MEMORANDUM BY BOB LAVENTURE, ASSOCIATE
CONSULTANT TO THE BRITISH HEART FOUNDATION NATIONAL CENTRE FOR
PHYSICAL ACTIVITY AND HEALTH (PH 96)
THE POTENTIAL OF PHYSICAL ACTIVITY TO IMPROVE
THE HEALTH OF OLDER PEOPLE
CONTENTS
Executive summary
1. Older People and Physical Activity—the
Potential;
2. Recent developments;
3. The role of the British Heart Foundation
National Centre;
4. Increasing levels of physical activity
among older people—Policies and action required
Appendices.
"The greatest risk for older adults is sedentary
living." (World Health Organisation 1997)
EXECUTIVE SUMMARY
Physical activity provides a substantial number
of benefits for the older person. Its importance as a public health
issue is highlighted by increasing evidence of effectiveness in
meeting those health needs and by the increasing numbers of older
people in the population.
Whilst the evidence relating to disease prevention
is well recognised there is increasing evidence relating to the
important role of physical activity in:
— The improvement of functional capacity
and the maintenance of independent living;
— Improvements in psycho-social health
benefits leading to an improved quality of life and the inclusion
of older people in society.
A range of policies are consistent in their
references to the need for older people to retain a level of functional
capacity and independence to enable them to remain in their own
homes, retaining the capacity to undertake activities of daily
living and maintain their social networks. This is an important
aspiration and need expressed by older people themselves.
There is very limited evidence of national or
local programmes designed to:
— meet the physical activity and health
related needs of healthy but sedentary older people;
— offer recreational and active leisure
choices in the community;
— provide appropriate programmes in
care settings for frailer, older people.
Low levels of physical activity among older
people may be attributed to the lack of provision and opportunity
as a result of:
— A lack of professional education
and training;
— An absence of sport, recreation and
exercise policy;
— An imbalance of resources and investment—which
to-date has excluded older people from national and local opportunities
to choose to be involved in a wide range of physical activities.
Recommendations are included to highlight actions
required to ensure that in the future, older people enjoy equality
of opportunity and are able to make informed choices to participate
in safe, effective and enjoyable opportunities for physical activity.
They highlight the need for:
— Support for professionals;
— Support for local activity;
— Developing the skills of front line
workers.
1. OLDER PEOPLE
AND PHYSICAL
ACTIVITY—THE
POTENTIAL
1.1 The Benefits of Physical Activity for
Older People.
There is mounting evidence of the importance
of physical activity for the older person. The World Health Organisation
(1), the American College of Sports Medicine (2) and the Report
of the US Surgeon General (3) have identified the range of benefits
of participation in regular physical activity for older people.
These are summarised as:
— The physiological benefits;
— The psychological benefits;
Other classifications Young and Dinan (4) summarise
these benefits as
— The prevention of disease;
— The prevention of disability;
— The prevention of immobility;
— The prevention of isolation.
"A regular programme of moderate exercise
is a very appropriate recommendation for almost all older adults.
Moreover, there is no known pharmacological remedy that can so
safely and effectively reduce a person's biological age and enhance
his or her quality-adjusted life expectancy."
Shephard, R 1997 (5).
1.2 Levels of Participation
There is substantial evidence relating to the
decline in levels of physical activity, exercise, fitness and
functional capacity among older people.
Levels of Physical Activity
In the 45-54 age group, only 39 per cent of
men and 35 per cent of women participate in enough physical activity
to benefit their health.—By the age of 74, this figure has
declined to 14 per cent for both men and women. (6)
Participation in at least 30 minutes of moderate
intensity physical activity on at least five days of the week.
Sedentary behaviour—increases with age.
Although 40 per cent of men and women aged 50 and over are sedentary,
the overall figures conceal an important difference. There is
a marked age effect among women. The proportion of women judged
to be sedentary increases steadily with increasing age, doubling
between those aged 50-54 (28 per cent) and those aged 80+ (65
per cent). (6)
Participation in less than 30 minutes of moderate
intensity physical activity less than once a week.
