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: President�s 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 50�s and young 70�s 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 person�s 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 50�s, 40% of men and women are sedentary. Among the over 80�s, 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 50�s 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?

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 Primary Health Care Orienteering Teams Stretch & Flex Swimming Self directed activities, Aquafit maybe with assistance Swimming lessons and support from leaders, Activity Mix coaches, instructors etc

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 community nursing staff Reminiscence Active Games Qualified older person Active Living Circuit instructors/teachers Gardening

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 Activity co-ordinators in nursing & residential Circuits (specific) settings Active Living Health and care teams with specific training

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 asthma diabetes visually impairment dementia functional assessment tests

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:

24. PARTNERSHIP WORKING (cont�) Walking Leaders Network partnership:

25. PARTNERSHIP WORKING (cont�) Active Older People Network partnership:

26. POLICY/STRATEGIC CONTEXT� THE KIRKLEES APPROACH

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