Regular movement is essential for seniors’ health and quality of life, particularly during recovery from illness, hospitalization or rehabilitation. Maintaining activity and adhering to prescribed OT/PT exercise regimes is crucial and can significantly impact outcomes, yet consistent engagement often falls short.
Movement and physical activity are vital and among the most powerful interventions for promoting overall health and enhancing the quality of senior living. Knowing techniques to keep seniors motivated and active is a key component of care, recovering from illness or injury, and promoting optimal levels of health and well-being: body, mind, and spirit. Regular movement and maintaining muscle tone and coordination are also critical to preventing injuries and enhancing overall resiliency. Home health care and private duty caregivers offer expert support and encouragement to help elderly patients remain engaged and adhere to prescribed exercises to maximize their physical health outcomes and support their cognitive and emotional well-being.
OT/PT Exercises Improve Post-Discharge Outcomes
For patients discharged after hospitalization or rehabilitation, performing the exercise regimens prescribed by occupational therapists (OT) and physical therapists (PT) can mean the difference between regaining independence and facing a cycle of deconditioning and declining function. In-home caregivers can support continued physical activity and encourage OT/PT exercises to prevent the negative impacts of inactivity. These regimens, tailored to meet the needs of recovering patients, are critical to guard against and rebound from the devastating effects of deconditioning that can occur during hospitalizations or sedentary periods.
Research published in the Journal of the American Geriatrics Society found that patients who adhere to their prescribed exercise programs are 2.5 times more likely to recover their pre-hospitalization functional status than those who don’t. Despite their importance, adherence to home exercise programs post-discharge is problematically low. Studies show that:
• Only 31% of discharged patients fully adhere to recommended exercise regimens
• Over 65% report decreasing their OT/PT regimens within two weeks of returning home
• By one month post-discharge, less than 50% continue any prescribed exercises
Sadly, this gap in adherence can have a serious impact on health outcomes.
Regular Movement Critical as We Age
Deconditioning—the physiological decline that occurs with reduced physical activity—severely threatens older adults. For recovering patients, what might be a temporary setback for younger individuals can trigger a cascade of irreversible decline in seniors.
Older adults are particularly susceptible to the effects of prolonged inactivity due to the natural aging process, which results in reduced muscle mass and diminished bone density. This, combined with the physiological declines from deconditioning, can lead to a rapid and significant reduction in physical and cognitive functions.
The Mind-Body Connection
The consequences of deconditioning are multifaceted and related. Understanding the mind-body connection and resulting impacts of deconditioning is crucial and can help motivate individuals and their caregivers to engage in recommended PT/OT activities and regular movement.
The human body responds to inactivity rapidly. Data shows that these changes happen more quickly and have more severe consequences for older adults, including:
• Muscle strength begins declining after just 24 hours of bed rest
• Older adults can lose 1-5% of muscle mass per day when immobilized
• Within a week of inactivity, cardiovascular efficiency decreases by up to 15%
• Balance and coordination diminish rapidly, increasing fall risk
• Bone density begins declining after just 3-5 days of immobility
These factors help to explain why approximately 30-50% of older adults experience functional decline during hospitalization that persists after discharge. The path back from deconditioning is steep, making prevention through consistent activity even more crucial. Dr. Kenneth Covinsky, a geriatrician at the University of California, San Francisco, notes that, “Many older adults who are hospitalized develop disabilities within days that can persist for months or become permanent.”
Overall, physiological impacts also include:
• Decreased muscle mass and strength
• Reduced cardiovascular efficiency
• Impaired balance and coordination
• Decreased bone density
• Reduced respiratory function
• Altered metabolism and insulin sensitivity
• Compromised immune function
As a result, seniors experiencing deconditioning can face difficulty with daily living activities, impaired mobility, increased risk of falls and injuries, loss of independence, and the need for higher levels of care.