(These figures include involvement in "heavy"
housework, gardening and DIY, walking and stair use as well as
sports and exercise activities.)
Sports and Exercise Activities
Participation in sports and exercise activities
do not play a large part in the overall activity levels of people
aged 50+ despite the fact that many of these people have considerably
more leisure time than the general population.(6)
Fitness and Functional Capacity
Functional capacity declines with age. This
loss of function is exponential and will eventually cross a threshold
level beyond which a person cannot maintain an independent life.
(6) for some older people, rising from a chair is difficult and
getting up off the floor is impossible.(6)
Inequalities in Participation.
Inequalitites relating to participation on physical
activity have been identified by Cooper et al (7).
1.3 Evidence of effectiveness
Physical activity and exercise interventions
A recent critical review of physical activity
interventions targeting older adults by King et al (8),
reported the possibility of higher physical activity participation
rates in older adult samples relative to younger samples. This
included frequency of participation as well as the duration of
the intervention. Several studies reported satisfactory longer-term
class or group participation rates extending up to three years
in at least one case. Both group/class based activities as well
as home based activity were found to be effective.
Functional decline
Skelton and McLaughlin (9) have reviewed a number
of research studies which indicate the ways in which appropriate,
specific, tailored and progressive exercise interventions can
demonstrate significant improvements in functional capacity in
a relatively short space of time. These studies also include improvements
in many of the risk factors for accidental falls eg 8-26 weeks
in the case of strength, static and dynamic balance, power, endurance,
transfer and postural hypotension.
Older people are just as likely to change their
physical activity related behaviour as young people and it is
possible to reverse age-and activity-related decline relatively
quickly. For example, among people over 75 years, 15 years of
rejuvenation of muscle strength (27 per cent) can be regained
in six months through strength training with one supervised class
a week and some home exercises. (9)
Falls and accidents among older people
A number of studies indicate the effectiveness
of exercise as an effective intervention in both stand-alone including
Skelton (in press 10), Campbell et al (11), FICSIT (12)
and as part of a combined intervention by Tinneti et al (12),
Queen Mary and Westfield College (13) and Wagner et al (14)
to prevent accidental falls and accidents among older people.
The cost of hip fractures
Using Department of Health benchmark figures
Dolan and Togerson (15) estimated the costs of hip, wrist and
vertebral fractures sustained as a result of a fall, to be in
excess of £940 million per annum. This figure includes acute
care, social care and long-stay hospital costs as well as primary
health care and follow-up costs.
1.4 Ageing and demographic trends
The UK population is gradually becoming older,
with the number of children aged under 14 projected to fall by
around three-quarters of a million (9 per cent), between 1996
and 2021 and the number of people aged 65 and over projected to
increase by over 2 million (30 per cent) between 1996 and 2021.
(16)
A more comprehensive review of the evidence
relating physical activity and the health of older people is included
as appendix 2.
RESEARCH EVIDENCE—SUMMARY
Physical activity provides a substantial number
of benefits for the older person. Its importance as a public health
issue is highlighted by increasing evidence of effectiveness in
meeting those health needs and by the increasing numbers of older
people in the population.
Whilst the evidence relating to disease prevention
is well recognised there is increasing evidence relating to the
important role of physical activity in:
— The improvement of functional capacity
and the maintenance of independent living.
— Improvements in psycho-social health
benefits leading to an improved quality of life and the inclusion
of older people in society.
This has important implications for current
and future policy in the social and caring services.
