Improving your health — and outlook — can be as simple as adding steps to your day. Don't just use the remote — change the channel by standing up and walking to the TV. When you're out, take the stairs instead of the elevator when you can.
"Start with walking and just increase your physical activity daily," said Dr. Dmitry Bogomolskiy, a Northwell Health geriatrician and hospitalist at LIJ Valley Stream Hospital. "It's all very individualized, but I tell patients to start somewhere, just start increasing your daily activity." Bogomolskiy is also an assistant professor of medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
The doctor’s advice matches suggestions from the American Heart Association and the U.S. Department of Health and Human Services for minimum amounts of physical activity each week to maintain health and fitness. For substantial health benefits, the AHA guidelines recommend that most older adults participate in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination of each per week. Older adults should also do strengthening activities that involve all major muscle groups at least two days a week.
"If seniors are able to get into things like Fitbits and step counters, I think that's very good because they can actually see something in numbers. They can see how 'today I walked 2,000 steps, maybe tomorrow I can shoot for 2,300 steps,' " Bogomolskiy said. "They can read their goals every single day. If it's a husband and wife, maybe they can do it together and they can see who's doing more each day and kind of have a healthy competition."
As well as increasing a person's physical stamina, exercise helps control blood pressure and generally improves seniors' blood glucose. Exercise also releases endorphins that fight depression and seasonal depression, he noted, so "getting out more, getting out into the outdoors and walking more, increases hormones that are good for mental well-being. It's definitely a mood modifier for the elderly."
For those who are ready to start exercising, Bogomolskiy recommends first seeing their physician so they know any cautions or restrictions that might apply. "Then 30 minutes once a day would be a good start," he said, but "start with three times a week and build yourself up from that. All of this has to be done [in consultation] with the health provider and depends on the risk factors the person has. If they have cardiac problems, then certain exercises aren't recommended. "
Social benefits, too
Exercise is also a social boon. "Even light to moderate exercise pays benefits in emotional and social interactions and self-esteem," said Corinne Kyriacou, associate professor and chair of the Department of Health Professions at Hofstra University.
She noted Medicare programs acknowledge the myriad benefits of exercising through the SilverSneakers fitness program, which promotes exercise and physical activity. SilverSneakers is included in many Medicare Advantage plans and can be purchased separately. "It helps seniors stretch benefits," she said.
Exercising need not cost a lot, Kyriacou said. The cost of formal gym programs can be supplemented via SilverSneakers; walking is generally free and can still be done in the winter at the mall, for example; and senior center classes make different types of exercise readily available.
"Everyone can get physically active because there's such a wide variety of programs," Kyriacou said. Regular exercise helps build strength, and flexibility and balance, both key to avoiding falls and maintaining older people’s independence. "Start walking more, but be careful on sidewalks," she said. "Call the mall to find walking groups. Do gardening and get outside."
Don't start right in with weights, she cautioned, but do think about doing water exercise so there's less impact on your joints.
Bogomolskiy also recommends swimming and pool exercises to minimize the wear and tear on joints with the added benefit of the water’s resistance.
Those with limited mobility can also benefit from exercise in water, which will help with supporting the body and reduce stress on joints and muscles, Bogomolskiy. They can also focus on upper-body strength training with weights or resistance bands. “Stretching exercises of the muscles that are disabled is also helpful as it will reduce further atrophy and muscle deconditioning,” he said.
And staying active and exercising can help seniors continue to live independently, Kyriacou said, since it helps their social and emotional health and lets them continue to do logistical things like shop. "Many physicians are now writing prescriptions for exercise. It's so important from a physical perspective," she said.
Research has shown, Bogomolskiy said, that tai chi is among the best exercises for seniors. "Tai chi helps with balance and core strengthening," he said. "It's a kind of slow exercise where you focus a lot on core training so it helps prevent falls. It's something that a lot of people can get into."
