Tricks of the Trade
What are some of the issues you have dealt with in training older adults?
Training older adults is very gratifying. They tend to be highly motivated and goal oriented. My clients in their 70s, 80s and 90s have often been told to exercise by their physicians. For these clients, the goal in training is, above all, to be healthy. Beyond that, they want to maintain their quality of life and independent living status.
Older adults are extremely compliant and make tangible improvements in strength, posture, balance and walking ability. One woman remarked that a whole world opened up for her when she was once again able to get down and back up from the floor. In addition to yielding physical benefits, exercise promotes a can-do attitude, builds self-esteem and lifts spirits. After a session, clients literally straighten up and smile, full of a sense of accomplishment.
I have found that engaging their intellect enhances compliance. My older clients all share an active interest in current events—politics, the stock market and world affairs—and they enjoy the social interaction of discussing these topics while taking a breather during their exercise sessions.
One aspect of the training program that can be challenging is helping them develop and use their core muscles. Why? For one reason, using their abs may be a new concept to them. Second, many of the traditional core exercises require floor-work, and older adults are often unable to get down onto the floor. However, I can teach them belly breaths and abdominal compression while they are in seated or standing positions. One cue that works well is “Make your pants loose.” Posture also plays an important role. While sitting, many older adults tend to slump forward and lean back on the chair. I encourage them to sit up tall: “No leaning allowed. Use your core muscles.”
I did have one client who presented some other challenges, in that she required extra time and patience. She was 95 at the time, European born and from an era of gracious living. There was no way I could dash in and out of her home on schedule. It was simply not courteous. In addition, there were other delays: she was often not ready for me on time, needed to excuse herself to use the bathroom and tended to overanalyze and belabor points regarding the exercises.
I always had to extend sessions to give her a decent workout. As time was running short, I would corral her attention by saying that we needed to do “10 of 10”—i.e., 10 reps of 10 exercises—before the end of the session. This strategy worked to get her to focus!
President, Joan Pagano Fitness Group
New York, New York
Some of the physical issues that challenge older adults are joint stiffness and decreases in bone density and muscle strength. As a result, I tend to design programs that focus on preserving physical function. The program includes multijoint exercises that mimic daily activities and improve flexibility and balance. I also find that circuit training—combining short bouts of aerobic exercise with strength and flexibility training—works well to prevent excessive fatigue and maximize enjoyment, especially in older adults who are deconditioned. Aerobic exercise can include anything that elevates the heart rate, from something as simple as marching in place or walking on a treadmill to stair climbing or biking. If clients have low bone density, I focus on impact activities and encourage them to accumulate at least 30 minutes of impact activity daily.
To help my clients increase their strength, the goal is to do strength-building activities at least two to three times per week. Sometimes the challenge is getting clients to use enough resistance to overload the muscle. Some people, especially my older female clients, tend to underestimate their abilities. Clients can accomplish the weight exercises with a number of different tools, but I tend to use body weight and resistance bands because clients can easily learn how to use them and then do the exercises on their own. If flexibility or balance is a major concern, I work appropriate exercises into the circuit routine or ask clients to supplement their training with a yoga or tai chi class.
Kelli Christensen, MS, CSCS
ACSM Clinical Exercise Specialist
Well Bodies Inc.
There are probably more dissimilarities among older adults than there are common characteristics. The broad range of chronological ages and physical attributes makes this population extremely diverse in its training needs. As a result, I have found it important to attract older adults by interest factors as well as ability levels. To do this, I offer various small-group programs with different goals. This helps me, as a trainer, know that clients participating together have similar goals. Groups vary from back care classes to cardio-health classes to golf or tennis training. Once I have put together a group of like-minded older adults with similar goals, I find that they form a cohesive group that works together to meet those goals.
A common trait among older adults is the need for socialization and friendship in the activity setting itself. I allow for mingling, both before and after sessions. This socialization time gives clients a chance to bond with others and creates more long-term interest in staying with the program. So, in addition to the class time, I set aside at least 15 minutes when they can meet beforehand. I also anticipate that they’ll want to stay after class. I have set up an area where participants can sit and talk with each other, which works well, especially if I have another class afterward. Clients have become friends, formed book clubs and planned mini-trips to attend community activities together. If I didn’t pay attention to older adults’ need for socialization, I don’t believe I would retain this population.
I also work closely to help these clients develop self-efficacy in goal setting. They may come to an exercise program with preconceived ideas of what they can and cannot achieve. These beliefs come from personal life experiences, physiological states, and experiences that peers have shared. At first I keep the goals small and simple so clients can achieve them and feel motivated right from the beginning. Then we build on the goals they’ve achieved. I also like to verbally recognize these accomplishments in the group, to empower the individuals. For older adults, the advantages of the small group are that it allows for friendships, helps them see what they are capable of and eventually promotes long-term participation.
Sarah A. Collins, MS
FIT SOLUTIONS BY SARAH LLC
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