Improving Physical Health
(Elderly Edition)
Forever Young, Forever Active
Exercise plays a vital role in improving the physical health of elderly with dementia. It not only maintains overall well-being but also offers numerous specific benefits for this population. Exercise can help enhance cardiovascular, muscle and bone health, improve balance and coordination, promote flexibility, and maintain overall mobility and stability. Furthermore, exercise has been shown to have positive effects on cognitive function and mood, providing a better quality of life for elderly with dementia.
The Health Promotion Board’s (HPB) National Physical Activity Guidelines recommends that adults and seniors get 150 minutes a week of moderate-intensity activity such as brisk-walking, or 75 minutes of vigorous aerobic activity such as jogging, in addition to strength-training activities two days per week.
While some may think that elderly should not exercise due to fear of injuries or aggravation, appropriate exercise is actually crucial to ensure healthy ageing even in their golden years. Healthy living and exercise is ageless as long as it is within safe measures. We acknowledge the fears and want to give you a peace of mind for elderly to exercise safely with our recommended elderly-friendly (& wheelchair-friendly!) exercises established later on in this article.
BENEFITS OF EXERCISING
We all know that exercising is beneficial towards improving our physical health. How then does exercising improve the physical health of elderly with dementia specifically? Here are dementia-specific advantages of exercising:
Cognitive Function
Physical Strength
Functional Mobility
Mental Health
Cognitive Function
Exercise sharpens mental focus, enhances memory, and delays the progression of age-related cognitive decline. It increases blood flow to the brain, maintaining the functionality of brain cells. It also generates new neurons, balances the neurotransmitters in the brain, contributing to cognitive function of elderly with dementia.
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Functional Mobility
Regular physical activity can improve endurance and stamina in elderly with dementia. It helps the body function more efficiently by energising the body and reducing fatigue. It hence promotes greater productivity for elderly with dementia to carry out their activities of daily living (ADL) with improved mental and physical capacity.
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Physical Strength
Exercise boosts cardiovascular health (heart and breathing rate), strengthens muscles and bones and promotes stability and strength in all aspects. Exercise, combined with a balanced diet, ensures healthy weight loss and proper weight management by burning calories and increasing metabolism. As such, exercising reduces the risk and severity of chronic diseases due to regulation of weight and hormone levels, and enhancements in our bodily systems.
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Mental Health
Exercise has a significant impact on your elder with dementia’s mental health by improving one’s mood and promoting better sleep quality. It releases endorphins which are brain chemicals that evoke pleasure and well-being, alleviating stress and providing relief. Regular exercise can improve sleep quality by regulating sleep patterns (falling asleep easily with less disturbances) and instilling a more restful and rejuvenating rest.
GETTING STARTED
Consult your Doctor
Ensure that your elder is not at major risk in engaging in physical exercises. Clarify with their doctor to determine which exercises are suitable. Being most coherent with your elder’s condition, they would be able to recommend appropriate exercise and advise against any should there be any negative repercussions from medication side effects or their underlying condition itself that we as laymen may not be aware of.
Warm Up & Cool Down
Before starting the exercise proper, stretch your elder’s muscles such that there is adequate blood flow to the areas that they would be working on. By doing so, the muscles would be awake and properly engaged, reducing the risk of soreness thereafter. Upon completing the exercise, engage in cool down exercises to bring your heart rate and blood pressure down to normal or resting level.
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Know your Limits
For starters, do not be too ambitious in your exercise plan. Start at a slow and manageable pace at short time intervals before progressing to higher intensity levels and frequency. By warming up your elder’s body to this new element of exercise in their schedule, it gives ample time for their body to get used to this system. Always be aware and listen to your body. It is perfectly normal to feel tired or slight discomfort upon engaging in a new physical activity after a while. However, if you feel uncomfortable or any pains in your body, do not force yourself as it will result in dire consequences instead. Take a break and rest, monitoring the pain as you do so. Should the pains persist and become unbearable, do seek medical help immediately.
TYPES OF EXERCISES
While there are a plethora of exercises out there, for elderly with dementia, it is important to cater to their individual preferences and engage in exercises that enhance their physical abilities and cognitive functioning. Here are some exercises that can be suitable for elderly with dementia:
MODIFIED ACTIVITIES
Elderly with dementia can still be young at heart. Modify traditional activities to suit the abilities of elderly with dementia. For example, play simplified versions of bowling, bean bag toss, or volleyball with your elder. These activities can still be fun by incorporating creativity and unique spice to the game. You can take control of the rules of the game and cater it to your elder’s strengths, providing them with opportunities for social interaction, physical movement, and enjoyment. This is also a good starter to keep your elder engaged if there is any initial resistance faced towards the concept of exercising.
AEROBIC EXERCISES
Ensure that your elder engages in 150 – 300 minutes of low-impact activities weekly. These include walking, swimming, line dancing or stationary cycling. These moderate-intensity exercises can improve cardiovascular health, strengthen muscles, and enhance mood. For instance, swimming invokes a calm and soothing feeling that also serves to improve one’s balance.
In conjunction with the importance of aerobic exercise, HPB rolled out “7 Easy Exercises to an Active Lifestyle” to promote healthy living amongst adults. As being healthy is of increasing importance as we age, HPB recommends doing these exercises at least 3 days a week, anywhere anytime.
Click here to find out more with step-by-step instructions.
