We all know that physical activity is of benefit to our health and welfare. But it becomes even more important to residents who live in care homes, where the ability to move around may often depend on the availability of staff to provide the necessary levels of support.
Research over decades has shown that care home residents spend most of their time inactive. Lack of engagement in physical activity, is defined as “any bodily movement produced by skeletal muscles that results in energy expenditure”, has detrimental effects on physical and psychological health and quality of life, and contributes to social isolation.
Additionally, an observational study suggests that 97% of residents’ days are spent sedentary (e.g. sitting, watching television), with low levels of interaction with staff and each other. Sedentary behaviour, defined as “any waking behaviour characterised by an energy expenditure“.
As far back as 2013 the National Institute for Health and Care Excellence (NICE) issued a quality standard call for “older people in care homes to be offered opportunities during their day to participate in meaningful activity that promotes their “health and mental wellbeing”.
‘Sit Less Move More’ study
This study reported in 2023 surveyed and interviewed more than 160 care home staff across the UK, to identify the barriers faced by residents to activity and how they could be overcome.
Backed by walking charity Paths for All, Perth and Kinross Health and Social Care Partnership, and Life Changes Trust, the research found that a lack of time among staff to support residents in being physically active and a fear of falling were the main barriers to physical activity.
Now the academic team behind the study say that significant changes and a “whole home” approach is required to make physical activity part of all care home activities.
A sedentary lifestyle
Dr Grant Gibson of the Faculty of Social Sciences said: “A sedentary lifestyle can result in losing the ability to balance, to rise from a chair, and to walk, as well as increasing the likelihood of falls when attempting to move“. Yet, how to ensure people with dementia in care homes have continuing access to activities that promote physical activity, or what the factors are in care homes that facilitate or present barriers to residents becoming more physically active, has seen relatively little research.
“We found a whole-home approach was needed to support residents to engage in physical activity and that it was vital that physical activity was encouraged as part of personal care, recreational preferences, social activities, and daily tasks – not just as ‘exercise’. Care homes need more resources, time and support to do that.”
As part of the research, the academic team explored how care homes across the world address this problem and developed a set of key recommendations for governments, local authorities, care home providers, staff, and managers.
The recommendations include appointing care home staff in specific activities coordinator roles; introducing support for care home staff at all levels to be better skilled in order to encourage care home residents to be physically active; and creating effective resources and knowledge exchange networks for care home staff regarding physical activity.
Dr Gibson added: “Many of the recommendations highlighted in this report require significant changes in care home services, not least increasing resources from their current level. But many elements are achievable with relatively minor changes. Most importantly, many of our recommendations will give care homes the opportunity to build on their staff as their greatest resource available and will ultimately help them to provide care that is best for their residents.”
The report highlights the pivotal role that activity coordinators play in facilitating a positive culture around movement and physical activity, and the need to recognise and support this critical role, with training, resources and networking opportunities.
The needs of residents in care homes amounts to much more than the provision of personal care. It is also important to look after the social health and welling of the person. Research over decades has shown that care home residents spend the majority of their time inactive. Sitting for long periods of time watching television.
The Sit Less Move More’ study found that a lack of time among staff to support residents in being physically active and a fear of falling were the main barriers to physical activity. Recommendations from the study focused upon the pivotal role that could be played by activity coordinators, more effective use of resources and more encouragement to residents to take part in physical activities.
Physical activity will need to become embedded in the culture of care homes if we are to see more residents participating in a range of physical activities that will improve their quality of life and provide some much-needed structure.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy