sail stay active and independent for life

An Information Guide for Adults 65+ Integrating the SAIL Guide into the SAIL Classes

Rachel Frazier

Chapter 6

SAIL Stay Active and Independent for Life:

Using the SAIL Guide in your exercise classes:

What…. Why…. How…. When….

2

What is the SAIL Guide?

Developed as a result of study participants request for

notes from education classes

Study participants were surveyed for information requests prior to classes

Includes 2 self-assessments: “Am I Ready to Exercise?” and “My Falls Free Plan” and steps for developing an exercise plan

3

The S.A.I.L. Guide Components

Individual Risk Assessment

Regular strength & balance exercise

Gait & assistive device training

Medication review

Management of chronic conditions

Vision correction

Education

Home safety improvements

4

Lessons Learned about Older Adults from the Education Classes

They read & rely on written information

They need & value health and falls prevention information

They trust & respect information from professionals

5

The Most Requested and Valued Information Was About…

Exercise, exercise, exercise!!!

Types…?

What’s best for me?

How to…?

What if…?

Where…?

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Providing information in Senior Fall Prevention Study resulted in:

Changes Made

To ↓ Fall Risks

All

Participants

↑ Exercise 49%

Home safety 28%

Discussed falls

w/MD

15%

Had medications

Reviewed

11%

Had vision checked 9%

Treated other

health problems

6%

7

Overall Effect of Providing Falls Prevention Information in Changing Modifiable Falls Risk

Factors

79% of all study participants made 1 or more changes

to reduce their risk of falls

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Discussing Falls Prevention Best Practices Is Important Because…

Offers health, exercise and falls prevention information that can be difficult for this age group to find

Increases peer support: group discussion is more

motivating than individual counseling

“We think about these things but don’t talk about them….”

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Chronic Disease Self Management

Health care system is designed for acute illness, not chronic conditions

Patient self management: Key to effectiveness & efficiency in care of chronic conditions (arthritis, diabetes, heart disease, etc.)

Self management tasks & skills necessary for living with chronic conditions (and aging!)

Source: Lorig Model: Chronic Disease Self Management Program (Lorig K, Holman HR; Stanford)

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SAIL Guide Chapters Building Your Exercise Plan & “Are You Ready to

Exercise?”

Understanding Your Health Issues and Exercise

Managing Your Health Care Needs

Staying On Your Feet

Keeping Yourself Independent Through Home Safety

What To Do If You Fall & “My Falls Free Plan”

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Chapter 1: Building Your Exercise Plan

Exercise health benefits are noticeable in 4-6 weeks (improved sleep, energy, strength, etc)

Those who attend 2-3x/week benefit the most

Exercise goals: improve and maintain fitness

Importance of strength & balance exercise to prevent falls & protect independence

Expect occasional exercise attendance barriers (health, vacations, family needs)

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Chapter 1: Building Your Exercise Plan

Discuss how to use weights

Discuss importance of increasing weights every 4-6 weeks as strength increases

Exercise safety:

Pain with exercise is NOT normal

Modify/exclude painful exercises

Talk test: exercise shouldn’t cause shortness of breath (or chest pain, dizziness, etc.)

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“Are You Ready to Exercise?” self-quiz

Section 1: Is it medically safe for you to exercise—what has your doctor told you?

Section 2: Are you strong enough to physically take care of yourself (bathing, dressing, eating)?

Section 3: Are you strong enough to get out of the house (other than for Dr’s appts) to participate in a 1-hr class?

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Chapter 1: Resources for Exercising at Home

• Most commonly requested & appreciated information in the study!

• Use professional references (National Institute on Aging, AARP, Arthritis Foundation, etc)

• Encourage them to order info listed in the SAIL Guide & bring to class to share

• Always ask in every class if they have any exercise questions—you’re their exercise expert!

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Chapter 2:

Understanding Your Health Issues & Exercise

Health problems are #1 barrier to regular attendance

Use “Are You Ready To Exercise” quiz & info in this chapter when in doubt about health & exercise

Instruct your participants to always discuss exercise plans with health care provider when being treated for any health problem!

It’s OK to start back to exercise part-time at first, then work back into full-time routine

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Chapter 2: Understanding Your Health Issues & Exercise

• Eye health: all adults 65+ need regular vision exams every 2 years

• Eye conditions are usually gradual & painless, and a common cause of falls (especially due to changes in depth perception due to age and/or bifocals)

• Ear health: if you or your family/friends suspect hearing loss, get a hearing test

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Osteoporosis causes bones to become thin and fragile—and is often painless

Osteoporosis is a major cause of fractures due to falls in adults 50+

Medicare covers “bone density tests” which diagnose osteoporosis

Ask your doctor for a bone density test if you’ve had a fracture after age 50, or for a family history of fractures in older adults

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• Calcium is found in dairy products, vegetables & other foods; read food labels & aim for at least 1200 mg calcium & 800 IU of Vitamin D in your diet, and use supplements if needed

• Take time to get to know what Medicare covers for preventive care, tests, and medical equipment

• Weight-bearing exercise, calcium, & vitamin D are important for bone health (strong bones)

• For free, non-biased local Medicare assistance please contact the Tennessee State Health Insurance Assistance Program (TN SHIP) at 1-877-801-0044

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Chapter 3: Managing Your Health Care Needs

>4 Daily Prescription & Over the Counter Meds

Not including vitamins/supplements

medication interactions can create new side effects

4 Types of Medications that can cause dizziness, drowsiness or weakness:

Antihypertensives - also used for heart conditions

Antidepressants - also used for pain & sleep

Diuretics - “water pills”

Major tranquilizers – includes pain & sleep medications

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Chapter 3: Managing Your Health Care Needs

Most older adults don’t know what “types” of medications they’re on, so….