2. RECENT DEVELOPMENTS
2.1 Policy Direction
In addition to the focus upon CHD, mental health,
cancers and accidents in Government Health Strategy through "Saving
Lives—Our Healthier Nation (1999), other policy frameworks
indicate the importance of complimenting disease prevention policies
with those which stress the need to maintain independent living
and mobility in later life eg
— Modernising Health and Social Services:
National Priorities Guidance 1999-2000—2001-02 (17)
— Better Services for Vulnerable People
(18)
— Better Government for Older People
(19)
— Reducing Health Inequalities, Acheson
(20)
This important policy direction and implications
for health and social care was also addressed in 1999, the International
Year of the Older Person, through the "Debate of the Age"
led by Age Concern England (21) which led amongst others, to the
following recommendations:
— The compression of morbidity as an
explicit health objective
— Reducing chronic illness and disability
should be a central and explicit objective of health policy
— The targets for saving lives should
be matched by strategies for reducing ill health and morbidity—
Similarly through the publication of "With
Respect to Old Age—a Report by the Royal Commission on Long
Term Care (22*) and "Fit for the Future, the Prevention of
Dependency in Later Life." (23)
These and other policies are consistent in their
references to the need for older people to be able to retain sufficient
functional capacity and independence to remain in their own homes
thus retaining the capacity to undertake activities of daily living
and maintain social networks. The balance between disease prevention
and quality of life is an important need expressed by older people
themselves.
2.2 Health Promotion in Practice
National Campaign
In 1997, the former Health Education Authority
included work with older people 50+ within the ACTIVE for LIFE
National Campaign to promote physical activity. In addition to
the public communications and media components, work included
a programme of underpinning research, professional advocacy and
support for a range of health and other professionals, including
a conference and seminar programme, guidance materials, publications
and a professional support network. This remains the only example
of a national programme relating to the promotion of physical
activity and the health of older people.
Local Programmes and Partnerships
There is no national intelligence or understanding
of the extent to which local programmes are addressing the physical
activity and health related needs of older people through health
promotion or local authority leisure and recreation provision.
Of the current programme of 26 Health Action
Zones (24) only four have evidenced specific work in this area.
A similar low figure was reported within the Cabinet Office Initiative
"Better Government for Older People". Although the Hackney
Senior's Health and Active Retirement Project is one example,
there is also limited evidence of these needs being addressed
through the Healthy Living Centre programme.
Through the Ageing Well programme of Age Concern
England a small number of health-related, physical activity, exercise
and recreation programmes have been developed. These vary in nature
and are based upon local needs. There has been no published evaluation
of the impact of these programmes.
A recent report from the Health Development
Agency (25) examining the first year of Health Improvement Programmes
gives no indication as to the inclusion of physical activity and
older people in local health strategies.
Falls and Accidents
Recent Department of Health commissioned work
has included the development of evidence-based guidance on policy
and education and training programmes relating to the role of
physical activity in the prevention of falls among older people.
A national programme of dissemination has recently been disseminated
and a three level education and training programmes for exercise
and health professionals is being implemented. (26)
2.3 Primary Health Care
Much attention has been focussed upon the role
of primary health care and in particular the development of a
significant number of exercise referral schemes. Based upon the
work of Riddoch et al (27), the Department of Health has commissioned
the development of a Quality Assurance Framework for Exercise
Referral Schemes (28). Evidence suggests that although these schemes
remain a popular form of physical activity intervention.
— few involve older people as a specific
population target group;
— few target healthy but sedentary
people;
— many adopt a "treatment"
perspective rather than a "prevention" perspective (as
evidenced by the many schemes that target people with CHD risk
factor);
— primary care does not have the resources
and is not an appropriate setting for such a "population"
strategy.
There is some evidence that Primary Health Care
professionals including General Practitioners are unwilling to
recommend physical activity programmes to older people which may
relate to concerns over appropriate provision and safety considerations.
2.4 Leisure, Recreation and Sports Development
Sport England, the Government Sports Development
Agency and the distributor of National Lottery Funding has no
current policy, strategy or development programme relating to
the needs of people over the age of 50 years.
In the last 10 years, there has been a welcome
and significant investment in Sports Development Officers, a valuable
resource within the individual Governing bodies of Sport and local
authority leisure, recreation and sports development departments.
