Functional Fitness for Older Adults


Patricia A. Brill
ISBN: 0736046569
ISBN13: 9780736046565
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Functional Fitness for Older Adults is an illustrated guide for activity professionals working with adults over the age of 65—especially those who are unable to complete activities of daily living because of poor functional fitness levels. This guide provides you with physical activity programs that are proven to be both safe and effective for improving the functional performance levels of your participants as well as improving their health-related quality of life. The guide includes a variety of specialized activity programs that are developed to meet the specific needs of older adults. They are designed to improve upper- and lower-body strength, balance, range of motion, and functional performance. Each exercise program is approximately 20 to 30 minutes long and works easily with busy schedules, a variety of participants’ needs, and institutional budgets. Specific guidelines are included for working with older adults with arthritis, chronic obstructive pulmonary disease, depression, diabetes, heart disease, hypertension, osteoporosis, or stroke. Extensive research has verified that the guidelines and programs are safe and will result in significant functional gains for most participants. There are nine activity programs to choose from. Three are basic strength training programs that are designed for different fitness levels, with each program including exercises to strengthen the major muscle groups needed for performing daily activities. One program is a walking and wheeling program for cardiovascular conditioning. The five remaining programs address specific functional needs, disabilities, and health concerns, including balance and mobility problems, incontinence, and dementia. These five programs may be offered in conjunction with one of the three strength training programs. Most of the programs may be conducted either on an individual basis or in a group setting, and both seated and standing exercises are included. These nine cost-effective programs offer safe and effective strategies for developing the functional performance levels of you participants. The functional fitness programs enable you to improve the quality of life for your older adult population, help those who are functional to maintain or improve their functional level, enable others to regain the ability to participate in activities that are meaningful, and increase the degree of independence for most. The general fitness programs provide an easy-to-difficult progression:
  • Lift to Function increases lower-body strength.
  • Squeeze to Function increases upper-body strength.
  • Strengthen to Function increases both lower- and upper-body strength.
  • Walk ’n’ Wheel to Function improves cardiovascular fitness.
  • Balance to Function reduces participants’ chances of falling.
The specialized programs enable you to address the specific functional needs of those with decreased ability to walk, incontinence, and dementia; and those who are wheelchair- or bed-bound also have specialized programs:
  • Step Up to Function improves circulation and strength needed for walking or climbing stairs.
  • Hold It to Function targets specific muscle groups to help reduce incontinence.
  • Remember to Function helps decrease behavioral disturbances such as wandering and agitation in those who have dementia.
  • Move to Function is designed for those who cannot stand and are bedridden because of muscle weakness or illness.
Functional Fitness for Older Adults includes materials that make it easy for you to conduct the programs. All exercises are organized into warm-up and cool-down exercises, upper-body exercises, lower-body sitting exercises, lower-body standing exercises, and seated modifications. Included are individual and group balance activities, foot exercises, and walking and wheeling activities. All exercise descriptions list the muscles worked and instructions for performing the exercise. Many also feature adaptations to the exercise, suggestions for those needing more of a challenge, and ideas for making the activities fun. You’ll find illustrated summary sheets to use as handy program guides for each of the nine programs. These sheets can be easily photocopied, then enlarged and laminated to create a “cheat sheet” for conducting each session. As those who have worked with older adults know, this population is notorious for not wanting to exercise, yet exercise is often the only thing that enables them to retain or regain a reasonable quality of life. The guide provides information on motivating frail or potentially frail elders to participate and keep participating:
  • Using goals and assessments to motivate
  • Strategies that encourage new residents of group living accommodations to join exercise programs
  • Vocabulary to use that will help you avoid turning potential participants off to the idea of physical activity
  • Turning exercise sessions into social occasions
  • Rewards and other types of positive reinforcement
The exercise instructions, abundant illustrations, and program guides put all the information you need to teach exercises and lead programs at your fingertips. Functional Fitness for Older Adults is the most comprehensive guide you’ll find to build your repertoire of programs for elders who want to improve their overall quality of life by increasing their physical abilities.

