NOTE #1 about This Sample: This paper uses APA style
for page numbers, with dates added, and the "References" bibliography at the end
also is in APA style.
NOTE #2 about This Sample: This is a magazine article
written as a research paper. An informal magazine article--as found in
magazines, trade publications, and newsletters--often will not have quotations
or paraphrases in it. If it does, it will briefly refer to the author and
title in the text of the article itself, without a separate bibliography.
(However, articles like this one written for more formal publications will have
quotations and paraphrases that are formally added, with a formal bibliography
at the end.)
Nicki L. Cook
EngC 3033-03 Jewell
D-III: Patient Care
The Benefits of an Exercise Program
in Nursing Homes
by
Nicki L. Cook
In the following diary entry, 84-year-old Anna Mae Halgrim Seaver (1997)
expresses a disturbing sentiment that is common among residents in today's
nursing homes:
I
don't much like some of the physical things that happen to us.
I don't care much for a diaper. I
seem to have lost the control acquired so diligently as a child ... Did
you ever sit in a wheelchair over an extended period of time? ... The seat
squeezes you into the middle and applies constant pressure to your hips ...
Most of the residents are in wheelchairs ... Captive prisoners of daytime
television; soap operas, talk shows and commercials (p. 11).
Seaver's
diary entry indicates that nursing homes are filled with physically unmotivated
and lonely individuals. A solution
that can improve the quality of life for the residents is for nursing homes to
set up an exercise class for those who are able to participate. The benefits of a regular exercise program include a more
physically fit group of individuals with more independence, the promotion of
positive interpersonal relationships among the residents, and finally, the
reduction of stress and anxiety levels.
Physical Fitness and Exercise
The primary reason why America's nursing homes must incorporate an
exercise regimen into the residents' lives is because it serves to increase
their physical fitness levels. In
fact, numerous studies have proven that regular exercise contributes to an
increase in energy and stamina, regardless of whether one is young or old.
Moreover, Applegate and Pahor (1997), researchers at the University of
Tennessee, stated the following regarding exercise among the elderly:
"Exercise programs do not need to be elaborate to have health effects....
Tai chi (Chinese shadow boxing) in the home probably improves balance, reduces
the risk of falls, and may improve strength" (p. 1863).
Likewise, another fitness study by Buckwalter and DiNubile (1997) focused
on the role that exercise played in the lives of debilitated nursing home
residents. These individuals were
exposed to eight weeks of exercise. Their
results indicated that "significant functional improvements accompanied the
strength and muscle mass gains” (p. 131).
These "functional improvements" refer to the independence that
is gained as a result of increased strength.
That is, the increased muscle strength enabled these people to rely more
upon themselves for their various needs. Therefore, they wouldn't be as
dependent on the nurses for assistance.
The story of Anna Kelly, a woman in her eighties, demonstrates the
independence she reclaimed as a result of her physical efforts.
Before the yoga class was introduced at her nursing home six months ago,
Ms. Kelly was very thin and frail. She
often complained of having no physical energy.
Ms. Kelly was dependent upon nurses for the majority of her needs. For instance, she needed help wheeling herself around,
eating, getting dressed, and bathing. However,
as a result of her weekly yoga class, Ms. Kelly is reaping the benefits of
increased strength and flexibility in her arm and shoulder muscles.
She now has the ability to dress herself from the waist up.
Ms. Kelly can also feed herself Moreover, she can wheel herself to the
cafeteria, to the craft room, or simply take a leisurely stroll outside in her
wheelchair. Not only can she engage
in her favorite hobbles again, but also she has the strength to do them for
longer periods of time without becoming fatigued as easily.
Research conducted by Mary Marmoll Jirovec, Ph.D., illustrates another
form of independence that many seniors often exhibit as a result of increased
physical activity. Her studies
focused on a possible relationship between seniors who exercise and a decrease
in their urinary incontinence, or the inability to control the bladder.
Dr. Jirovec (1991) has concluded that "the incidence of urinary
incontinence within this sample of nursing home residents was decreased after
the exercise regimen. Apparently, urinary incontinence in nursing homes is ...
related to the atrophy of mobility skills such as walking that often develops
within institutionalized settings" (p. 149).
Promotion of
Positive Interpersonal Relationships
In addition to improving residents' physical fitness levels and
increasing their independence, the institution of an exercise program also
serves to promote positive relations among the residents.
For example, Ruuskanen and Parkatti (1994) researched many of the factors
that are linked with exercise. They
concluded that "physical activity ... increases the possibilities for a
more varied and stimulating social life" (p. 990).
Furthermore, in Dr. Jirovec's "Literature Review," she states
that the researchers of another exercise experiment "reported some
improvement in residents' social behavior" (p. 146).
Clearly, the social atmosphere in many nursing homes is an area that is
in need of
great improvement. That is, it is not uncommon to find residents who stay in
their rooms the entire day. Some
spend this time sleeping. Others,
as Seaver stated earlier, stare at a television screen all day long. Unfortunately, these withdrawn behaviors often lead to
loneliness and depression.
