Perceptions of physical activity among elderly residents and professionals in assisted living facilities

Background

Physical activity is often described as being important for people of all ages, but what different people mean when they talk about physical activity is unclear.

Method

A phenomenographic method was used to analyze how 13 older people and 17 professionals answer the question, “If I say physical activity, what does the concept mean to you?” as part of semi-structured interviews conducted in four assisted living facilities in two different municipalities.

Results

We identified a number of different perceptions of physical activity, with the older people and professionals having different responses. Elderly and professionals alike, define physical activity as a requirement for life and as an opportunity to maintain the body although they define the concepts in different ways. Elderly define the concept as a way to create meaning and the professionals have the attitude that the concept means everyday activities.

Conclusion

The concept of physical activity may be defined in many different ways. This study has shown that elderly and professionals do not define physical activity in the same way. Therefore, professionals need to be aware of these differences when talking with elderly about individual needs in everyday life.

     

Green Care Farms Promote Activity Among Elderly People With Dementia

In the Netherlands, an increasing number of green care farms are providing day care to community-dwelling elderly people with dementia. Currently, it is unknown whether activities, activity participation, and facility use of elderly people with dementia at green care farms differ from those at regular day care facilities. The authors performed group and individual observations at 11 green care farms and 12 regular day care facilities. Activities of elderly people at green care farms were more frequent, occurred outdoors more often, were of a higher physical intensity, and more often were aimed at individuals than activities at regular day care facilities. Therefore, the green care farms’ environment may be more beneficial for elderly people with dementia than the regular day care facility environment.     

Development and evaluation of the physical activity questionnaire for elderly Japanese: the Nakanojo study

The Physical Activity Questionnaire for Elderly Japanese (PAQ-EJ) is a self-administered physical activity questionnaire for elderly Japanese; the authors report here on its repeatability and direct and indirect validity. Reliability was assessed by repeat administration after 1 month. Direct validation was based on accelerometer data collected every 4 s for 1 month in 147 individuals age 65-85 years. Indirect validation against a 10-item Barthel index (activities of daily living [ADL]) was completed in 3,084 individuals age 65-99 years. The test-retest coefficient was high (r = .64-.71). Total and subtotal scores for lower (transportation, housework, and labor) and higher intensity activities (exercise/sports) were significantly correlated with step counts and durations of physical activity <3 and >or=3 METs (r = .41, .28, .53), respectively. Controlling for age and ADL, scores for transportation, exercise/sports, and labor were greater in men, but women performed more housework. Sex- and ADL- or age-adjusted PAQ-EJ scores were significantly lower in older and dependent people. PAQ-EJ repeatability and validity seem comparable to those of instruments used in Western epidemiological studies.     

Life-course perspective for physical activity and sports participation

The purpose of this paper was to discuss physical activity and sports participation in a life-course framework, long-term tracking, determinants, and correlates of physical activity from childhood to old age, and present possible causal links and pathways for the continuity of physical activity. It seems that intensive participation in general in physical activity and sports, as well as participation at school age, are important predictors of adulthood participation. Especially, inactivity rather than activity tends to track from youth to adulthood. Socioeconomic status, place of residence, and personal upward social mobility are related to participation. If physical activity is at a low level in early adulthood, it does not easily become a part of life later on, particularly among blue-collar workers, women, and people with initially poor perceived health. Furthermore, in old age, earlier physical activity seems to be the key determinant along with gender. Repeated social reinforcement in the form of support for autonomy, competence, and relatedness is important especially in transition periods and life events such as secondary schooling, change in employment, and change in family structure. In contrast, retirement presented itself as a good chance of starting new leisure time activities. A life-course approach provides understanding on long-ranging developmental trajectories. According to these results in particular, the polarization of exercise to the active and inactive portions of the population is accumulated over time, and gender and social background features require special attention.     

Optimal health and function among the elderly: lessening severity of ADL disability

Despite mounting evidence implicating sedentary behavior as a significant risk factor among the elderly, there is a limited amount of information on the type and amount of activity needed to promote optimal health and function in older people. Overall muscle strength and mass decline 30–50% between the ages of 30 and 80. The loss of muscle mass accounts for most of the observed loss of strength. The loss of muscle tissue is due to a decrease in the number of muscle fibers and to atrophy of the type II muscle fibers. The declining strength reduces the capacity to carry out basic activities of daily life and puts people at risk for falls and dependence on others. The objective of the present review is to examine the role of exercise training as a primary tool for increasing cardiopulmonary and muscular fitness in order to lessen the severity of disability in activities of daily living and to attain optimal health and functioning among the elderly.     