'Good for the brain'
In an Exercise for Energy class at the Huntington Senior Center, Maxine Wolberg, 72, of Huntington, a volunteer with Suffolk County’s Retired Senior Volunteer Program, leads a class of 25 seniors, each standing by a chair, in an hourlong session, playing music and keeping up a running commentary. Participants work on strength and cardio training using hand weights and repetitions, do leg exercises, squats and yoga moves, and practice their balance, including standing on one foot and raising the other leg.
To distract them during harder moves, Wolberg shared dietary and exercise information from things she's read. "Exercise is good for the brain, coordination and balance," she said. "People can be older and still be physical and keep up."
Participants use the chairs for balance and support as Wolberg leads them in squats to build leg strength. "Get those legs strong. You know why we're doing this? To get off the toilet, right," she nods in reply to a shouted answer. "Eight more."
In another move she uses hand weights to work on triceps — the muscles on the back of the upper arm — calling for more repetitions to a few groans from the mostly willing crowd. "No moaning," she said. "We have guests. Don't make us look bad. Push those weights forward and suck in the belly."
Dorothy Boey, 79, of Cold Spring Harbor, has been coming for three years and takes several exercise classes at the center, including strength-training and tai chi, which helps her balance. Boey likes the workouts, she said, adding that the leg exercises in Wolberg’s session and the strength class help her sleep better because her arthritis doesn't hurt as much when she works out.
Leona Gordnick, 91, of Northport, who has been coming to classes since 2001, takes three exercise classes a week. "My balance gets off and this helps me. It's the only thing you can do — I'm fighting it."
In Jim Denniston's exercise class, Fitness Training for Seniors, at the Huntington Senior Center on another morning, the focus is on strength training with hand weights. Denniston, 73, of Northport, who taught physical education in high school and was a college athletic director, eased members back into the routine after a summer hiatus.
"Over the next eight weeks we'll concentrate on getting back to the strength levels we had before the summer. I hope you exercised over the summer," he said to noncommittal murmurs. "We'll do three sets, with 12 reps each, do them slowly and work our way back in."
He queued up music — Elvis’ “Burning Love” on this morning — and started off with jogging in place to get the heart rate up, then launched the group into arm curls. He, too, will share information and tips from his reading, relating a recent a health article advising that people who are more active in daily life live longer. "Keep moving, walking, doing things that keep you on the go. Don't be sitting all the time, it's not good for your heart," he told the class. "Get up and move. Walk a little, even 10 minutes. Just keep moving."
"People go to the gym to work out and you see them competing for the closest parking space," he said with a chuckle and shake of his head during a rest break. "Incorporate movement into your lifestyle."
Denniston noted strength training helps avoid muscle loss and decreased metabolic resting rates; it also increases bone mineral density, reducing the risk of osteoporosis.
He's learned over his years teaching senior exercise classes to increase difficulty by adding repetitions and slowing the movements so the muscle stays contracted longer and thus works harder, rather than asking seniors to buy heavier weights. "Seniors are very frugal," he said.
Ninety-four-year-old Donald Clarke of Northport has been attending classes at the center for 20 years, four a week these days. He also walks up and down his steps at home and outside in his driveway. Weight training and exercising his legs help keep his heart rate up. "As people get older the legs are important," he said.
Strength and flexibility
Christina Butcher, healthy living director for the YMCA of Long Island who oversees the Y's aquatics and health and wellness programs, said seniors at the Y most often participate in strength and flexibility training, though there’s been an increase in requests for meditation classes as people look for ways to reduce stress. Members over age 50 make up 55 percent of the Y's approximately 65,000 members across Long Island, said Tamar Simpson, the Y's director of marketing and communications.
"Strength is very important for fall prevention," Butcher said. "You want strong muscles to keep yourself upright." The strength training programs also often incorporate balance elements, and the Y's Moving for Better Balance class uses elements of tai chi to improve balance and increase confidence.
