A retirement care home patient takes a walk outside with a helper.

A retirement care home patient takes a walk outside with a helper.

Steps in the right direction

Increased strength, better balance and improved mood are among the health benefits for seniors who spend time walking outdoors

Swiss researchers who put subjects through an exercise regimen of an hour a week, made an interesting discovery.

The exercise was walking to piano music, and the more intense the music, the more challenging the movements.

At the end of the test period, researchers found that apart from the anticipated improvement in muscle strength, the women’s balance was greatly enhanced so that after six months, their risk of falling had halved.

The subjects were compared to another group which did only normal exercises with no music and who made no gains in balance.

The seniors in the study lived in retirement communities in Switzerland.

Retirement homes are growing in popularity all over the western world, drawing residents who have sold larger homes, are unable or disinclined to cook their own meals, and want to spend their twilight years with fewer responsibilities and more social interaction. 

Many are able to stay in their communities, close to amenities, and are re-assured when nursing care is provided in-house.

But if there’s a weak spot, it’s a lack of outdoor exercise. The lives of residents become more sedentary than ever, and many spend hours each day sitting.

And sitting, health care practitioners are saying, is the new smoking: a very unhealthy habit.

The benefits of exercise go far beyond the physical, of fluidity of movement and bone strength. Not getting enough is associated with countless physical, emotional and mental disorders.

Many retirement homes offer exercise programs that range from tai chi to lifting weights, and walking the corridors. But that’s not enough, says a Langley family doctor who is concerned about the tendency of many seniors to remain confined to the floor of their residential care facilities.

“A short daily walk outdoors, if only 10 to 20 minutes, would likely ameliorate some of their symptoms of distress,” said Dr. Cheryl Mason.

“As a GP, I get asked to treat depression, agitation, insomnia and so on,” she said, noting that patients, particularly those with Alzheimer’s, are on medications which may be contraindicated, or not recommended.

“There is not a lot left to treat them with,” Mason said. 

One solution is to encourage residents to get back to the basics: Making walking outdoors part of their daily routine.

“Those patients of mine who do get outdoors for a daily walk or outing seem to do so much better overall, both physically and emotionally,” she added.

But there are barriers. The facilities say they don’t have the staff, and it’s up to the families to take the residents outside. It’s more difficult to persuade residents who have led previously sedentary lives to get up and walk, and in many cases, areas such as treed boulevards where seniors could safely walk, are not always in walking distance from residences.

Mason applauds community agencies such as the Langley Seniors Resource Centre for organizing outings and other social excursions.

She suggests action could go further: Local governments should compel developers of retirement and long-term care homes to ensure adequate greened walking corridors.

“I would like to see some co-ordinated community effort,” Mason said. Patients who are cognitively impaired become isolated in their own homes because they do not have the ability to venture outdoors.

“They need someone to take them out every day,” Mason said. 

“We need a community program that has senior high school students or others in the community provide volunteer hours as companion walkers,” she said, adding that a short course could be offered to teach companion walkers how to treat seniors with courtesy and respect.

These students should be encouraged to become companion walkers for those who cannot walk alone, or who have cognitive or other challenges which make going outside alone inadvisable.

Exercising outdoors, even for those who walk at a slow pace, pays huge dividends, Mason said. It can reduce stress and soothe the mood.

There is scientific and anecdotal evidence that supports a daily prescription for getting close to nature, and she encourages families to see that infirm parents or grandparents get sunlight and fresh air every day.

The family of one of Mason’s patients, a woman with dementia, did just that with positive results. 

Carolyn, the niece of a patient who lives in the assisted-living wing of a Langley retirement home, decided to pay Marie to be a ‘companion walker’ for her aunt, who suffers from Alzheimer’s disease. In only one month, her aunt’s demeanor improved.

“She seems happier,” Carolyn said.

Marie walks twice a week with the aunt, and when the weather gets warmer and dryer, the frequency will increase. As she walks around the courtyard where the aunt lives, Marie engages the aunt in conversation and talk about the colours of spring flowers.

“I walk with her every day that I work,” Marie said. 

“The more stimulation she gets, the better for her. It keeps her in better health, and the more they (seniors) do it, the longer they will stay independent.

“This is what all retirement communities need.”

At 74, Carolyn’s aunt is one of the youngest residents on her floor in the care home.

“She has always been an active and fit person, so not being able to come and go when she wants has been a hard adjustment to make. Having a walker to get her out and converse with has made her happier and has eased some of her anxiety,” Carolyn said.

Those walks with Marie suit her better than organized outings and are a much healthier alternative to her habitual pacing of corridors.

The family appreciates Mason’s commitment to her patients’ well-being regardless of how old they are or their level of dementia.

“She cares about the quality of life my aunt is having, and by encouraging a walking program is giving her options to keep well and active,” Carolyn said.

Like Mason, she realizes that retirement homes have limited resources to organize this.

“They don’t have the staff, and they don’t have the time.”

With Canada’s aging population, the number of people with dementia is rising. How does exercise help them? Light aerobic exercises increase blood to the brain, rejuvenate the lungs and heart, while resistance or weight training helps build lean muscle mass and boosts metabolism. This helps to control blood sugar levels.

The important element is to exercise outdoors.

“We know that sunlight and exercise improve mood and cognitive function, so let’s get our citizens in residential care back out into the outdoors for that daily walk or outing,” Mason said.

“That historical ritual should be available to all.”

The deterioration of mind-body co-ordination is one of the perils of dementia, so regular exercises to enhance flexibility and balance are important. These might include stretching and tai chi. 

Dancing, particularly beneficial for those with dementia because its movements encompass aerobics, flexibility and balance, is a good option for people who are unable to find the motivation for weight training and traditional exercises. 

Whatever they choose, residents must be encouraged to spend time outdoors every day, Mason says.

“I wonder when some of the residents of Langley’s residential care facilities last went outside?”