Effect of age and physical activity level on functional fitness in older adults

It is difficult to distinguish between the effects of age and physical activity level in the functional fitness level of older adults. The objective of this study was to determine the effects of age and physical activity level on some functional fitness parameters in community-dwelling older adults.Two hundred twenty-nine elderly (111 female; 118 male) aged between 65–87 years living in the Balçova municipality region were divided into two groups: the young elderly (65–69 years old) and the elderly (70 years old or over). The “seven-day physical activity recall questionnaire” was used to estimate physical activity level (PAL). The functional fitness evaluation included the body mass index (BMI), the lower body strength (LBS), the dynamic balance, and the aerobic endurance. The young elderly were significantly worse with regard to BMI and significantly better with regard to LBS, dynamic balance, and aerobic endurance than the elderly; in contrast, PAL did not affect any of the functional fitness parameters. The young elderly showed worse BMI than the elderly when the age groups were less active. The young elderly showed better LBS and dynamic balance than the elderly when the age groups were more active. The young elderly showed significantly better aerobic endurance than the elderly in both the less and more active age groups. This study confirms that age affects functional fitness, whereas PAL generally does not. However, being more active is advantageous for the young elderly with regard to BMI, LBS, and dynamic balance.     

Accessibility of sports facilities for persons with reduced mobility and assessment of their motivation for practice

This study aims to create awareness, both within the scientific community and among providers of sports facilities, for individuals with impaired or reduced mobility, promoting the development of technical solutions that allow greater autonomy and social integration of people with disabilities. The purpose of this work is, on the one hand, to evaluate the accessibility of sports facilities for people with reduced mobility and, on the other hand, to investigate why this user group has such low rates of participation in sporting activities. Firstly, using the Portuguese norms and legislation transcribed from European Community directives, a check list was created comprising all the items that sports facilities should abide by in order to provide accessibility and safety to people with reduced mobility. Another questionnaire was designed aimed at this user group, with questions pertaining to their desire and ability to use sports facilities. This questionnaire was distributed in Portugal, in the greater metropolitan area of Porto, to users of Rehabilitation Centres and Physiotherapy Clinics. The results obtained from the check-list showed the compliances and non-compliances of the respective sports facilities, proving that many barriers preventing the participation of people with reduced mobility still exist. Twenty-four people with permanent impairment of the lower extremities (paraplegia) answered the questionnaire pertaining to the desire and ability to perform physical activity. Two individuals (8%) had sporting activities available to them in their area of residence and only five (21%) performed any physical activity. The main reason given for not taking part in any activity was the lack of adapted sports facilities. All the participants felt that taking part in sports is beneficial. The benefits stated were: general well-being and development of the psychomotor component (e.g. coordination, balance, body posture), of physical condition (e.g. strength, resistance, flexibility) and social integration and quality of life. Besides wellbeing, they also mentioned social interaction, a way of occupying their time and an escape from the routine as the main motives for which they would like to take up physical exercise.     

Being part of an enacted togetherness: Narratives of elderly people with depression

In this article, we explored how five elderly persons with depression engaged in everyday activities with others, over time, and how this was related to their experience of meaning. Repeated interviews and participant observations generated data that was analysed using a narrative approach. Analysis identified togetherness as an acted relation, "enacted togetherness", emphasising how the act of doing everyday activities with someone created togetherness and belonging, and being part of an enacted togetherness seemed to be a way for the participants to negotiate and construct meaning. Opportunities for doing things together with someone were closely associated to the place where the participants lived. Furthermore, engagement in activities together with others created hope and expectations of future acting. Findings from this research can extend our understanding of how participating in everyday activities is experienced as a social process including change over time, presenting the perspective of elderly people themselves. In light of these findings, we highlight the need to consider how opportunities to become part of an enacted togetherness can be created. Also, we aspire to contribute to the debate on how to understand the complexity related to social aspects of ageing and add to the emerging understanding of everyday activities as transactional, incorporating people and the environment in a dynamic process that goes beyond the individual.     

The impact of physical health and socioeconomic factors on sexual activity in middle-aged and elderly Taiwanese men

Sexual activity in older people has become a topic of growing interest. The aim of this study is to investigate the effect of physical health and socioeconomic factors on the sexual activity of middle-aged and elderly Taiwanese men. From August 2007 to April 2008, 744 men older than 40 years were enrolled from a free health screening in Kaohsiung, Taiwan. All participants received detailed physical examination and answered questionnaires that collected demographic and lifestyle information, and medical history as well as answered items from the International Prostate Symptoms Score and five-item version of the International Index of Erectile Function (IIEF-5). Overall, 100 (13.4%) participants reported to be sexually inactive in previous 6 months. Older age, lower education levels, loss of a partner, erectile dysfunction, and increased number of comorbidities were found to be independent predictors for sexual inactivity. In conclusion, most middle-aged and elderly Taiwanese men remain sexually active. In addition to erectile dysfunction and loss of a partner, lower education levels and increased number of comorbidities were found to be predictors for sexual inactivity. Further research would need to elucidate whether improvement of those factors could help to preserve sexual activity.     

The exclusion of older people in disability activism and policies — A case of inadvertent ageism?

Using Sweden as a case, the article discusses the tendency within disability activism and policies to overlook elderly people. From an analysis of a major Swedish government investigation on disability it is clear that disability policies in Sweden have come to rest upon stereotyped age norms that divide the life course into set stages, and there has been a tendency to define elderly disabled people as elderly rather than disabled. It is argued that this exclusion is partly the result of a successful endeavor to provide disabled people of younger ages with rights that are typical of non-disabled citizens. Justice and equality have been defined in comparison to citizens of similar ages: children, youth and adults of “active age”. Based on the analysis of the paper it is argued that activities of movements struggling to liberate oppressed populations may contribute to ageism, and that anti-ageist research must go beyond the idea that ageism is a simple matter of attitudes towards older people.     

A case study on the perception of aging and participation in physical activities of older Chinese immigrants in Australia

This qualitative study explores how older Hong Kong ChineseAustralians perceive aging and to what extent this perception affects their participation in physical activities. The main methods used were in-depth interviews with 22 participants ranging in age from 60 to 91 years. Interviews were translated from Chinese (Cantonese) and transcribed into English. Content analysis was used to find recurring themes from the interview data. The main findings indicate that the perception of aging is to some extent influenced by culture. Some participants defined aging as being measured in years, and others defined it by the state of one's physical health, appearance, and capacity to continue fulfilling one's social roles. These perceptions strongly influenced their preferences for and participation in physical activities. Acknowledging the fact that Chinese-speaking people are not culturally homogeneous, this article makes some recommendations to health service providers with regard to the development of appropriate physical activity programs.     

Overview of the physiological changes and optimal diet in the golden age generation over 50

Basically, our lifespan is determined genetically. However, several other parameters such as the environment, lifestyle and diet have a high impact on living in the best of health. Many older persons suffer from various diseases, which often cannot be avoided; however, their development can be postponed and symptoms can be mitigated by a balanced diet, moderate physical activity as well as a healthy lifestyle. These diseases are, for example, sarcopenia (degenerative loss of muscle mass), osteoporosis (decomposition of bone structure), digestive restrictions, sensory impairment, water imbalance or a compromised immune system. Psychological modifications, obesity and loss of weight also commonly occur in older adults. To define an adequate diet for elderly between the ages 50 and 80 is difficult, even impossible, because the nutritional requirements differ between the dynamic quinquagenarian and the frailer eighty-year-old. However, several studies have shown that sufficient consumption of high-quality proteins, calcium, vitamin D, anti-oxidative food compounds, water as well as adapted energy values and nourishment with high-nutrient density in combination with physical activity especially help one to remain healthy to a great age. The cornerstone of healthy ageing is the maintenance of normal bodyweight in order to prevent the development of diseases such as osteoporosis, coronary heart disease or diabetes type 2. This publication will review the physiological changes that occur with advanced age and consequential nutritional recommendations for elderly persons.     

Elder Abuse in Residential Settings in Sweden

ABSTRACT

To investigate frequencies and types of elder abuse occurring in residential settings in two municipal areas of Sweden, nursing staff were asked to answer a questionnaire; 499 responded. The findings indicated that elder abuse involving the staff did occur. Eleven percent of the staff knew of situations of elder abuse and two percent admitted that they themselves had been abusive towards an elderly resident. Psychological and physical abuse related to caring activities were most common. In the specific situations reported, the abusers were mostly characterised as hot-tempered, exhausted, and burned out. The abused people were often mentally and/or physically handicapped and generally over 80 years old. Feelings such as powerlessness, anger towards the abuser, and compassion for the abused person were reported. To cope with the situation, they talked to each other or to the manager. They recommended more education and support as the main preventive strategy.     

Rapid repetitive passive movement promotes knee proprioception in the elderly

Joint proprioception plays an important role in the generation of coordinated movements, maintenance of normal body posture, body conditioning, motor learning, and relearning. Previous studies have demonstrated that proprioceptive function of the elderly can be enhanced via specific exercises; however, not all of the elderly can actively and safely participate in physical activities. The purpose of this study was to evaluate the effects of rapid repetitive passive movement in an average velocity of 90°/s on knee proprioception in the elderly. A repeated-measure design was employed. Two age groups (12 young/12 elderly) were intervened with repetitive passive movements of 60 repetitions to the knee joint via two machines (isokinetic dynamometer/self-designed machine) in separate days. Changes in proprioception were evaluated via joint active repositioning and kinesthesia, both before and after the intervention. The results revealed that all subjects demonstrated good test–retest reliabilities on proprioceptive measurements. For the active repositioning and kinesthesia, significant statistical main effects were found for group and time, but not for machine. No statistical interactions were revealed. Despite of age-related proprioceptive declines, elderly subjects could benefit from rapid repetitive passive movements. This indicates that repetitive passive movement may be an alternative to physical activity for those who are home-bound, in a sedentary lifestyle, or with other health conditions that may limit their abilities to actively maintain or strengthen joint proprioception.     

