PARTICIPATION AND PARTICIPATION AND OLDER PEOPLEOLDER PEOPLE

David MorbyDavid MorbyAssistant Head of ServiceAssistant Head of Service

Alison MorbyAlison MorbyPhysical Activity Development ManagerPhysical Activity Development Manager

Kirklees Metropolitan CouncilKirklees Metropolitan Council

DEFINITION OF TERMSDEFINITION OF TERMS

Physical ActivityPhysical ActivityPhysical ActivityPhysical Activity

Exercise Sport Leisure Dance/ OthersExercise Sport Leisure Dance/ Others Activity MovementActivity Movement

(Source: President’s Council on Physical (Source: President’s Council on Physical Fitness & Sports, 2000)Fitness & Sports, 2000)

– ““any bodily movement produced by skeletal muscles that results in energy any bodily movement produced by skeletal muscles that results in energy expenditure” (Bouchard 1990)expenditure” (Bouchard 1990)

– something you dosomething you do

Community FacilitiesCommunity Facilities

– A facility within a community ie sports centre, community centre, church hall, A facility within a community ie sports centre, community centre, church hall, day care centre, residential home, sheltered housing, park, street, houseday care centre, residential home, sheltered housing, park, street, house

DEFINITION OF TERMS cont…DEFINITION OF TERMS cont…

Older PersonOlder Person

– Age Concern, WHO, sport and recreation bodies traditionally define Age Concern, WHO, sport and recreation bodies traditionally define the older person as a person over the age of 50the older person as a person over the age of 50

– Relative term as there are old 50’s and young 70’sRelative term as there are old 50’s and young 70’s– Self-identification may be more accurateSelf-identification may be more accurate

WHY IS PHYSICAL ACTIVITY WHY IS PHYSICAL ACTIVITY IMPORTANT?IMPORTANT?

““A regular programme of moderate exercise is a very appropriate A regular programme of moderate exercise is a very appropriate recommendation for almost all older adults. Moreover, there is no recommendation for almost all older adults. Moreover, there is no known pharmacological remedy that can so safely and effectively known pharmacological remedy that can so safely and effectively reduce a person’s biological age and enhance his or her quality reduce a person’s biological age and enhance his or her quality adjusted life expectancy” (Shephard 1997)adjusted life expectancy” (Shephard 1997)

Disease prevention and management and improvements to quality Disease prevention and management and improvements to quality of lifeof life

Psychological benefitsPsychological benefits Social benefitsSocial benefits Reduction in the complications of immobilityReduction in the complications of immobility Reduction in costs of health and social care and other servicesReduction in costs of health and social care and other services

HOW ACTIVE ARE OLDER PEOPLE?HOW ACTIVE ARE OLDER PEOPLE?

““Despite the increase in the promotion of exercise and physical activity Despite the increase in the promotion of exercise and physical activity for the prevention of functional decline and disease, people in the UK for the prevention of functional decline and disease, people in the UK become less physically active as they age” (Skelton, Young et al 1999)become less physically active as they age” (Skelton, Young et al 1999)

Among the over 50’s, 40% of men and women are sedentary. Among the over 50’s, 40% of men and women are sedentary. Among the over 80’s, 40 % of men, 65% of women are sedentaryAmong the over 80’s, 40 % of men, 65% of women are sedentary

Only 3% of men and women aged over 50 take part in sport or Only 3% of men and women aged over 50 take part in sport or exercise activity at least 5 times a weekexercise activity at least 5 times a week

20% of over 50’s climb no stairs at all in a week20% of over 50’s climb no stairs at all in a week In minority ethnic communities aged over 55, those who are In minority ethnic communities aged over 55, those who are

sedentary account for:sedentary account for:– 57% of African-Caribbean men and 59% of women57% of African-Caribbean men and 59% of women– 67% of Indian men and 78% of women67% of Indian men and 78% of women– 73% of Pakistani men and 85% of women73% of Pakistani men and 85% of women– 85% of Bangladeshi men and 92% of women85% of Bangladeshi men and 92% of women

