoy.
"It’s one of our most well-attended events, and the differentiator is that we’re being data-driven in our programming approach," says Sarah Matyko, corporate director of life enrichment at SRG.
Zest activities are designed to incorporate proven benefits for the mind, body and soul. Program directors consider the end goal during the planning phase. “We begin with the end in mind," Matyko says. “Do we want residents to socialize and enjoy the process? Do we want them to get exercise, which we know really helps prevent decline?”
Weaving in other elements
Mind activities are designed to build up cognitive reserves. That’s done in part by educational programming and boon club groups, but it also includes nutrition.
SRG launched Fresh Zest to offer a plant-based menu item at every meal. Chefs also highlight ingredients that are proven to help with health conditions such as arthritis experienced by community residents. The chef will highlight the beneficial ingredient, hand out printed information sheets, and make dishes for residents to sample.
“It's a way for us to educate them on how to be healthy in their lifestyles now," says Matyko.
Programming for the body component of Zest is based on research from the Blue Zones, the areas of the world where people are most likely to live to age 100 and beyond.
“What we learn from the Blue Zones is that it’s not going to the gym arid pumping weights," Matyko says. “It's actually infusing feel-good movement into your day.”
For example, every SRG community has a walking club. To add variety and enrichment, members go to places like museums to take their walks. Exercise classes are designed to feel more like play. Zest Cardio Beat is one of the most popular: Participants learn choreographed dance routines using stability balls as props. It’s so popular that it has a waiting list at most communities.
The soul component of Zest involves more meditative pursuits such as paint-and-sip classes or aromatherapy sessions.
Taking a person-centered approach to fitness allows SRG’s Zest programs to be adapted to an individual resident’s abilities “What Zest is really all about is meeting residents where they are in their life, because we can adapt any activity,” Matyko says.
An 87-year-old resident at SRG’s The Village at Northridge had a lifelong desire to skydive. His wish was fulfilled at an in-door “skydiving” facility that uses a vertical wind runnel to simulate the experience of jumping from a plane. The resident said afterward that it had been the best day of his life.
Those kinds of experiences can have long-lasting health benefits for residents. “Every component of Zest, from the literal meaning of the word all the way down to the experiential programming that we offer, is grounded in science," Matyko says.
At Five Star Senior Living, fitness programming is provided by Ageility, a division of Five Star’s parent company, AlerisLife.
Ageility offers fitness and rehabilitation services for older adults at Five Star communities as well as in free-standing clinics and for other operators. The scalable programs include classes for small and large groups and one-on-one personal training.
“Our fitness programs are designed to help older adults reach their physical potential, regardless of their specific constrains and condition,” says Denise Kelly, senior vice president of lifestyle services at AlerisLife.
One-on-one activities are customized for each person based on their abilities and interests. One current client is a Five Star resident training to participate in the National Senior Games in May.
Knowing the science
While most older adults don’t plan to become athletes, it is important for everyone to remain as active as possible. Physical activity plays a large role in mitigating or even preventing many chronic conditions, including heart disease, diabetes, and dementia. Older adults with stronger muscles are less likely to experience joint injuries. Exercise is also proven to help manage depression and anxiety.
Adding a social component by exercising with others is even more beneficial. MIT AgeLab conducted a study of the Silver Sneakers exercise program in partnership with Tivity Health. The study found that older adults who participated in the program not only benefited from the physical activity itself, but they were also less lonely and had better overall health.
Although a person’s current condition must be taken into account when planning any fitness program, Kelly cautions against treating older adults too delicately.
“Many rehab and fitness providers are so worried about injury that they actually neglect to challenge older adults,” she says. That lack of challenge can lead some older people to give up on trying to be healthy.
“A major benefit of Ageility is that we have an understanding of how much to challenge older adults,” Kelly says.
In 2021 Ageility rolled out a new wellness program for people with Alzheimer’s and other forms of dementia. The program is called MOVE, for Motivate, Optimize, Validate, and Engage. It has three components: traditional exercises to improve balance, strength, and endurance; stress management activities such as yoga, walking and message; and enrichment programming including gardening, cooking, and art. The program is customized to each person.
