Stereotypes of what it means to be “elderly” have been happily undermined in recent years. The Hollywood film Cocoon showed us that old people still knew how to party, still cherished notions of the future and still knew how to be “physical”. Australian writer Dorothy Hewett’s recent acclaimed novel The Toucher explores the torrid affair between a woman in her late ’60s and a much younger man with such vivacity that no reader can fail to be convinced of the burning flames of geriatric passion.
In recent years the idea of the old Rockwellian character napping in a rocking chair on the front porch has given way to a more enlightened vision. The elderly, it seems, are rediscovering their bodies, encouraged by the medical fraternity who are spreading the word that habitual exercise gives the elderly a new lease of life.
At least half of the functional decline traditionally associated with ageing is not about body parts being unable to respond to physical demands; it is about disuse. Inactivity prompts the decline in muscle bulk, strength and endurance and the increase of joint stiffness. According to most physiotherapists, these negative side effects are more about a lack of exercise than a lack of capability.
According to Peter Hough, the chief physiotherapist at the Mount Eliza Centre, by the year 2021 there will be 2.7 million people in Australia aged 65 and over, or 12.9 per cent of the population. The size of this figure emphasizes the need for our community to understand how best to approach the physical and mental issues of getting older. “The elderly refrain from exercise due to a multitude of social, environmental, personal and motivational reasons,” he says, “and programs must be provided which meet each of these needs as well as any physical limitation of the elderly person. Companionship and social needs are often listed as strong motivating factors to the aged.”
In Western society there is the expectation that the ageing will become more sedentary—a tradition in Western society but not necessarily in other cultures—and that is certainly changing. “In the last decade we’ve seen a challenge to government and health care workers to ensure the elderly understand the relationship between exercise and independence, and that message is getting across,” Mr Hough says. “We need to be encouraging healthy levels of activity in middle age moving into retirement. Community health centers are taking a more progressive role in this area, as are local councils and other bodies such as the Arthritis Foundation and the National Heart Foundation.
There is a growing awareness of preventive health through traditional health care providers. The elderly can approach their local council, most of which have a recreation services coordinator who is involved in the setting up of services for the elderly. In Frankston, for instance, there is a Fabulous Fifties program catering for the 50 to 80-year-olds who take part in a water-based exercise program and lecture program. In Melbourne, the City Baths has an over-50s hydrotherapy program with an instructor (also over 50) who runs through exercises in the water with music to make it more enjoyable. As well as the physical benefit, it provides a good social benefit. Michael Vadiveloo, a physiotherapist at the City Baths, emphasizes the phrase “Move it or lose it”. “If they don’t move those joints, they will lose the use of them. Those who have led a sedentary life will have problems with joints which may have been alleviated with exercise such as aquarobics. “It’s a warm environment and it’s particularly good because the elderly have the effect of the buoyancy of the water, which takes away the weight of the water on their joints and allows them to do exercises they wouldn’t be able to do on land.”
Jamie Barclay, the manager of the baths, says the average age of those undertaking the elderly program is 70 and the oldest is 92. While many of the elderly stay all morning for coffee and tea afterwards, he emphasizes that the fitness programs are not just a bit of splashing around: “The tempo of the class is the same tempo as our adult water class.”
Dr Malcolm Scott, a medical practitioner who has a long history of working with elderly people, acknowledges that “a lot of diseases will stop (them) from exercising, but if you don’t exercise, obesity is a hell of a problem. An older person put to bed gets very unfit very fast and getting them back on their feet is hard. Dr Scott believes that the elderly are aware of the need to exercise but, like most people, cannot be bothered. “The real problem is why they don’t do what they know they should do.”
Physiotherapist Peter Hough also emphasizes that falling is one of the main problems of elderly inactivity and one that is being tackled on Friday in a symposium at the Mount Eliza Centre on Falls and the Elderly. “Falls become a vicious cycle because a fall commonly leads to fear, which leads to diminished activity levels and becoming house-bound, which leads to a further likelihood of falls, which leads to further fear, which leads to progressive social isolation. The best way to combat elderly falls is through physical exercise, building strength and coordination.”
Mr. Hough suggests walking, lawn bowls, or golf may be appropriate, depending on the individual. How much should the elderly exercise? “The recommendation would be daily or five times weekly with a 20 to 30-minute program,” he says. “This might simply be walking. In terms of fitness, we need to raise the heart rate and the respiratory rate to obtain a training effect. It should also include pure enjoyment. We must provide programs that are attractive and will motivate people in post-retirement life—that’s really the challenge.”