Physical activity: Belong dementia care villages have onsite gyms for residents

| Christine Hollywood

It is well known that exercise and fitness brings huge benefits for our mental and physical health across all ages, increasing our mobility and strengthening our bodies. As well as boosting communities and the economy, UK Active say every £1 spent on sport and physical activities generates almost £4 in return, and prevents 30 million additional GP visits, and 37,000 premature deaths, in the UK each year.

UK Active, whose mission is to ‘get more people, more active, more often,’ calls for the government to offer more support and clearer policy on exercise and fitness. The good news is that GPs can prescribe fitness classes on the NHS for women and girls through Sport England’s This Girl Can initiative, and this opens up the potential for activities like boxing, yoga and dance to address non-medical needs which have an impact on health.

Ahead of national health initiatives, Belong, the not for profit organisation providing nursing and dementia care in North West England, makes sure their residents have access to a variety of fitness opportunities if they wish, whatever their health needs.

Belong runs seven care ‘villages’ in Atherton, Crewe, Didsbury, Macclesfield, Newcastle Under Lyme, Warrington and Wigan with another opening later this year in Chester, and two more planned by 2024. Each village is made up of six households, with a maximum of 13 residents in each. The households are open plan with bedrooms leading from a communal space, and designed to recreate many of the characteristics of a family home.

Each village has its own gym

This structure is unusual compared to traditional care settings. Even more unusual is that each village has its own gym with bespoke equipment developed for older people and those with cognitive impairment. This includes exercise and therapy bikes to increase muscle strength and mobility, improve cognition, and posture.

Amazingly, some of the bikes also provide a choice of virtual locations to cycle! Many people choose to cycle through neighbourhoods and places they’ve lived before or know well. This is hugely enjoyable, and it leads to social interactions sharing memories of places and happy times.

The Silver Fit bike uses a game to encourage movement. A 3D camera registers even the very small movements a person makes. They can see their progress as they go and the final results are displayed on a screen with a suggestion for a specific movement or exercise for them to do.

Belong recognises that enjoyment is key to supporting people to exercise for longer. The use of these technologies has extended periods of exercise so that now residents who use the machines typically spend fifteen minutes exercising rather than five.

NHS Physical Activity Guidelines for Adults over 65 recommend at least two and half hours of moderate intensity exercise each week with a further 75 minutes of vigorous exercise for those who are already active. This includes activity to improve muscle strength at least two days a week, and for those at risk of falls, activities to improve balance and coordination.

Exercise leads to wellbeing in older people

Exercise is also shown to produce wellbeing outcomes in older people too such as alleviating stiffness and pain, lower blood pressure, improved sleep patterns, improved mood, greater participation in social activities, and greater memory capacity.

Belong’s Operations Manager, Sue Goldsmith, was appointed in 2020 to support the organisation as it grows. She looks after four Belong villages and visits each on a weekly basis. Sue tells me, “Fitness is an integral part of the Belong model”. The organisation has embraced the fitness of all its residents at its heart by “investing heavily” in opportunities for movement and exercise whatever their health needs. This extends across the spectrum from those who are mobile to people in bed who can join in with gentle movements to prevent contractures.

Sue says, “there is choice available to all Belong customers; some prefer one-to-one gym work while others prefer the group based activities. All seem to enjoy doing activities they’ve taken part in earlier in their lives and very often the skills are still there. If not, lost skills can often be reactivated through activity.”

Exercise specialists create bespoke plans for residents

Belong employs an Exercise Specialist in each of its villages to support residents. All of them are Level 3 trained in GP Referral which means they have specific knowledge of physical conditions that can improve with exercise. A Lead Specialist oversees the running of the Exercise team.

The Specialists work closely with a physiotherapist initially, to create bespoke plans to improve mobility. These personalised programmes can also support rehabilitation and manage the symptoms of conditions like diabetes, COPD, hypertension, lower back pain, dementia, obesity, osteoporosis, and arthritis. Individual plans are regularly reviewed and updated.

Even during Covid lockdowns exercise opportunities continued in the villages. The Belong Active Youtube channel was used most days and Exercise Specialists took remote classes via the Belong Facebook portal. When Covid restrictions began to be lifted they took the lighter bikes into residents’ rooms so they could continue cycling.

The organisation has won a number of awards for its exercise service, including the 3rd Sector Care Award 2018 for Innovative Quality Care Outcomes. It has also been independently assessed by The National Centre for Sport and Exercise Medicine (Nesta), achieving a level 2 for ‘Emerging Practice,’meaning it provides each resident with the opportunity to improve their quality of life through physical activity, no matter what their physical or mental capacity.

The assessment reflected that Belong had captured both qualitative and quantitative data via diary logs, and blood pressure, mobility and cardio-respiratory readings which showed positive change. Results indicated improvements in quality of life, “demonstrated by residents who were previously restricted to wheelchairs regaining the ability to walk; increasing mobility and strength, and greater participation in meaningful activity” (Belong website). Other indicators included shorter hospital stays.

Belong is taking great leaps forward in care provision for older people and promoting accessibility to fitness activities. Opportunities to participate easily and safely in sport and exercise activities, and to reap the health benefits, need to be widely available to everyone; no matter what age we are, exercise boosts the health of our bodies and minds. I’m loving the sound of those bikes that take you to places you know, already!

To get in touch with Belong, email Susan Goldsmith.

Photo credit: Picture Yourself Active

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