A destination campus
Vivalon is a nonprofit that provides services to older adults and vulnerable populations in Marin County, Calif. The organization is building a new Healthy Aging Campus in San Rafael to provide health care, fitness, and engagement opportunities for older adults in the area.
The building, set to open in 2023, will have a geriatric health clinic on the first floor, activity spaces and a café on the second floor, and more than 60 affordable senior apartments on the third through sixth floors.
The new campus will provide a one-stop place for older adults to stay physically, mentally, and socially engaged. Activity spaces will include classrooms, a library, art studio, auditorium, physical therapy center, gym, and cafe. A computer lab will provide a space for people to learn how to use new technology and software.
The multifunctional auditorium incorporates a dance studio with a barre and mirrored walls. Those features can be covered with sliding curtains to transform the space into a theater for live presentations and movies.
The clinic and second-floor spaces are designed by MBH Architects of Alameda, Calif. Their goal was to create a space that promotes well-being.
"There's a lot of activity going on that helps to maintain an independent and healthy lifestyle for seniors," says Tammy Ng, project manager and senior associate at MBH Architects.
The cafe, clinic, and some other areas of the campus will be open to the public, which will provide more opportunities for social interaction. The downtown location is intended to make it easier for residents and visitors to take advantage of activities in the building and in the city surrounding it.
Fitness “house cells"
For some communities, an outside contractor is the best way to provide fitness programming for residents. FOX Rehabilitation is a private contractor that offers its rehabilitation and exercise physiology services in senior living communities and private homes.
Although rehabilitation therapies are most often thought of after a medical event, illness, or injury, they can have even greater rewards as a preventative measure.
“Identifying small indicators of functional decline before a large-scale problem happens is really what therapy is great for," says Dr. Travis King, chief quality officer at FOX Rehabilitation.
For example, the right exercise program implemented in time can reduce an older adult's risk of falls by 25 percent . Clinical changes that might lead to a fall are usually apparent long before a person's first fall. Those include difficulty rising from a chair, unsteadiness when walking, slow movements, and reduced participation in activities and meals.
''Just because a person has those impairment-level changes doesn’t mean that they’re going to fall tomorrow," King says. "It does mean that if they stay on the path they're on, they are likely to have a fall in the future."
In addition to physical therapy and rehab services, FOX offers exercise physiology, which is more akin to personal training. The exercise physiologist is a trained professional who designs and leads exercises for people without need for a particular skill or physical therapy.
Exercise physiology is offered in communities as part of die FOX Optimal Living wellness program. It' also available to individuals who want to maintain fitness in general or continue to improve after rehab is done.
Getting over the hurdles
Despite all the proven advantages of physical fitness, it can sometimes be a challenge to get older adults to actually do the exercises that they know will help them.
King, of FOX, has found that establishing a friendly and trusting relationship is the best foundation for motivating someone to exercise. “The relationship that's established between a clinician and a patient or resident is important in the likelihood of improvement for that patient,” he says.
Offering the hope of meaningful improvement is also a key factor. A resident who believes he may never be able to walk down to the dining room again can be encouraged if he feels his legs getting stronger after a few weeks of doing the appropriate exercises.
"If we show them small gains in areas that they thought were unattainable, then we can show them the bigger picture," King says. Incremental improvements can restore hope and offer a reason to keep trying.
"A big part of maintaining function is to continue to do things you enjoy doing," King says. Once a person stops participating in life, they enter a downward spiral that can lead to greater limitations. That spiral can be reversed or prevented with the right proactive treatment.
For true motivation, fitness goals must also be in line with the person's true desire. ''Asking an older adult what they want to be able to do with their life is so important," says King.
Science and experience have shown that physical fitness is not just for young people. "We've proven in the literature that older persons' bodies can respond to resistance and training just like the young," King says.
Published Senior Living Executive