By Phyllis Hanlon
When her alarm clock rings during the week, 85-year-old Amelia Costa springs out of bed in her Florida home and grabs a light breakfast before heading to the gym where she’ll spend close to two hours. Following her regimen of stretching, speed walking on the treadmill and working out on an assortment of weight machines, she showers and gets ready for volunteer activity at the local hospital and/or library. Sunday mornings she joins her fellow choir members at a nearby church and partakes in a social hour after the services. For Costa, “active aging” involves several dimensions that, in combination, contribute to her overall health.
Growing awareness of the importance of remaining active throughout life has given rise to an “active-aging industry.” General contractors now build houses with aging in mind; designs include elevators, lower counters, wide doorways and other amenities that enable seniors to remain living safely in their homes. And many communities have active senior centers, while private and public health centers, gyms and YMCAs offer programs specially geared toward older adults.
Reports and studies offer guidelines
During the last couple of decades more researchers have focused their attention on aging as the world population is, in general, living longer. These studies have yielded useful information that helps prepare for better health in the advanced years.
- A 2012 study, The Theory and Practice of Active Aging, examined active aging as a “radically nontraditional paradigm of aging,” proposing that as people age it’s possible to experience improvements in health status, contrary to long-held beliefs that with longevity comes disability. The findings showed that vigorous exercisers could postpone disability by as much as 16 years.
- Another study, Active Aging: A Global Goal, highlights the fact that active aging has become a topic of international interest. The authors cite information disseminated by the World Health Organization (WHO), which lists seven long-term determinants for active aging: education; socioeconomic status; profession; life styles; health status; personality factors; and cognitive aptitude.
- Towards Global Age-Friendly Cities: Determining Urban Features that Promote Active Aging, studied ways in which municipalities can provide safe and welcoming neighborhoods for its senior citizens. As the population ages, cities and towns have become more aware of the need to address the issues that come with advanced years.
- The World Health Organization prepared the Global Age-Friendly Cities Guide, which offers a checklist and recommendations for creating an infrastructure that meets the needs of an aging population.
Defining “active aging”
Colin Milner, founder/CEO of the International Council on Active Aging (ICAA), launched the organization two weeks after 9/11 as a way to help change the way we age.
“Research says we don’t age well. We’re inactive, have chronic health issues and not enough money to fund retirement. We don’t prepare and adjust to changes as we age,” he said. “My goal is to help fulfill life’s potential.” Sixteen years later, that message is still needed, he added.
Milner defines active aging as “being engaged in life, no matter your socioeconomic status or abilities.” He asserted that a person who is engaged tends to be more active and social. However, he pointed out that being active does not necessarily mean running marathons and participating in Iron Man events. Rather, he explained that small activities can accumulate and provide benefits. For instance, something as simple as taking the stairs instead of the elevator keeps the blood pumping. The key ingredient is engagement, whether physically, socially, emotionally, intellectually or spiritually.
Self-motivation is important when it comes to remaining active as the years advance, according to Milner. “If you’re not inspired or motivated to get off the couch, you won’t. There are literally a variety of barriers, including self-perception, access, safety and lack of social connections,” he said. “Overcoming the barriers starts in the brain. Until you say, ‘I want to do this,’ it’s hard to change your mind.”
The ICAA provide the education, information, current knowledge, science and best practices so professionals who work with seniors can do a better job, Milner said.
Start early and don’t stop
Barbara Resnick, Ph.D., R.N., past president of the American Geriatrics Society (AGS), chair in gerontology at the University of Maryland School of Nursing and long-time researcher on physical activity for older adults, explained that aging involves several changes that vary from one person to the next. Muscles and bones weaken, but at different rates; sensory changes, i.e., vision, hearing and balance, occur at different stages during the aging process. “There is a lot we can do – not to prevent these changes – but to optimize what we still have,” she said.
Active aging actually begins in the younger years, noted Resnick. Individuals who are active early in life should continue to walk, move and otherwise engage in some sort of activity. She admitted that aging presents everyday challenges, but the way a person responds makes a difference. As a clinician, she uses social cognitive theory to encourage older patients to remain engaged. She offers encouragement and asks the patient to set goals, but acknowledges that fear – of falling, of failing – often prevents an individual from participating in active behavior.
Resnick added, “Active aging means something different for everyone, but it’s the ability to use your brains and your bodies.” So, in addition to keeping active physically, she encourages patients to volunteer or participate in a project that holds meaning for the individual. Such engagement not only provides social stimulation but also maintains cognitive functioning, a critical aspect of successful aging.
No blueprint exists for active aging, according to Resnick. Each individual must find what works for them personally, optimize what abilities exist, accept changes and build resilience.
