Successful Aging

1
Successful Aging

• Barbara Resnick, PhD, CRNP
• University of Maryland

2
Conceptualization

• There are 29 different definitions of successful
  aging

3
Common themes

• The definitions generally focus on either
  objective ( comorbidities impaired function) or
  subjective (I feel good! QOL) approach.
• The central theme associated with successful
  aging tends to be one in which health is "good"
  and that the individual is free of physical and
  mental disabilityor just feels successful and
  glad to be here!

4
Conceptualization

• Common themes are not always prevalent!
• Resilience
• Maintenance of an active life style
• Good supportive relationships.more important in
  some studies
• Montross et al., 2006

5
(No Transcript)
6
Conceptualization

• Is successful aging
• A. A state of mind
• B. Objective physical and cognitive function
• C. Social engagement
• D. All of the above?

7
Conceptualization

• Physical and mental OPTIMIZATION of function not
  absolute function
• Accepting changes and functioning at the highest
  level possible.
• Physically
• Mentally
• Socially

8
So Who is Most Successful?

• More educated more successful
• Race/MS inconsistent
• Younger
• Volunteers
• Those who adhere to healthy behaviors
• RESILIENCE

9
Resilience

• The capacity to spring back from a physical,
  emotional, financial, or social challenge
• Adaptive behavior
• Less likely to succumb to the challenge
• Dynamic process and influenced by life over time
  

10
Resilience

• Positive interpersonal relationships
• Strong Self efficacy
• Positive Self-esteem
• A sense of purpose
• Spirituality
• Ability to use Humor
• Creativity
• Acceptance of changes (physical and mental)
• Maintaining a positive attitude
• Ability to identify and utilize resources
• Self-determination
• Optimism

11
Need MOTIVATION to be RESILIENT

• Resilient reintegration for success requires
  increased energy/motivation to happen
• MotivationThe inner urge that moves or prompts a
  person to action

12
Interventions to Facilitate Successful Aging

• Healthy behaviors throughout lifespan
• Cognitive stimulation
• Maintaining a purpose in life

13
Benefits to Exercise

• Meta-analytic reviews provide strong evidence
  that participation in either non-specific
  physical activity or specific aerobic or
  resistive exercise helps to
• decrease risk of coronary heart disease and
  stroke
• lower incidence of viral episodes
• decrease progression of degenerative joint
  disease
• prevent osteoporosis of the lumbar spine
• decrease incidences of falls
• increase gait speed and
• improve mood, memory and quality of life.

14
New ACSM AHA Guidelines

• Do moderately intense aerobic exercise 30 minutes
  a day, five days a week OR
• Do vigorously intense aerobic exercise 20 minutes
  a day, 3 days a week AND
• Do eight to 10 strength-training exercises, 10-15
  repetitions of each exercise twice to three times
  per week AND
• If you are at risk of falling, perform balance
  exercises AND
• Have a physical activity plan

15
Stretching Exercises How Often?

• Minimum 3 times/week
• Do after muscles warm
• Example after endurance activities and resistance
  training
• Warm shower/bath, etc

16
Flexibility Training

• Flexibility-related activity results in greater
  range of motion around the joint.
• Flexibility exercises should be performed a
  minimum of 2 days a week.

17
Conversely..

• Sedentary lifestyles exacerbate coronary heart
  disease, degenerative joint disease and
  osteoporosis, and likelihood of falls and other
  injuries.
• It is not just what you dobut what you dont do!

18
Other Healthy Behaviors

• Maintain ideal body weight
• Dont smoke
• Drink moderate amounts of alcohol
• Safe sex, seat belt use, and smart living (eg
  dont go up the stairs carrying laundry and 12
  packages!)

19
Benefits of Mind Stimulation?

• Limited evidence that mental stimulation will
  prevent cognitive decline/dementia.
• Cognitive remediation thru technology/gaming

20
Despite what we know

• Only 30 engage in regular physical activity
• Obesity continues to be a major problem
• Approximately 9-11 of older adults smoke
• HIV continues to rise in older adults
• Preventable falls happen

21
OUR JOBis to make successful aging happen!
22
Factors that Influence Motivation/ Resilience

• Social supports
• Beliefs (SEE OE)
• Unpleasant/pleasant sensations
• Mood
• Personality Resilience
• Goals
• Environment
• Policies

23
Function Focused Care

• An exemplar of where we need to go in terms of
  care and optimizing successful aging.

24
Definition

• Function focused care is a philosophy of care in
  which staff acknowledge older adults physical
  and cognitive capabilities and potential with
  regard to function and engage them in functional
  and physical activities (e.g., bathing, turning
  in bed or ambulating) by integrating these
  activities into routine care.

25
The Contrast to FFC

• FFC contrasts with current care in which involves
  completing tasks for older patients or limiting
  the amount of activity they need to perform
  (e.g., giving a urinal or bedpan versus
  helping/encouraging individuals to stand and walk
  to the bathroom to urinate).

26
What are your thoughts????
27
Four Components

• (I) Environment and Policy/Procedure Assessments
• (II) Education
• (III) Developing Function Focused Goals and
• (IV) Mentoring and Motivating.

28
I Environment/Policy

• Person Environment Fit
• Barriers to access of PA opportunities
• Policy as relevant restraint use falls

29
II Education

• Assessment skills
• Philosophy
• Goal development
• Motivational tricks of the trade

30
III Developing the Goals
31
IV Mentoring and Motivating

• Making it happen.

32
Safety

• Promote ambulation and mobility
• Gait belts
• Sturdy equipment
• Appropriate exercise equipment on the unit
  (weights, pedometers for fun)
• Rest areas along the hallway and clear paths
• Fun goals (walk to gift store/coffee bar/unit
  kitchen)
• Increased patient visualization
• Appropriate chair and bed height

33
(No Transcript)
34
Successful Aging Can Happen
People who roll with the waves of life!