Supporting healthy ageing in later life
Staying active in later life is a vital part of healthy ageing. Regular physical activity, including muscle strengthening and aerobic activity is essential, however the uptake of and adherence to physical activity programmes by older people can be variable (Goodman et al. 2010).
All types of physical activity - from walking and gardening to exercise and dance classes - can improve mobility, protect against ill-health, enhance mental well-being and lower the risk of cognitive decline, as well as keep individuals more independent for longer (UK Active).
Both the Five Year Forward View and Public Health England’s One You campaign highlight the need to encourage healthy lifestyles in people of all ages, to prevent the development of lifestyle related chronic diseases such as heart disease, type 2 diabetes, stroke, and some cancers.
Nurses and health care assistants are well placed to assess an older person’s level of fitness and provide advice on suitable physical activities.
Nurses and healthcare assistants should encourage older people to take part in regular mental activities to maintain cognitive skills and prevent memory loss. Just as the body needs physical exercise to keep fit, the brain needs mental exercise to stay active and alive. It doesn't matter so much what types of activities older people engage in. The key is participating in new and different activities that encourage mental activity. Reading and writing can certainly help keep the brain active, however, finding a new hobby can challenge the mind in exciting ways. Older people may find the following activities mentally stimulating:
Most of the activities above can be done in pairs or groups which will provide older people with mental stimulation and also important social interactions. It is important to remember that activities should be age-appropriate and maintain an individual’s self-respect and dignity.
Lee, M. (2006) Promoting mental health and well-being in later life: A first report from the UK Inquiry into Mental Health and Well-Being in Later Life. Age Concern & Mental Health Foundation.
The past 60 years have seen cultural changes related to sexual behaviour from the “swinging sixties”, the advent of drugs to help physical relationships and access to relationship sites via the internet in the last two decades. Whilst it is clear that men and women engage in sexual activity in their 70’s and 80’s (DeLamater 2012) the continuation of relationships into increasing older age and the development of inter-generational marriages and remarriage is becoming common (Weeks 2002).
Whilst it is normal to experience changes in sexual desire and activity in later life it is widely recognised that there is great individuality about the extent and timing of these changes. In addition the more sexually active the person is the fewer the physical changes the person is likely to experience in his or her pattern of sexual response. It is believed that people who have sexuality intimate relationships live longer, are happier with the quality of their lives, have higher self-esteem and less depressive symptoms. Kiecolt –Glaser and Newton (2001) suggests that regular consensual sexual expression contributes to physical and psychological wellbeing and may reduce physical and mental health problems.
Talking to older people about their sexual health needs is an essential role of the nurse. It constitutes part of a holistic assessment and nurses are well placed to start discussions and inform people about what is usual in the ageing process. Nurses should seek to understand their own views, beliefs and prejudices, as these will influence interactions. Being sensitive to this will help improve interactions and allow for reflection on what further knowledge and skill is needed to work with older people in understanding their needs. We know that talking about the broad issues relating to sexual activity is an appropriate way of identifying issues and misconceptions that might not have been previously discussed.
Nurses may also uncover issues of ill health or abuse and it is important to have knowledge of referral mechanisms and safeguarding contacts. Nurses should become familiar with the common difficulties and treatments that are relevant to older people. These might be pharmacological, non-pharmacological or psychological, and may also include an educative or supportive element. Sexual intimacy is important for wellbeing and should be a part of older people’s lives, if they wish (Garrett 2014).
Delamater, J (2012) Sexual Expression in Later Life: A Review and Synthesis. Journal of sex research, Vol 49, No 2, pp. 125-141
Garrett, D (2014) Psychosocial barriers to sexual intimacy for older people British Journal of Nursing, Vol 23, No 6, p16-20
Kiecolt-Glaser, J. K & Newton, T. L (2001) Marriage and health: His and hers. Psychological Bulletin, 127, pp. 472-503
Weeks, D. J (2002) Sex for the mature adult: Health, self-esteem and countering ageist stereotypes. Sexual and Relationship Therapy, Vol 17, No 3, pp. 231-240