However, whilst some of these resources have addressed inequalities
in sports participation among ethnic minority communities, disabled
people and women, there has been no such investment in relation
to older people.
Through an ongoing programme of development
and assistance through National Lottery Funding, Sport England,
in collaboration with the Youth Sport Trust, has a national infrastructure
of developmental programmes that target young people. Whilst a
similar mechanism would not be appropriate for older people, national
and local support in the form of accessible, evidence based and
high quality programmes and resources is lacking. Some National
Governing Bodies of Sport do make provision for continued participation
but largely as a result of "Veteran" competition programmes
eg the ASA Masters Swimming programme.
There is a similar imbalance in dance related
arts provision.
With the exception of newly commissioned work
relating to falls and accident prevention referenced above, few
local authorities and health authorities have invested specific
human resources in this area. There is a small number of partnership
developments posts supported by Age Concern England.
Whilst the potential impact of demographic change
upon services is recognised, not all changes have a negative "cost
of care" implication. The new generation of "baby boomers"
have experienced some of the opportunities that have materialised
from the "Sport for All" policies of the 1980's and
the expansion in the commercial exercise and fitness industry
and may have different expectations of their middle and later
years.
The private sector exercise and fitness industry
has recognised the potential for growth among the "mature"
market with a number of international providers eg the Keizer
Foundation, Powerjob, Nordik Track. Consequently are actively
promoting new forms of services and programmes for the older person
through niche marketing and special provision.
2.5 Training and Education
Sports and Exercise Sciences
The British Association of Sport and Exercise
Sciences (BASES) membership includes all UK University and Institutes
of Higher Education departments for leisure and recreation, sport
and exercises and health sciences. BASES has recently undertaken
a review of physical activity, exercise and sports relating to
older people. The review included curriculum development in first
and second level degree courses, research activity and support
for local community interventions and included biological and
social science applications.
The findings of the report (29) indicate
— Only 31 per cent of institutions
contacted (n = 26) were at least partly concerned with older adults,
thus only 30 per cent of undergraduate students were studying
for an award that has a partial focus on older people. At post-graduate
level about 66 per cent of students were studying for an award
that had at least a partial focus upon older people.
— Only 8 per cent of final year under-graduate
research projects involved older people with this figure rising
to 18 per cent among post-graduate research. Only 14 of the 83
institutions referred to specific research projects undertaken
by staff. This figure is reflected in the low level (4 per cent)
of papers presented to the BASES annual conference.
— Only 12 per cent of institutions
reported any extra-curricular activity relating to developing
links and support for local community interventions involving
older people.
These low figures indicate a marked lack of
related education and training among future sports, exercise and
health science professionals.
Physical Education and Teacher Training
Professional education and training for the
physical education profession is predominantly concerned with
the implementations of the National Curriculum for Physical Education,
GCSE and A level physical education and more recently, support
for sport in schools through external funding from Sport England
and the Youth Sport Trust. There is no physical education or teacher
training provision or support for anyone working with people over
the age of 18.
Training for Exercise, Fitness and Health Professionals
A UK survey of professional education and training
programmes for the exercise and fitness industry undertaken by
the Health Education Authority and Exercise England (30) reported
significant differences in curriculum development, standards and
assessment methods that relate to older people and special populations.
This is to some extent the result of piecemeal development brought
about by competition within the private sector and an absence
of guidelines or framework to assist nationally and locally developed
training programmes. This situation is mirrored in the health
and care sectors where a small number of local schemes have been
developed without any reference to evidence, national guidelines
or quality standards. Many of these schemes do not relate to the
NVQ Frameworks in Health and Social Care.
Although not specifically relating to the needs
of older people, recent Department of Health initiatives (eg the
Quality Assurance Framework, for Exercise Referral Schemes and
the National Fitness Register) are eagerly awaited as a means
of providing national standards in exercise and fitness training.
