Transcript PARTICIPATION AND OLDER PEOPLE
PARTICIPATION AND OLDER PEOPLE
David Morby Assistant Head of Service Alison Morby Physical Activity Development Manager Kirklees Metropolitan Council
DEFINITION OF TERMS
Physical Activity
Physical Activity Exercise Sport Leisure Dance/ Others Activity Movement (Source: President’s Council on Physical Fitness & Sports, 2000) – – “any bodily movement produced by skeletal muscles that results in energy expenditure” (Bouchard 1990) something you do
Community Facilities
– A facility within a community ie sports centre, community centre, church hall, day care centre, residential home, sheltered housing, park, street, house
DEFINITION OF TERMS cont…
Older Person
– – – Age Concern, WHO, sport and recreation bodies traditionally define the older person as a person over the age of 50 Relative term as there are old 50’s and young 70’s Self-identification may be more accurate
WHY IS PHYSICAL ACTIVITY IMPORTANT?
“ A regular programme of moderate exercise is a very appropriate recommendation for almost all older adults. Moreover, there is no known pharmacological remedy that can so safely and effectively reduce a person’s biological age and enhance his or her quality adjusted life expectancy” (Shephard 1997) Disease prevention and management and improvements to quality of life Psychological benefits Social benefits Reduction in the complications of immobility Reduction in costs of health and social care and other services
HOW ACTIVE ARE OLDER PEOPLE?
“Despite the increase in the promotion of exercise and physical activity for the prevention of functional decline and disease, people in the UK become less physically active as they age” (Skelton, Young et al 1999) Among the over 50’s, 40% of men and women are sedentary. Among the over 80’s, 40 % of men, 65% of women are sedentary Only 3% of men and women aged over 50 take part in sport or exercise activity at least 5 times a week 20% of over 50’s climb no stairs at all in a week In minority ethnic communities aged over 55, those who are sedentary account for: – – – – 57% of African-Caribbean men and 59% of women 67% of Indian men and 78% of women 73% of Pakistani men and 85% of women 85% of Bangladeshi men and 92% of women
HOW ACTIVE ARE OLDER PEOPLE? cont…
In the UK, among those over the age of 50: – – – 20% of women and 14% of men do not have the flexibility to wash their hair comfortably 47% of women aged 70-74 have insufficient leg muscle power to step on a bus without using arms 25% of women aged 70-74 do not have enough strength in the legs to be confident getting out of a chair without using arms In Kirklees: – Seven out of ten adults are not active enough to meet the recommended level of physical activity – – Over 50% of people over 65 were sedentary Considerably more people on low incomes never did any activity – 28% compared with 5% of the wealithiest – More South Asian people were sedentary than any of the other population groups (CLICK: 2001)
PHYSICAL ACTIVITY RECOMMENDATIONS FOR OLDER PEOPLE
There are no national guidelines in the UK for physical activity specific to older people, but the recommendation for the adult population is to take part in: “30 minutes of moderate physical activity, on at least five occasions a week” (Department of Health) Evidence also suggests that for the maintenance of independence once or twice a week is satisfactory but should be considered a minimum (Evans 1999 , WHO 1997) Intentional or habitual physical activity A ‘bit at a time’ approach
WHAT ARE THE BARRIERS FOR OLDER PEOPLE?
Intrinsic Barriers Relate to an individual’s beliefs, motives and experiences concerning physical activity Extrinsic Barriers Relate to the broader physical activity environment, skills and attitudes of others and the types of opportunity available Likely to be addressed by those working directly with the older person ie peer mentor, instructor, health visitor, GP, care worker etc Likely to be addressed by those responsible for policy and strategic development Myths and perceptions Previous experiences Family advice Lack of interest Lack of confidence Fears of overdoing it Safety concerns Absence of role models Stereotypical images of ageing Health concerns Type of activity Access/location Safety concerns Transport Sport and recreation policy Skills and attitudes of instructor Lack of social support Cost Culturally appropriate facilities/settings
PLANNING ACTIVITY FOR OLDER PEOPLE
The Active for Later Life resource identifies a framework for working with older people which is organised into related and overlapping areas which may be helpful in the planning and programming of activity “Making Activity Choices” (for people entering old age) Increasing the “Circle of Life” (for people in the transitional phase) “Activity in Later Years” (for frailer older people)
KEY ISSUES
Consultation Activity Choices Facilities Safety Instructors/Leaders Role Models Pricing Policies Marketing and Promotion Partnership Working Influencing the Strategic Process
CONSULTATION
Encourage and value participant contribution Seek views on a wide range of issues Involve a wide variety of older people Use appropriate consultation methods Follow up consultation with feedback and action Ongoing consultation and involvement
CONSULTATION METHODS USED IN KIRKLEES
Utilisation of older adult panel Focus groups Face to face interviews Conference Peer mentors Outreach work Community consultation events Survey User groups
Turn listening into action
Activity Area
“Making Activity Choices” Independent and unsupervised activity
ACTIVITY CHOICES
Focus Providers Activity Type
Disease prevention, maintaining activity levels & functional capacity Starting & sustaining participation in physical activity Involvement in active leisure, sport & exercise programmes Active Living and Lifelong Learning Leisure & Recreation and activity providers Sport, Exercise, Active Living Kirklees Leisure & Recreation Services Kirklees Active Leisure Voluntary sector sports, exercise and activity clubs Private sector health and fitness clubs Primary Health Care Teams Self directed activities, maybe with assistance and support from leaders, coaches, instructors etc Walking Circuit training Exercise to music Practical Conservation Dance (various) Tai Chi Badminton Tennis Bowls Line dancing Yoga Cycling Orienteering Stretch & Flex Swimming Aquafit Swimming lessons Activity Mix
Activity Area
“Increasing the Circle of Life”
ACTIVITY CHOICES
Focus Providers Activity Type
Maintaining independence, social networks and functional capacity Older Peoples Services/ Managers Exercise, Activity to improve functional capacity – Active Living Supervised classes and groups within a health, social, residential or care setting Movement, dance and walking (assisted) activities Chair based programmes and games Home based exercise/ activity programmes Activity co-ordinators in nursing and residential settings Physical Activity Development Officers (Local Authority) Healthcare Professionals Home visitors – community nursing staff Qualified older person instructors/teachers Circuits Danceability Activi-chi Tai Chi Walking Chair aerobics Chair activities parachutes, batons, scarves, balls, fans, bean bags etc Reminiscence Active Games Active Living Circuit Gardening
ACTIVITY CHOICES (cont…)
Activity Area Focus Provider Activity Type
“Activity in Later Years” Improvement in, quality of life Specialist services Functional activity Requires adapted physical activity Maintaining independence and activities of daily living Rehabilitation ie falls, cardiac rehabilitation etc Specific needs ie dementia Physiotherapists/ occupational therapists Physical Activity Development Officers (Local Authority) -, specialist training Exercise practitioner with additional training Activity co-ordinators in nursing & residential settings Health and care teams with specific training Functional exercises Physiotherapy programmes Active Games Chair activities parachutes, batons scarves, balls, fans, bean bags etc Reminiscence Circuits (specific) Active Living
FACILITIES
Programmes to promote physical activity will be able to utilise some existing settings and facilities within communities, but there will be a need to be imaginative and develop new ways to reach older people ie; residential/nursing homes, day care centres, sheltered accommodation, hospitals, garden centres, shopping centres, churches, parks, the home Key criteria - is the setting; – Acceptable to older people?
– – Accessible to older people?
Affordable for older people?
– – Sensitive and flexible pricing?
Safe for older people ?
SAFETY
Facility/venue Activity Individual Older people are more at risk when they are being inactive than when they are being active.
Is there any evidence of older people being harmed by exercise/activity?
