Active and Healthy Aging: The Keys to Living Well

In honor of Memorial Day and my friend Stella Wetterhahn … Stella Was A World War II Veteran and a Nurse.  She will be in my heart forever…

Every Saturday, after my workout, I get on a bus and head Downtown to meet my friend Stella. I have known Stella since 2007. She will be 92 in July. Stella is a retired Nurse. She served in World War II. Stella has never deviated from the schedule she had as an Army and Private Duty Nurse. She worked the 11:00 PM to 7:00 AM shift.

Stella and I meet at the local library because she likes to read the newspaper. When we meet, we discuss the daily news and chat about what is going on in the neighborhood. When we finish at the library, we head over to the corner Deli. I once asked her “what keeps you going at your age?”

Stella laughed and said “There are three keys:
1.Structure,
2.Getting out, and
3.Connecting with people”.

Without knowing it, Stella defined the concept of Active and Healthy Aging. Research identifies Active Aging as “the development and maintenance of optimal physical, mental, and social well-being and function in older adults”. [1] In her article, “A Concept Analysis of Healthy Aging,” Linda Hansen-Kyle defines Healthy Aging as “a process of slowing down while adapting to optimally function and participate in life.”[2]

A Review of Trends:

Research shows that Adults age 65 to 85+ are the fastest growing population and group; a trend that is to continue for at least the next 50 years. [3] Research indicates that 88 percent of Adults age 65 and over report having at least one chronic condition (e.g. Heart Disease, Diabetes, or Arthritis). [4]

The statistic in the literature that caught my attention said “one third to one half of woman age 70 and over have challenges with mobility”. [5] Several studies document the need for physical activity to maintain mobility and independence. [6] Research shows that the act of “getting out” and engaging in 150 minutes of physical activity is beneficial for older adults. [7] For people like Stella, the recommended 150 minutes can translate into 30 minutes of walking each day. [8] Stella’s definition of Active and Healthy Aging is going to library each day, going for a walk, and not staying inside for long periods of time.

My friend has a set purpose, destination, and routine for each day.

Stella’s reference to “connecting with people” means that she has an established social network. She has successfully created a system of support to address any needs that may come up. When Stella is not able to get outside due to inclement weather, for example, the Deli Shop owner will deliver food to Stella’s door. She receives the assistance that she needs from people in her neighborhood.

Stella’s reference to “connecting with people” is also corroborated by current research. Studies show that having a social network, engaging with people, and participating in social activities may delay cognitive decline and other health-related consequences. [9]

When our Saturday visits end, I walk away from Stella smiling. She personifies the keys of Active and Healthy Aging.  At the age of 92, Stella may move a bit slower and have occasional pain in her knees, but she thrives in her neighborhood and community.

She has taught me about resiliency, Active and Healthy Aging, and living. I know my keys to Active and Healthy Aging will include exercise, healthy eating, and activities to maintain my mobility and independence. What are your keys to Active and Healthy Aging?

[1] Marshall, V. W., & Altpeter, M. (2005). Cultivating Social Work Leadership in Health Promotion and Aging: Strategies for Active Aging Interventions. Health & Social Work, 30(2), 135-144.

[2]Hansen-Kyle, Linda. “A Concept Analysis of Healthy Aging.” Nursing Forum. Blackwell Publishers Ltd. 2005.

[3] Rogers, N. L., Green, J. L., & Rogers, M. E. (2012). Physician-prescribed physical activity in older adults. Aging Health, 8(6), 601+

[4] Marshall, V. W., & Altpeter, M. (2005). Cultivating Social Work Leadership in Health Promotion and Aging: Strategies for Active Aging Interventions. Health & Social Work, 30(2), 135-144.

[5] Marshall, V. W., & Altpeter, M. (2005). Cultivating Social Work Leadership in Health Promotion and Aging: Strategies for Active Aging Interventions. Health & Social Work, 30(2), 135-144.

[6] Rantakokko, M., Iwarsson, S., Hirvensalo, M., Leinonen, R., Heikkinen, E., & Rantanen, T. (2010). Unmet Physical Activity Need in Old Age. Journal Of The American Geriatrics Society, 58(4), 707-712. doi:10.1111/j.1532-5415.2010.02792.x

[7] Centers for Disease Control and Prevention (CDC). How much physical activity do older adults need? www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html

[8] Centers for Disease Control and Prevention (CDC). How much physical activity do older adults need? www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html

[9] Flatt, J. D., & Hughes, T. F. (2013). Participation in social activities in later life: does enjoyment have important implications for cognitive health? Aging Health, 9(2), 149+.

This article were originally published in the “Endless CapABILITIES Blog”, and National Center on Health, Physical Activity and Disability, sponsored by The National Center on Health, Physical Activity and Disability (www.nchpad.org). NCHPAD is part of the UAB/Lakeshore Research Collaborative and supported by Grant/Cooperative Agreement Number U59DD000906 from the Centers for Disease Control and Prevention (CDC).

Expectations, Perceptions, and Achievement

I came across a book called “Everybody Belongs: Changing Negative Attitudes toward Classmates with Disabilities.” by: Arthur Shapiro. The book was written several years ago and yet the themes from the book apply easily in 2019.  Mr. Shapiro’s book offers in-depth perspectives and strategies about how to change negative attitudes and biases about disabilities.