HOW ACTIVE ARE OLDER PEOPLE? HOW ACTIVE ARE OLDER PEOPLE? cont…cont…

In the UK, among those over the age of 50:In the UK, among those over the age of 50:

– 20% of women and 14% of men do not have the flexibility to wash their 20% of women and 14% of men do not have the flexibility to wash their hair comfortablyhair comfortably

– 47% of women aged 70-74 have insufficient leg muscle power to step 47% of women aged 70-74 have insufficient leg muscle power to step on a bus without using armson a bus without using arms

– 25% of women aged 70-74 do not have enough strength in the legs to 25% of women aged 70-74 do not have enough strength in the legs to be confident getting out of a chair without using armsbe confident getting out of a chair without using arms

In Kirklees:In Kirklees:– Seven out of ten adults are not active enough to meet the Seven out of ten adults are not active enough to meet the

recommended level of physical activityrecommended level of physical activity– Over 50% of people over 65 were sedentaryOver 50% of people over 65 were sedentary– Considerably more people on low incomes never did any activity – 28% Considerably more people on low incomes never did any activity – 28%

compared with 5% of the wealithiestcompared with 5% of the wealithiest– More South Asian people were sedentary than any of the other More South Asian people were sedentary than any of the other

population groupspopulation groups(CLICK: 2001)(CLICK: 2001)

PHYSICAL ACTIVITY RECOMMENDATIONSPHYSICAL ACTIVITY RECOMMENDATIONS FOR OLDER PEOPLE FOR OLDER PEOPLE

There are no national guidelines in the UK for physical activity There are no national guidelines in the UK for physical activity specific to older people, but the recommendation for the adult specific to older people, but the recommendation for the adult population is to take part in:population is to take part in:

““30 minutes of moderate physical activity, on at least five occasions 30 minutes of moderate physical activity, on at least five occasions a week”a week” (Department of Health) (Department of Health)

Evidence also suggests that for the maintenance of independence Evidence also suggests that for the maintenance of independence once or twice a week is satisfactory but should be considered a once or twice a week is satisfactory but should be considered a minimum minimum (Evans 1999 , WHO (Evans 1999 , WHO 1997)1997)

Intentional or habitual physical activityIntentional or habitual physical activity

A ‘bit at a time’ approachA ‘bit at a time’ approach

WHAT ARE THE BARRIERS FOR WHAT ARE THE BARRIERS FOR OLDER PEOPLE?OLDER PEOPLE?

Intrinsic BarriersIntrinsic Barriers Extrinsic BarriersExtrinsic BarriersRelate to an individual’s beliefs, motives and Relate to an individual’s beliefs, motives and experiences concerning physical activityexperiences concerning physical activity

Likely to be addressed by those working directly Likely to be addressed by those working directly with the older person ie peer mentor, instructor, with the older person ie peer mentor, instructor, health visitor, GP, care worker etchealth visitor, GP, care worker etc

Myths and perceptionsMyths and perceptions

Previous experiencesPrevious experiences

Family adviceFamily advice

Lack of interestLack of interest

Lack of confidenceLack of confidence

Fears of overdoing itFears of overdoing it

Safety concernsSafety concerns

Absence of role modelsAbsence of role models

Stereotypical images of ageingStereotypical images of ageing

Health concernsHealth concerns

Relate to the broader physical activity environment, Relate to the broader physical activity environment, skills and attitudes of others and the types of skills and attitudes of others and the types of opportunity availableopportunity available

Likely to be addressed by those responsible for policy Likely to be addressed by those responsible for policy and strategic developmentand strategic development

Type of activityType of activity

Access/locationAccess/location

Safety concernsSafety concerns

TransportTransport

Sport and recreation policySport and recreation policy

Skills and attitudes of instructorSkills and attitudes of instructor

Lack of social supportLack of social support

CostCost

Culturally appropriate facilities/settingsCulturally appropriate facilities/settings

PLANNING ACTIVITY FOR PLANNING ACTIVITY FOR OLDER PEOPLEOLDER PEOPLE

The Active for Later Life resource identifies a framework for working The Active for Later Life resource identifies a framework for working with older people which is organised into related and overlapping with older people which is organised into related and overlapping areas which may be helpful in the planning and programming of areas which may be helpful in the planning and programming of activityactivity

