The Rules of Engagement

“Dad had his stroke on September 14, 2005, and that tragic day changed our family in so many profound ways.” Diana Klein

Diana Klein’s father, Herb DeVaan, had a devastating stroke which affected his ability to talk, walk and use his right arm. The family quickly became medical advocates for their father, learning what they could about stroke and its recovery. This handsome, easy- going man was an avid golfer, traveler and the “go-to” person for his five children. He cared for his wife who suffered with arterial sclerosis. Now, he was the one who needed to be cared for. Doctors, therapists and rehabilitation programs were the cornerstone of his recovery in those first months. But, Herb himself played the most vital role with his dedication and enthusiasm. As Diana says, “Every therapist that worked with Dad emphatically raved about how engaged he was in his own recovery and in his life. He was already strong, but the therapy he received empowered him and in those early days we saw rapid progress in his physical state.”

The DeVaan children faced further challenges when their Mother died unexpectedly a year later. They surrounded Herb with the support and services he needed to continue to live an independent life without his wife. One of those services was exercise training twice a week. As a clinical exercise specialist, I often incorporate exercises prescribed by physical therapists, but my role is somewhat different. Once physical therapy ends, the need for exercise does not. While the physical therapists focused on specifics, such as regaining strength in Herb’s affected leg, I worked on developing an overall exercise plan that included his whole body. Herb worked out like most people you’d see at the gym; however, his exercises were modified to account for his limitations. He rode a stationary bike and did chest presses, leg lifts and abdominal exercises that most people would find challenging. Every day had obstacles and new hurdles to overcome, but Herb’s children knew that to feel engaged in his life, their father needed his physical health, as well as intellectual stimulation and emotional support.

“My dad is an amazing man, but what I admire about him the most is his ability to adapt to adversity. He goes with the flow whatever life hands him and always with a quick smile, twinkle in his eye and his captivating sense of humor. He may have ups and downs but above all my dad is a survivor.”

Physical Engagement

An important predictor for feeling happy, successful and fulfilled in later life is engagement: the feeling of being of value to someone or something greater than us. As human beings we need to feel needed. As a fitness professional, I think about the role exercise plays in the ability to be engaged in life. Sometimes it’s the ability to walk or wheel to and from a meeting or social activity. Other times it’s being able to continue a sport or engage in a hobby like dancing or knitting. When thinking about caring for ourselves as we age, it’s important to consider those activities that engage us – and then

think about what is needed to stay engaged, not only the logistics required such as home layout and access to friends, families and activities, but the physical abilities that need to be maintained.

Television, magazines, and social media inundate us with advertisements for elderly services to help us when daily tasks become challenging. We may think this is what we need and, yes, sometimes we do. But often, we consider things like cleaning or cooking services when these tasks may be just the things keeping us physically healthy. When we have trouble doing a household chore, instead of hiring someone to do it for us, look for ways to continue doing the chore safely. For example, if you have low back pain while washing dishes, consider placing a tall stool near the sink. This takes the strain off your back but still allows you to complete the task. It may be a small thing, but it matters.

Aging is often about loss. The less we lose and the more we can continue to do on our own, the better our mental and physical health. The self-worth that comes from caring for oneself is the basis of adulthood. Sometimes, we think we need a life raft when what we really need is a better way to swim.

Exercise training is a vital part of your health care plan. The single most threatening occurrence older people face is not disease but falling. According to gerontologist, Juergen Bludau at Brigham and Women’s Hospital, a teaching affiliate of Harvard University, each year about three hundred and fifty thousand Americans fall and break a hip. Almost half of those people end up in a nursing home and another 20 percent can never walk again. The three factors that increase an older adult’s chances of falling are muscle weakness, balance problems and taking multiple prescription medications. The first two can be addressed simply by exercise. It is never too late to build muscle.

Studies have shown that even 90-year old people can increase muscle mass. And balance is a learned skill. Babies try to stand, fall over, and try again until they master the art. As adults, we forget to train our balance, and, when it fails us, we tend to think it’s normal. But it too can be relearned and improved through safe exercises that challenge the visual (eye), vestibular (ear) and muscle responses. Medications should be addressed at each doctor’s visit and questions about how they affect balance, sleep, eating and other aspects of health need to be raised.

Aging is inevitable. To breathe deeply, strengthen our muscles and minds, and move through our days under our own power for as long as possible is the gift we give our communities, ourselves and our children.