Medications should be reviewed with their pharmacist (at no cost!) and their doctor to identify and discuss potential medication risks for falls

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Medication Safety Tips

Take medications as directed on their labels

Know side effects—keep written info for reference

Discuss ANY and ALL medication problems (including costs) with doctor(s) & pharmacist

Don’t ‘skip’ doses of daily medications—

take medications at regular daily times

Have all prescriptions filled at same pharmacy

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Chapter 4: Staying on Your Feet

Low back, hip, knee, ankle or foot problems should NOT be ignored—they are not a “normal” part of aging

It is important for seniors to always let their doctor know if they have any problem(s) walking, standing, sitting or balance problem so that it can be diagnosed, treated and managed to protect independence

23


Our feet change with age—we lose the ‘fat pad’ on the

bottom, & feet widen Foot problems are often a sign of health problems

(diabetes, poor circulation, arthritis, gout, etc) Podiatrists specialize in only foot & ankle care, and are

covered by Medicare Footwear should give feet comfort and protection, and

should have a ‘tread’ on the bottom to prevent slipping

24


Shopping for shoes--what to look for:

Strong arch support

Plenty of toe room

Good comfortable cushioning

Tread pattern on the bottom

No open heels or slip-ons

25


Walkers & canes are assistive devices and can provide increased safety and independence if needed temporarily or long term

Medicare covers physical therapy for walker/cane fitting and training, & mobility problems

• Not using the right type or the right size walker or cane can cause falls or give unsafe support for walking problems

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Chapter 5: Keeping Yourself Independent Through Home Safety

Being aware of potential fall hazards at home helps protect independence and prevent falls

Ask them to use the SAIL Guide home safety checklist before class & discuss what they changed, & what was ‘safe’ or ‘unsafe’

Every county has an Area Agency on Aging that has local resources for home repair and modification assistance for seniors

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Most falls occur where you spend most of your time

1-2 steps & small pets are common causes of falls caused by tripping

Hold dog leashes with the fingers (not around the wrist) so you can let go if dog bolts

Don’t use ladders alone or if balance is weak—always have another person with you for safety

28


Clear, dry walkways & stairs reduce slips & trips

Good lighting: improves vision & balance

Stairs with railings on BOTH sides

Keep things within reach from waist level

Footwear with a tread to grip the floor

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In Case of Emergency: What To Do If You Fall

Schedule a practice “getting up from the floor” session in class after you’ve worked with your participants for at least 1-2 months & know their capabilities

Older adults often lose confidence in ‘floor activity’ abilities, and can regain this confidence with this practice

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“My Falls Free Plan”: A Falls-Risk Self-Assessment

3 sections:

Recent history of falls in last 6 months

Health-related falls risk factors

Health behaviors related to falls

The more “Yes” answers, the greater the risk of falls

Goal: Be aware of risk factors & discuss falls risks with health care provider(s)

31

My Falls Free Plan: Self Administered Falls Risk

Assessment

Self assessment questionnaire

Health care professionals can discuss and evaluate positive elements

Helps seniors think about long-term falls prevention action plan their healthy aging plan

Qualifies for New Medicare V Code: V15.88 History of Fall/Risk for Falls when shared with their doctor

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Using My Falls Free Plan in the SAIL Classes

Encourage them to complete it at home

Encourage them to take it to their doctor if any concerns are identified that they have not already discussed with their doctor

Don’t expect any discussion of their results in class—seniors consider it private health information, not a topic for social/exercise group discussion

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How Instructors Integrate the SAIL Guide Into SAIL Classes

Offer one “Tip of the Day” from SAIL GUIDE per class during flexibility/stretching component of class (exercise, home safety or health, etc.)

Make sure each participant gets a copy of guide in the first 1-2 weeks of starting class

Encourage participants to bring a tip to share in class from the SAIL Guide

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In Summary…

Information is empowering!

Peers & professionals (you!) provide the motivation, information and support that builds confidence in healthy aging

Encourage them to discuss any and all health related concerns and health related exercise issues with their health care providers —you don’t have to have all the answers in this area!

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Check Your Knowledge – 1 True or False – All SAIL Participants received a SAIL Guide.

TRUE!

Check Your Knowledge – 3 What percentage of study participants made

1 or more changes to reduce their risk of falls?

79%

Check Your Knowledge – 2 The SAIL Guide does NOT contain information to use for education during a SAIL class.

FALSE!

Use your class to help your seniors…… Stay Active and Independent for Life

through exercise and education

Questions?

39

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