In Physical Activity and Aging, it is mentioned that there physical activity impacts people’s mental health as well as their physical health by making people feel that they are in charge of their health as well as for other reasons. It seems as though physical activity also allows people a reason or motivation to socialize, to meet new people, and to get out of the house to walk or go to the gym, whereas people who do not engage in physical activity may be more likely to be home-bound or less likely to have opportunities to engage with others. In what ways may design help to promote some of these other benefits of physical activity that promote mental as well as physical health?
Throughout the readings, I got the impression that the information presented in the articles could seem quite daunting, and that an older person looking to do something to promote their health may be overwhelmed by the recommendations for physical activity as documented in the research. For example, it was reported from the Nurses Health Study that 1 hour of walking per day reduced the risk of obesity and diabetes. Yet one hour of walking seems like a lot for people who are not yet active or who are not currently meeting the guidelines for physical activity. In what ways can these guidelines seem more doable or manageable? How might they be reframed in such a way to increase self efficacy for exercise?
The idea that you’re only as old as you think you are is a powerful one and it strongly relates to last week’s discussion on ageism. This statement made me think: how can we get young people to be forward thinking so that they are encouraged to engage in physical activity and other healthy behaviors so that they can think and feel young in their older age? I would also assume that you’re only as old as you feel you are also holds true. Again, how can we encourage people to engage in behaviors that make them feel young when they’re still young? Because youth is often tied to health in our society, it seems in some ways like a self-fulfilling prophecy in that people who think they’re young will be healthier and will do things to promote health while those people who think of themselves as their current age or older will engage in less healthy behaviors and will experience a decline in health. How might design help people to change their thinking about their age by promoting activity/mobility or by helping people to reject ageist notions?
The Mobility reading makes the point that if you believe the comments about being old and getting frail, you’re likely to develop behaviors that essentially reinforce this idea. So, for instance, if you develop a problem with your hip, knee, or foot that makes having a walker or cane useful, does the sheer act of using it reinforce your own mental image of yourself as more frail? How likely is using a walker or cane to change the way your friends see you? Further, does using a walker or cane make you less likely to engage in the kinds of exercise that might make a walker or cane unnecessary?
Getting in and out of the bathtub is one activity where many seniors are somewhat fearful because of the wet and slippery surfaces and the fact that some of the movement has to be one-footed. Despite the fact that grab bars, tub (and shower) transfer benches, and other transfer aids have been around a long time, many seniors are reluctant to install them in their own homes for fear of being thought “frail” or “less able.” How could you change this mind-set?
Having to give up the car keys represents a major loss of independence for most seniors and it can lead directly to less physical exercise and many other behavioral changes. What elements would you include in a program designed to help seniors make the transition from driving to non-driving without falling into the non-exercise trap? Assume the target senior lives independently in his/her own home and doesn’t want to move elsewhere.
1. Despite being confirmed many times over, all the research in the world regarding active aging and its positive health effects cannot convince a large number of elderly people in my community to exercise or be active in any form. They don't their lives to be anything like that of the 71-year-old long-distance runner; they just want to read and relax all the time. Experiences like these make me wonder: Is the idea that elderly people want to stay young a misperception in some cases? In cultures in which elderly people feel they have "paid their dues" in their youth, is there a better way to advocate good exercise and health habits?
2.Repeating exercises 15 times or lifting weights might seem very tedious to some. What are some creative ways to give the elderly the same physiological benefits but without boring them or making them feel like they're doing a chore? How might we roll exercising and, say, spending time with grandchildren into one fun event? e.g. lifting a baby up and down or swinging a toddler for fun.
3. The correlation between lack of physical activity in youth and increased risk of disease in old age to be quite scary; it especially hits the mark for someone who has just entered her 20s. Is there a good way to highlight this correlation in order to make the youth more active? Why is it that so many young people are so afraid of thinking about old age? How might we bridge the generational gap to put the young and the old on the same life page? Would a stronger awareness of the connection between the two stages of life help to eradicate the negative stereotypes/comments about older people that become a self-fulfilling prophecy in old age?
