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Seniors gym sees improvements in strength and balance

ACFI should support prevention strategies such as outcome-based training programs that focus on strength and balance and recognise exercise physiologists under the allied health worker definition, Nathan Hall tells Natasha Egan.

There’s no Lycra, mirrors or loud music – just some of the reasons why clients of Uniting’s gyms for seniors find it an inviting environment, says Nathan Hall, service manager Uniting Seniors Gym.

The two centres, which are located in Lilyfield and Waverley in Sydney provide a tailored strength-based training program and the right level of support, says Hall, an exercise physiologist.

“Everyone is assessed by the exercise physiologist and then an exercise program is developed for them based on their needs and goals,” Hall tells Australian Ageing Agenda.

“From there we support them in that initial package. Over five or six sessions we slowly build their confidence. They can build their level of independence and it is great to see when someone does.”

The gyms have access to Commonwealth Home Support Program funding and members are a mix of Uniting clients and self-funded seniors. While the gym enthusiasts complete their training program, an exercise physiologist is on the floor to supervise, assist and answer questions, says Hall.

“Working on a client’s strength and power has great improvements in balance and the ability to react to unplanned movements, for instance a trip, as well as the strength to regain balance and prevent a fall,” he says.

Hall, who started out in the fitness industry, says he became involved in aged care after completing a degree in exercise science and getting his exercise physiologist qualification.

“A role came up that combined the gym program and the strength program but then also utilising the skills of my degree, such as chronic disease management, which fit in well,” he says.

That was more than 13 years ago, when he started at Uniting tasked with developing the Seniors Gym from inception. Today he spends more time managing operations and focusing on commissioning new sites in NSW and the ACT. Uniting is opening gyms in Chatswood, Orange and Canberra later this year, he says.

The gym has grown to more than 400 clients attending two to three times a week at each site, including about 80 to 90 people each day, says Hall.

“We have been collecting outcomes on functional ability and strength for the last 10 years. This evidence has shown that as soon as someone starts at the Seniors Gym, the normal impact of muscle strength is either improved or remains constant. We have seen improvements in results by an average of 15 to 30 per cent.”

Seeing positive changes in clients is what Hall likes most about his job. “In terms of clients, you are able to see not only functional and strength gains but also growth in their confidence, mood and general wellbeing,” he says.

Some residents of Uniting aged care facilities are transported to the gyms to complete strength and balance programs but Hall says the numbers have dropped over the years due to the shift in resident demographics. While residents may be older and frailer, he says it shouldn’t exclude them from strength training activities.

Uniting recently ran a 10-week strength and balance program at two facilities, which had positive outcomes and will continue at one site, says Hall.

“They could walk a little bit quicker. They could sit and stand from a chair a few more times. Their balance improved and taking wellbeing scores, they were feeling better within themselves.”

A key issue in residential aged care is that the Aged Care Funding Instrument (ACFI) doesn’t easily allow for these types of strength-based programs, which need to be consistent, he says.

“Exercise classes are often run within residential aged care as a recreation program, however there needs to be a clear shift to an outcome-based program that focuses on strength and balance, which will also impact on a reduced need for passive pain management.”

Hall would like to see a focus on prevention strategies, rather than disability or reactive programs, in ACFI, as well as a broadening of the allied health worker definition.

“I support the need for exercise physiologist to be added as an allied health worker within the ACFI to assist with the development of targeted exercise programs that help prevent, manage and treat disease.”

For residential providers looking at running similar programs, Hall advises they should be outcome focused, delivered by appropriately qualified staff and not a purely leisure-based program.

“This provides education and the benefit to the client. Targeted exercise programs not only improve physical needs but they also impact on psychological and emotional needs of the clients.”

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