““Making Activity Choices”Making Activity Choices”(for people entering old age)(for people entering old age)

Increasing the “Circle of Life”Increasing the “Circle of Life”(for people in the transitional phase)(for people in the transitional phase)

““Activity in Later Years”Activity in Later Years”(for frailer older people)(for frailer older people)

KEY ISSUESKEY ISSUES

ConsultationConsultation Activity ChoicesActivity Choices FacilitiesFacilities SafetySafety Instructors/LeadersInstructors/Leaders Role ModelsRole Models Pricing PoliciesPricing Policies Marketing and PromotionMarketing and Promotion Partnership WorkingPartnership Working Influencing the Strategic ProcessInfluencing the Strategic Process

CONSULTATIONCONSULTATION

Encourage and value participant contributionEncourage and value participant contribution Seek views on a wide range of issuesSeek views on a wide range of issues Involve a wide variety of older peopleInvolve a wide variety of older people Use appropriate consultation methodsUse appropriate consultation methods Follow up consultation with feedback and actionFollow up consultation with feedback and action Ongoing consultation and involvementOngoing consultation and involvement

CONSULTATION METHODS USED CONSULTATION METHODS USED IN KIRKLEESIN KIRKLEES

Utilisation of older adult panelUtilisation of older adult panel Focus groupsFocus groups Face to face interviewsFace to face interviews ConferenceConference Peer mentorsPeer mentors Outreach workOutreach work Community consultation eventsCommunity consultation events SurveySurvey User groupsUser groups

Turn listening into actionTurn listening into action

ACTIVITY CHOICESACTIVITY CHOICESActivity AreaActivity Area FocusFocus ProvidersProviders Activity TypeActivity Type

““Making ActivityMaking Activity Disease prevention,Disease prevention, Leisure & RecreationLeisure & Recreation Sport, Exercise,Sport, Exercise,Choices”Choices” maintaining activitymaintaining activity and activity providersand activity providers Active LivingActive Living

levels & functionallevels & functionalcapacitycapacity

Independent andIndependent and Starting & sustainingStarting & sustaining Kirklees Leisure &Kirklees Leisure & WalkingWalkingunsupervised unsupervised participation inparticipation in Recreation ServicesRecreation Services Circuit trainingCircuit trainingactivityactivity physical activityphysical activity Exercise to musicExercise to music

Kirklees Active LeisureKirklees Active Leisure Practical Practical ConservationConservation

Involvement in activeInvolvement in active Dance (various)Dance (various)leisure, sport &leisure, sport & Voluntary sector sports,Voluntary sector sports, Tai ChiTai Chiexercise programmesexercise programmes exercise and activity exercise and activity BadmintonBadminton

clubsclubs TennisTennisActive Living andActive Living and BowlsBowlsLifelong LearningLifelong Learning Private sector healthPrivate sector health Line dancingLine dancing

and fitness clubsand fitness clubs YogaYogaCyclingCycling

Primary Health CarePrimary Health Care OrienteeringOrienteeringTeamsTeams Stretch & FlexStretch & Flex

SwimmingSwimmingSelf directed activities,Self directed activities, AquafitAquafitmaybe with assistance maybe with assistance Swimming lessonsSwimming lessonsand support from leaders,and support from leaders, Activity MixActivity Mixcoaches, instructors etccoaches, instructors etc

ACTIVITY CHOICESACTIVITY CHOICESActivity AreaActivity Area FocusFocus ProvidersProviders Activity TypeActivity Type

