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An Administrator's Perspective on the Organization of Physical Activity for Older Adults in Long-Term Care Facilities

  • Veerle Baert
    Affiliations
    Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Gerontology (GERO) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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  • Ellen Gorus
    Affiliations
    Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Gerontology (GERO) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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  • Koen Calleeuw
    Affiliations
    Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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  • Werner De Backer
    Affiliations
    Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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  • Ivan Bautmans
    Correspondence
    Address correspondence to Ivan Bautmans, PhD, Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium.
    Affiliations
    Frailty in Aging Research (FRIA) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Gerontology (GERO) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Published:September 29, 2015DOI:https://doi.org/10.1016/j.jamda.2015.08.011

      Abstract

      Background

      The positive influence of physical activity (PA) on health is well documented. Even at old age, PA remains useful but participation in PA decreases with age. In long-term care facilities (LTCFs), PA appears to be reduced to a bare minimum. Because administrators have a key role in developing the care policy of LTCFs, it is important that they support the organization of PA in LTCFs.

      Objective

      The main objective of this mixed-method study was to identify motivators and barriers for organizing PA in LTCFs according to administrators. A secondary goal was to examine the knowledge of the World Health Organization (WHO) guidelines regarding PA and to reveal potential motivators and barriers for the implementation of the guidelines.

      Methods

      First, 24 administrators completed semistructured interviews. Data were analyzed using the deductive approach of qualitative content analysis. The obtained motivators and barriers were categorized on 3 different levels (intrapersonal, interpersonal, and community) according to the socioecological model by 2 independent reviewers; conflicts were resolved with a third researcher. Next, 127 administrators of Flemish (Belgium) LTCFs completed an online questionnaire survey containing open-ended, unique, and multiple choice questions regarding the LTCFs, PA, and the WHO guidelines, as well as statements (scored on a 5-point Likert scale) regarding perceived motivators and barriers for organizing PA sessions in the LTCF.

      Results

      In the qualitative component, the administrators reported 31 motivators and 24 barriers for organizing PA in the LTCF. In the survey, maintaining or enhancing general health of the residents (98%) and improving the psychological well-being of the residents were marked as key motivators at the intrapersonal level. The administrators (97%) were convinced that PA is a useful way to spend time for LTCF residents. Encouraging social contact (94%) and countering loneliness (86%) are the motivators cited at the interpersonal level. At the community level, the infrastructure of the facility (91%) and adequate and sufficient material (88%) are the main motivators. The barriers that were presented to the participants were scored as less important. The majority of the administrators (83%) are not familiar with the WHO guidelines for PA; 70% of the participants believe that the guidelines are useful, but only 40% is convinced that it is realistic to implement the guidelines in an LTCF.

      Conclusions

      This study described different motivators and barriers for administrators to organize PA in LTCFs. Contrary to other studies, lack of staff, lack of adequate equipment, and lack of financial resources were rejected as potential barriers for organizing PA. Despite the fact that administrators were not familiar with the WHO guidelines for PA, they believed that the guidelines are useful. The participants reported several barriers for implementation of the guidelines. Administrators of LTCFs are motivated to implement the guidelines if PA can be integrated in daily activities and education of LTCF staff regarding PA is provided.

      Keywords

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      References

        • Weening-Dijksterhuis E.
        • de Greef M.H.
        • Scherder E.J.
        • et al.
        Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life.
        Am J Phys Med Rehabil. 2011; 90: 156-168
        • De Souto Barreto P.
        • Demougeot L.
        • Vellas B.
        • Rolland Y.
        How much exercise are older adults living in nursing homes doing in daily life? A cross-sectional study.
        J Sports Sci. 2015; 33: 116-124
      1. Organization WH. Global recommendations on physical activity for health. 2010; Available at: http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf?ua=1. Accessed April 25, 2015.