BALANCE & COORDINATION
Include balance exercises that promote balance and coordination to build stability and reduce the risk of falling, such as balancing on one leg, heel-to-toe walking, or following simple zumba steps. There are many of such free Community Physical Activity Programmes introduced by HPB to get Singaporeans to move. Click here to find out more.
MIND-BODY EXERCISES
Mind–body exercises such as gentle yoga, Tai chi and qigong are elderly-friendly exercises that consist of simple movements and meditation to improve balance, relaxation and mind-body connection. They enable elderly to practise mindfulness and evoke a sense of serenity while keeping their body fit and agile. They contribute to both the physical and mental well-being of an elderly, providing clarity of thought and improved body awareness, reducing the risk of falls.
COGNITIVE STIMULATION ACTIVITIES
Physical exercises, coupled with an element of cognitive stimulation, are very beneficial for elderly with dementia. A way to provide such integration can be done through playing music and encouraging the individual to perform exercises in rhythm while engaging in brain stimulating activities like solving simple puzzles.
HOUSEHOLD CHORES
Participating in light household chores such as folding laundry or gardening can provide a sense of accomplishment and purpose. These activities are low-impact exercises that encourage movement and normalcy into the lives of elderly with dementia without causing much strain. Gardening also promotes peace, reducing stress and agitation that is common in elderly with dementia. It provides sensory and cognitive stimulation through skills such as planning and recall.
ActiveSG
ActiveSG has curated a set of “Easy Workouts for Seniors” aimed at helping all seniors stay active and healthy. In this playlist, they have a total of 15 short step-by-step videos, walking your elder through the routine from start till end.
These videos are informative and beneficial for everyone as they include Easy (seated catered for wheelchair-bound) and Advanced stages at the bottom right hand corner for all elderly to do the same exercise but at their own pace. This shows that all seniors, even the wheelchair-bound, have the chance to engage in exercises to stay healthy as well. They incorporate layman terms such as describing an exercise to be that of a movement of a daily activity to make the process of following instructions much easier and engaging. At the end of the playlist, is this video that is a thorough follow through of exercises all in 1 video. Throughout the videos, there will be Chinese voiceover and subtitles for the Chinese community to participate in these activities too.
WHEELCHAIR-FRIENDLY EXERCISES
Another push by HPB in 2017 is the “You Can Get Moving” campaign consisting of 7 simple sit-down exercises, where anyone can get moving. Available in all 4 national languages, these exercises are easily accessible for all. They serve to improve physical strength and coordination, therefore, reducing the risk of falling and promoting personal well-being.
Watch this video for the English Version.
Click here to view their website with step-by-step details and videos to learn.
For wheelchair-bound elderly with dementia, there are exercises catered for them too. As they are unable to engage in conventional exercises that require leg movements, it is essential to focus on exercises that promote physical mobility, flexibility, enhance motion and cognitive stimulation. Ensure that the wheelchair is locked properly before engaging in exercises.
Chair Exercises
Chair exercises focus on range of motion and strength. Such include arm circles, leg lifts, seated marches, or gentle stretching. Chair exercises are convenient, not requiring much equipment and can be easily modified based on your elder’s capabilities.
Motion Exercises
Perform gentle but effective movements to maintain joint flexibility and prevent stiffness. This includes moving the arms, wrists, fingers, legs, and ankles in all ways possible, through their full range of motion.
Wheelchair Push-Ups
Train your elder’s upper body by having them place their hands on the wheelchair arms and slowly push themselves up. This engages their arm muscles and improves posture. Do assist them in the event that they lose grip or do not have enough strength to push their body weight up.
Seated Shoulder Rolls
Have your elder roll their shoulders forward and backward in a circular motion. This alleviates tension in the shoulder and improves upper body mobility.
Hand and Finger Exercises
Have your elder engage their hands and fingers through simple gestures such as finger taps, finger spreads, or squeezing a stress ball. These help maintain hand dexterity and improve circulation and mobility.
LEG EXERCISES
If your elder is wheelchair-bound, there is a high tendency of numbness in the legs due to lack of blood circulation when there is little to no mobility in the bottom half of their body. Here are some leg exercises to stimulate blood flow. Do so at a safe pace and only increase intensity if your elder is comfortable. If not, small movements are still as useful to keep their blood circulating.
Seated Marching
Encourage your elder to lift their knees alternately while seated. If possible, lift their knees higher to engage more. This helps to improve circulation, and maintain mobility.
Seated Leg Extensions
Have your elder to extend their legs one at a time, straightening the knee as much as they can, and then slowly returning to the starting position. This exercise serves to improve lower body strength and train the thigh muscles.
Seated Side Leg Lifts
Have your elder to lift one leg out to the side, keeping the knee as straight as possible, and then slowly lower it back down. This exercise targets the hip muscles and improves strength and flexibility.
These are but a few of the exercises out there and are definitely not exhaustive. It is important to consult with your elder’s doctor to provide personalised exercise recommendations specific to your elder. Above it all, safety is of paramount importance. Ensure that the environment is free from potential hazards, with proper equipment used, and clear instructions given. While the exercises may be simple especially to laymen, it is essential to always keep an eye out for them in the event of an emergency. Be adaptable to their needs and adjust the activities when required. Take this as a chance to foster stronger bonds with them, keeping yourself healthy.