Plan incorporates goals of Healthy People 2010
When your elderly patients leave the rehab unit or complete a course of physical therapy, you send them off with a home program and many admonitions to continue exercising. You only can hope they will find the self-motivation to continue the lifestyle changes you have put in place.
A new comprehensive wellness program put together by two companies with expertise in rehabilitation services and strength training does not leave that self-motivation to chance. Instead, the wellness program from Genesis Rehabilitation Services and Keiser Corp. keeps older adults on the healthy path by addressing their total spiritual, medical, physical, and psychosocial needs.
"Therapists never see the end results. They get somebody with issues; they work on them for X number of visits, and then it’s, Now keep doing this on your own or go somewhere.’ There’s nowhere for them to go. They’re not going to do the correct exercise program at home," says Don Callahan, a sales manager for Fresno, CA-based Keiser Corp. Keiser manufactures pneumatic strength-training equipment.
Genesis, based in Kennett Square, PA, developed the wellness program along with Keiser for use in skilled nursing facilities, assisted living facilities, and continuing care retirement communities. Genesis hires a wellness coordinator with a background in exercise physiology to work at the facility — the salary is partly covered by the facility — and Keiser provides the strength training equipment at a discount.
The wellness coordinator caters the program to existing wellness initiatives at the site and works with the on-site occupational, physical, and speech therapists to set goals for individual residents, says Laura Caron-Parker, OT, rehabilitation clinical specialist for Genesis. "Everyone talks about wellness, but people usually think of exercise only," she explains. "True wellness encompasses so many other pieces. We want to expand the scope of what defines wellness, and we think that the more people understand it and talk about it, the more it will happen. It’s really the way we all should be living anyway."
One unique feature of the program is that it incorporates 17 of the 28 focus areas of the federal government’s Healthy People 2010 initiative, which seeks to increase the quality and years of healthy life as well as eliminate health disparities.
The focus areas featured in the wellness program are: access to quality health services; arthritis, osteoporosis and chronic back conditions; diabetes; disability and secondary conditions; educational and community-based programs; environmental health; health communication; heart disease and stroke; medical product safety; mental health and mental disorders; nutrition and overweight; oral health; physical activity and fitness; respiratory diseases; substance abuse; tobacco use; and vision and hearing.
"The whole philosophy of what the United States is looking at is improving the health of people and communities, and we’ve agreed to say if the nation is looking at this, then we need to incorporate it as well," Caron-Parker says. "It meets our mission of providing pathways to healthy living. It matches. No other large organization has taken that on and incorporated Healthy People 2010 into their wellness program," she adds.
Seniors see benefits
While exercise is not the only component, it certainly plays a starring role. "When you put a 60-, 70-, 80-, 90-year-old person on a strength training program, their lives change. It’s not like a young person. Their balance improves. It’s the best fall prevention program you could have," says Callahan of Keiser.
Keiser’s approach is to provide senior-friendly fitness equipment that is not intimidating and then to teach people how stability and mobility training can improve their quality of life. When Callahan teaches older adults how to use the equipment, he invariably gets a roomful of stares if he talks about strengthening quadriceps. If on the other hand, he asks who in the room has ever had trouble standing up from the toilet, he suddenly has everyone’s attention.
"They all react, and I’ll say this is really the getting off the toilet’ machine. If you’re having trouble with that, you better get on this machine twice a week," Callahan says. "You’re talking to a group of people who have never really exercised before. They don’t know what it’s going to do for them. They’re saying I’m 78, 88, years of age. What is this going to do for me?’"
Callahan shares the following benefits of strength training for an aging population:
- Builds muscle.
- Improves balance.
- Improves coordination.
- Strengthens accident resistance.
- Increases muscle strength and endurance.
- Strengthens and builds connective tendons, ligaments, and supporting bony structures.
- Improves physical appearance.
- Builds power, an important factor in preventing falls in older adults.
- Aids in weight control.
- Increases joint mobility.
- Prevents constipation, diverticulitis, colitis.
- Increases flexibility.
- Improves posture.
- Enhances self-esteem.
- Improves sense of well-being.
- Fosters independence.
- Improves emotional outlook.
The wellness coordinator helps residents set fitness goals, track progress, and find varying ways to meet fitness goals through such efforts as walking clubs, stretching classes, aquatics, tai chi, yoga, and instruction on proper breathing and relaxation. For the medical component of the program, Genesis offers a clinical practice department with specialists who consult on clinical and quality issues. Services offered include routine vision and dental screenings, overall wellness assessments, health promotion, classes on such topics as how to talk to your doctor, and collaborative health care programming.
For the psychosocial component of the wellness program, courses are offered on such topics as relationships, stress management, dealing with death and dying, and making healthy lifestyle choices. Activities to enhance relationships and challenge minds also are offered, including games and book groups.
On the spiritual end, program coordinators work to enhance affiliations with local clergy to provide worship services on-site or transport residents to houses of worship in the community. Classes are offered in the arts and in disciplines such as journaling. "What we want to do is get them out of their rooms to develop relationships, to feel good about themselves, and have the opportunity to help others," says Caron-Parker.
The pilot site for the wellness program is Waterford Glen Assisted Living in Wall, NJ. The facility has assisted living, a memory-impaired wing, and 30 skilled nursing rehabilitation beds, says Mary Ann Bryan, executive director. "This is a new concept coming into assisted living to have a wellness coordinator who is professionally trained in this type of program," she says. "Most places have exercise classes, but it’s more of a benefit to the residents to have someone who understands the physiology of the body, who can do the measuring tests to see if progress is being made. We can see the improvements."
The coordinator at Waterford Glen is working with the maintenance director to build outside exercise stations along the walking paths and to put in a putting green. Waterford also is talking with a local swim club to provide swim time for the residents on Saturday mornings. The facility also is working to provide a variety of on-site medical care, including visits from a physician, podiatrist, dentist, ophthalmologist, psychiatrist, and psychologist, Bryan says.
"We want to help people maintain the physical and cognitive level they have when they come here so they are able to enjoy living here for a lot longer before they need the next level of care," Bryan says. "People are coming to assisted living at much older ages than in the past. We have an average age of 90. Sometimes, it takes a crisis to make them come here, and we want to prevent further crises."
Need more information?
Mary Ann Bryan, Executive Director, Waterford Glen Assisted Living, 2021 Highway 35, Wall, NJ 07719. Phone: (732) 282-1910.
Don Callahan, Northeast Sales Manager, Keiser Corp., 31 Millbrook Road, Wayland, MA 01778. Phone: (888) 544-9844. E-mail: Donc@keiser.com.
Laura Caron-Parker, Rehab Clinical Specialist, Genesis Rehabilitation Services, 152 Weston Road, Weston, CT 06883. Phone: (203) 247-0616. E-mail: Laura. Caron-Parker@genesishcc.com.