Additional mental and emotional impacts can include increased rates of depression and anxiety due to the loss of independence and mobility. Social isolation often follows, as older adults become less able to participate in activities they once enjoyed, further exacerbating the downward spiral of their health. Psychological impacts can also include reduced confidence and self-efficacy, diminished quality of life, and loss of identity and purpose.
Moreover, the loss of muscle strength and coordination increases the risk of falls and fractures, which are significant health hazards for older adults. These injuries can lead to extended hospital stays, where the cycle of deconditioning is likely to continue, creating a challenging environment for recovery. For all of these reasons, it is crucial to implement and maintain strategies that promote regular physical activity among older adults.
Understanding and Overcoming the Barriers to Exercise Adherence
By knowing and addressing the hidden dangers of deconditioning, family and private-duty caregivers can help support patients’ overall health and maintain their independence and quality of life, even in the face of illness and aging.
A range of factors can contribute to why senior patients struggle or do not desire to engage in movement activities and PT/OT exercises. Understanding these barriers is essential to addressing the problem.
Common Factors Include:
• Pain or discomfort
• Depression. fatigue and reduced endurance
• Fear of falling or injury
• Confusion or feeling overwhelmed by complex regimens
• A lack of proper caregiver training or adequate equipment at home
Additionally, challenges can include lacking the assistance or supervision needed to complete exercises safely, limited space in the home environment, competing priorities for caregivers, and Inadequate instruction or follow-up.
There is Help and Hope: Strategies for Success
An important starting point is identifying and incorporating tailored exercise programs that address individual capabilities and limitations. Home health care and healthcare professionals can play a vital role by providing the support and encouragement to keep geriatric patients engaged in physical activity.
Beginning with and building upon achievable routines that will build physical strength, motivation, confidence, and a positive view and approach will help to ensure that movement becomes a consistent part of daily life. Seeking guidance and assistance from trained professionals ensures activities and exercises are performed properly and safely. This will avoid the risk of injury to both the patient and caregivers, build patients’ confidence, and make completing exercises and activities more desirable. Learning and understanding techniques to both motivate and assist patients in completing regimes while providing compassionate support, ensuring patients feel respected and heard, and operating safely within limitations are also vital.
Building Motivation Through Meaningful Goals
The ultimate goal extends beyond short-term recovery to establishing sustainable patterns of physical activity that support long-term health and independence. This requires thoughtful approaches that respect autonomy while providing necessary support.
Physical activity becomes more sustainable when connected to meaningful outcomes. It is essential to focus on functional goals that matter to the individual, such as visiting a grandchild or tending to a garden. Celebrating progress toward these goals regularly is crucial, along with making the connection between exercises and valued activities explicit. Adjusting goals to maintain an appropriate challenge level is essential as capabilities change.
How caregivers discuss and frame physical activity significantly impacts participation. Encouraging rather than directive language should be used and focusing on strength and ability rather than weakness or limitation is beneficial. Offering choices within the framework of necessary activities, acknowledging effort and persistence more than perfect execution, and framing exercise as self-care rather than medical treatment when possible, can enhance participation.
Optimal support requires collaboration between caregivers and clinical professionals. Maintaining open communication with therapists about progress and challenges is vital, as is requesting clear demonstrations of exercises and hands-on training in assisting. Written instructions with pictures for reference are helpful, and seeking guidance on appropriate adaptations for good and bad days is necessary. Reporting changes in conditions that might necessitate exercise modifications ensures that support remains effective and tailored to the individual’s needs.
The Mind-Body Connection: How Physical Activity Protects Cognitive Function
The relationship between physical movement and brain health represents one of the most compelling reasons for maintaining activity levels in older adults. Far from separate systems, the brain and body function as an integrated unit, with physical activity providing direct cognitive benefits.
The Neurobiological Connection
Research has identified several ways that exercise directly benefits brain function:
• Increased cerebral blood flow: Physical activity improves cardiovascular efficiency, delivering more oxygen and nutrients to brain tissues.
