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Dec 17

When Exercise Is The Best Medicine – Forbes

Exercise Programs Comments Off on When Exercise Is The Best Medicine – Forbes

For seniors, health benefits of exercise extend to both physical and emotional well-being.

The new year is almost here, which has many people thinking about their resolutions. The most common one, perhaps not surprisingly, is to exercise more. And yet, research shows that very few people actually stick to that resolution, with a substantial number giving up by mid-January.

But not everyone is throwing in the towel quite so quickly. Among those who get to the gym regularly are Bill, Carl and Dalia[1]. Their average age is 77, and their commitment to exercise tells us a lot about how we can improve senior health outcomes by integrating fitness into our care delivery systems.

An abundance of research demonstrates that exercise can improve the health of seniors. One study found that seniors who participated in fitness classes reported significantly better physical and emotional health and lower impairment. Another linked aerobic exercise to cognitive functioning in older adults. Our hearts, our muscles, our immune systems, and our brains: all of them benefit from exercise as we age.

Moreover, by improving health, exercise can also help shrink the cost of care for older adults by reducing the need for expensive hospitalizations. Knowing this, the question for physicians and care delivery organizations is not whether to recommend exercise for our senior patients, but how to hardwire exercise into the care we provide and ensure that our patients heed our calls to step up their physical activity.

One way health systems are encouraging exercise is by offering fitness-related benefits to their members. Just recently, the health insurer Devoted Health announced that it would offer Apple Watches as a fitness benefit. More typically, many Medicare Advantage plans offer programs like Silver&Fit and SilverSneakers, which provide seniors with a variety of benefits including low-cost gym memberships. Unfortunately, the success of these plans varies greatly and opinions about their effectiveness vary.

Nevertheless, in the world of senior fitness, there are success stories. Encore Wellness provides customized fitness programs to seniors under its Nifty after Fifty banner. The company began as a subsidiary of CareMore, the health care delivery system that I lead. Today, Encore Wellness is an independent company that serves 20,000 members not all of them CareMore patients at 30 facilities in California, Arizona, Nevada and Virginia. Its leaders say Encore/Nifty has a 20% penetration rate meaning that 20% of eligible people take advantage of its offerings.

How Encore convinced members to come in the door and keep coming back is a story that offers important lessons for those of us who care for seniors. Originally, the company made a fairly typical pitch, explaining that it could help them lower their blood pressure, shed pounds and stave off diabetes. It landed with a thud, says Michael Merino, Encore Wellness / Nifty After Fifty president and CEO.

Merino says the company decided to poll regular customers to find out what kept them coming back. Most said they enjoyed seeing their friends and meeting the staff in the fitness centers. So Encore decided to make its programs more social. It started offering group exercise classes, monthly movie matinees (with free popcorn), Wii bowling competitions, and monthly themed potluck parties. Weve transitioned from the fitness place where people also socialize to the social place where people also exercise, he says. Either way, weve found theres net more exercise going on and at the end of the day, thats our objective.

Moreover, in an age when an astonishing 43% of older adults report feelings of loneliness, which studies show can have the same effect on early mortality as smoking up to 15 cigarettes a day, Merino says Encores social programs are valuable in their own right as an effective way to alleviate the loneliness that adversely affects the health status of seniors.

But if friends and flicks get people in the door, its much more than that that keeps them coming back. In a traditional gym, seniors often face an intimidating barrage of loud music, toned bodies in Yoga pants, inattentive trainers, and unfamiliar equipment. At Encore Wellness centers, the machines are easy to use and customized for the needs of seniors.After members are personally evaluated, theyre given an electronic key-card. When inserted into the machines, a display tells the member how many reps to do and at what resistance level.

In addition, each member receives one-on-one attention from specially trained wellness coaches who remain in contact with the members physician to discuss their needs and individual progress. If a member doesnt show up for a scheduled workout, they get a friendly phone call reminding them to show up. Each workout is computer monitored and personally supervised and constantly evaluated, says Sheldon Zinberg, a physician who founded both CareMore and Encore Wellness. And thats what makes the difference.

To see that difference in action, one need look no further than Carl, who is 80 and has been diagnosed with Chronic Obstructive Pulmonary Disease. After he was hospitalized for his illness and then admitted to a skilled nursing facility, Carls wife Dalia convinced him to come to the gym. As he spins the wheels on one of Encore Wellnesss custom exercise bikes, he explains that, when he got out of the nursing facility, he couldnt walk. Now Im getting around, he says proudly. Dalia is quick to add that hes gotten strong enough to carry his own oxygen cylinder around.

Next to Carl, Bill, 78, works out his knees on another machine. Bill started coming to the gym for physical therapy after knee replacement surgery. Now he comes three times a week. When you get older, if you dont use it, you lose it, he says.

Encore Wellness notes that its efforts to help people like Carl, Dalia, and Bill stay healthy results in significant cost savings. Falls are the most common cause of nonfatal, trauma-related hospital admissions among older adults. Nationally, they result in more than 800,000 hospitalizations each year, which cost more than $50 billion to treat a number thats expected to rise to $67.7 billion by 2020.

But Encore Wellness notes that Nifty after Fifty members experience 89% fewer falls and 80% fewer fractures than non-members which the company says saves the health system between $724 and $1,929 per member per year, largely due to reduced hospitalizations.

Many health care providers say exercise is a drug, and that we should integrate it into patient care like we do other medications. I appreciate the sentiment, but I beg to differ. Unlike many medications, when done appropriately and under a physicians supervision, exercise has almost no negative side effects. And unlike expensive new drugs, as Encore Wellnesss model shows, exercise can reduce costs in the health care system. For these reasons, its time for physicians, nurses, and health care organizations systems to make their own new years resolution to prioritize exercise as an intervention they prescribe to their patients.

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When Exercise Is The Best Medicine - Forbes

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