The Y also tries to create a social atmosphere, offering coffee and a place to sit and talk. "They're maintaining independence, but they still need that social element. It's just as rewarding and just as important," Butcher said.
While walking and daily living activities are good exercise, Butcher noted osteoporosis must be combated with weight-bearing exercise to help strengthen weak bones and prevent further bone loss.
In general, she said, instructors want to engage participants to learn what they're looking for and guide them to appropriate activities. Exercising at least two times a week will show results, Butcher said, and offers good health benefits. "The more times a week you exercise, you'll see more benefits," she said. "Two to three times a week is plenty to see healthy improvement."
Tips for staying fit
Seniors should do four types of exercise — aerobic, strength, stretching and balance — as they build a well-rounded program, said Christine Thompson, physical therapy supervisor at the Sports Therapy and Rehabilitation Services program at Northwell Health in Manhasset.
"Never just jump right in," she said. "Check with your doctor and start with a walking program to build your aerobic exercise."
And be consistent. "It's not going to happen overnight, but stick with it. Within a few weeks, you will feel really good."
If you're starting from a point of little exercise, she suggests beginning by walking a block, then add a half-block each day. "If you walk 10 to 20 minutes, and then add 5 minutes a day, you'll be up to 40 minutes after three weeks."
When the weather is too cold or too hot to comfortably walk outside, she advises going to a mall that opens early for walkers. "It's safe, it offers a smooth floor surface. Most malls will do that," Thompson said.
Use stretchy elastic power bands to do some strength training (different colors indicate higher or lower levels of resistance), and lightweight dumbbells, even holding water bottles for a bit more resistance. Progress depends on the person, but if an exercise begins to feel too easy, she suggested adding repetitions to increase workout time.
In addition to walking, work the upper body then the lower body with specific strengthening exercises. Try to work the major muscle groups — legs, hips, back, chest and shoulder areas and abdomen.
For safety and until you're sure of your balance, stand at a counter and hold on while you march in place. Practice squats while being careful of your knees — "keep the knee aligned with the ankle, not bent forward over the toes — keep your tush back," she said.
To help with the balance challenges many people face in their late 60s and 70s, ranging from inner-ear changes to neuropathy and vestibular issues that can cause dizziness, Thompson recommends:
• Stretch to gain flexibility. Lean against the wall and stretch out your calf muscles. Lean forward in a chair to stretch hamstring muscles — start with your legs out straight and then lean forward to stretch toward your toes.
• Tip your ear to your shoulder to stretch the side of your neck, with or without some pressure from your hand on your head. Try to hold for 10 to 30 seconds for three to five repetitions.
• Walk as a warm-up. "Before any exercise you want to warm up and cool down — don't just stop. Stretch before and after."
• Be aware of safety when doing balance exercises — stand near a chair, a counter or in a corner where the walls can catch you if you lose your balance. Stand on one foot and then the other. Try to put one foot in front of the other, heel to toe.
• For older adults a good goal is 30 minutes five times a week, plus strength training at least two days — and build up from that.
"Start slow," Thompson said. "You weren't doing this all your life. Listen to your body and know your limits. It should not be painful."
— Kay Blough
Chair yoga — in person or via the internet
Dimmed lights and soft music set a calm mood at a chair yoga class at the Wyandanch Public Library, but muscles and joints still get a workout.
The class focuses on strengthening, primarily, then endurance, with goals of stability and comfort. Some exercises are done while sitting on a chair, others while holding onto it for balance.
"We have two rules," explained instructor Marcia Salvesen. "If it hurts, don't do it, and don't judge your own practice more harshly than your neighbors’." Salvesen, 58, of Blue Point, leads the 15 to 20 attendees in an hourlong class each Tuesday at 11 a.m. as they do a gentle style of yoga while seated, imparting the breathing and mind-body benefits of a traditional yoga class.
