Program planning for seniors - Instruction

American Fitness, May-June, 2002

Older adults, now the fastest-growing United States population sector, have special wellness needs, but health and fitness professionals often use a fragmented approach to address seniors specific concerns. A comprehensive program that takes into account six dimensions of wellness for older adults has been proposed and proven successful in communities nationwide. Health and fitness professionals are advised that this integrated approach will be helpful in treating the physiological changes associated with aging, the impact of aging on health care costs and the overall quality of life for seniors.

In the March-April 2001 issue of ACSM's Health and Fitness Journal, Bill Armbruster, M.S., and Laura A. Gladwin, M.S., AFP, AFAA Lead Consultant, suggested a comprehensive approach to successfully meet the needs of older adults in their article, "More Than Fitness For The Older Adult." They note that wellness is more than the absence of disease. In fact, there are six powerful dimensions of wellness for older adults, each significant on its own, but more powerful when integrated into one comprehensive program. These dimensions include physical, emotional, intellectual, spiritual, social and vocational areas of functioning. Many people are unaware of or simply fail to develop and maintain dimensions other than the physical.

The physiological changes associated with aging and the rate in which they occur must be understood, recommend Armbruster and Gladwin. For example, the efficiency of oxygen intake and expenditure decline with age, leading to a decrease in performance and mobility in sedentary older adults. In addition, connective tissue stiffens and muscle strength and endurance decline significantly. This causes delayed reactions, decreased vision, impaired sensory perception and postural imbalance. In fact, falls and chronic disease contribute, more than any other factor, to the continued rise in health care costs among the elderly. Other concerns are the ability to cope with emotional challenges at a vulnerable time of life and the perceived loss of control that renders older adults to depression.

The authors indicate the physical dimension of wellness can be achieved through a variety of exercises that focus on muscle strength and endurance, flexibility, coordination, balance and cardio respiratory fitness. Chair exercises and Tai Chi are two specific methods seniors with low fitness levels or arthritis can begin an exercise/fitness routine. The emotional dimension can be addressed by helping seniors develop confidence in managing their health. Disease-related problem solving, managing emotions, cognitive symptom management, communication skills and use of community resources are a few methods to integrate the emotional dimension. Encouraging the use of one's mind to enhance knowledge and increase creativity will result in a better understanding and appreciation for oneself and others. Seeking purpose and meaning in life, as well as refocusing on values and ethics, is important to a senior adult. Health and fitness instructors can teach techniques that will enable introspection through relaxation.

Health and fitness programs can be designed to provide an environment that enhances social interaction. Seniors should have an opportunity to establish and pursue personal interests and achieve personal growth through meaningful activities, such as volunteering. Programs can integrate training into action planning and problem solving on issues specific to senior adults. It is important for health and fitness professionals to accept the challenge of developing wellness programs that meet the needs of older adults.

About ACSM

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. Nearly 18,500 members are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness and health quality of life.

ACSM's Health & Fitness Journal is a bimonthly publication available through ACSM's Certification Resource Center. Also available through the ACSM Communications and Public Information Department are brochures addressing exercise for older adults. Single copies are free when you send a self-addressed stamped envelope to ACSM, P.O. Box 1440, Indianapolis, IN 46206 or visit www.acsm.org.