Out of the Dark
My goal here is to give some insight into how a fitness program for seniors encompasses more than just muscles and bones. I may use clients as examples but names will always be changed.
Jane (not her real name)
- Age: 94
- Current Basic Status: Cardiovascular issues, arthritis, neuropathy, legally blind, hearing aids, uses a walker, needs assistance with some ADLs (Activities of Daily Living)
- Background: former educator; college-educated; married; husband recently deceased; no children; well-traveled
- Personality: Sensitive, likes to feel included in activities; talkative; enjoys puns, storytelling, and singing; determined; enjoys learning; inquisitive; wants to get things right, likes to be challenged.
- Fitness Goals: To walk without the walker, to feel less afraid of falling.
- Current Program Includes: A healthy dose of balance training, proprioception (body awareness) drills, and resistance training
To be honest, Jane is one of my favorite people to work with because she is so determined to make her body work better within its current constraints. Even after she has a 30-minute training session with me, she will motor along with her walker. It is such a joy to hear her say, “I almost walked a full mile today!” You go girl!
Jane is not unique in her vision issues, though she provides a challenge for me in that visual cues simply do not work. For example, if we are working on a balance drill where Jane is asked to stand on one foot for 30 seconds, I can not ask her to pick a focal point. Another challenge is that I can’t demonstrate an exercise and expect her to “see” what I am doing. Vision impairment is a common factor behind fear of falling. Additionally, when an older adult loses their vision they can socially withdraw.
Jane is unique in that she is extremely aware of her surroundings and responds well to specific instructions like, “Please turn 90 degrees to your right,” or “Take 3 giant steps backward.” Because Jane responds to these instructions and because she uses her sense of touch to navigate around the world when working with her I direct her attention inward to her muscles, bones and joints so that she can feel what she is doing.
For example, when we are doing balance drills, I cue her as if I were cueing Tadasana. For those non-yogis out there, Tadasana is standing mountain pose and looks like the picture to the left. I cue this by saying, “Feel your feet in your shoes, feel your feet on the floor. Now, move up your leg and feel your ankles, now notice your calves and shins. Now feel your knees, thighs, hips, tummy, back, shoulders, neck, head.” Drawing internal attention to each major section of the body gives her the opportunity to focus on individual body parts and how they relate to the whole.
After several sessions of cueing Tadasana before executing any balance drills, Jane now does this on her own and she feels more confident. I love hearing her say to herself: “feet, ankles, calves, knees, thighs, hips, belly, back, shoulders, neck, head.” She straightens right up! This is the basis of proprioceptive training.
Jane’s resistance training protocol includes a variety of leg and core strengthening exercises such as the Payloff Press (arms only!), leg press, hamstring curl, dorsiflexion with resistance (lifting toes while heels stay on the ground) and the obstacle course.