INSTRUCTORS/LEADERS
Appropriate training for all those involved in leading, teaching and instructing in physical activity programmes is essential for an activity intervention for older people Training courses for those delivering physical activity working with older people is a recent area of development and there needs to be consideration of; – Validity and credibility – – Appropriateness of course content Experience and expertise of the course tutor team – – External validation and continuing education requirements Assessment procedures and certification Details of training opportunities for those working with older adults can be found in the Active for Later Life resource National Register of Exercise Professionals
COURSES UNDERTAKEN BY KIRKLEES INSTRUCTORS
Walk Leaders Community Sports Leaders Award (CSLA) Basic Expedition Leaders Award (BELA) YMCA : Exercise to Music – Older Person Module YMCA : Circuit Training – Older Person Module Falls Course Senior Peer Mentoring British Association of Cardiac Rehabilitation Award (BACR) EXTEND Excel 2000 Jabadeo (Centre for Movement Studies) First Aid Chair Based Exercise Leadership for Frailer Older People (Leicester College) In-service training : cardiac rehabilitation pulmonary rehabilitation asthma diabetes visually impairment dementia functional assessment tests
ROLE MODELS/PEER MENTORS
What is the role of the Senior Peer Mentor?
Point other adults in the right direction Provide appropriate information about physical activity Be a positive role model Share information about opportunities and benefits of physical activity Be someone to talk to and share experiences with Understand their concern from ‘their point of view’ What does a Senior Peer Mentor not do?
Provide medical advice ‘Make’ people healthy Counsel people Lead or instruct exercise or sport activities
MARKETING & PROMOTION
Positive images Appropriate messages Information in different format/languages Culturally sensitive Appropriate channels for communication Specific informational cues for public places Involve older people
Appropriate Flexible
PRICING POLICY
PARTNERSHIP WORKING
At a local level there are a number of individuals, groups and organisations who have a role to play in the development of activities for older people. However, there is a need locally to re-assess their potential for collaboration.
Golden PALS partnership:
Partner
Leisure and Recreation Social Services NHS Trust Sheltered Housing Primary Healthcare Team Residential Home Excel 2000
Role
Support, equipment, funding Funding advice, information Physiotherapy support, referrals Referrals, promotion Referrals, advice/information Care staff, venue Instructor
PARTNERSHIP WORKING (cont…)
Walking Leaders Network partnership:
Partner
Leisure and Recreation (KMC) Highways Countryside Unit Primary Healthcare Teams Peer Health Education Project Countryside Agency/BHF Health Promotion Service Walking Leaders
Role
Meeting venues, newsletter, funding advice, information, support, developing walks Promotion, modification of environment Funding advice/information Promotion Staffing, promotions Funding advice, newsletters, resources Training, advice Provision of activity, newsletter, peer mentoring, older people
PARTNERSHIP WORKING (cont…)
Active Older People Network partnership:
Partner
Leisure and Recreation (KMC) Social Services (KMC) Corporate Development (KMC) Primary Care Trusts Acute Trusts Kirklees Older People Network Age Concern Excel 2000 Senior Peer Mentors (PAM’s)
Role
Meeting venues, newsletter, advice, information, training Advice, information, training, events Advice, information, funding Funding events, advice, information, PR& marketing Information, advice, access to patients, promotion Consultation, training, advice Consultation, advice, information Training opportunities, advice Advice, links to older people
POLICY/STRATEGIC CONTEXT… THE KIRKLEES APPROACH
NATIONAL POLICY/ STRATEGY IE NSF COMMUNITY STRATEGY VISION 2012 CULTURAL STRATEGY LOCAL HEALTH PLANS SPORT & RECREATION STRATEGY PHYSICAL ACTIVITY & HEALTH ACTION PLAN (HIMP’s) PHYSICAL ACTIVITY & HEART HEALTH DEVELOPMENT PLAN PALS DEVELOPMENT PLAN ACTIVE OLDER PEOPLE DEVELOPMENT PLAN PHYSICAL ACTIVITY & FALLS DEVELOPMENT PLAN
LOCAL PUBLIC SERVICE AGREEMENT (LPSA) TARGET
To reduce the number of people aged 18 to 64 on low incomes who are sedentary by 1,200 To reduce the number of people aged over 65 who are sedentary by 900
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