1. (Based on “Old But Not Frail”) How could the “vicious cycle” of frailty be effectively interrupted? Which factors seem most important for intervention?
2. There appears to be a generally negative and fear-inducing rhetoric surrounding aging, even in scientific papers such as Stewart’s “Physical Activity and Aging”. She reports that after the mid-twenties, things go “generally downhill for most physical and cognitive functions”(2). Doesn’t it seem logical that a more positive approach to aging should stem first and foremost from the scientific world?
Based on the last question, how can the medical world incorporate the physical challenges associated with aging into a constructive approach to aging?
-Where in the home do most falls occur e.g. on stairs, in bathrooms, or in normal walking spaces. If they occur mostly in bathrooms and on stairs, is there research to show that altering the environment somehow (e.g. design) can dramatically reduce the probability of falling?
-In the first class during the exercise I said it was hard for me to imagine myself as being very stooped and frail when old, and I was chastised about that in a friendly way. According to the Old but not frail article, research shows that “people who had more positive views about aging were healthier over time.” If this is the case, then it seems that my initial thoughts were beneficial to my long-term health.
-The physical activity and aging article references standard muscle mass declines with age starting in the mid-20s. Is this an average for all Americans (e.g. some don’t exercise and lose muscle mass, some do and do not) or typical for individuals? It seems to me that will enough strength exercise, one should be able to build muscle despite their age.
For elderly people, exercise is very often important, but how can we help them overcome mental barriers that cause them to think that they are not capable or too tired to do any physical activities?
Most people know that it's a viscous cycle when elderly people feel tired easily and has less strength, which then cause them to be less active, and this eventually resulted in them being even weaker. How could we stop this cycle? We can't force the elderly people to do exercise even when they are tired.
I know the importance of exercise for the elderly people, and I have elderly grandparents at home too. But people in my family often asks whether we should try to get my grandfather to do more exercise and to restrict him to a healthier diet, or should we just let him do what he enjoys doing and to enjoy life?
1. Abby talked to us about the success of "stealth interventions" when it comes to getting people to exercise. It strikes me that such interventions for kids is more obvious than for older adults: start a soccer game, a relay race or even an enthusiastic game of tag and kids are happy. Older people need forms of physical activity that are more considerate of the more strength training as the age and exercise that is more considerate of changes that accompany aging: increased fatigability, muscle weakness, decreased endurance capacity and muscle wasting (Figure 1, Physical Activity and Aging). They also need more strength training and warm-up/cool-down time. How do we design stealth interventions that accommodate these exercise needs of people as they grow old?
2. I have been working for a doctor of adolescent medicine who specializes in eating disorders across the weight spectrum, from severely underweight patients to morbidly obese patients. The question of how to promote a healthy body image often comes up at our lab meetings; it's a hard question to answer, and one that I think has many ties to promoting messages of anti-ageism. Recently Nike started a controversial campaign to embrace different body types. The ads featured close up photos and declarations like "I have thunder thighs" or "My butt is big... and that's just fine..." How do these messages work against the purpose they were perhaps meant to serve? How might we design an anti-ageism campaign that is more sensitive, more effective?
3. The story of Mr. W in SF (Luggen, Hill: Mobility) makes me wonder how we can balance the messages: take precautions so you don't fall and by all means keep moving!! Is there something we can design that bridges that gap (i.e. decreases risk of falling AND encourages physical activity)?
1 - If losing mobility threatens self esteem, to what extent is the
incorporation of positive reinforcement in exercise routines being
studied (do people in group exercise classes with upbeat music do better
than people who exercise alone?)
2 - Families can do a lot to encourage exercise and notice the onset of
frailty. Given the important role families could play, why are they
(we) so under-educated about aging versus child rearing?
3 - How do exercise and perceptions about exercise change once someone
starts using a walking aid?
1. (Stewart and Kolata) Running can help older people (and younger people) stay in shape, but as frailty increases after age 80, does the impact of running outweigh the benefits? Would cycling or swimming work better?
