Overview

Impact Feature Issue on Social Inclusion Through Recreation for Persons with Disabilities

Aging with Developmental Disabilities:
Meeting Social and Recreation Needs

Author(s)

Erin Simunds is a Physical Therapist with Courage St. Croix, Stillwater, Minnesota

Sonja McGill is a Physical Therapist with Courage St. Croix, Stillwater, Minnesota

Alice, Gerrie and Linda are three middle-aged friends with developmental disabilities who have known each other since childhood, when they lived together in foster care. Today, they share an apartment, and are often looking for places and activities where they can all go to have fun. Participation in regular exercise has afforded them the opportunity not only to spend time together working out at a local wellness center, but also to stay fit enough to enjoy a variety of activities together and with their other friends.

Supporting Lifelong Wellness

In 2001, Courage St. Croix, a rehabilitation center in Stillwater, Minnesota, that is part of Courage Center, began taking steps to design a wellness center that would allow people with disabilities the opportunity to exercise regularly. The center’s staff asked individuals with disabilities who were currently using Courage services to define barriers for exercise and identify the components of a wellness center that would help them sustain an ongoing program of exercise. Input from focus groups produced a list of common barriers to lifelong exercise for persons with disabilities:

  • Fear of injury or re-injury.
  • Presence of pain.
  • Reduced level of energy.
  • Lack of transportation.
  • The intimidating atmosphere of most exercise clubs.
  • Lack of staff knowledge on how to tailor exercise with respect to disabilities.
  • Inaccessible equipment (e.g., lowest weight is too high, difficult transfers).
  • Lack of support for participation (e.g., training, dressing assist).

Respondents also indicated that a variety of program options needed to be offered including independent exercise, group activities, fitness assistance, and personal training. This list became the guiding principles for designing a wellness center that would meet the needs of people with disabilities.

A pilot project, supported by the Bayport Foundation, began at Courage St. Croix in May of 2001 to develop a wellness center. Center programming included accessible weight machines, stationary aerobic equipment, a circuit training class, and a fitness assistant class for persons who have experienced a stroke. Evaluation of the project showed that participants experienced an improvement in their physical abilities as well as gains toward achieving their personal fitness and recreation goals. Information on this pilot project found its way to the doorstep of Alice, Gerrie, and Linda, who were interested in getting into shape for personal reasons. Alice wanted to go on a vacation with Search Beyond Adventures, a company that provides escorted vacations for travelers with disabilities but felt as if she did not have enough energy or endurance to walk around sightseeing. Gerrie had difficulty keeping up with Linda and Alice when they walked together in the community and wanted to improve in that area. And Linda wanted to have the stamina to visit friends in various settings around the community.

The three began working out together at the wellness center twice a week in the summer of 2001. They participated in open gym where they used weight machines and stationary aerobic equipment that specifically fit their needs and goals. Within a few months, they saw improvements in their physical condition, and this led to a greater ability to participate in social activities with friends. For instance, last year Alice was able to take a vacation to San Francisco and walk up and down the hills sight-seeing with the group without any difficulty. Gerrie has found that working out on the treadmill has allowed her to walk faster and keep up with Linda and Alice when they walk around the community. And Linda has been able to visit a friend with a broken leg in a local nursing home located on a steep hill – parking the car and walking up the hill to visit without even thinking twice about it.

Aging, Disability, and Exercise

Anyone who watches television, reads magazines, or listens to the radio for even a short time will encounter our society’s obsession with defying the aging process and its glorification of youthfulness. In the midst of this frenzy to resist aging, it is important to search through the hype, biases, and stereotypes to truly understand and accept the natural aging process and its effects on us all.

