 Think you are too old or too frail to exercise? Think again. The National Institute on Aging (NIA) reports that it's possible for frail older people to at least partly restore some measure of lost endurance, strength, balance and flexibility through exercises especially designed for their needs. In a previous column, we considered the subject of exercise for healthy but sedentary older individuals. In this column we discuss seniors who—due to illness, surgery or other circumstances—believe they are too frail to exercise.
There are 35 million Americans over age 65. By 2030 there will be 70 million Americans in this age bracket, comprising 20 percent of the population. Society has a vested interest in helping these elderly citizens stay healthy and independent throughout their long lives, and it may be easier than we think. One study demonstrated that seniors who regularly engage in simple physical activities, such as household and garden tasks, have significantly greater flexibility, strength and endurance than their less active counterparts.
Unfortunately, a change in lifestyle can contribute to physical decline. I spoke to an 81-year-old who reported a decline in strength since she left her daily household tasks behind to move to a senior retirement apartment complex, where her meals are served in the dining room, her apartment is cleaned and her laundry is taken care of for her.
"I used to lift my groceries out of the car and lift three or four plates out of the dishwasher at one time," she says. "Now I struggle to carry my dinner plate from the buffet line to my dinner table."
Lesson learned? Use it or lose it. She hopes to regain some of her lost strength by participating in an armchair exercise program available to residents in her building.
Michael Villapando teaches "Gentle Tai Chi" classes to help older people living in senior apartment buildings, residential care and nursing homes maintain or regain strength and endurance—or possibly postpone or prevent the need for a walker or cane. Gentle tai chi is perfect for frail older people because it can be performed standing near a chair for support, seated or even in a wheelchair, says Villapando. He describes it as a slow therapeutic exercise that lets inactive seniors work at their own level to build strength, balance and serenity.
Jean Boes, 93, takes Michael's "Gentle Tai Chi" class, plus a strength training chair exercise class at the Inn at Willow Glen Retirement Community. "I don't know how I lost my strength and energy," she says. "My husband and I used to dance and never tire, but after he died I had a fall, followed by a knee operation, and activity stopped after that."
Jean says she enjoys every day more fully since starting the daily exercise program. "I have gotten stronger and can do more of the activities of daily living for myself," she says.
There's hope for regaining strength and independence even after injury, surgery, stroke or the onset of Parkinson's disease. Henry Haeussler drives from Palo Alto to take part in a balance and safety exercise program at Community Hospital of Los Gatos. Haeussler rode horses daily until two years ago, when a deer darting across the path caused his horse to rear up, throwing him to the ground. After back surgery, he had to use a wheelchair.
Haeussler started a one-on-one physical therapy program at the hospital's rehabilitation center, then progressed to a low-level "Safety and Balance" class designed by physical therapists with special training to help frail participants build strength at their own speed. Many students do the exercises seated or standing with a walker for support. Later Haeussler went on to the level two "Safety and Balance" class, where he developed the ability to stand and build flexibility and strength in his upper and lower body and legs. "I still can't lift a bale of hay," he says, "but I'm on two feet and have come a long way."
Other special exercise classes offered at Community Hospital of Los Gatos include the free "Seniors Armchair Fitness," taught by Los Gatos family physician Dr. Ernest Thomas. The class is a mix of strength training and health education. And the hospital's Vestibular and Balance Disorders Program retrains participants who suffer from dizziness caused by inner ear conditions.
Many local recreation departments and senior centers provide special exercise classes for less active older people. The Campbell and Willows senior centers offer the popular Feldenkrais class. Feldenkrais is a series of easy, gentle movement sequences and visualizations designed to develop flexibility and coordination, improve the use of the muscular-skeletal system, and reduce stress.
Popular classes at the Cupertino Senior Center and the Los GatosSaratoga Department of Community Education and Recreation include "Functional Fitness" and "Gentle Yoga."
"Yoga teaches techniques to improve balance, stretch the back and release tight joints while honoring each student's individual ability," says Los GatosSaratoga teacher Thea Sawyer.