““Increasing theIncreasing the Maintaining Maintaining Older Peoples Older Peoples Exercise, Activity toExercise, Activity toCircle of Life”Circle of Life” independence, socialindependence, social Services/ ManagersServices/ Managers improve functionalimprove functional

networks and networks and capacity – Active capacity – Active LivingLiving

functional capacityfunctional capacity

Supervised classesSupervised classes Movement, dance andMovement, dance and Activity co-ordinators inActivity co-ordinators in CircuitsCircuitsand groups withinand groups within walking (assisted)walking (assisted) nursing and residentialnursing and residential DanceabilityDanceabilitya health, social,a health, social, activitiesactivities settingssettings Activi-chiActivi-chiresidential or careresidential or care Tai ChiTai Chisettingsetting Chair based Chair based Physical Activity Physical Activity WalkingWalking

programmes and programmes and Development OfficersDevelopment Officers Chair aerobicsChair aerobicsgamesgames (Local Authority)(Local Authority) Chair activities -Chair activities -

parachutes,parachutes,Home based exercise/Home based exercise/ Healthcare ProfessionalsHealthcare Professionals batons, batons,

scarves,scarves,activity programmesactivity programmes balls, fans, balls, fans,

bean bean Home visitors – Home visitors – bags etcbags etccommunity nursing staffcommunity nursing staff ReminiscenceReminiscence

Active GamesActive GamesQualified older personQualified older person Active Living CircuitActive Living Circuitinstructors/teachersinstructors/teachers GardeningGardening

ACTIVITY CHOICES (cont…)ACTIVITY CHOICES (cont…)Activity AreaActivity Area FocusFocus ProviderProvider Activity TypeActivity Type

““Activity in LaterActivity in Later Improvement in,Improvement in, Specialist servicesSpecialist services Functional activityFunctional activityYears”Years” quality of lifequality of life

Requires adaptedRequires adapted MaintainingMaintaining Physiotherapists/ Physiotherapists/ Functional Functional exercisesexercises

physical activityphysical activity independence andindependence and occupational occupational activities of dailyactivities of daily therapiststherapists PhysiotherapyPhysiotherapylivingliving programmesprogrammes

Physical ActivityPhysical ActivityRehabilitation ie Rehabilitation ie Development OfficersDevelopment Officers Active GamesActive Gamesfalls, cardiac falls, cardiac (Local Authority) -,(Local Authority) -,rehabilitation etcrehabilitation etc specialist trainingspecialist training Chair activitiesChair activities

-- parachutes, parachutes, batonsbatons

Specific needs ieSpecific needs ie Exercise practitionerExercise practitioner scarves, balls, scarves, balls, fans,fans,

dementiadementia with additionalwith additional bean bags etcbean bags etctrainingtraining

ReminiscenceReminiscenceActivity co-ordinatorsActivity co-ordinatorsin nursing & residentialin nursing & residential Circuits (specific)Circuits (specific)settingssettings

Active LivingActive LivingHealth and care teamsHealth and care teamswith specific trainingwith specific training

FACILITIESFACILITIES

Programmes to promote physical activity will be able to utilise some Programmes to promote physical activity will be able to utilise some existing settings and facilities within communities, but there will be a existing settings and facilities within communities, but there will be a need to be imaginative and develop new ways to reach older people need to be imaginative and develop new ways to reach older people ie; residential/nursing homes, day care centres, sheltered ie; residential/nursing homes, day care centres, sheltered accommodation, hospitals, garden centres, shopping centres, accommodation, hospitals, garden centres, shopping centres, churches, parks, the homechurches, parks, the home

Key criteria - is the setting;Key criteria - is the setting;– Acceptable to older people?Acceptable to older people?– Accessible to older people?Accessible to older people?– Affordable for older people?Affordable for older people?– Sensitive and flexible pricing?Sensitive and flexible pricing?– Safe for older people ?Safe for older people ?

SAFETYSAFETY

Facility/venueFacility/venue ActivityActivity IndividualIndividual

Older people are more at risk when they are being inactive Older people are more at risk when they are being inactive than when they are being active.than when they are being active.

Is there any evidence of older people being harmed byIs there any evidence of older people being harmed byexercise/activity?exercise/activity?

