How can elderly people exercise healthily?

The title of this piece is ‘How can older people exercise healthily?’. It could also have said ‘What are the options for getting older people to exercise healthily?’. In addition to the fact that older people can choose to exercise more and therefore want to understand how they can best do this, others, such as care providers or the government, may also feel called to encourage seniors to become more active. Especially when it comes to elderly people who have never really exercised, and have no intention of doing so on their own. However, policymakers (and others) should not forget that everyone has the right not to exercise. People should not simply lose their “freedom of movement” due to standards imposed on them. Although, despite this limitation, the government still has a task to continue to effectively encourage older people to exercise. So the question is: What are good ways to reach (in)active seniors and to encourage them to participate in exercise activities?

Motives of seniors to exercise

People have motives that cause them to do certain things. Older people, in turn, may have different motives for taking up sports.

These motifs are:

  • On the doctor’s advice.
  • For fun.
  • New interpretation after retirement.
  • Desire to exercise and keep fit. This applies to most.

Competition and performance are not important motivations for seniors to exercise. For them, sports is primarily a social activity and being outdoors. With the information about the offer, providers must respond to the different motives that older people may have for taking up exercise. For example, it is important to link social aspects, which older people attach so much importance to, to sport. As long as it is facilitated, older people will exercise. However, the next step towards permanent exercise is more difficult. You can only get older people to exercise structurally by changing their intrinsic motivation and through general behavioral change. You can achieve this if the elderly enjoy it .

Do you want to know the reasons that some seniors do not exercise enough? Then read What prevents the elderly from exercising healthily?

The image of movement

Older people have a certain image of sports and exercise, and that image does not always have to match reality. Yet this image can prevent them from getting involved. For example, non-athletes associate sports with intensive physical exertion, competition and goal-oriented training. They make no connection between sport and fun. Or older people believe that they are unable to perform even a single activity due to physical limitations.

There are a number of points that can support a positive image of sports in old age:

  • Even people in a wheelchair can still move with weights, stretching and even wheelchair aerobics is possible.
  • Physical activity does not only have to be approached as a sport in your spare time, but can also be seen as exercise during daily activities.
  • Exercise activities can be connected to daily life as much as possible. Taking a walk outside is also a healthy activity.
  • Any additional exercise helps, regardless of intensity, duration, frequency and type. Exercise is good, even if you only do it a little. Every little bit helps.
  • It may have a stigmatizing effect if ‘senior offerings’ are referred to as such by sports providers.

How do you reach seniors?

The group of elderly people who are already active usually find their way to exercise and sports on their own initiative. These people often have a long history of exercise and are therefore used to being busy in addition to their daily activities. The situation is very different for seniors who have never, or almost never, exercised in their lives. Within this group a distinction can be made between vital elderly people and vulnerable elderly people. The latter in particular generally participate much less in various social activities, which means that their social environment is also much smaller. It is therefore more difficult to reach them. However, there are a few ways to achieve this contact with inactive, vulnerable elderly people.

Those contact methods are:

  • From senior to senior: There is great importance in linking active elderly people to inactive elderly people. Active seniors can be used to reach inactive seniors, for example by acting as role models in targeted promotion.
  • From intermediary to senior: Seniors can be reached with the help of intermediaries such as volunteers. These are people who are usually already in contact with the elderly. Where there is a lack of professionals, these volunteers are invaluable. Social events can also be used to reach out. Recruitment in general practices and the use of existing communication channels, such as oral presentations or door-to-door newspapers, are finally a final way for this form of contact.
  • From primary caregiver to senior: Inactive elderly people who usually have little social life, on the other hand, do have regular contact with their GP or physiotherapist. Primary care providers like these should be more focused on guiding these patients toward a desired lifestyle.
  • From sports provider to senior: Sports providers have sports offerings, and it is important to bring this offering to the attention of seniors through promotion. There are a number of means to carry out thorough promotion. The best way, according to sports providers, is promotion by word of mouth *. Providers often have their own website , or offer their exercise options on the municipality’s website. Advertisements are used in local newspapers or door-to-door leaflets are distributed . Another paper promotion, and the last form used by sports providers, is flyers to primary caregivers . These would have the least effect.

* How does word of mouth work? This advertising is achieved in three ways: 1. Older people themselves ask others to participate. 2. Providers encourage older people to bring others with them. 3. Deployment of key figures: volunteers who visit lonely and inactive seniors.

Internet and healthy aging

The Internet has grown enormously in recent years. Young people find their way around this more easily than older people. Apparently they have more feeling for the basic principles of internet use, which means they can pick things up much faster. Of course, this does not alter the fact that they too can be overwhelmed by the digital world and everything surrounding it. At first impression, the Internet is a complex entity, and that is a major hurdle for many. For example, sports providers also think that the internet does not really work well for seniors due to their lack of computer knowledge. The elderly are a group in particular that need to be properly informed about this.