About the Author

Patricia A. Brill, PhD, is the founder of Functional Fitness, L.L.C., a consulting company that designs and implements fitness and wellness programs for seniors. She has developed and produced 4 exercise and training videos for seniors as well as 10 functional fitness exercise programs with accompanying illustrated guides. For the last decade, she has conducted research and designed exercise programs for older adults living at home, in independent and assisted living communities, or in nursing homes, as well as in dementia care facilities. Older adults’ regular participation in these exercise programs has resulted in their being able to walk, travel, bathe, dress themselves, and perform many social and physical activities they were previously unable to participate in. In 1998, Dr. Brill was awarded the American College of Sports Medicine Healthy People 2000 Physical Activity Promotion Award for designing and implementing a research strength training program for a large assisted-living corporation. In 1997, she was awarded the South Carolina Governor's Award for Research in Aging for the design and implementation of a placemat that illustrates a strength-training program called "The Kitchen Table Is not Just for Eating . . . Let's Exercise." Dr. Brill also was presented with the University of South Carolina’s Award for Excellence in Research for the 1994-1995 academic year for the creation of a Functional Fitness Strength Training Program to Restore Activities of Daily Living in Frail Individuals. In 2001 she won the National Mature Media Award for her dementia and exercise training video. Dr. Brill is a fellow of the American College of Sports Medicine. She has published more than 25 peer-reviewed research articles, coauthored a fitness prescription provider guide for physicians and health professionals, and has presented on exercise for older adults at more than 15 national conferences. In her free time, Dr. Brill enjoys boating, traveling, and listening to blues music. She resides in Houston, Texas. Dr. Brill’s exercise and training videos that accompany some of the Functional Fitness for Older Adults exercise programs can be ordered from Functional Fitness, L.L.C at

Table of Contents

Part I: Functional Fitness for Older Adults

Chapter 1.
Functional Independence and Quality of Life
Quality of Life
Benefits of Functional Fitness
Muscles Used in Activities of Daily Living

Chapter 2. Activity Programming for Older Adults
Assessing Needs
Selecting Appropriate Programs
Ensuring Exercise Safety and Effectiveness
Recruiting Participants in Group Settings
Motivating Older Adults to Continue Participating
Making Your Job Easier

Chapter 3. Exercise Guidelines for People With Chronic Conditions
Heart Disease or Hypertension
Parkinson’s Disease
Peripheral Vascular Disease
Hip Fracture
Low Back Pain

Part II: Functional Fitness Programs

Chapter 4.
General Functional Fitness Programs
Lift to Function
Squeeze to Function
Strengthen to Function
Balance to Function
Walk ’n’ Wheel to Function

Chapter 5. Fitness Programs for People With Functional Disabilities
Step Up to Function
Hold It to Function
Move to Function
Remember to Function

Part III: Exercise Instructions and Program Guides

Chapter 6.
Exercise Instructions
Warm-Up and Cool-Down Exercises
Upper-Body Exercises
Abdominal Exercises
Lower-Body Sitting Exercises
Lower-Body Standing Exercises and Seated Modifications
Lower-Body Standing Exercises
Individual Balance Activities
Group Balance Activities Standing in a Line
Group Balance Exercises Sitting in a Circle
Sitting Foot Exercises

Chapter 7. Program Guides
Lift to Function Exercise Program
Squeeze to Function Exercise Program
Strengthen to Function Exercise Program
Balance to Function Exercise Program
Walk ’n’ Wheel to Function Exercise Program
Step Up to Function Exercise Program
Hold It to Function Exercise Program
Move to Function Exercise Program
Remember to Function Exercise Program


A reference for activity professionals, physical therapists, nurses, aides, caregivers, or students working with older adults in independent and assisted-living communities, nursing homes, Alzheimer’s care facilities, or home health care. A supplementary text for courses in health care, physical or recreational therapy, exercise science, and long-term care activity programs. A training manual for fitness instructors to share with their assistants, including certified nursing and activity assistants.