INSTRUCTORS/LEADERSINSTRUCTORS/LEADERS Appropriate training for all those involved in leading, teaching and instructing Appropriate training for all those involved in leading, teaching and instructing

in physical activity programmes is essential for an activity intervention for in physical activity programmes is essential for an activity intervention for older peopleolder people

Training courses for those delivering physical activity working with older Training courses for those delivering physical activity working with older people is a recent area of development and there needs to be consideration people is a recent area of development and there needs to be consideration of;of;– Validity and credibilityValidity and credibility– Appropriateness of course contentAppropriateness of course content– Experience and expertise of the course tutor teamExperience and expertise of the course tutor team– External validation and continuing education requirementsExternal validation and continuing education requirements– Assessment procedures and certificationAssessment procedures and certification

Details of training opportunities for those working with older adults can be Details of training opportunities for those working with older adults can be found in the Active for Later Life resourcefound in the Active for Later Life resource

National Register of Exercise ProfessionalsNational Register of Exercise Professionals

COURSES UNDERTAKEN BY COURSES UNDERTAKEN BY KIRKLEES INSTRUCTORSKIRKLEES INSTRUCTORS

Walk LeadersWalk LeadersCommunity Sports Leaders Award (CSLA)Community Sports Leaders Award (CSLA)Basic Expedition Leaders Award (BELA)Basic Expedition Leaders Award (BELA)YMCA : Exercise to Music – Older Person ModuleYMCA : Exercise to Music – Older Person ModuleYMCA : Circuit Training – Older Person ModuleYMCA : Circuit Training – Older Person ModuleFalls CourseFalls Course

Senior Peer MentoringSenior Peer MentoringBritish Association of Cardiac Rehabilitation Award (BACR)British Association of Cardiac Rehabilitation Award (BACR)EXTENDEXTENDExcel 2000Excel 2000Jabadeo (Centre for Movement Studies)Jabadeo (Centre for Movement Studies)First AidFirst AidChair Based Exercise Leadership for Frailer Older People (Leicester Chair Based Exercise Leadership for Frailer Older People (Leicester College)College)

In-service training :In-service training : cardiac rehabilitationcardiac rehabilitationpulmonary rehabilitationpulmonary rehabilitationasthmaasthmadiabetesdiabetesvisually impairmentvisually impairmentdementiadementiafunctional assessment testsfunctional assessment tests

ROLE MODELS/PEER MENTORSROLE MODELS/PEER MENTORS

What is the role of the Senior Peer Mentor?What is the role of the Senior Peer Mentor? Point other adults in the right directionPoint other adults in the right direction Provide appropriate information about physical activityProvide appropriate information about physical activity Be a positive role modelBe a positive role model Share information about opportunities and benefits of physical activityShare information about opportunities and benefits of physical activity Be someone to talk to and share experiences withBe someone to talk to and share experiences with Understand their concern from ‘their point of view’Understand their concern from ‘their point of view’

What does a Senior Peer Mentor not do?What does a Senior Peer Mentor not do? Provide medical adviceProvide medical advice ‘‘Make’ people healthyMake’ people healthy Counsel peopleCounsel people Lead or instruct exercise or sport activitiesLead or instruct exercise or sport activities

MARKETING & PROMOTIONMARKETING & PROMOTION

Positive imagesPositive images Appropriate messagesAppropriate messages Information in different format/languagesInformation in different format/languages Culturally sensitiveCulturally sensitive Appropriate channels for communicationAppropriate channels for communication Specific informational cues for public placesSpecific informational cues for public places Involve older peopleInvolve older people

PRICING POLICYPRICING POLICY

AppropriateAppropriate FlexibleFlexible

PARTNERSHIP WORKINGPARTNERSHIP WORKING At a local level there are a number of individuals, groups and organisations At a local level there are a number of individuals, groups and organisations

who have a role to play in the development of activities for older people. who have a role to play in the development of activities for older people. However, there is a need locally to re-assess their potential for However, there is a need locally to re-assess their potential for collaboration.collaboration.