Training and Education for the Older Person
In collaboration with Age Concern England, the
British Heart Foundational Health Centre for Physical Activity
and Health is currently developing a Senior Peer Mentor Activity
Motivator programme to involve older people in physical activity
training opportunities. The Northumberland Health Action Zone
and Wealden District Council in East Sussex have developed innovative
approaches to the training of older people to become leaders,
organisers and teachers of recreation and fitness programmes.
CURRENT PRACTICE—SUMMARY
Current health and care policies are consistent
in identifying the need for older people to be able to retain
sufficient functional capacity and independence to remain in their
own homes, retain the capacity to undertake activities of daily
living and maintain their social networks. For those in different
care settings, independence and mobility remain important components
of an enhanced quality of life. The balance between disease prevention
and quality of life is an important need expressed by older people
themselves.
There is very limited evidence of national or
local programmes designed to:
— meet the physical activity and health
related needs of healthy but sedentary older people
— offer recreational and active leisure
choices in the community
— provide appropriate programmes in
care settings for frailer, older people;
There is more evidence of physical activity
opportunities in residential and care settings;
Low levels of physical activity among older
people may be attributed to the lack of provision and opportunity
as a result of
— A lack of professional education
and training;
— An absence of sport, recreation and
exercise policy;
— An imbalance of resources and investment.
which to-date have excluded older people from
national and local opportunities to choose to be involved in a
wide range of physical activities.
3. THE ROLE
OF THE
BRITISH HEART
FOUNDATION NATIONAL
CENTRE FOR
PHYSICAL ACTIVITY
AND HEALTH
AT LOUGHBOROUGH
UNIVERSITY
The British Heart Foundation National Centre
for Physical Activity and Health is committed to long-term developmental
activity in the area of physical activity and older people through:
— partnership development with a range
of national and local agencies;
— accessible programmes and activities
for older people;
— the provision of guidance, support
and information to professionals.
3.1 Partnerships
The National Centre is currently developing
partnership working with:
— Age Concern England, and Ageing Well
— British Association of Sport and
Exercise Sciences
— Health Development Agency
— The Beth Johnstone Foundation
— The Institute of Leisure Amenity
Management
— International Society for Ageing
and Physical Activity
3.2 Outline of Programmes
THE ACTIVE
FOR LATER
LIFE RESOURCE
The BHF National Centre is currently undertaking
work based upon the development of the Active for Later Life Resource,
a professional toolkit designed to provide advocacy guidance and
outline programmes for service managers and providers. The resource
will include a framework designed to stimulate:
— Activity choices in the local community
— Home base activity programmes
— Programmes relevant to a range of
older people settings, including the home, day centres and residential
and care.
And will include a Senior Games and Activities
Pack.
The Active for Later Life resource will be available
from Autumn 2000 onwards and will be supported through a national
training and professional education.
THE DEVELOPMENT
OF THE
SENIOR PEER
ACTIVITY MOTIVATOR
PROGRAMME
Working in partnership with Age Concern England
and the Ageing Well programme, the programme comprises training
in health behaviour change, communication, using a posture check
and chair games and activities to be delivered by older people
Senior Peer Mentors with older people.
The course aims to provide senior peer mentors
with the skills necessary to:-
— Promote the benefits of regular physical
activity
— Where appropriate, promote participation
in physical activity eg attendance at a seniors (or an exercise
for the older person) exercise session or a local walking group
— Increase daily activity levels and
opportunities to socialise with inactive older people.
Additional planning includes a number of opportunities
to build on Senior Peer mentoring skills whereby Senior Peer Activity
Motivators may make a decision to undertake additional training
and education to become activity leaders. Leadership and teaching
skills will be developed in a number of areas providing access
to a range of skills, experiences and qualifications eg through
the Central Council for Physical recreation and British Sports
Trust Community Sports Leadership Award Scheme, Walk leadership
and exercise class leadership.
CURRICULUM DEVELOPMENT
IN HIGHER
EDUCATION
Continued work with the British Association
of Sport and Exercise Sciences to: further develop
— opportunities for curriculum development
relating to physical activity and ageing.