Peer advice
Sonia Rapaport, 62, uses her 20 years of experience and skills in Aikido – she has been a black belt for 12 years – in her work as a physical therapist, rehabilitation instructor and educator for the Visiting Nurse Service of New York, a nonprofit that offers prevention and proactive wellness programs for people of all ages, and its affiliate, Partners in Care. Her understanding of the body as it ages helps guide her work and is reflected in the advice she offers older clients. She reminds older adults that “use it or lose it” might have been inspirational for the 20- or 30-year old body. While it’s important to keep moving, joints and muscles need a bit more loving care as the decades pass.
Rapaport encourages older adults to continue engaging in sports and athletic activities they enjoy, but to dial down the intensity. “Just walk or run a little slower, stop every ten stairs, sit out a dance or two, but the important thing is to look at what some perceive as limitations as a positive, not a negative,” she said. “Exercise is important and it feels good, but you don’t have to be a superstar. Even gentle exercise, when done consistently and under your doctor’s supervision can keep you feeling stronger and help delay the onset of serious health problems.”
A good target goal is 2-1/2 hours per week, at minimum, of moderate exercise. Walking is usually a good choice, but a weekly routine could also include gardening, doing household chores or exercising while watching television, according to Rapaport.
National programs
Several nonprofit organizations, whether they focus on older adults or on a more general population, serve as a good resource for achieving and maintaining an active lifestyle.
The National Council on Aging (NCOA) created the Aging Mastery Program (AMP) as part of its goal of “Improving the Health and Economic Security of 10 million Older Adults by 2010.” CEO Jim Firman indicated that AMP helps “develop new expectations, norms and pathways for people 50 to 100, to make the most of the gift of longevity.”
Five years ago, NCOA created the AMP concept as a way to engage and “…expose baby boomers in a fun way to the many dimensions of aging well and to learn to take actions to change and improve quality of life,” said Firman. “We took a complex subject and broke it down to make it easier for people to understand.”
The AMP core curriculum comprises ten classes with several electives. The program begins with a focus on gratitude. “We’re given the gift of years and like any gift, we have to be grateful, mindful and spend it wisely,” Firman said. During the ensuing weeks, participants learn safe exercise practices, better sleep habits, ways to improve relationships and advanced care planning. “We see AMP as a gateway. It gives you a sense that you can make small changes. We do this as a lifelong pursuit,” he added.
Statistics show that the program is working. Firman noted that 98 percent of participants say the program is fun; 96 percent report improved quality of life, other than the physical aspect; 95 percent have seen improvements in health; and 77 percent cite better financial literacy.
The Duxbury Senior Center was one of five original test sites for AMP. Joanne Moore, center director, noted that their site had 40 participants initially whose ages ranged from 50 to 90. They added the electives, Nutritional Vital Signs and Bucket List, to the core curriculum and also included a technology component by providing a tablet with software that made the computer senior-friendly.
Moore reported that participants lost weight, slept better, reconnected with friends and discussed funeral plans with family as a result of the program. But one of the most surprising results was the social interaction the course promoted. “Participants didn’t want to end the program. They had become a cohesive group and said they’d miss their friends,” Moore said. “People also continued learning after the core curriculum was completed and were looking for more education.”
Center in the Park, located in Philadelphia, also served as a pilot site for AMP. Lynn Fields Harris, executive director and chair of the National Institute of Senior Centers, reported that her center also added a nutritional elective where participants shared recipes and watched demonstrations. “Additionally, some of our participants are caregivers and wanted more information on resources. We also did electives on safe homes,” she said.
Harris found that AMP was a way to engage newer participants in other programs at Center in the Park. “We look at AMP as an overarching health promotion that feeds into an evidence-based program,” she said. “We’d like to promote it as something community partners and insurers might want to fund. The beauty of being a community-based program is that we use community resources.” Center in the Park has partnered with a nearby community hospital, which provides speakers for AMP.
Much like the Duxbury program, participants at Center in the Park have primarily been more focused on everyday life activities related to improving health since partaking in AMP. “They eat healthier and drink more water, pay attention to quality of life issues,” Harris said. “They’ve experienced and have expertise in these areas, but it’s mastering the information and putting it into practice that is the focus.”
National organizations with localized programs
The YMCA is another agency that provides a range of wellness options for older adults. However, rather than provide a standardized program, every local branch creates its own specific courses, classes and programs, according to Kevin Dietz, media relations for the national organization.