Golden PALS partnership:Golden PALS partnership:

PartnerPartner RoleRole

Leisure and RecreationLeisure and Recreation

Social ServicesSocial Services

NHS TrustNHS Trust

Sheltered HousingSheltered Housing

Primary Healthcare TeamPrimary Healthcare Team

Residential HomeResidential Home

Excel 2000Excel 2000

Support, equipment, fundingSupport, equipment, funding

Funding advice, informationFunding advice, information

Physiotherapy support, referralsPhysiotherapy support, referrals

Referrals, promotionReferrals, promotion

Referrals, advice/informationReferrals, advice/information

Care staff, venueCare staff, venue

InstructorInstructor

PARTNERSHIP WORKING (cont…)PARTNERSHIP WORKING (cont…)

Walking Leaders Network partnership:Walking Leaders Network partnership:

PartnerPartner RoleRole

Leisure and Recreation (KMC)Leisure and Recreation (KMC)

HighwaysHighwaysCountryside UnitCountryside UnitPrimary Healthcare TeamsPrimary Healthcare TeamsPeer Health Education ProjectPeer Health Education ProjectCountryside Agency/BHFCountryside Agency/BHFHealth Promotion ServiceHealth Promotion ServiceWalking LeadersWalking Leaders

Meeting venues, newsletter, funding Meeting venues, newsletter, funding advice, information, support, developing advice, information, support, developing walkswalksPromotion, modification of environmentPromotion, modification of environmentFunding advice/informationFunding advice/informationPromotionPromotionStaffing, promotionsStaffing, promotionsFunding advice, newsletters, resourcesFunding advice, newsletters, resourcesTraining, adviceTraining, adviceProvision of activity, newsletter, peer Provision of activity, newsletter, peer mentoring, older peoplementoring, older people

PARTNERSHIP WORKING (cont…)PARTNERSHIP WORKING (cont…)

Active Older People Network partnership:Active Older People Network partnership:

PartnerPartner RoleRole

Leisure and Recreation (KMC)Leisure and Recreation (KMC)

Social Services (KMC)Social Services (KMC)Corporate Development (KMC)Corporate Development (KMC)Primary Care TrustsPrimary Care Trusts

Acute TrustsAcute Trusts

Kirklees Older People NetworkKirklees Older People NetworkAge ConcernAge ConcernExcel 2000Excel 2000Senior Peer Mentors (PAM’s)Senior Peer Mentors (PAM’s)

Meeting venues, newsletter, advice, Meeting venues, newsletter, advice, information, traininginformation, trainingAdvice, information, training, eventsAdvice, information, training, eventsAdvice, information, fundingAdvice, information, fundingFunding events, advice, information, Funding events, advice, information, PR& marketingPR& marketingInformation, advice, access to patients, Information, advice, access to patients, promotionpromotionConsultation, training, adviceConsultation, training, adviceConsultation, advice, informationConsultation, advice, informationTraining opportunities, adviceTraining opportunities, adviceAdvice, links to older peopleAdvice, links to older people

POLICY/STRATEGIC CONTEXT… POLICY/STRATEGIC CONTEXT… THE KIRKLEES APPROACHTHE KIRKLEES APPROACH

NATIONAL POLICY/STRATEGY IE NSF

COMMUNITY STRATEGYVISION 2012

CULTURAL STRATEGY

SPORT & RECREATION STRATEGY

PHYSICAL ACTIVITY & HEALTH ACTION PLAN

PHYSICAL ACTIVITY & HEART HEALTH

DEVELOPMENT PLAN

PALSDEVELOPMENT

PLAN

ACTIVE OLDER PEOPLE

DEVELOPMENT PLAN

PHYSICAL ACTIVITY & FALLS

DEVELOPMENT PLAN

LOCAL HEALTH PLANS(HIMP’s)

LOCAL PUBLIC SERVICE AGREEMENTLOCAL PUBLIC SERVICE AGREEMENT(LPSA) TARGET(LPSA) TARGET

To reduce the number of people aged 18 to 64 on low To reduce the number of people aged 18 to 64 on low incomes who are sedentary by 1,200incomes who are sedentary by 1,200

To reduce the number of people aged over 65 who are To reduce the number of people aged over 65 who are sedentary by 900sedentary by 900

For more information contact:

david.morby@kirklees.gov.ukalison.morby@kirklees.gov.uk