— BASES own development activity via
the BASES continuing professional education scheme—A series
of events and seminars.
— The continuing professional training
of:
— Sports development officers and
sports coaches, including work with the governing bodies of sport.
— The leisure and recreation industry
— Exercise and health science professionals.
THE 2003 INTERNATIONAL
SOCIETY FOR
AGEING AND
PHYSICAL ACTIVITY
(ISAPA) WORLD CONGRESS
ON PHYSICAL
ACTIVITY AND
AGEING
In August 2003 the BHF National Centre will
host the ISAPA World Congress on Physical Activity and Successful
Ageing including a World Summit on interventions. The major international
health conference relating to physical activity and the needs
of older people, the Congress will target a national and international
audience comprising:
The exercise and fitness industry, Academic institutes
and higher education, health professionals, including health promotion,
General Practitioners, Primary Health Care, physiotherapists and
occupational therapists, those that work in residential and care
settings. The leisure and recreation industry and national and
international age related organisations.
4. INCREASING
LEVELS OF
PHYSICAL ACTIVITY
AMONG OLDER
PEOPLE
As a result of the first three sections of this
evidence, the following areas are highlighted for action together
with constructive recommendations. These recommendations are designed
to ensure that in the future, older people enjoy equality of opportunity
and are able to make informed choices to participate in safe,
effective and enjoyable opportunities for physical activity.
These opportunities will contribute greatly
towards improving the quality of life of older people, maintaining
their independence and assist in the inclusion of older people
in the life of the community.
As a result, there will be a decrease in the
demands made upon public health, social and caring services. The
recommendations also recognise the need for the provision of quality
standards of service delivery exemplified by the impending National
Service Framework for Older People and other similar other quality
standards of care and service delivery.
The proposals are based on the following areas
of complimentary activity.
— Support for professionals
— Support for local activity
— Developing the skills of front line
workers
4.1 National Leadership and Development
DEVELOP A
NATIONAL BLUEPRINT
Given the range of sectors, interested bodies,
agencies and different providers with the potential to be involved
in promoting physical activity with older people, there is a need
for a blueprint which outlines a national framework or plan of
action for the promotion of physical activity with older people.
Such a framework would provide a collective
direction for current and future development as serve as a planning
tool for policy makers and programme designers. The framework
would outline guiding principles and priority areas for action
and provide support for organisations, agencies and individuals
in planning for and addressing the physical activity needs of
older people.
PROVIDE LEADERSHIP
A number of agencies and organisations have
an important role to play, but there is currently no identifiable
lead agency or organisation in a position to take this work forward.
Without clear leadership and direction, future development will
continue to be piecemeal and uncoordinated.
FACILITATE COLLABORATION
AND PARTNERSHIP
Clearly no single agency has the sole responsibility
for this work. There is a need to ensure that local collaboration,
partnerships and alliances (exemplified by the Local Health Improvement
Programme) are reflected by complimentary national alliances between
government departments and non-governmental organisations, age-related
agencies, health organisations and the physical activity community.
The Cabinet Office Initiative "Better Government
for Older people" has demonstrated the potential for "joined
up" thinking when applied to national and local government.
DEVELOP A
STRATEGIC APPROACH
There are a number of initiatives being carried
out, but there is a lack of co-ordination, with a resultant loss
of health focus. There is a need to bring together many of these
initiatives and ensure that they are aimed at maximising the benefits
to public health. This implies a "joined up" strategy
involving all the appropriate government departments and key players.
4.2 Advocacy
INCREASE AWARENESS
AND PROFILE
Although there is ample evidence relating to
the health benefits of physical activity for the older person,
this area has received little attention and should be given a
higher priority and status.
There is a need to raise the profile of physical
activity for older people across all sectors including government
departments, non-governmental organisations, and the broad range
of national and local providers and agencies. This is required
to ensure the inclusion of the promotion of physical activity
with older people within the Local Health Improvement Programmes
in addition to other local programmes and initiatives.
