Koltyn first did a pilot study in Texas using hand and ankle weights with the elderly. Among those who did the exercises, she found a significant increase in physical functioning and a decrease in pain in the course of doing daily activities. She then decided to look more closely at what was available to people in long-term care facilities and how much they actually participate in those programs — an effort she hopes will lead to more funding and maintenance of programs for older adults.

For many elderly, the issue of physical activity comes up in the course of rehabilitation after a fall or other disabling experience. Once the rehab stops, so does the opportunity or encouragement for regular movement.

“There’s this belief that physical activity is very important in rehabilitation, but then there’s a lack of follow-up,” Koltyn said. “I think we know activity is beneficial, but I don’t think the message that you need to continue it has been embraced yet.”

It’s not only a question of weight or exercise training, but of how much people do for themselves in the course of a day. Koltyn said her questions include: Do people walk? How much do they stay in bed? Do they dress themselves? Do they go to a common eating area or are they served in bed?

“I think we take for granted a lot of the small physical activities that we do day-to-day,” she said. “But they become very, very important when you see what happens to individuals when they do not do them on a daily basis.”

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Getting Over Your Fears
Michael Suydam, a physical therapist in practice in Merrick, N.Y., said one of his goals is to educate families as much as possible about what a patient is able to do and how. “When you have family support, it’s wonderful,” he said, “A person makes out much better.”

As a caring relative or friend, one of the hardest parts may be learning to get over your own fears. Suydam says he was working with an elderly woman recently after she fell. She had osteoporosis and suffered a compression fracture in her back and was in pain. For six weeks after the fall, she stayed in bed or in a wheelchair.

In her sessions with him, he encouraged the woman to be active. But he said her husband was very afraid, thinking she would fall again. However, keeping her inactive, he said, “is actually a disservice. You want to encourage her, let her roll onto her side and back, go from a lying down position to a sitting position. In those movements, she’s using arm muscles, hip muscles, leg muscles. Exercises and activities as simple as those help retard osteoporosis, increase circulation and increase energy level.”

At first, as Suydam worked with the woman, he said, “her husband probably thought I was being mean to her.” But as she got stronger and was able to first sit up by herself, then walk, he said her husband’s disbelief turned to a realization that she could indeed resume activity.

When it comes to caring for an elderly person, “you don’t want them to lay there vegetating,” Suydam said. For example, they can be helped by arm swings, leg exercises, light weights, knee strengthening and coordination activities.

“The effect of laying around for six weeks for an elderly person?” Suydam said. “It is like laying around for three years for you and me. The deconditioning that takes place is exponential.”

Instead, he encourages relatives to get instructions from a physical therapist, nurse or other knowledgeable healthcare person on just what an older person’s limitations are and how you can help them move.

Whatever energy you may expend in learning, “it’s worth it,” he said. “It’s very rewarding to help a person become as independent as possible.”