Exercising two birds with one stone
Our parents may be exercising already. Let's try to recognize that, so we can protect it from slipping away as things change in the future. If we look at the minimum guidelines for older adults' exercise each week, we may find ways our parents are working toward these already:
- Aerobic activity — 150 minutes a week of moderate movement like brisk walking might happen through daily walks around the neighborhood. Their aerobic is not the same as yours, and definitely not the same as your teenager's. Even a walk around Costco or splashing in the pool can count for this, if it's raising your parent's heart rate.
- Muscle-strengthening — at least two days a week, could occur through hauling their Costco purchases into the house or lifting the trash bag into the can. Walking up and down stairs is a great leg exercise.
- Balance activities — regular practice (such as standing on one foot or balancing while reaching) can help prevent falls. Putting away dishes and changing bedsheets help with this.
- Flexibility — gentle stretching may happen when getting dressed or picking things up off the floor.
The purpose of this initial list is to baseline what they are currently doing and particularly to capture how some seemingly unrelated activities are contributing to their physical health. If someone starts driving your parent to Costco, it might inadvertently decrease the weightlifting they're getting from that trip. By knowing the value of that action, you might ask the companion to carry a drink and phone in their hands to prohibit them from being too helpful.
Adding in things called exercise
Some folks like things that look like exercise, like swimming laps or meeting with a personal trainer. If so, you won't need to do anything other than help them maintain engagement. But for those who don't like this structure, you can help by finding extra motivation to make it worthwhile. I felt the same way when my children were young and I was busy: if exercise didn't also count as family-time or yard work, I wasn't making space for it on my calendar. Using the same list as before, here are some ways we can weave in extra value for a hesitant exerciser:
- Aerobic activity — Children and dogs. Interacting with them, particularly outdoors, can get your parent moving.
- Muscle-strengthening — Small children and dogs. Lifting them, throwing things to them, and bending down to get the things they leave on the ground can engage different muscles then your parents use regularly. Laundry, dishes, and
- Balance activities — gardening or walking on an uneven path can pull your parent out of their standard body position.
- Flexibility — reorganizing a crowded space can cause your parent to reach further and in different directions than normal.
Physical therapy and rehabilitation
When your parents add new movement to their routine, or particularly if their capabilities decrease due to an injury, a physical or occupational therapist can be a great help. All states allow you to start working with a physical therapist before getting a prescription from a primary care doctor, though some have limits on how long until a prescription is needed. My experience with physical therapy has been that the initial visit may be with a doctor of physical therapy who creates a plan, then follow-ups are often with physical therapy assistants to implement the plan. Some clinics have the assistants working with multiple patients at the same time. Because this experience can vary significantly across clinics, you and your parent may choose one that's less convenient to access but has more focused supervision of your parent.
After a hospital stay, surgery, stroke, or fall, physical or occupational therapy may be recommended and covered by insurance.` There is overlap in the two disciplines, with occupational focused more on how you do activities while physical therapy is more on your body's general abilities. Both may be useful after a hospitalization or injury that impacts your parent's strength, balance, or endurance.
One of the scariest statistics I've heard about older adults and injury is related to hip fractures: between 25% and 50% of the injured will die within 12 months of their fracture. There is a lot to pull apart about the demographics and circumstances of those who break their hips, but the big part within our control is to get them out of bed and moving as part of their recovery. Having an existing routine and local assistance will make a difference.
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