Access to the internet, at least physical access, is gradually becoming commonplace for the elderly. And that is a positive thing, because the internet is an instrument with countless possibilities. Seniorweb.nl is a good example of a website with information that focuses exclusively on the elderly. The internet can be used by seniors in different ways.

The Internet can be used as:

  • Source of information. Examples are Vrijdagwijzerdenhaag.nl andgezondheidenwelzijndenhaag.nl. These sites are specifically aimed at the elderly.
  • Means of communication: The internet can be used as a means of communication between care providers and seniors, but also between seniors themselves. Examples are redactiebelkring.nl and tichaaglanden.nl.
  • Personal file: This requires a more active role from older people and ensures more involvement on their part. For example, TNO has created ‘Quality of Life’, which can be found on redactiedossier.nl. Diavitaal’s My Diabetes Dossier is also an initiative that works with this.
  • Digital assistant: Elderly people can use the internet to determine and keep track of measured values, for example blood or cholesterol, at home.
  • Combination of the above. Examples of such applications are seniorgezond.nl and Cybertraining. Both were developed in the LUMC, a center of medical provision.

For older people, the Internet could complement traditional ways of providing information, such as group meetings and flyers. The Internet can increase the self-care of seniors and it is also possible to monitor health at home. The internet can therefore provide welcome support to seniors.

Concrete activities to increase participation of seniors in exercise activities

There is a variety of concrete activities and interventions to reach the elderly and get them moving. This is an overview:

  • Methodologies: Beweegmaatjes (based on volunteers, can be found on beweegmaatje.nl), GLANS (information about healthy living), Van Klacht Naar Kracht (referral to primary care).
  • Other initiatives to promote physical activity: SCALA (Sports stimulation for people with a Chronic Condition: Lifelong Active), ‘Exercise and health for people over 50’ with one of the themes ‘In Balance: a proven effective and accessible fall prevention /fall reduction project’, the COACH method, CiB (Communities in Motion), Active lifestyle chain approach in primary care and GROSSO (a district-oriented approach to improve the living and health situation of elderly people with a low socio-economic status). Finally, certain lifestyle interventions and walking programs embedded in a socio-cultural association.
  • Tip when approaching seniors: It is more effective to discuss with the person how exercise can be incorporated than to refer to the sports offer.

Inactive seniors, some with a very small social environment, can be reached by approaching them personally and using outreach . This works by visiting them, for example with an Exercise Buddy. It is important to combine the intervention with something social such as drinking coffee: older people also need that. For example, outreach can mean taking inactive elderly people to a sports club without them having to participate, for the purpose of getting to know each other.

Content of the offer and other conditions to convince seniors

Sports providers must think about their sports offering for the elderly. The group of seniors is in any case not a homogeneous group, so one can expect a variety of wishes and needs. The Dutch standard for exercise is still at least 30 minutes of moderately intensive exercise 5 days a week . It is recommended that older people also start doing this. It is therefore important for providers to ensure that the sports offering matches the wishes and needs of this target group.

The most commonly practiced sports by the elderly are recreational walking and cycling. Other activities they like to engage in are swimming, tennis and dancing. For example, there is: MBvO (More Exercise for the Elderly: gymnastics, games, (folk) dancing and swimming), GALM (Groninger Active Living Model) and GALM+.

All these exercise activities offer opportunities for social contact for the elderly, which should be taken into account, especially by sports providers. The government should also encourage course offerings to increase social and physical self-confidence, such as fall prevention, electric bicycle courses and buddies.

There are a number of other conditions that must be met to get older people to exercise. Those conditions (and options) are:

  • Location is crucial in attracting participants. The recommendations made here are: ensure that activities are located in the center of the target community, limit travel for inactive participants and work with a network of drivers if possible. Redesigning the public space may be a requirement.
  • The health promotion program must be tailored to the target group. Consider adjusting the lesson pace. Lessons for different ages are also recommended; so not ‘senior’ is > 55.
  • Involve the target group as actively as possible; give seniors a voice.
  • Take into account socio-economic disadvantage and cultural and gender differences.
  • Provide an accessible offer : This could be free introductory lessons or the possibility of borrowing a tennis racket. Cost is often an important consideration. No long questionnaires in advance and a good picture of the offer in terms of ‘How well can seniors do this?’. Provide opportunities for sports and exercise on different days and times. Finally, emphasize in communications that people are never too old to learn.
  • Also mention innovative exercise concepts with the offer.
  • Use of a qualified trainer. In this way, elderly people can be coached and motivated in an appropriate manner. Interventions that achieve the best results in the longer term take self-determination theory into account . This theory states that people achieve the most optimal form of motivation when three points are met, namely autonomy, competence and relatedness.

A safe start

Once seniors are ready to start exercising more, they can particularly benefit from a safe start. Runners are dead runners, so to speak. Even the road to Rome begins with a first step.

When starting to exercise, keep the following in mind:

  • Check with your doctor whether your health permits exercise.
  • Take your health status into account when exercising.
  • Always start slowly.
  • Stick to a training schedule.
  • Stay motivated by focusing on short-term goals.
  • Recognize problems while moving.