Perth Physical activity project for older adults in care homes

Presented by: Lisa Dods, Lora Kettles and Kirsty MacDuff

Generations working together conference 2016

www.perth.uhi.ac.ukPerth College is a registered Scottish charity, number SC021209.

What we are going to talk about

Perth Older Adults Physical Activity Project

Perth College UHI, NHS, Live Active > 5 local care homes

Background to projectOlder adults programme deliveredLimitations and barriersResults and outcomesLooking forward

Background

2014 - Introduction of HND Fitness, health and exercise

Students have to research and report specific implications of exercise. Assessment of health fitness then deliver a 12 week programme to special population groups:

Go4Gold annual event for care homes

Care Home Activity Programme

January 2015-

12 week programme with pre and post tests

Warm up/seated exercise

Otago strength and balance exercises

Fun games (Boccia, Kurling, Golf)

3 elements

Importance of Physical ActivityOlder adults

• The current guidelines for older adults over the age of 65, state that they should be active daily to reduce the risk of health conditions such as diabetes, strokes and cancer (Department of Health, 2011).

• The number of older adults above 85 is growing, as people are living for longer. By 2031, there will be a 38% increase in adults over the age of 85 in the UK (All our futures report, 2007).

• With the number of older adults rising, there has been an impact on public health costs and frail older adults account for the highest health care costs nationwide (Youg & Khow, 2015). A way of reducing these costs are to keep people healthy and active and reduce falls in older adults.

Importance of Physical Activity

Older adults• As we age, older adults see a decrease in physiological

function including aerobic capacity, bone density and loss of muscle mass (ACSM, 2014). By increasing bone density which can reduce injuries and the chances of developing osteoporosis (ACSM, 2014).

• It is important to take part in physical activity to prevent age related sarcopenia, as 40% of muscle force can be lost over the lifespan (Concannon et al., 2012). Sarcopenia limits muscle function and by doing exercises to build muscle mass, the participant can prevent loss and build strength.

True or False?

TASK 1: Complete the 8 questions on the question card located under your seat

Answer – Q1

Q1 – True - Over a week, activity should add up to at least 150 minutes (2 ½ hrs) of moderate intensity activity. This can also be 75 minutes of vigorous activity (Department of Health, 2011).

Answer – Q2

Q2 – False - Older adults should also undertake physical activity to improve muscle strength on at least two days a week. Older adults at risk of falls should incorporate physical activity to improve balance and co ordination on at least two days a week (The ‑Department of Health, 2011).

Answer – Q3

Q3 – False – Activity levels decrease with age. Statistics show that less than 10% of over 75 year olds are meeting the current recommendations for strength and only 20% are meeting the 150 minutes per week for moderate intensity activities (The Scottish Health Survey, 2012).

Answer – Q4

Q4 - True - British Statistics show twice as many older adults living in care homes were classified as inactive compared with those who live in private households. 78% of men in care homes were inactive 86% of women in care homes were inactive (BHF Current levels of physical activity in older adults factsheet, 2014).

Answer – Q5

Q5 – True - Nursing home residents spend 80-90% of their time seated or lying down No standing activity leads to active loss of bone and muscle

1 wk bed rest leg strength by ~ 20% ⇓1 wk bed rest spine BMD by ~1% ⇓(Krolner 1983; Tinetti 1988; Skelton 2001; Beyer 2002)

Answer – Q6

Q6 – True - Falls are a major source of injury for older adults and entail substantial healthcare costs. Structured physical activity programmes aimed at improving postural stability are most effective at preventing falls (BHF Current levels of physical activity in older adults factsheet, 2014).

Answer – Q7

Q7 – True - The National Institute for health and care excellence (NICE) Guidelines (2008) state that tailored, community-based physical activity programmes can improve mental wellbeing in over 65’s.

Answer – Q8

Q8 – False - A tailored exercise programme can reduce falls by as much as 54 per cent (Age UK, 2013).

Benefits for both Benefits both the older adults and students can gain from taking part in Physical activity project:

•Improve health and wellbeing•Improved social life•Self esteem•Improve communication skills•Confidence•Creates new ways of working together•Can help people feel less isolated•Fun•Interactions with different generation•Promotes greater understanding and respect•Mutually beneficial activity•Increase employability

Our Physical Activity Project

Preparation

All students trained instructors Theory - older adults and exercise Health and functional fitness tests for older adults Seated exercise to music Visit to Michael Woods Centre, Glenrothes Taught Boccia, Kurling and Adapted Golf 1 day Strength and balance course and 1 day Walk leaders

course (Paths for all)

HND Fitness, health and exercise

Functional Fitness tests

• 30 second chair stand• Chair sit and reach• 8 foot up and go• Back scratch• Handgrip test• Single leg stand• 6 minute walk

Functional Fitness Tests

“Life in your years”-requires more than just stamina and energy, requires

strength and balance to feel confident in all other activities you go on to do....