        • Kalinowski S.
        • Wulff I.
        • Kolzsch M.
        • et al.
        Physical activity in nursing homes—Barriers and facilitators: A cross-sectional study.
        J Aging Phys Act. 2012; 20: 421-441
        • Nelson M.E.
        • Rejeski W.J.
        • Blair S.N.
        • et al.
        Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association.
        Med Sci Sports Exerc. 2007; 39: 1435-1445
        • Cesari M.
        • Vellas B.
        • Hsu F.C.
        • et al.
        A physical activity intervention to treat the frailty syndrome in older persons—Results from the LIFE-P Study.
        J Gerontol A Biol Sci Med Sci. 2015; 70: 216-222
        • Landi F.
        • Abbatecola A.M.
        • Provinciali M.
        • et al.
        Moving against frailty: Does physical activity matter?.
        Biogerontology. 2010; 11: 537-545
        • Freiberger E.
        • Sieber C.
        • Pfeifer K.
        Physical activity, exercise, and sarcopenia— Future challenges.
        Wien Med Wochenschr. 2011; 161: 416-425
        • Dickinson H.O.
        • Mason J.M.
        • Nicolson D.J.
        • et al.
        Lifestyle interventions to reduce raised blood pressure: A systematic review of randomized controlled trials.
        J Hypertens. 2006; 24: 215-233
        • Vogel T.
        • Brechat P.H.
        • Lepretre P.M.
        • et al.
        Health benefits of physical activity in older patients: A review.
        Int J Clin Pract. 2009; 63: 303-320
        • Bastone Ade C.
        • Jacob Filho W.
        Effect of an exercise program on functional performance of institutionalized elderly.
        J Rehabil Res Dev. 2004; 41: 659-668
        • Blankevoort C.G.
        • van Heuvelen M.J.
        • Boersma F.
        • et al.
        Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia.
        Dement Geriatr Cogn Disord. 2010; 30: 392-402
        • Crocker T.
        • Young J.
        • Forster A.
        • et al.
        The effect of physical rehabilitation on activities of daily living in older residents of long-term care facilities: Systematic review with meta-analysis.
        Age Ageing. 2013; 42: 682-688
        • Koeneman M.A.
        • Verheijden M.W.
        • Chinapaw M.J.
        • Hopman-Rock M.
        Determinants of physical activity and exercise in healthy older adults: A systematic review.
        Int J Behav Nutr Phys Act. 2011; 8: 142
        • Biddle S.
        • Mutrie N.
        • Gorely T.
        Psychology of Physical Activity: Determinants, Well-being, and Interventions.
        Routledge, New York, NY2015
        • Baert V.
        • Gorus E.
        • Mets T.
        • et al.
        Motivators and barriers for physical activity in the oldest old: A systematic review.
        Ageing Res Rev. 2011; 10: 464-474
        • Weeks L.E.
        • Profit S.
        • Campbell B.
        • et al.
        Participation in physical activity: Influences reported by seniors in the community and in long-term care facilities.
        J Gerontol Nurs. 2008; 34: 36-43
        • Chen Y.M.
        Perceived barriers to physical activity among older adults residing in long-term care institutions.
        J Clin Nurs. 2010; 19: 432-439
        • Benjamin K.
        • Edwards N.
        • Ploeg J.
        • Legault F.
        Barriers to physical activity and restorative care for residents in long-term care: A review of the literature.
        J Aging Phys Act. 2014; 22: 154-165
        • Benjamin K.
        • Edwards N.
        • Caswell W.
        Factors influencing the physical activity of older adults in long-term care: Administrators perspectives.
        J Aging Phys Act. 2009; 17: 181-195
        • McLeroy K.R.
        • Bibeau D.
        • Steckler A.
        • Glanz K.
        An ecological perspective on health promotion programs.
        Health Educ Q. 1988; 15: 351-377
        • Casey D.
        • Murphy K.
        Issues in using methodological triangulation in research.
        Nurse Res. 2009; 16: 40-55
        • Creswell J.W.
        Research design: Qualitative, quantitative, and mixed methods approaches.
        Sage Publications, Thousand Oaks2009
        • Baert V.
        • Gorus E.
        • Guldemont N.
        • et al.
        Physiotherapists' perceived motivators and barriers for organizing physical activity for older long-term care facility residents.
        J Am Med Dir Assoc. 2015; 16: 371-379
        • Benjamin K.
        • Edwards N.
        • Guitard P.
        • et al.
        Factors that influence physical activity in long-term care: Perspectives of residents, staff, and significant others.
        Can J Aging. 2011; 30: 247-258
        • Van Malderen L.
        • Mets T.
        • Gorus E.
        Interventions to enhance the quality of life of older people in residential long-term care: A systematic review.
        Ageing Res Rev. 2013; 12: 141-150
        • Evans J.
        Straightforward Statistics for the Behavioral Sciences.
        Brooks/Cole Publishing, Pacific Grove, CA1996