Nursing Homes

Fifty-Plus Fitness Library

Library : Year 2 | Session 7: Monitoring your Fitness Program

Dear Dr. Bortz,

I spend one afternoon a week volunteering in a local nursing home. As I was helping with a meal the other day, I wondered if these people had any evaluation of how fit they were. The nurses are always checking their pulses, temperatures, and blood pressures, but what about their fitness? It seems to me that this is really more important to their overall wellness than those other measurements. Any reaction? Nancy Bledsoe

Dear Nancy,

First off, thanks and congratulations for giving of yourself as you do. Your volunteering is a noble gesture. Of course, you are right that fitness is not generally included in any survey of old people regardless of their circumstance. Doctor Mary Tinetti at Yale wrote a paper in JAMA a few years ago in which she reported that leg strength, not diagnosis, not cholesterol level, not age, not medication use, not any of the usual measurements, but leg strength was the single most powerful predictor as to whether a person was going to have to enter a nursing home. Maybe, we ought to be measuring leg strength as a standard test. Beyond this, research workers at Cal State Fullerton have devised a simple, six-item physical performance test which sounds like it might be valuable. The six activities which are measured: 1) The number of times you can arise from a chair in 30 seconds. 2) Using five pounds weights for women and eight pounds for men, see how many arm curls you can do in 30 seconds. 3) March in place for 2 minutes so that your knee reached a point midway between knee and hip. Count how many steps you take. 4) While seated, extend one leg, see if you are able to touch your toe with your finger. 5) See how closely your hands approximate while reaching behind your back. 6) Time yourself from arising from a chair, walking 8 feet, and returning to the chair. These research workers have established numerical ranges derived from 7000 healthy older persons up into their 90s. By using this, or a similar testing procedure, caregivers to older persons could develop a real sense about how their charges were doing that surely would have more significance than what they are now doing that bears little, if any, relationship to their quality of life.