PARTICIPATION AND OLDER PEOPLE

1
PARTICIPATION AND OLDER PEOPLE

• David Morby
• Assistant Head of Service
• Alison Morby
• Physical Activity Development Manager
• Kirklees Metropolitan Council

2
DEFINITION OF TERMS

• Physical Activity
• Physical Activity
• Exercise Sport Leisure
  Dance/ Others
• Activity
  Movement
• (Source Presidents 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

3
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 50s and young
  70s
• Self-identification may be more accurate

4
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 persons 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

5
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 50s, 40 of men and women are
  sedentary. Among the over 80s, 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 50s 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

6
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)

7
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

8
WHAT ARE THE BARRIERS FOR OLDER PEOPLE?
Intrinsic Barriers Extrinsic Barriers
Relate to an individuals beliefs, motives and experiences concerning physical activity Likely to be addressed by those working directly with the older person ie peer mentor, instructor, health visitor, GP, care worker etc 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 Relate to the broader physical activity environment, skills and attitudes of others and the types of opportunity available Likely to be addressed by those responsible for policy and strategic development 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
9
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)

10
KEY ISSUES

• Consultation
• Activity Choices
• Facilities
• Safety
• Instructors/Leaders
• Role Models
• Pricing Policies
• Marketing and Promotion
• Partnership Working
• Influencing the Strategic Process

11
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

12
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

13
ACTIVITY CHOICES

• Activity Area Focus Providers Activity Type
• Making Activity Disease prevention, Leisure
  Recreation Sport, Exercise,
• Choices maintaining activity and activity
  providers Active Living
• levels functional
• capacity
• Independent and Starting sustaining Kirklees
  Leisure Walking
• unsupervised participation in Recreation
  Services Circuit training
• activity physical activity Exercise to music
• Kirklees Active Leisure Practical Conservation
• Involvement in active Dance (various)
• leisure, sport Voluntary sector sports, Tai
  Chi
• exercise programmes exercise and activity
  Badminton
• clubs Tennis
• Active Living and Bowls
• Lifelong Learning Private sector health Line
  dancing
• and fitness clubs Yoga
• Cycling

14
ACTIVITY CHOICES

• Activity Area Focus Providers Activity Type
• Increasing the Maintaining Older Peoples
  Exercise, Activity to
• Circle of Life independence, social Services/
  Managers improve functional
• networks and capacity Active Living
• functional capacity
• Supervised classes Movement, dance and Activity
  co-ordinators in Circuits
• and groups within walking (assisted) nursing and
  residential Danceability
• a health, social, activities settings Activi-chi
• residential or care Tai Chi
• setting Chair based Physical Activity Walking
• programmes and Development Officers Chair
  aerobics
• games (Local Authority) Chair activities -
• parachutes,
• Home based exercise/ Healthcare
  Professionals batons, scarves,
• activity programmes balls, fans, bean
• Home visitors bags etc

15
ACTIVITY CHOICES (cont)

• Activity Area Focus Provider Activity Type
• Activity in Later Improvement in, Specialist
  services Functional activity
• Years quality of life
• Requires adapted Maintaining Physiotherapists/
  Functional exercises
• physical activity independence and occupational
• activities of daily therapists Physiotherapy
• living programmes
• Physical Activity
• Rehabilitation ie Development Officers Active
  Games
• falls, cardiac (Local Authority) -,
• rehabilitation etc specialist training Chair
  activities
• - parachutes, batons
• Specific needs ie Exercise practitioner scarves
  , balls, fans,
• dementia with additional bean bags etc
• training
• Reminiscence

16
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 ?

17
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?

18
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

19
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

20
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

21
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

22
PRICING POLICY

• Appropriate
• Flexible

23
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 Role
Leisure and Recreation Social Services NHS Trust Sheltered Housing Primary Healthcare Team Residential Home Excel 2000 Support, equipment, funding Funding advice, information Physiotherapy support, referrals Referrals, promotion Referrals, advice/information Care staff, venue Instructor
24
PARTNERSHIP WORKING (cont)

• Walking Leaders Network partnership

Partner Role
Leisure and Recreation (KMC) Highways Countryside Unit Primary Healthcare Teams Peer Health Education Project Countryside Agency/BHF Health Promotion Service Walking Leaders 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
25
PARTNERSHIP WORKING (cont)

• Active Older People Network partnership

Partner Role
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 (PAMs) 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
26
POLICY/STRATEGIC CONTEXT THE KIRKLEES APPROACH
NATIONAL POLICY/ STRATEGY IE NSF
COMMUNITY STRATEGY VISION 2012
CULTURAL STRATEGY
LOCAL HEALTH PLANS (HIMPs)
SPORT RECREATION STRATEGY
PHYSICAL ACTIVITY HEALTH ACTION PLAN
PHYSICAL ACTIVITY HEART HEALTH DEVELOPMENT PLAN
PALS DEVELOPMENT PLAN
ACTIVE OLDER PEOPLE DEVELOPMENT PLAN
PHYSICAL ACTIVITY FALLS DEVELOPMENT PLAN
27
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

28

• For more information contact
• david.morby_at_kirklees.gov.uk
• alison.morby_at_kirklees.gov.uk