As a personal trainer in London who has had older clients over 70 years old, I know the challenges they face when it comes to their health and fitness. We live in a society which tends to sideline older people, but equally older people often feel that a decline in their health and fitness is an inevitable part of aging, so without realising it many older people are needlessly sidelining themselves.
Costs to the NHS of elderly care
Residential care is the biggest cost, as elderly people reach the point where they cannot look after themselves independently, and have to go into a care home. I think in many cases this can be postponed or even avoided altogether if people are more proactive about their own health & fitness throughout the whole of their lives.
There was a news item several months ago which highlighted the £2.3 billion cost to the NHS of treating elderly people who have fallen and injured themselves. It is not inevitable that when you get old you are going to have falls, certainly not to the extent that it is happening in the UK. It is a symptom of the general decline in physical activity, decline in the quality of nutrition, and decline in mental activity and sense of purpose which seems to occur as people get older.
Physical activity for the elderly in London
Exercise slows the aging process. It boosts well-being and quality of life, mobility and agility, resilience to a range of diseases, and enables you to stay independent for longer. It’s not so much old age which makes you more susceptible to illness, disease, and falls, but rather the sedentary lifestyle which creeps up on elderly people.
Fear of falling is a major issue for older people. That’s why regular exercise is vital to prevent getting to this stage in the first place. For older people who have reached the point that they are unsteady on their feet, physiotherapy with an emphasis on restoring balance, good posture, and agility, are vital. In London, the resources for this are not sufficient to meet the growing need.
Many London Borough Councils have put in place programmes for physical activity for the elderly in their Boroughs, but the rise in the numbers of elderly people over the last couple of decades means that there is not enough provision for all. The wider the range of physical activity elderly people can do, the better. Find something you enjoy: dancing, ping-pong, nordic walking (the nordic walking poles give confidence and help prevent falls), swimming (great for those with inflamed joints), yoga and Tai-Chi.
Organisations like Better Leisure has senior fitness classes in their facilities, such as the over 60’s swimming classes at Ironmonger Row Baths, run by people trained in elderly health & fitness needs.
There are also personal trainers in London who have qualifications specialising in elderly clients, such as Marc Nyte, who is a personal trainer, physiotherapist, and sports massage therapist. The personal training company MotivatePT has trainers who specialise in the elderly, and who do home visits throughout London.
In Hyde Park there’s a Senior Playground near the Serpentine, an outdoor gym for the elderly with a cross trainer, a recumbent bike, and several other pieces of equipment. It’s the creation of the Knightsbridge Association, with funding from Westminster Council and the Royal Parks. Every park in London should have these facilities if we’re serious as a society about promoting the health & fitness of older people.
More and more physiotherapists in London specialise in elderly health-promotion, both in the NHS and in private practice.
Physical activity with friends
A major problem of getting older in the UK is loneliness and isolation, sitting at home inactive, a lack of connection with fellow human beings. This can cause anxiety and depression and loss of purpose in life, a shrinking sense of self-worth and self-confidence.
Reduced self confidence attacks your powers of proactive assertiveness, vital for getting out into the world and seeking help and support and friendship. All these things reduce your motivation to eat healthily and exercise, which in turn damages your health. And the worse your health, the less you feel able to connect with other people. It can become a vicious cycle of physical and psychological decline.
A great way to break this negative spiral is to combine friendship with physical activity. Join a ping-pong group and make new friends. Go to a swimming class and share a coffee with your new swimming friends afterwards.
A major barrier to elderly fitness is osteoarthritis, a degenerative disease where the cartilage in your joints wears down, causing inflammation, pain, and restricted mobility. Cartilage is the rubbery flexible tissue which protects and lubricates the ends of bones at the joint, and when it degenerates it loses its flexible shock absorbing quality, becomes brittle and stiff and worn down, and bony spurs can grow at the end of the bone which cause pain when you move.
Good nutrition can delay the onset of this disease, and help slow its progress and ease the symptoms of pain and inflammation if you already have it. A diet rich in the antioxidant vitamins A, C, and E helps combat free radicals which cause degeneration.
Carrots are a rich source of vitamin A. Citrus fruit is an excellent source of vitamin C. Vitamin E is found in spinach, almonds, sunflower seeds, pumpkins and pumpkin seeds, and olive oil. The elderly can benefit hugely from making all these foods a regular part of their diets.
Obesity can increase the risk of osteoarthritis in the knees and hips, because excess weight puts a continual strain on these joints. In addition, visceral fat (dangerous body fat around the vital organs) produces chemicals which cause inflammation. Weak muscles around the joints also make it more likely you’ll get osteoarthritis, and exercise which strengthens the muscles around the joints will reduce your risk.
Pain management is a major part of getting people with osteoarthritis more active. Pills, hot/cold packs, can ease the pain of movement and encourage more physical activity.
This has similarities to osteoarthritis, being a disease which inflames the joints, but its cause is auto-immune, which means that your immune system attacks healthy cells which line the joints. Most affected are the knees, hips, and finger joints. Over 400,000 people in the UK suffer from this disease, mainly women. The Rheumatiod Arthritis Society in the UK offers advice and support to sufferers.
Good nutrition can help reduce the symptoms, particularly foods rich on omega 3 essential fatty acids. The best source of omega 3 is oily fish (salmon, mackerel, sardines). If you don’t like fish, other rich sources are flax seeds, flax seed oil, chia seeds, and walnuts.
Omega 3 helps fight inflammation by suppressing the production of enzymes and cytokines (cell-signalling proteins secreted by the immune system) and reducing the auto-immune response.
In addition to anti-inflammatory drugs, there is a new generation of drugs called biologic agents which can halt the disease, but they are very expensive and can have side-effects.
Attitude and motivation
There is a tendency for older people to lose their sense of purpose and energy to rise to a challenge. An elderly person’s self-image can all too easily shrink and decline, which causes a vicious cycle of thinking you can do less and less, which in turn means you do less and less.
The more you can challenge yourself to stay active and eat healthily, the more healthy and happy and independent you will stay for longer into your old age, your golden years.
Dominic Londesborough is a personal trainer in London and author of the Fitness4London.com blog.