Therefore, a regular exercise program would serve as an activity that
would encourage many of these elderly people to come out of their secluded rooms
and into a positive atmosphere that would serve to improve the camaraderie among
the residents. Likewise, to encourage further socialization, each person
could be paired up with another individual for the class. This allows the pair to practice the routine together and
help each other with the various stretches.
It also allows them to motivate each other. More importantly, it provides them with an opportunity to
make friends with those they had once considered strangers.
The following is an example of a man whose social life dramatically
improved after deciding to join his nursing home's Tai Chi class.
Bill was placed under the care
of the Prairie View Nursing Home by his children several years ago. During his first two months at Prairie View, he did not
associate with any of his peers. When
his son came to visit, he discovered that his father was becoming very
antisocial and quite unhappy. The
son suggested that he become an active member of Prairie View's Tai Chi class.
After attending only one session, Bill made several new friends. Now he
and his friends get together outside of the class.
They play poker and chess. The
friends also requested that their dining room seating arrangements be reassigned
so that they can sit together.
Reduction
of Stress and Anxiety
Finally, a third benefit of instituting an exercise program in nursing
homes is that it would help reduce the stress and anxiety levels of the
participants. It is important to realize that although it may not seem as
though retired individuals have stressful issues to deal with, most elderly
people living in nursing homes would disagree.
For instance, in her diary, Anna Mae Halgrim Seaver (1997) commented
further about her dismal life in the nursing home.
"The afternoon drags into early
evening. This used to be my
favorite time of the day.... Pop open a bottle of Chablis and enjoy the fruits
of my day's labor with my husband. He's gone. So is my health. This is my world" (p. 11).
This excerpt mentions a few common causes of anxiety among the elderly.
These include boredom, the loss of a spouse, and deteriorating health.
Another cause of anxiety is the fact that these individuals often live
far away from their loved ones. What
can worsen this situation, however, is when a person's family does live close
by, but never comes to visit.
Similarly, adjusting to life in a new environment that does not allow for
the freedom they once had can also be very difficult.
Ruuskanen and Parkatti's (1994) research in nursing homes has led them to
believe that "depression is often attributable to these life changes"
(p. 990).
Another source of anxiety and depression among seniors is the poor
self-image that often develops with age. That
is, as people age, they often become discouraged as their bodies become weaker
and more fragile. The activities
that were once easy for them to engage in suddenly become very strenuous and
difficult. This leads to
frustration. However, 83-year-old Edith Mucke, an avid walker, discovered that
exercise has simplified many of the tasks in her life.
"She finds that the vacuum cleaner isn't as heavy to push. Doors
open more easily." Her ability
to do many of these tasks again has improved her self-confidence (Meier, 1997,
p. E2).
Therefore, given that physical activity is highly beneficial in the
prevention and treatment of anxiety and even depression among the nursing home
patients, an exercise program is essential
to the maintenance of their well being.
Ruuskanen and Parkatti (1994) have also stated the following: “A trend
was found for a positive association between contentment with life in the
nursing home or meaningfulness of life and a physically active lifestyle"
(p. 989). Therefore, it is clear
that a fitness program would not only help the elderly cope with various forms
of stress, but also help them rediscover that they still have a lot to live for.
Conclusion
As a final thought, we should be aware that there is a great need for
America's nursing homes to institute a fitness program for its residents.
Research has demonstrated that elderly residents suffer from lethargy,
isolation, and stress. While many
claim that it is too costly to introduce an exercise program in all nursing
homes, it is important to consider how we can afford not to help them.
The story of Allen Peters reinforces the fact that American nursing homes
must take more responsibility for prioritizing their residents' needs.
Allen Peters used to jog every day.
Peters said that exercise kept his mind and body fit.
When his wife died, he moved into a nursing home.
His state of mind became melancholy.
His body grew decrepit and weak. Finally,
he decided that in order to end this dismal period of his life, he would begin
exercising again. Each morning he
begged the nurses to take him outside for a walk.
However, they claimed they were too busy.
It is unfortunate that this simple request was not acknowledged.
This intensified his depression until he finally gave up.
Residents such as Mr. Peters are becoming physically unmotivated and
unhappy. Therefore, they deserve
this opportunity to live a full life to the end.
-----.
References
Applegate, W.
B., & Pahor, Marco. (1997).
Geriatric medicine. Journal
of the American
Medical Association, 277, 1863-1864.
Buckwalter, J. A., & DiNubile, A.
T. (1997, September). Decreased
mobility in the elderly. The
Physician and Sports Medicine, 127-133.
Jirovec, M.
(1991). The impact of daily
exercise on the mobility, balance and urine control of
cognitively impaired nursing home residents. International
Journal of Nursing Studies, 28.
(
145-151.)
Meier,
P. (1997, February 3). Pumping a
little iron. Star Tribune, pp.
E1, E2.
Ruuskanen, J.
M., & Parkatti, T. (1994). Physical
activity and related factors among nursing
home residents.
Journal of
American Geriatrics Society,
42, 987-991.
Seaver, A.
(1997, June 27). My world now.
Newsweek, 127, 11.
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