Maintaining an exercise routine at any age requires significant motivation. However, the difficulty is often exacerbated with age.
According to a recent study published in the Archives of Physical Medicine and Rehabilitation, elders commonly report they cannot, will not or should not exercise.
Physical activity significantly declines progressively with age. As a direct result, elders experience preventable functional decline, loss of independence and increased medical conditions or diseases. Exercise can potentially delay, prevent or reverse the effects of a sedentary lifestyle. Despite the evidence supporting the health benefits for older adults, most seniors remain physically inactive.
A growing amount of literature documents the health benefits of physical activity among older adults. Many health care organizations have issued consensus statements extolling exercise for seniors, including the National Institutes of Health, the American College of Sports Medicine, American Heart Association, American Academy of Family Physicians, American College of Obstetricians and Gynecologists and the U.S. Surgeon General's Office. Establishing and sticking to an exercise plan requires one primary tool: motivation.
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Motivation is defined as the forces acting on or within a person to initiate behavior. This definition includes both intrinsic and extrinsic factors.
The motivation equation adapted by Geelen and Soons encompasses four subjective factors: Motivation equals perceived chance of success multiplied by the perceived importance of the goal divided by the perceived cost multiplied by the inclination to remain sedentary.
The first factor, perceived chance of success, is most critical. The numerator also includes the perceived importance of the goal. Older adults have often developed a set of beliefs contrary to those of the rest of the population.
Equally important, most seniors have experienced a health care system very different than today's health system. The system in the past was more focused on cure and less on prevention and was driven by an outdated pathophysiology on the benefits of exercise. Through much of their lives, older adults were counseled that effective treatment of illness required physical inactivity. For example, the standard care of myocardial infarction and back pain called for prolonged periods of bed rest; now, exercise is the recommended practice.
The denominator of the motivation equation includes perceived costs of attempting to exercise.
The costs may be monetary, including the cost of gym membership, or purchasing appropriate attire, or the cost may be the risk of failure, pain, fatigue, loss of energy or time. The denominator also includes the inclination to remain sedentary, or the perceived benefits and value of remaining sedentary and avoiding activity. This includes habits of prior experiences, psychological issues and environment.
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The methods required to overcome challenges of initiating exercise are multifaceted and require many layers. A source of great encouragement comes from physicians. Elders encouraged by their physicians to exercise report fewer barriers and exercise more than those without this level of support.
Additionally, physicians are able to address safety concerns expressed by seniors, address the costs of activity and treat concurrent morbidities. An additional source of support comes with education. Older adults must be educated about the benefits of physical activity. This, in turn, empowers seniors to play a more informed, active role in their own health.
Though the health benefits of physical activity for older adults are well established, exercise is an under-used form of health promotion, particularly for elders. Physicians, clinicians and concerned family members must play a more active role in motivating their aging patients to exercise.
To learn more about motivating older adults to exercise, contact Ingra Gardner at (863) 382-2134 or email gardneri @nuhope.org.
Ingra Gardner is the executive director of NU-HOPE Elder Care Services, the designated lead agency of home and community-based services in Highlands and Hardee counties.