Salvesen, who's been teaching since 2002, is trained in hatha yoga and certified by The Himalayan Institute, a nonprofit based in Honesdale, Pennsylvania. She's been offering chair yoga classes for 5½ years at the Wyandanch library.
She focuses on helping attendees stretch and strengthen their trunks, urging participants to press down into their feet and hips, and lengthen and stretch to create space.
"We're not the Rockettes," she laughed. "If there are 20 bodies in the room, there should be 20 shapes when we do a movement. It's about breath, space in your body and strength to hold that space."
Carmela Clemente, 89, of Deer Park, has been attending the class for about two years. "It's very helpful for me," she said. "I have a bad shoulder, and she works with me. Some of the same stretches I did in physical therapy I'm doing here."
Clemente’s body notices when she misses class for a week or two. "I feel like I'm not balanced any more. When I go, I have a better day, really a better couple of days.," Clemente said, adding that the yoga and swimming at Deer Park High School’s pool also enrich her social life.
Fannie Batchelor, 88, of Wyandanch, likes the class for the stretching as well as the friendly atmosphere. She's been attending for about five years. "For me, it's great. I used to walk three miles a day, and my son believes in exercise, so this is good exercise plus you meet some nice folks,” she said. “It's much better than staying home just looking at the TV."
Using chairs for support helps ease pressure on his bad knees, noted Dennis Drennan, 76, of Lindenhurst. He retired 11/2 years ago after 40 years at LIU Post as a public safety officer. Drennan has been coming for more than nine months and has started taking Salvesen's Monday chair yoga class at Central Islip Public Library. "I've got bad hips and bad knees," Drennan said. "With the chair I don't have to put my full weight on it in position and it makes me able to continue with the yoga."
For those who can’t travel, the Glen Cove Senior Center offers its chair yoga class remotely to participants who can link from their homes using the internet.
Selfhelp, a nonprofit based in Manhattan that promotes independent living through community-based services, provides computers and hookups to those who qualify and want to attend classes from a remote location; it also works with related agencies for those not in their immediate service area. It also offers classes and secure chat through its Virtual Senior Center, where participants learn to use Skype and email.
Instructor Patti Mitchell’s weekly chair yoga classes in Glen Cove offer remote access once a month. It's great socialization, said Mitchell, 53, of Glen Cove, who's been teaching yoga and other exercise classes since 1998. Those dialing in follow along as she demonstrates moves and can see other classmates through the camera records the class. Large thumbnail images show the faces of the online participants appear on the monitor for class members and Mitchell to see.
There can be challenges — including the weather's impact on the connections — Mitchell said, and she's learned to ask remote participants to mute their audio so background sounds don't overwhelm the class. Overall, it's a positive experience, she said.
"It's wonderful because it's interactive. We once had someone who was part of the senior center and then they became housebound but could still join in,” Mitchell said. “This whole program, it allows them to connect to other people."
The virtual participants can be regional — there were participants from the East End and Jamaica, Queens, at one point — but more recently people have joined from Baltimore and Chicago. "They say ‘thank you, see you next month’ when we're done," Mitchell said.
Carol Waldman, the center's executive director, called the virtual program immensely exciting. "It's really given the seniors who are homebound a way to engage with the community and get the exercise they need," she said.
The center has been participating with Selfhelp's program for about five years, Waldman said, also offering remote connections to a cooking program with an emphasis on healthy eating and nutrition, as well as a virtual bereavement support group. (Anyone interested in sharing their talents to lead a virtual class should contact Waldman.)
For more information on Selfhelp programs and its Virtual Senior Center, call 718-559-4460 or email email@example.com.
Chair yoga classes are offered across Long Island, so residents should check with their local senior centers, offices on aging and libraries. For information about the Glen Cove Senior Center's chair yoga class, call 516-759-9610 or visit glencoveseniorcenter.com; for information about the Wyandanch class, call 631-643-4848 or visit wyan.suffolk.lib.ny.us.