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Promotion of physical activity.

In this instalment of the Evidence Hub, we research the facilitators and barriers experienced by healthcare personnel in the context of reablement and physical activity.

Introductory points

This article presents:

  • “Being physically active is important for maintaining function and independence in older age”.
  • Healthcare professionals (occupational therapists, physiotherapists, registered nurses and home care workers) identify facilitators and barriers to engaging reablement clients in physical activity.
  • Data is interpreted at the following levels: Individual (client), Professional, Organisational, System.
  • Individual practitioners, teams and organisations can compare these findings with their experiences to identify existing strengths and opportunities for improvement in reablement practice.

If you would like to review the full article, you can do so by clicking this link: Promotion of physical activity in older adults .

Relevance to Australian context

The study was undertaken in a Norwegian setting. However, the contextual factors are applicable to the Australian aged care service environment.

Key concepts

Physical activity is “…any bodily movement produced by skeletal muscles that requires energy expenditure”.

Therefore, physical activity is not limited to exercise programmes, but includes everyday activities in the home and community.

Strategies that promote physical activity need to:

  • Reach the people who need them.
  • Be effective in the short and long term.
  • Be meaningful to the individual.

Participant goals: facilitators and barriers

Professional level: facilitators and barriers

Organisational level: facilitators and barriers

System level: facilitators and barriers

Reflective questions

The following series of questions is prompted by the research. They can help identify both achievements and opportunities for improvement in wellness and reablement practice. Using these questions to inform work practices and policies can demonstrate evidence-based practice and supports compliance with aged care quality standards.

There is a lot to consider from this research. Don’t try to tackle it all at once! Use the question bank as a checklist, ticking the items your organisation is doing well and noting the items that represent opportunities for improvement.

You could discuss/review selected questions to:

  • The Board
  • Your Consumer Advisory Body
  • Management meetings
  • Clinical Team meetings
  • Staff development sessions
  • Individual staff members

Client considerations

  • Does our assessment process explore the client’s previous activity history (including self-care, work, housework, volunteering, leisure, community and social participation)?
  • Do we explore what activities will enhance a client’s quality of life?
  • Do we share evidence-based ageing science with clients? This can promote understanding of how physical activity impacts independence and wellbeing, improving motivation.
  • Are our team skilled at developing meaningful SMART goals in collaboration with our clients? Consider a documentation audit.
  • Do we effectively identify and explore (including making referrals) the functional impact of medical conditions, falls, pain and cognitive impairment?
  • Do we have strategies to identify if anxiety/fear of falling is a barrier to physical activity? (Note: A sensitive approach is important to avoid escalation of anxiety and fear)
  • Do we engage family and support networks in promotion of reablement, including sharing ageing science?
  • Do we look for “just right challenges” in the client’s home? (not eliminating all physical challenges, but still promoting accessibility)

Professional considerations

  • Does every member of our team have strong knowledge of reablement principles?
  • Do we promote physical activity through exercises and daily activities?
  • Do we deliver evidence-based exercise programmes?
  • Do we have evidence that we customise exercise programmes sufficiently for individual needs?
  • Are clients provided with easy-to-follow exercise instructions, accommodating sensory (e.g., visual) and cognitive needs?
  • Are we good at communicating client progress and changes with all members of the team?
  • Does our team have a clearly identified and uniting reablement philosophy?
  • How do we identify staff who need additional training in reablement?
  • What reablement training opportunities are available to our team?
  • How do we help staff (aged care support workers) have successful experiences in promoting reablement through physical activity? (e.g., mentoring, shadowing an allied health professional etc.)

Organisational considerations

  • Does our organisation have a clear vision for what reablement means and looks like?
  • How do we promote reablement referral for people with early signs of functional decline (e.g., needing help for shopping or housework)?
  • Is reablement integrated at all levels of support at home (not just CHSP)? Are reablement principles promoted to all staff?
  • What strategies can we implement to develop reablement competencies? What resources are available to us?
  • Have we identified the most effective communication strategies for our team? (including in-person, written, verbal, electronic, etc)
  • Do we use the LifeCurve™ to help spot early signs of decline, like needing help with shopping or heavy housework?

System considerations

  • Do we identify opportunities for clients to continue being physically active in the community post-reablement This does not just mean exercises; it includes any meaningful activity that promotes physical activity.
  • Do we introduce community-based activities before (preferably) or immediately after the reablement period?
  • Do we promote reablement principles in the wider community (e.g., with GPs and other health service providers)?

Here are some ideas that may help your organisation address some of the identified issues

Staff development opportunities: reablement

  • Keep Able is a wellness and reablement hub that offers a range of information and staff development opportunities. All resources are free and include downloadable/printables, e-learning, PowerPoint presentations, podcasts, videos and an evidence hub. Keep Able can also develop resources in response to provider needs. You can explore our website or contact us for detailed information about our full suite of offerings.

Understanding and sharing ageing science to motivate staff and clients

  • If you want to share accessible ageing science with your team and clients, consider exploring the LifeCurve™ content available at KeepAble. Understanding LifeCurve™ can help:
    • Promote early referral (hence improving reablement potential).
    • Enhance client motivation by helping them understand how they can take control of their ageing journey.
    • Staff promote active ageing within their team and with their clients.

Promoting the importance of everyday activities in reablement

  • “Everything you do for me, you take from me”: eLearning and Bitesize resources for staff education. Look out for additional downloadable/printable resources for staff and clients. Coming soon!

Evidence-based exercise programmes and falls prevention

Identifying opportunities in the community for continuing physical activity after reablement

  • LiveUp – An online resource that can be accessed by older adults, families or healthcare providers. You can search online liveup.org.au or call 1800 951 971 to find low-cost community activities for clients anywhere in Australia.