Social care and support for elderly men and women in an urban and a rural area of Nepal

This study has aimed to describe the care and support for urban and rural elderly people of Bhaktapur district, Nepal. Efforts were made to identify the feeling of some features of general well-beings associated to mental health, person responsible for care and support, capability to perform daily routine activities, sources of finance and ownership to the property. More than half of the respondents were found having single or multiple features of loneliness, anxiety, depression and insomnia. The rate of point prevalence loneliness was found higher in the above 80 years of age, urban respondents. Almost 9 in 10 respondents were capable themselves to dress, walk and maintain personal hygiene and majority of them were assisted by spouse, son/daughter-in-laws. Family support was common sources of income and ownership to the property was absolutely high.     

Social care and support for elderly men and women in an urban and a rural area of Nepal

This study has aimed to describe the care and support for urban and rural elderly people of Bhaktapur district, Nepal. Efforts were made to identify the feeling of some features of general well-beings associated to mental health, person responsible for care and support, capability to perform daily routine activities, sources of finance and ownership to the property. More than half of the respondents were found having single or multiple features of loneliness, anxiety, depression and insomnia. The rate of point prevalence loneliness was found higher in the above 80 years of age, urban respondents. Almost 9 in 10 respondents were capable themselves to dress, walk and maintain personal hygiene and majority of them were assisted by spouse, son/daughter-in-laws. Family support was common sources of income and ownership to the property was absolutely high.     

Yearlong physical activity and health-related quality of life in older Japanese adults: the Nakanojo Study

We hypothesized that the health-related quality of life (HRQOL) would be poorer in physically inactive older adults. This was tested in a sample of 73 male and 108 female free-living healthy Japanese participants, age 65-85 years. We measured accelerometer step counts and their metabolic equivalents (METs) throughout each 24-hr period for 1 year. At the end of the year, HRQOL was assessed. Physical activity was grouped into quartiles. HRQOL was poorer in the lowest quartiles of participants with respect to both step count and duration of activity >3 METs; however, our sample showed no better HRQOL in those participants exceeding minimum standards of daily physical activity, corresponding to counts of around 5,500 and 4,500 steps/day and durations of around 13 and 14 min/day in men and women, respectively. Causation cannot be demonstrated from this cross-sectional study, but nevertheless we suggest that elderly individuals should be encouraged to meet such standards of habitual physical activity.     

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.     

Ergonomic aspects to be considered in planning public spaces destined for elderly people

As has happened in many other countries, Brazil has also witnessed an evident change in the question of accessibility over the last twenty years. In line with this theme, that of old age has only become evident in the last two decades. For a long period of time, the elderly have been systematically ignored as an object of investigation and have not been contemplated with consistent public social policies. Therefore, the main objective of this research is to verify the conditions of physical accessibility that allow the elderly to use public spaces, taking as a study case the S?o Gon?alo square and the Solón de Lucena Park, in the city of Jo?o Pessoa--PB, identifying the biological and functional losses suffered by elderly people due to the aging process and verifying the specific physical needs of this segment of the population. Qualitative methods were adopted, such as systematic observations with the production of behaviour maps, in addition to a review of the literature and analysis of the data. The research identified problems related to the physical accessibility of the elderly to public spaces that generate difficulties for displacement, use, information and orientation, contributing to the planning and ergonomic guidelines which aim at improving these environments, such as the use of different and contrasting colours on the urban furniture and floor, for example.     

Quality of life of older people in Israel: a comparison between older people living at home who are members of a ‘supportive community’ and nursing home residents

The supportive community is a program that was developed in Israel for older people who live at home. The program provides its members with a service package that includes medical and social services, emergency call-button, cultural activities, and a ‘community parent’ who is responsible for the members. Using quantitative method, this study compared the level of quality of life between 55 older people living in their homes who are members of a supportive community (average age = 74.7) and 60 elderly people living in nursing homes (average age = 75.8). As expected, results indicate that quality of life among the older people living at their homes who are members of a supportive community was higher than among the older people living in a nursing home. In addition, the quality of life of married, educated, functionally independent older people in good health and with a good economic situation was higher. Predictor variables of quality of life were: the place of residence, health status, and age. In light of increased life expectancy and the growing need to care for the older population, the practical application of the study focused on a recommendation for the social services to continue the support community development program.