Talking With Your Older Patient: A Clinician's Handbook

Encouraging Wellness

People of all ages can benefit from healthy habits such as regular exercise and good nutrition.

"I'd like you to try this exercise routine. Just start low and go slow."

Mrs. Green is surprised when Dr. Lipton recommends that she exercise regularly. She responds with a list of excuses: exercise is for young people, it's not safe for people over 65, it takes too much time, exercise equipment costs too much. Dr. Lipton listens empathetically and then tells her that exercise and physical activity are good for people of all ages and that being sedentary is far more dangerous than exercising. He explains that Mrs. Green can "start low and go slow" by walking for 10 minutes at a time and building up to at least 30 minutes of physical activity on 5 days or more each week. At her next office visit, Mrs. Green says that she has more energy than she used to; in fact, she's ready to try a dance class at her senior center.

Exercise and Physical Activity

Exercise has proven benefits for older people. It reduces risk of cardiovascular disease, stroke, hypertension, type 2 diabetes, osteoporosis, obesity, colon cancer, and breast cancer. It also decreases the risk of falls and fall-related injuries.

Like the rest of us, older people may know that exercise is good for their health, but they may not have the motivation or encouragement to do it. You can guide your patients by asking about their daily activities and whether they engage in any kind of regular exercise or physical activity.

There are several ways to encourage older patients to exercise:

Whenever appropriate, let them know that regular physical activity—including endurance, muscle-strengthening, balance, and flexibility exercises—is essential for healthy aging.
Help patients set realistic goals and develop an exercise plan.
Write an exercise prescription, and make it specific, including type, frequency, intensity, and time; follow up to check progress and re-evaluate goals over time.
Refer patients to community resources, such as mall-walking groups and senior center fitness classes.
Tell them about Go4Life^TM, NIA's exercise and physical activity campaign. It has exercises, motivational tips, and free materials to help older adults start exercising and keep going. Check out www.nia.nih.gov/Go4Life.

Too Old to Exercise? Studies Say ‘No!'

Together, exercise and lifestyle changes such as becoming more active and healthy eating reduce the risk of diabetes in high-risk older people. In one study, lifestyle changes led to a 71 percent decrease in diabetes among people 60 and older.
In another study, moderate exercise was effective at reducing stress and sleep problems in older women caring for a family member with dementia.
Older people who exercise moderately are able to fall asleep quickly, sleep for longer periods, and get better quality of sleep.
Researchers also found that exercise, which can improve balance, reduced falls among older people by 33 percent.
Walking and strength-building exercises by people with knee osteoarthritis help reduce pain and maintain function and quality of life.

For more information on exercise, nutrition, and older people, contact:

Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, Georgia 30333
1-800-232-4636 (toll-free)
1-800-232-6348 (TTY/toll-free)
www.cdc.gov/aging
Nutrition, Physical Activity, and Obesity: www.cdc.gov/nccdphp/dnpao
Healthy Aging: http://www.cdc.gov/aging/index.htm.

The CDC has resources on nutrition and physical activity for older adults. The Division of Nutrition, Physical Activity, and Obesity addresses how healthy eating habits and exercise can improve the public's health and prevent and control chronic diseases.

Department of Agriculture
Food and Nutrition Information Center (FNIC)
National Agricultural Library
10301 Baltimore Avenue, Room 105
Beltsville, MD 20705
1-301-504-5414
www.nal.usda.gov/fnic

The FNIC website provides over 2,000 links to current and reliable nutrition resources.

National Institute on Aging (NIA)
Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225 (toll-free)
1-800-222-4225 (TTY/toll-free)
www.nia.nih.gov
www.nia.nih.gov/Go4Life

NIA has free online and print materials to show older adults how to start and maintain a safe, effective program of endurance, flexibility, balance, and strength-training exercises and to make smart food choices for healthy aging.

National Resource Center on Nutrition, Physical Activity & Aging
Florida International University
OE 200
Miami, FL 33199
1-305-348-1517
http://nutritionandaging.fiu.edu

A group serving nutrition programs funded by the Older Americans Act, the Center aims to increase food and nutrition services in home- and community-based social, health, and long-term-care systems serving older adults. Link to the program "Eat Better & Move More."

Nutrition

Older patients may develop poor eating habits for many reasons. These can range from a decreased sense of smell and taste to teeth problems or depression. Older people may also have difficulty getting to a supermarket or standing long enough to cook a meal. And although energy needs may decrease with age, the need for certain vitamins and minerals, including calcium, vitamin D, and vitamins B₆ and B₁₂, increases after age 50.

Try these strategies to encourage healthy diets:

Emphasize that good nutrition can have an impact on well-being and independence.
If needed, suggest liquid nutrition supplements, but emphasize the benefits of solid foods.
If needed, suggest multivitamins that fulfill 100 percent of the recommended daily amounts of vitamins and minerals for older people, but not megadoses.
Offer a referral to a nutrition services program, such as Meals on Wheels. Programs in your area are provided by the local Area Agency on Aging or Tribal Senior Services. Contact Eldercare Locator at 1-800-677-1116 for your Area Agency on Aging.

In Summary

Talk to your older patients about the importance of exercise and physical activity. Staying active can benefit older people in many ways.
Encourage your patients to get a free copy of Exercise and Physical Activity: Your Everyday Guide from the National Institute on Aging.
Talk to your older patients about their eating habits.
Consider having your older patients keep a food diary, if necessary, to make sure they are getting the correct nutrients.

Publication Date: October 2008
Page Last Updated: June 26, 2013