Those who study aging define it as the natural progression of biological, psychological, and social functioning after the point of maximum development (Birren & Schaie, 1985). Research has found the following benchmarks of this progression (Kailes, 2003):

  • The peak of biological functioning – when our bodies are the strongest and most limber – is around 25 years of age. After this, our bodies lose strength, flexibility, and organ capacity at a rate of about 1% yearly. Despite this early decline, a person usually does not experience physical illnesses related to aging until after age 70 because the body is resilient.
  • Psychological maturity occurs at approximately age 35 and is defined by cognitive skills of learning, coping, creativity, and memory. After this peak, it becomes more difficult to process and recall new information. Aging in this area occurs much more slowly as people find compensatory strategies to replace lost abilities.
  • The peak for social functioning is around 55 years of age, a point in life where people have reached a pinnacle in their careers, social roles, community participation, and personal relationships. After this peak, life events such as retirement and the deaths of friends disrupt individuals’ social networks. In addition, the loss of physical skills may influence the ability to drive independently and perform usual recreational activities.

People with disabilities are likely to experience some of the effects of aging decades earlier than the general population. In addition, people with disabilities are more likely to have higher rates of certain health problems such as obesity, hypertension, high cholesterol, heart disease, diabetes, respiratory infections, and osteoporosis than their age-matched peers without disabilities. Many of these conditions or factors can lead to secondary health problems such as pain, fractures, and loss of balance. These secondary conditions add to the overall complexity of well-being and make it more difficult for someone with a disability to remain healthy and independent (Kailes, 2003).

Addressing the physical, psychological, and social dimensions of aging is important for all of us as we grow older, including individuals with disabilities. One of the best options available for maintaining well-being is exercise. Regular exercise increases and maintains muscle strength and flexibility keeps, bones solid, improves heart functioning, and assists in weight control. In addition, exercise has been shown to be valuable in improving mental health and sharpening cognitive abilities. It can be a social activity, especially if frequently done with the same group of people, and it can sustain the physical ability to engage in other social and recreational activities. Research on the importance of exercise for persons with disabilities is just beginning, but preliminary findings indicate that even mild physical activity can prevent secondary conditions and will address most of the issues encountered with aging (Snow, 2001).

Meeting Needs of Older Adults

It sounds easy. Just exercise and you will have a good life as you get older! However, we all know that finding the opportunity and motivation to exercise regularly is just not that simple. Recreation programs can offer options for aging adults with disabilities to exercise and socialize by doing the following:

  • Ensuring that fitness staff is trained in the characteristics and fitness needs of aging individuals with a variety of disabilities, and knowledgeable about adapting fitness activities to enhance the participation of such individuals. In addition, programs should have equipment and activities suitable for the needs of older adults with disabilities, such as weight equipment that targets the larger muscle groups of the legs, which are important for walking independently without a cane or crutches.
  • Performing an initial screening of physical abilities and personal goals for individuals. This will ensure that the exercise routine designed is motivating to the individual and tailored to maximize physical skills without the possibility of injury.
  • Encouraging a fitness center culture where members represent a wide range of abilities, body types, and ages. This will allow camaraderie between members who have similar experiences and prevent members from feeling intimidated or excluded.

And as far as staying personally motivated to exercise, Linda, Alice, and Gerrie had these responses when asked what keeps them coming back. Linda said, “We come here to see the other people and staff. They are a fun group. It does not feel like working out, it feels like this is another family for us.” Alice added, “We even had a potluck dinner one night after working out. Another member had been taking a cooking class so he could live in an apartment independently and he needed to practice. We all made a dish and brought it to share.” And Gerrie said that she notices when one of the members does not come on a regularly scheduled day, and she will tell the member they “skipped” the next time she sees them. Everyone tries to keep the commitment to exercise and looks out for one another.

Conclusion

In addition to continuing their regular workouts with each other, Alice, Gerrie, and Linda have some new fitness-related goals. Alice and Linda would like to lose weight and they plan to join a nutrition group when it is offered this fall. And Gerrie is working toward walking on the treadmill without holding the rails. If she can do this for five minutes, she will win a bet with a staff member and get a fitness center t-shirt as her winnings.

Refernces

  • Birren, J., & Schaie, W. (1985). The handbook of the psychology of aging. New York: Van Nostrand.

  • Courage St. Croix. (2002). Health, wellness and fitness pilot report. Stillwater, MN: Courage St. Croix.

  • Kailes, J. W. (2003). Aging with a disability. Retrieved from www.jik.com/awdrtcawd.html

  • Snow, L. (2001). Aging with a physical disability. Orthopaedic Physical Therapy Clinics of North America, 10(2), 251–263.