Can you imagine sitting in the same spot for hours on end looking at the same unchanging scenery? This happened to a colleague of mine who travelled the width of Australia by train. Once away from the city and suburbs and into the outback she had 3-days of repetitive flatland to look at. And from a not very comfortable seat. At least she was able to wander the train and stretch her legs – a much needed activity to stave off stiffness and boredom. This scenario can equate to an older person who might not be so able to “stretch the legs” or have anywhere to wander to. In both cases, it doesn’t take long for health and well-being to suffer, activity provision can help.
Immobility
It is well known that immobility has a fast-acting impact on health. Hospital staff are trained to get postoperative patients moving as soon as possible. This prevents a whole range of conditions from occurring. Airlines warn us to keep moving lower limbs to avoid thrombosis. There is plenty of research around that supports the benefit of moving frequently to maintain health. This leads me to wonder why we don’t place more importance on ensuring that older people move as much and as often as they can.
Promoting Enablement, Not Disablement
I travelled to Australia last year, thanks to a Churchill Travelling Fellowship, and was struck by the different approach they had in many care settings to physical activity. It seemed to be an accepted ‘norm’ to assess, set a goal or two and then generate a care plan to promote physical activity. The route to physical activity was invariably through engagement with an activity rather than prescribed exercises. The older person was involved in the process from the outset and interests, hobbies and leisure pursuits were explored to arrive at an appealing plan.
In one case a lady with very limited function of both hands loved baking and wanted to do cake mixing by hand as a way of maintaining what limited movement she had. The manager was adamant that every person should remain as independent as possible not only for their sakes, but because it reduced the pressure on the care team. She promoted enablement not disablement. This struck me as sitting well with the Australian society ethos of just getting on with life.
Activity Provision – Start Small
I have often said that perhaps we care too much in this country. Maybe our cultural desire to always care for and ‘do’ for others promotes dependency. I know there are some older people who love to be waited on hand and foot. In my experience they are a minority. Most are frustrated by what they can’t do or are not allowed to do. Family members can be very protective and care staff can be risk averse. Hours sat in the same place and little stimulation is a recipe for poor health and ill-being rather than well-being. It might take a major shift in our thinking to change this scenario. They say that water erodes the stone, maybe we need some small changes that over time would have an impact. Ensuring that everyone has a goal that encourages moving more often would be a good start.
If you want to know more about how NAPA can support your activity provision got to www.napa-activities.co.uk.
