“You’re never too old to improve strength and stamina,” we find ourselves saying to yet another new home care client at our first meeting. Perhaps it’s a delightful older woman who is no longer able to care for herself. It’s not due to a specific disease or injury. It’s a generalized weakness and a loss of mobility developed over time that keeps her now from doing her own personal care, housework, and errands.
She’s lost her independence to a large degree because of too little walking, stretching, lifting, and reaching. As it common, she’s also developed a terror of falling, which keeps her even frozen to the couch – a fear that becomes a self-fulfilling prophesy, as more muscle loss causes greater unsteadiness on her feet. Surely this is the harbinger of some future fall if it’s allowed to continue in this direction.
“Mom, I toooooold you to join the gym and work out! I do the elliptical a half hour each session, and it would do you a world of good, too,” enthusiastically inserts the adult daughter. “Work up a sweat every day! Take an aerobics class! You’ll love it!”
Mom looks at daughter with a jaded eye, no doubt recalling that recently she was too weak to rise from the toilet herself and was stuck there until a visitor arrived. It’s clear that the two women’s realities are light years away each other in terms of what "becoming stronger" means. As a result, the elder bristles and erects a stone wall of refusal. The daughter feels at her wit’s end. This, too, is all too common.
“I find that an aggressive family member can turn off an elder to more activity because they each have such different ideas of what that involves,” says Concord’s Diantha Millott, a certified personal trainer whose specialty is working with chronic disease, disabilities and geriatrics. “The message ‘you have to work long and hard or you won’t improve’ is just not true. Five minutes of walking inside the house at their own speed can be very effective. Gentle prodding and support are key.”
Families would do best to make that prodding coincide with something the elder feels is important. One of our caregivers, Nick, who holds a degree in applied fitness, believes it’s at the very least a matter of respect to let people choose their own goals. “If their goal is ‘I want to be able to walk to the mailbox and back,’ then that’s where we focus. Often the children have ideas that are more about what they wish for their parents. I’ve never seen it be productive to tell an elder what to do.” He offers our clients concrete information about how more activity will benefit them, which helps motivate them to meet their own goals – but on their own terms.
A challenge to helping an elder gain strength is the myth that they’ll “bulk up,” says Millott. “Women are particularly worried about this, but I assure them we are working to improve their balance and stamina, support their joints, reduce swelling in their legs and feet, and increase their blood circulation. This isn’t about trying to look like Arnold Schwarzenegger!”
A successful practice for increasing activity is to fit it into what gives them pleasure, points out Mary Ann, another of our caregivers. “Bring them to look at the birds at the window, go outside to see the plants growing. Acknowledge that for them activity may be difficult or tiring to do, but that it’s worth trying even for a short distance. And I make sure I don’t do things for them that they could do for themselves, to keep them active.”
Because we regularly find ways to encourage and support more activity with our home care clients, including but not limited to formal “exercises”, many of us notice improved mental functioning linked to increased physical activity. This is for a variety of reasons, likely increased blood circulation being a primary cause. Also, activity stimulates the body to create “feel good” chemicals, helping to improve mood and reduce perceptions of pain, which further increases motivation and acceptance of activity.
Millott adds a few additional, concrete tips to help your loved one get and stay moving:
• Make sure they stay well hydrated through the day, especially before, during and after exercise
• Create a safe environment to practice balance building. Stand with the elder’s back in a corner, but not touching the wall. Have a second person stand in front of the elder, with both pairs of hands lightly touching, ready to engage if help is needed.
• Always be aware of and respect any restrictions on activity placed by a physician.
• Look for social opportunities such as joining a walking group or water aerobics class to help provide motivation and accountability.
Focusing on the elder’s own goals, celebrating achievements, and enjoying camaraderie with regular practice, aging people can maintain or improve their independence and enjoyment of life, regardless of age.