For instance, in Southbridge, Mass., the Tri-Community YMCA offers some well-known programs, such as Silver Sneakers, but also created a few unique classes aimed at older adults. Sue Casine, Tri-Community’s senior program director, said, “Fifteen or 20 years ago, we invented ‘Fit After 50,’ which has been hugely successful.”
The low-impact classes include the same aspects of a more rigorous class, but provide modifications and are appropriate for those with different fitness levels. Instructors offer special precautions for shoulders, hips and knees, which are often problem areas for older adults. “We do muscle strengthening for those areas,” she said. “Elders are so appreciative. They have time to learn and we’ve added a lot of options from chair yoga to beginner Zumba.” Casine reported that senior participants at this Y range in age from 60 to 85.
While participants gain physical benefits from attending any of the Y’s programs, Casine emphasized that the social benefits are just as important. She reported that participants care about one another and have developed lasting friendships. “They follow up when members are sick or injured,” she said. Some members have created informal walking groups and marched in local parades together. “Being around people of a similar age is motivating,” she said.
In addition to exercise and fitness classes, the Y sponsors monthly luncheons with a variety of guest speakers who address age-related topics, such as creating a will and safety tips at home.
Elder-friendly communities
Today’s 55 communities have changed from a “reactive” model to a proactive one, according to James A. Antonucci, Ph.D., executive director of Heron’s Key, a Life Plan Community in Gig Harbor, Wash. With a focus on environmental gerontology, Antonucci is implementing the THRIVE wellness program into the community, a concept that maximizes the “vitality, health and wellness of all residents.”
Antonucci said, “We’ve come up with a strategy to socially engage people. That might range from watching a movie or playing bingo to orchestrating a program and participating,” he said. An active community setting brings together like-minded individuals that engage in some type of activity, whether gardening, tennis, winemaking or some other hobby.
A Life Plan Community conducts a comprehensive assessment of each resident and creates a personalized plan to foster engagement. “We use a scale that measures cognition, satisfaction with life and needs and wants,” Antonucci said. The plan is reassessed annually to ensure that individual needs are being met. “These ‘elder friendly communities’ take a proactive approach based on science.”
People are living 8.7 years longer than they did 25 years ago, according to Antonucci. Elder-friendly communities offer several benefits to ensure that those extra years are meaningful: they keep older adults out of the emergency department; enable them to remain living independently longer; impart a sense of control; and provide motivation to stay active.
Story ideas
- What role does/should a health care provider play in promoting active aging?
- How does a person’s personality affect their attitude toward active aging?
- What cultural factors influence attitudes towards active aging?
- What does your particular community do to promote active aging?
- Which other professionals (e.g., pharmacist, massage therapist, health food store owner, etc.) can have an impact on active aging?
- What impact does technology have on active aging?
- Gerontologists are in short supply and great demand in this country. How does this shortage of health care workers trained in geriatric issues, such as nurse’s aides, physical therapists, certified nursing assistants, etc., also apply?
- What are the pros and cons of living in a 55 community as it relates to active aging?
Additional sources
- Active Aging Week
- Active Aging Week strives to promote the seven dimensions of wellness: social, emotional, spiritual, environmental, occupational, intellectual and physical. Intellectual relates to cognitive functioning and explores way to keep cognitive abilities sharp.
- In 2017, Active Aging Week celebrated its 15th anniversary. More than 3,000 host sites, including senior centers, retirement communities, health clubs, parks and recreation centers, government agencies and non-governmental organizations nationwide, participate in a series of weeklong educational and inspirational events that promote healthy living for seniors. The International Council on Active Aging® organizes the event. Local sites offer different activities, such as group walks and exercise classes, health fairs and education, arts and crafts classes, concerts, dances and demonstrations. Active Aging Week in 2018 will be Sept. 23-29.
- American Geriatrics Society
- This national nonprofit organization of geriatric health care professionals is dedicated to improving health, independence and quality of life of older people.
- American Society on Aging
- Function Focused Care
- This website offers information and techniques on encouraging residents in institutional living settings. Experts address many of the issues that prevent older adults from engaging in an active lifestyle.
- Gerontological Society of America
- Members of this research-based society foster collaboration between biologists, health professionals, policymakers, behavioral and social scientist and other age study scholars.
- International Council on Active Aging (ICAA)
- ICAA does not conduct research, but translates existing information and studies and partners with professionals who work with the aging population, e.g., the wellness team in a retirement community or a parks and recreation department.
- National Council on Aging
- National Institute on Aging
- National Institute of Senior Centers
- Self-perception on aging (article)
- U.S. Administration on Aging
- Visiting Nurse Service of New York
Phyllis Hanlon is an independent writer specializing in topics that include business; alternative, medical, mental and respiratory health; spirituality; business and individual profiles.