• Growth factor production: Exercise stimulates the release of brain-derived neurotrophic factor (BDNF) and other compounds that support the growth and maintenance of neurons.
• Reduced inflammation: Regular movement helps control systemic inflammation associated with cognitive decline and neurodegenerative diseases.
• Enhanced neuroplasticity: Activity promotes the brain’s ability to form new neural connections, potentially compensating for age-related changes.
• Improved insulin sensitivity: Exercise helps regulate glucose metabolism, affecting brain energy utilization.
Cognitive Domains Enhanced by Movement
Physical activity doesn’t just protect against decline—it actively enhances specific cognitive functions such as:
• Executive function: Regular exercise improves planning, organizing, and completing tasks.
• Processing speed: How quickly the brain can respond to information increases.
• Attention: Both sustained focus and the ability to ignore distractions improve.
• Memory: Working and episodic memory are enhanced with consistent activity.
The Critical Role of Post-Discharge OT/PT Exercise Adherence
When elderly patients return home after hospitalization or rehabilitation, they embark on a crucial journey of recovery. Adhering to occupational therapy (OT) and physical therapy (PT) exercises, which are meticulously designed to meet individual patient needs, is vital for restoring function and preventing further decline. Regular movement enhances neuroplasticity, improves insulin sensitivity, and boosts cognitive domains such as executive function, processing speed, attention, and memory.
Dr. Kirk Erickson, a neuroscientist at the University of Pittsburgh, notes that even modest amounts of physical activity, as little as three 40-minute walks per week, can increase hippocampal volume by 2%, effectively reversing age-related brain atrophy by 1-2 years. His studies highlight that even modest amounts of physical activity can result in significant benefits, such as increasing hippocampal volume and potentially reversing age-related brain atrophy. Furthermore, research suggests that consistent physical activity can reduce the risk of developing Alzheimer’s disease and slow its progression in those already experiencing cognitive decline.
In-home caregivers play a pivotal role in maintaining physical activity among older adults, particularly those recovering from illness or hospitalization. Their constant presence and support can transform sporadic exercise into sustainable habits, ultimately alleviating the challenges of adhering to prescribed OT/PT exercises.
The collaboration between healthcare professionals and caregivers is essential in reinforcing the importance of regular movement and exercise adherence for the elderly. By fostering a supportive environment, caregivers can help elderly patients achieve optimal physical and cognitive health, reducing the risks of rehospitalization and exacerbation of chronic conditions such as cardiovascular disease, diabetes, and arthritis.
As a full-service holistic home care agency, Perfect Care Match’s care team is specially trained to care for the whole person, including encouraging regular movement and supporting OT/PT exercise regimens. PCMatch specializes in Alzheimer’s disease and other forms of dementia. We also ensure our caregivers are thoroughly trained to provide safe ambulation and transfers, infection control, medication management, and home care safety protocols.
Be sure to read our additional blog article Practical Tips You Can Use for ensuring elderly patients engage in regular movement and complete OT/PT regimens.Contact us today to learn more about our flexible caregiving models of care to meet your unique needs.
References
Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., … & Landefeld, C. S. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. Journal of the American Geriatrics Society, 51(4), 451-458.
Gillis, A., & MacDonald, B. (2005). Deconditioning in the hospitalized elderly. The Canadian Nurse, 101(6), 16-20.
Northey, J. M., Cherbuin, N., Pumpa, K. L., Smee, D. J., & Rattray, B. (2018). Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British Journal of Sports Medicine, 52(3), 154-160.
Forkan, R., Pumper, B., Smyth, N., Wirkkala, H., Ciol, M. A., & Shumway-Cook, A. (2006). Exercise adherence following physical therapy intervention in older adults with impaired balance. Physical Therapy, 86(3), 401-410.
American Physical Therapy Association. (2019). Physical therapy guide to healthy aging. APTA.
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., & Olson, R. D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020-2028.