Linda Sheer, who teaches "Posture and Balance" and "Gentle Tai Chi" in the Los GatosSaratoga program, also leads the "Therapeutic Yoga" class at Prince of Peace Lutheran Church Wellness Center in Saratoga. The class is designed for people with various forms of disability, including multiple sclerosis. People in wheelchairs are welcome, but they must bring along an assistant to help them.
The city of Campbell's 55-plus programs for less active older adults includes the classes "Core Strengthening" and "Armchair Fitness." Whether the participant is seated or standing, the exercises can strengthen most parts of the upper and lower body, legs and ankles. A doctor should be consulted prior to starting an exercise regimen, but in most cases armchair fitness programs are appropriate after a stroke, surgery, hip replacement or onset of a heart condition, as well as for people who have lost strength due to extreme lack of activity. The Campbell Adult Center offers a free "Armchair Fitness" class twice a week following a hot lunch in the center's banquet hall.
For those who can't get out of the house, a fitness program in the home is an option. Occupational therapist Julie Groves owns and operates Therapy In Your Home, providing physical, occupational and speech therapy, as well as programs for strengthening and maintaining fitness. Her staff designs programs to fit individual needs and goals.
The options available to those who want to regain fitness and independence are truly endless. If transportation is a problem, the federally sponsored Outreach and Escort program provides low-cost, door-to-door transportation. If you want to stay home to work out, you can tune in to a daily TV chair exercise program on PBS called Sit and Be Fit. And the NIA has produced an educational exercise video to help inactive people build strength and get back in shape. For those worried about falling and a possible hip fracture, non-prescription hip pads worn under clothing are an option. They're not too popular with fans of fashion, but a study of 82-year-olds with little protective body fat and brittle bones, showed that hip fractures were reduced by half among wearers.
Although there are a couple of conditions or situations that prohibit exercising, studies have shown that even people over 90 can more than double their strength by participating in specially designed programs for special situations and frail people. But a doctor should always be consulted first, and any new exercise program should be very easy in the beginning. A common mistake is to try to do too much too soon. The result could be sore muscles, discouragement and even injury. It's best to start with a manageable program.
Starting an exercise program at this late stage * is it worth the effort? Both frail and not-so-frail elders have a lot to gain from starting a lifelong fitness regimen: possible prevention of falls and fractures, postponement or avoidance of the need for assistive devices such as walkers and canes, greater confidence and independence in the activities of daily living and improved quality of life. My suggestion: Go for it!
Gentle exercise programs
Adult and senior centers offer a variety of fitness programs, including those that cover balance and safety, armchair exercise, gentle yoga, Feldenkrais, gentle tai chi, core strengthening, functional fitness, tai chi for arthritis, strength training and swimming. Check a center near you to learn what is available.
Campbell Adult Center 55-plus
Programs, 408.866.2146
Cupertino Senior Center, 408.777.3150
Los GatosSaratoga Community Education and Recreation, 408.354.8700, ext. 221
Saratoga Senior Center, 408.868.1257
Sunnyvale Senior Center, 408.730.7360
Willows Senior Center, 408.468.6400
Outreach and Escort Transportation Program, 408.436.2865
Therapeutic yoga, Prince of Peace Wellness Center, 408.395.1249
Therapy in Your Home, 408.358.0201 or tiyh@home.com
Adaptive Exercise and Vestibular Disorders, Community Hospital of Los Gatos, 408.378.6131, ext. 4182
Michael Villapando Gentle Tai Chi, 408.415.219.9077 or yinyangmv@hotmail.com
For an exercise video and 100-page exercise booklet from the National Institute on Aging, send a check for $7 payable to the National Institute on Aging to NIAIC, Dept. F, P.O. Box 8057, Gaithersburg, MD 20898-8057.
Rita Baum has a master's degree in gerontology and has worked in the field of aging for more than 20 years.
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Photograph by George Sakkestad