Mr. Shapiro’s book cites studies that show that the concept of disability is generally viewed negatively. [i]  Research shows that children develop misperceptions about disabilities by the age of 5. [ii] Mr. Shapiro writes about how we integrate attitudes, perceptions, and prejudices about disabilities very early from books, media, and through interactions in community settings like schools. Research shows that developed prejudices tend to increase and become more set as children progress through school. [iii]

The research highlighted by Mr. Shapiro gave me pause, misperceptions about disabilities form by the age of five.  I am bothered about the negativity that can and does exist about disabilities.  When I read that misperceptions become more fixed as children age, I become increasingly bothered.

I am bothered by an observation that I keep encountering, the idea that expectations for people with disabilities are generally lower. I read an article which cited research that said “people with disabilities are still habitually regarded as people to be pitied because of disability or admired based on minimal efforts and achievements.” [iv]

Based upon my review of this literature, I started to consider the idea of expectation in the context of my fitness regimen. When I started my fitness journey in 2006, I was originally driven by a notion that I would attempt to walk without the aid of crutches, canes, or any support  device, in all environments, full-time.

In the 13 years that have passed, my walking and fitness goals have shifted and changed from walking device free to improving and maintaining movement and ability.  However, the notions of effort, progression, performance, and the “can and try” principle created a standard of expectation and achievement in my program and goals.

Effort

I always make an attempt or a repeated sequence of attempts in a fitness task even if I do not achieve the intended result. The team of Fitness Professionals I work with expects 100% of my effort regardless of the nature of the task.

Expectations of my achievement have also increased over time. The  goals are always to improve, expand, and create ability compared to setting a standard of minimal achievement.

Progression

The team of Fitness Professionals working with me are helping me to learn new movement patterns, modify existing ones, and lessen compensatory movement  patterns that I have developed from Spastic Cerebral Palsy.

Performance

The Fitness Professionals provide feedback based on the performance I deliver or based upon the needs that they see. The feedback that I receive is skill-specific and not disability-specific. I am taught skills at a pace and frequency that support me to improve upon or achieve a specific task.

The “Can and Try Principle”

My team employs the “Can and Try Principle”.

Can I perform the task?

Not always.

Will I try to perform the task?

Always.

From this principle, my team of Fitness Professionals has supported a dynamic process and approach that determines the level and intensity of the support that I may need to learn or re-learn discrete skills to improve existing movement patterns or to learn new ones.

Mr. Shapiro’s notion of “Everybody Belongs” is an ideal that we have not yet reached, but is an end that we need to continue to work towards.  The concept of combining effort, progression, performance, and the “Can and Try Principle” has the potential of significantly raising individual expectations and general standards of achievement for people with disabilities in health, fitness, and many other settings.

Tell me Wiley’s Walk Readers, what other principles or approaches support increasing expectations and standards of achievement for people with disabilities?

[i] Shapiro, A. (2000). Everybody Belongs: Changing Negative Attitudes toward Classmates with Disabilities. New York: Routledge Falmer.

[ii] Shapiro, A. (2000). Everybody Belongs: Changing Negative Attitudes toward Classmates with Disabilities. New York: Routledge Falmer.

[iii] Shapiro, A. (2000). Everybody Belongs: Changing Negative Attitudes toward Classmates with Disabilities. New York: Routledge Falmer.

[iv] Harris, L. (1991). Public attitudes toward people with disabilities. New York: Louis Harris and Associates.

This article were originally published in the “Endless CapABILITIES Blog”, and National Center on Health, Physical Activity and Disability, sponsored by The National Center on Health, Physical Activity and Disability (www.nchpad.org). NCHPAD is part of the UAB/Lakeshore Research Collaborative and supported by Grant/Cooperative Agreement Number U59DD000906 from the Centers for Disease Control and Prevention (CDC).

Living without the Label

I am almost 44 years old.  I work and own my own home.  I earned more than one college degree.  Does it sound like I am reciting a resume? Sometimes I feel that way in my interactions with the world.

I have been called “inspirational” and “courageous”.   I am not these things. I am just a woman who tries to live the best life I can.  I often raise the question: What is “it” that makes me inspirational or courageous?

I walk differently.

My movements are stiff.  My hips swivel.  My feet drag. Premature birth caused me to walk the way I do.  Spastic Cerebral Palsy (CP) is the diagnostic label and the cited reason for the way I walk.

Cerebral Palsy is also the force that shaped my attitude, drive, and approach for living my best life.  CP is just a fact of my life.  I had to learn to adapt.  Walking from one place to another, I am slower.  I exert more energy. Because I use support devices,  my hands are not free to carry groceries,  an umbrella, or even a purse. There are alternatives for all of these dilemmas.

I hire someone to assist me with groceries. I use a shoulder strap for carrying a purse. There is no easy answer for the umbrella other than I get wet because I am too stubborn to wear a hat.

People with any type of disability have to become proficient at adapting. Most are excellent planners and are masters of their time.  We give up time to move and function in the world.  What I describe here is not courage.  It is adapting to a circumstance that I do not control.

I have had to become a master at communicating- to relate, advocate, and educate the world. The primary message is always: I am just me.

CP does not define the core of who I am.  I may walk differently but there is nothing wrong with my brain.  The label of CP does not make me spectacular or comparable to an Olympic athlete.

Adapting is not done by choice.  The choices I make are around what kind of life do I wish to have?

I choose to embrace a life of possibility over limitation.

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