The Strength and Balance exercise programme incorporates 14 Otago style exercises which are simple, can be combined with walking to reduce sedentary behaviour and improve strength and balance, therefore reducing the risk of falls in older adults.

Strength and Balance Programme

Our Physical Activity Project

Provided games equipmentProvided extra trainingInsured through Live Active as volunteers

Live Active Leisure – Colin Melville

Wellbeing Officer

Our Physical Activity Project

Helped to design and set up project Provided Support Liaised with Care homes Helped to collect feedback from residents and care

home staff

NHS – Carolyn Wilson, Falls Prevention Manager

Limitations/Barriers

• Students anxious prior to going into homes.

• Some residents initially unwilling to participate.

• Couldn’t do all tests as planned.

• College didn’t have own adapted games.

• Weather (student travel and for outdoor walks).

How we overcame these barriers….

Example of test results

Example of pre and post testing results from one male resident at Louise Brae Care Home

Test Week 1 Week 12

Back Scratch 37cm 7cm (improvement)

Up and Go 15seconds 8.5 seconds

Seated Sit and Reach 0cm +13cm (improvement)

Sit to Stand 5 13 Amazing

improvement!!

• All care homes reported a steady increase in the numbers of residents participating with many residents attending every week.

• By the end some care homes had up to 18 residents attending. This equates to approximately 75 residents overall who benefited from the programme.

• Care home staff were continuing the exercises.

Outcomes

• Majority of students were apprehensive during the planning stage of the project.

• The project opened our minds to working with this special population.

• “I loved getting to meet the residents of the care home and being able to build a working relationship with them…”

• Seeing the improvements in the residents mobility week by week was amazing – purely down to the students interventions.

Student Feedback - Kirsty

• Upon completion of the 12 week programme I continued going weekly…”

• Next steps for some students include taking a GP referral course, to advance their education and allow them to work closer with groups like this.

• Some students are considering this career pathway, with one student successfully seeking employment as an Activity Co-Ordinator Assistant within the NHS.

• Overall the project had been hugely valuable for both students and residents.

Student Feedback - Kirsty

Feedback on first few weeks of the programme:

•Unsure what to think at the start, it was a new experience.

•“I’ve not played golf in years!!” (the games were at hit from the start!)

•Willing to give it a try

Residents Feedback - Lora

Feedback at the end of the programme:

•By the end of the programme some residents stated that they “thoroughly enjoyed taking part”

•“Looked forward to a ‘wee bit of sport”

•“I feel my legs are more flexible and I get around easier”

•“Oh aye! Legs feel better. Not so much pain up my legs”

•“Sad that its ending, I was just getting used to taking part”

•“Changed the rest of my life”

Residents Feedback - Lora

Residents feedback on the students:

•“I enjoyed the energy and enthusiasm of the teachers, very motivating”

•“Enjoyed meeting the students and taking part in the exercises”

•Very friendly and always listened, encouraging during the sessions

•‘Having the school children and students in made the session enjoyable’

Residents Feedback - Lora

Feedback from the staff:

•“The students conversed as well as interacting with the residents which they enjoyed. The residents enjoyed the new activities brought to the home.”

• “Everything. Games. Music. Laughs. Exercise”

•“I feel the residents are now keener to participate in physical activities and have asked when they will be returning to Beechgrove. They met young people who they love and they all appeared livelier after the sessions.”

•“Family members have commented that the teachers were very bubbly and happy. It was a breath of fresh air.”

Care home staff feedback - Lora

Feedback from the staff:

•“The programme was effective as the students were very good at explaining their programme to the residents which encouraged them to participate.

•They made it fun which helped the residents to be more involved which then was a benefit to their fitness

“The return of the programme would be eagerly accepted.”

Care home staff feedback - Lora

Changes made to this year - 2016

Delivering programme this year in 4 residential homes

HND Students had more training:

Falls awareness session for students– Carolyn Wilson.

Live Active delivered additional workshop using equipment.

Alison Clyde delivered Generations working together workshop with students.

Used Later Life Training functional fitness tests.

Purchased more games equipment.

Looking Forward

Project to be delivered each year

New college projects at care homes including ‘playlists for all’ project run by Perth College UHI computing students

Jobs opportunities for students: Wellbeing activity coordinator/ Older adults instructor posts

Continue to help at Go4Gold events

Speaking at SQA Event next week encourage other colleges to get involved with similar projects

Look to improve links for students working with older adults

Questions