PROMOTING INDEPENDENCE
Whilst the role of physical activity in the
prevention of and management of disease is well established, its
value in maintaining independent living and an improved quality
of life among older people has not received sufficient recognition
in public health policy.
EDUCATING OLDER
PEOPLE
There is a need for education and promotion
of the health benefits of physical activity to enable older people
to experience, value and make informed choices and increase their
participation.
Older people should be encouraged to advocate
for the right to a quality of life that includes access to physical
activity opportunities and choices.
4.3 Support for Professionals
A significant number of professionals at a local
level have the potential to play a part in the promotion of physical
activity among older people. Work to support professionals should
include:
Guidance
The provision of clear and practical evidence-based
guidance on how to develop local strategies for physical activity
as set out in the National Service Framework for CHD.
Networks
Develop a network of physical activity/leisure
co-ordinators with the responsibility for ensuring that older
people are included in all local physical activity development.
These co-ordinators would facilitate links between all agencies
at a local level.
Co-ordination
The identification of one organisation (or an
alliance of organisations) to maintain and support physical activity
networks for older people. This is essential for sustainable action
at a local level. This would ensure some degree of co-ordination
of local activity and ensure compatibility with government policy.
The functions for such an organisation would
include:-
— Advice on local policy and strategy
— Information, evidence and data, sharing
good practice
— The building of local exercise alliances
and partnerships
— Co-ordination of local activity
— Develop an alliance for physical
activity
NB These suggestions would be replicated by
any other approach to promoting physical activity eg with young
people.
4.4 Support for Local Activity
Community level programmes have the potential
to increase participation in physical activity among older people
across a range of settings. Stimulating community level action
can help to improve environmental and social conditions for older
people as well as increase physical activity participation. Such
action needs to meet the needs of an increasingly diverse older
population.
Work needs to be undertaken in a number of areas
eg:
Inclusion
Ensuring the inclusion of physical activity
programmes for older people within other local strategic development
eg The Healthy Communities Collaborative, Sport England's Active
Communities programme, the "Homezone" initiative, Safe
and Sound.
Collaborative action
Collaboration between Government departments
eg DOH, DCMS, DETR on a funding programme for locally led projects
that would aim to tackle the social exclusion of older people.
These projects would strengthen links between health, education,
leisure and the caring and social services and based on learning
from current practice including Health Action Zones and fulfil
a number of broader social objectives as well as promoting physical
activity.
Establish a programme of development that secures
the promotion of physical activity for older people within:
(a) Primary Health Care Groups and Trusts
(b) Social, caring and residential services
and the merging of health and social care responsibilities into
care trusts.
Resourcing
Develop a strategy to ensure an equitable approach
to National Lottery funding including the New Opportunities Fund
as well as existing physical activity and recreation funding for
programmes and facilities eg through Sport England.
4.5 Developing the skills of front-line workers
A range of front-line workers and practitioners
eg exercise teachers, health care workers, sports coaches and
recreation leaders, community workers, health visitors and volunteers
are in a position to plan and organise a variety of programmes
for older people.
Enjoyable and effective programming
Sustained participation by older people will
only be achieved if programming ensures safety, enjoyment and
meets the varied needs of older people. Effectiveness of health,
outcome eg an increase in functional capacity can only be achieved
with training and education which develops programmes that are
specific, progressive and tailored to individual need.
Reflecting needs and interests
Training programmes need to reflect the wide
range of physical activity needs and interests of older people
including dance and games related activities, Tai Chi and walking
as well as more structured exercise and fitness classes. There
is a need to encourage and provide leadership training to new
and existing leaders about the participation, motivational and
programming needs of older people.
Setting standards
Training programmes must reflect national occupational
standards and competencies.
Investing in the skills of older people
Older people should be included within training
and education programmes to encourage the development of their
skills in becoming physical activity leaders, teachers and organisers.
January 2001
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