Blog Post by Jacqueline Sinke

Jacqueline is the owner of Fitness & Function, LLC. Her company provides personalized mobile wellness services including in-home personal training, therapeutic exercise, and fitness and nutrition consulting. For the past seven years, Jacqueline has also been a fitness instructor for seniors at the Elsie Stuhr Center in Beaverton. 

Exercise for Seniors…A Relatively New Idea

We all know that exercise is important to obtain and maintain health and fitness. However for older adults, the benefits of exercise often make the difference between independence and dependence. 

Purposeful exercise, rather than just exercise, can be strategically used to prevent chronic disease and illness. However, in my business, I have also found that purposeful exercise helps many seniors to manage existing chronic conditions. Exercise also reduces the risk of falls, fractures, and loss of function.

I have been working as a health fitness professional for over 18 years. I specialize in working with individuals with chronic medical conditions and with older adults.  In the last 15 years, exercise for seniors has really evolved in relation to the specific types of exercises recommended and the overall attitude of physicians and care providers.

About 10 years ago when I was implementing functional fitness programs for seniors in assisted living facilities, I clearly remember the staff at the facilities being opposed to the idea and thinking that I had lost my mind. The next stumbling block was the medical community. Doctors were reluctant to give seniors medical clearance for exercise participation. Often the reason for not recommending exercise was that the patient was “at high risk of falling,” even when the exercise program was designed to help seniors by reducing their risk of falling.

At that time most physicians seemed quite unaware of the tremendous benefits of appropriate exercise for seniors including function, physical health, and mental wellness…even for seniors in monitored environments like assisted living and nursing homes. Since then, attitudes have changed. Even the AMA (American Medical Association) and ACSM (American College of Sports Medicine) have recent initiatives under titles like “Exercise is Medicine.” In these initiatives, physicians are encouraged to recommend exercise and physically active lifestyles for their patients. Gratefully, the benefits of exercise to health and wellness are now generally recognized.

There are now specific exercise recommendations, tests, and prescriptions for older adults and frail older adults for the prevention, treatment and management of chronic medical conditions. Health and fitness professionals now need to specialize, depending on the population group they choose to work with, to provide safe and effective exercise programs. Guidelines and recommendations are set by the ACSM and the AHA (American Heart Association).

I specialize in exercise for older adults across all five levels of functioning as well as for individuals with chronic medical conditions. I take my business on the road by providing mobile wellness services such as therapeutic exercise, personal training, and home fitness care. Most of my clients are seniors who are either living independently at home, with or without a caregiver; or who are residing in assisted living, independent living, or an adult foster home.

Each individual’s reason for exercise is different. Prevention of falls and fractures are a common goal. For those who exercise, even if a fall occurs, the severity of injury is reduced. For several clients with type 2 diabetes, the research shows that exercise of  appropriate quality and quantity, both moderate and intensive, utilize blood  glucose   uptake in a way that approximates several diabetes drugs such as Metformin, Pioglitizone, and Rosiglitizone. For these diabetic patients, exercise can reduce daily blood glucose levels and A1c.

Clients with peripheral artery disease, atrial fibrillation, neuropathy, and seizures need a supervised exercise program that both helps treat the condition and helps maintain functional independence.

The client with a hip replacement, who has maximized his physical therapy sessions, can continue to get the benefits of joint stability, bone density, muscle strength, and mobility by continuing a recommended exercise program.

A breast cancer survivor with lymphedema, osteopenia, osteoporosis, fatigue, depression, and loss of energy can benefit from specific exercises that stimulate lymph drainage. Through exercise, she can slowly and progressively increase her overall strength, endurance, and bone density.

A 72 year old female client with high blood pressure, hyperlipidemia, and osteopenia is, through exercise, able to reduce her blood pressure and obtain near normal levels of LDL, HDL, and triglycerides.

A 94 year old with Alzheimer’s disease, hip and shoulder replacement, difficulty walking, and frailty can use exercises to maintain strength for mobility, so she can continue to live with her family.

Many of the personal training clients I have are long-term clients; I have been training them for 3 to 6 years one to three times per week. For many, the exercises performed help maintain independent living skills, and they can enjoy living life at home. For some staying at the same service levels is important in order to keep health care expenses down.

For others, the benefits are to regain strength, mobility, and stamina. They want to return to a previous level of functioning and maintain this function and health over time. As the in-home personal training business has evolved, my company began offering “Home Fitness Care.” This new term describes what we do to help seniors remain independent living at home by making sure they receive needed exercise. Our programs follow the health guidelines set by ACSM and AHA.

Most seniors are very clear that they won’t perform the exercises on their own and need a gentle push. They want someone who can hold them accountable and monitor and supervise their progress. We often provide progress reports to family members and healthcare providers upon request. In cases where we observe a change in behavior, physical function, vital signs or medical condition, we report to the listed emergency contact. Also, blood pressure and heart rate monitoring can be part of the exercise care sessions. 

It has happened several times that through our observation and questioning about feelings, pain, discomfort, sleep, fatigue, nutrition, or hydration, we were able to catch an important, emergent change in health status that was missed by family members or other caregivers. In each session, I ask clients how they feel that day and how they were feeling after the last exercise sessions and the day after. Thus, I am able to detect and record unusual patterns and uncover issues with falling, sleep, and medication. As health fitness professionals, we observe movements and talk to the clients during the 45 to 60 minute exercise sessions. We also keep records on balance, number of repetitions, resistance used, stretches, and flexibility.

Family members or physical therapists are often the ones who refer new clients to us. We begin with an initial consultation at their home to see if home fitness care or personal training/therapeutic exercise training is the appropriate fit for both parties. Prior to any exercise, we require the client to complete a health/medical history form and need a medical release from the healthcare provider. After the medical release is received we can perform an assessment so that an exercise/activity plan can be developed. For the exercise training sessions we often bring exercise equipment and do not recommend clients to purchase equipment until it becomes clear what is needed.

I have worked with many seniors and seen their lives change for the better. Exercise made it happen. Quality of life is precious for each senior and this is preserved through physical activity. It is never too late to start, and you are never too old to begin. Please don’t hesitate to contact me with any questions or comments. 

Jacqueline Sinke, Owner
Fitness & Function LLC.

Email: fitnessfunction@comcast.net
Phone: 503-267-1030
Web: www.FitnessAndFunction.com