2. (Kolata) When dealing with negative stereotypes of older people, does humor make a difference? I.e., stereotypes put bluntly versus the teasing humor seen in cards. (One person quoted in the story hates the cards.)
3. (Luggen & Hill) Women are more likely than men to have falls. Is this because the men who have survived this long are in better average shape, because women are more likely to live alone, or are there other factors?
1.) Physical Activity and Aging KERRY J. STEWART
Kerry reports that Alzheimer?s patients that received care with exercise were better off physically after 2 years. Did this treatment also help with their cognitive disabilities? Could exercise be used as a preventative measure for Alzheimer?s disease?
2.) Mobility , Ann Schmidt Luggen
It is said that the problems exercise affect are the ones that can cause the individual to avoid exercising. What is the best way to convince somebody that the benefits of exercise can outweigh the risks? The tips to promote activity simply list preparation and simple things like maintaining good posture. How can the ?activation energy? be provided to see more vigorous activities happen?
3.) Old but Not Frail: A Matter of Heart and Head , GINA KOLATA
Gina writes that frailty may be brought on in seemingly healthy individuals by cardiovascular disease that may prevent blood flow from reaching parts of the body necessary for mobility. While exercise may help prevent this from happening is there anything that can be done after the fact?
The guide from the National Institute on Aging seems aimed at an audience who has NEVER done any exercise. For how many older people is this the first time they are exercising in their life?
The story of Mr. W who lived in San Francisco's Chinatown points to the importance of how issues are discussed with patients. How can physicians be more careful when speaking to patients about fall risks? What type of a dialogue or discourse should be had to send the message that exercise is essential for older people?
What is the best way to convince patients that increasing their exercise will increase their quality of life and decrease the likelihood of disease? Scientific data? Pleading? Prescriptions-for-exercise?
One of the articles mentioned the power of positive thinking. How do you think we as a society can improve our perception of aging and older people? Should the media play a big role in this quest?
The same can be said of stereotypes of aging and older people, how do you think we can make them more positive? What are positive stereotypes that you have come across? What cultures do you think have a positive view/perception of aging?
1.) What is it about exercise that is beneficial for aging adults in particular? More specifically, what kinds of exercise are most beneficial? How should older adults exercise and how often should adults exercise? When is exercise not a good idea? What studies in the Stewart paper substantiate this? (Stewart/Exercise Guide papers).
2.) What diseases afflict older adults that specifically affect movement and functional capacities? What is the leading cause of accidental death in men/women over 65, and what factors contribute to this cause? How can these concerns be addressed so that older adults have less fear of this happening to them, and how does this fear affect mobility? How can design address these issues? (Luggen paper)
3.) Looking at the design of assistive devices on the last page of the Luggen paper, what are the pros and cons of each device in terms of helping older adults walk? What does each design specifically address?
do any services exist to help the aging who have lost their drivers license?
what products exist to automatically detect if someone has fallen?
what products / services exist to help manage the fear of falling?
1. In all of these readings there is clear evidence that exercise, really in any form, greatly improves quality of life and life span. What are some influences that could positively affect the amount of exercise people get as they age, aside from scientific articles saying "it's good for you?" A couple examples from the articles: positive verbal reinforcement, design of environment, active activities with family and friends...
2. It seems that in the studies described the participants had chronic diseases that would require continued interaction with medical staff or medical devices. What is it about the current industry/ system of health care that medical professionals are able to get their patients to come to complicated procedures (say dialysis) and to take complicated pill regimes, but they can't convince (or don't convince) their patients to get more exercise. Is it something inherent in the individual or is it a problem with the system?
3. There seems to be a wealth of very precise, scientific medical information relating to everything about the body and aging. For example Luggin's article "Mobility" tells exactly why people fall, how people are injured when they fall, and what the factors contribute to their injuries. The information is quite technical and feels very sterile. How can this very technical information be conveyed to people in a way that's more human and not so sterile?