Many people continue to view increasing age in correlation with decreased activity, falls, and frailty. Older adults are typically regarded as “homebound”, often spending a significant amount of time in their home or at a facility likely participating in quiet, independent tasks. The stereotypes exist. But guess what? There’s a paradigm shift happening. We must work to put these stereotypes to rest– to prove this is not what aging should look like.
We all know, maintaining independence with mobility is one of the key components contributing to longevity. But just how important is it? A study done by Jacobs et al. (2018) found that in in over 3,000 community-dwelling elderly adults aged 70 to 90, leaving the house daily was associated with lower mortality risk, independent of social, functional, or medical status. It was concluded that even at advanced ages, the frequency one intentionally leaves the house continues to predict SURVIVAL. A majority of the subjects were able walk independently or required an assistive device but there were a few subjects who were unable to walk, and positive benefits remained significant despite mobility limitations! Remaining homebound or leaving the house with a frequency of 1 time/week has been found to be correlated with increased social vulnerability, medical comorbidities, and higher rates of hospitalization. Promoting regular community engagement outside of the home is fundamental sustaining optimal health and well-being.
How do we help make it easier for the aging population to remain active outside the home? Social support and accessibility are important determinants of feasibility in leaving the house. With social encouragement to participate in community activities and ease of access, people are more likely to interact. It is also well documented that physical activity has a significantly positive effect on health measures and survival of older people, including the oldest old. Physical activity can help keep older adults on their feet and improve ability to move freely in and out of the house. Healthcare professionals can assist with exercise program creation and implementation as well as education regarding strategies to improve ease of community ambulation including training with appropriate assistive device, minimizing fall risk, and energy conservation strategies. Sedentary lifestyles can be extremely limiting accompanied by decreasing strength, balance, and activity tolerance that could vastly restrict one’s frequency of community interaction.
As clinicians, it is our job to help older adults see the possibilities, to show them they are capable of continuing to live an extraordinary life. Questioning their involvement in the community and frequency of participation in activities outside the home can be used as a clinical measure of risk and indicate a need for intervention and encouragement of community engagement. Whether someone needs resources regarding ideas for activities within the community, mobility training, or education, we are on the frontline to keep our patients up and active. It’s time to step up to the plate. We ARE able to make a difference.
References: Jacobs JM, Hammerman-Rozenberg A, Stessman J. Frequency of leaving the house and mortality from age 70 to 95. J Am Geriatr Soc. 2018;66:106-112.