​Also, when you are standing, walking and moving around, your circulation is greatly increased as compared to sitting and remaining sedentary.  Circulation and blood flow moves thoughout the body and through all systems, including our digestive system.  Gravity is a big enemy to our skin and the effects that it has on it.  This is why we are spending so much money on all those great skin products that never live up to their claims!  However, when it comes to our digestive systems, gravity can be a great ally, as it pulls everything down... and out.  And I'll let your imaginations put that puzzle together!  So if you are battling a bout of constipation, get out and move and let the blood circulate and gravity pull!

Sarcopenia is a term we use to describe age related muscle loss.  As we age, some muscle loss is expected, however, not consuming enough daily calories to maintain muscle mass can exacerbate the sypmtoms of Sarcopenia.  "The proteins in your muscles are constantly being broken down.  If you aren't consuming enough protein in your diet, the breakdown exceeds synthesis and you have a loss of muscle mass", this according to Roger Fielding, PhD, associate director of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.  Dr. Roger Fielding added, "If you aren't consuming enough protein in your diet, the breakdown exceeds synthesis and you have a loss of muscle mass."  And without strong muscles to support your joints, your balance may suffer, leaving you at a greater risk for an unintended fall.

So what can you do?  On average, older adults should consume 0.6 grams of protein per pound of body weight per day.  That's about 90 grams for someone that weighs 150 pounds.  An important note, make sure to spread those protein grams throughout the meals you would eat in a day.

Thanksgiving is right around the corner and this is your official "license to eat"!  Of course, make sure to eat the pumpkin pie in moderation!

When all this Covid-19 madness started, my first thought was that my clients are going to lose all the progress that we have made.  The majority of my clients are 65 and older, and most of them feel intimidated by the internet.  The thought of using a computer to exercise, forget it!  In fact, a few of them do not even have email addresses!  Crazy right?!  Well, not really.  None of us like to feel overwhelmed, dumb or frustrated.  Those feelings can be magnified by some Seniors when their friends having an easier time grasping the new world of computers and the internet. 

One observation that I have made during this time of quarantine about my senior clientele and the internet, they have many questions about all the phases that exist of accessing the internet.  They are certainly not dumb!  I don’t think anyone believes that.  However, I do believe that a lot of our Seniors feel as though there are too many complicated steps to access their exercise and trainers online.  Along with this belief, we must remember that our seniors did not grow up with text messaging, FaceTime and Xbox live.  They grew up in a time where real, face to face contact was the main way of communicating or a phone call.  If you’ve worked with Seniors, even if it's only a few clients, then you understand what I am saying.  Let’s just say, I have clients I can text and clients I need to call!  Honestly, I think our Seniors are on to something with the calls vs. texts, but that’s another subject for another time.

So how do we convince our Seniors to hop online (pun intended) and train with us via the internet?  I have found that by breaking down the process into phases, and then further breaking the phases down into simple steps allows for thorough understanding while limiting frustrations.  I have also discovered that when explaining virtual sessions in this particular blueprint, I inadvertently answer questions that a Senior may have, but doesn't necessarily want to ask for fear of feeling insecure and unknowledgeable.  Remember, for a lot of our Seniors, many responsibilities have been taken, or redirected from them (I.e. driving, cooking, etc.) for a number of reasons.  The last thing I want to do, is make someone feel as though this is one more thing they cannot do or understand.  This is the blueprint, or process, that I follow and that has had success with my clients.  The motivation to actually exercise, that’s up to you!  Lastly, both parties need to be PATIENT!  We all have loads of time right now, so lighten the mood, make a joke and relax. Remember, with every mistake made, you’re closer to the answer.

A few things to consider before you start...
-  You want them to pick a place that provides enough lighting so you can be seen by your trainer or client.  Typically, I like to use the natural light of the sun, so anywhere next to a window is great.  It is a good idea to have the camera facing away from the window so you can avoid any wash out that will make you appear dark.
-  Also, make sure you have plenty of room to move around and do the movements and exercises.

The Blueprint:

1. Power button: The computer has a power button. So does the platform you, as a trainer or Senior, choose to use for these virtual (online) sessions.  ZOOM, Skype or FaceTime are great platforms and there are many more similar ones out there.  I like to use ZOOM because they have a “free” option and it's super easy to access.  Learn how to turn the “power” on to the app or platform first.

2. Access (this is the hardest step for most):  There are a few steps we need to cover to access the session.  Now, the app is on and we need to get into the “room” or session so that we can see our trainer or instructor.
- Room numbers/codes:  Think of this as the address. This number or code is what we need to enter into the computer that will give us access to session.
- Video/Audio:  Hopefully, the default (original) settings are still set and not much needs to be done other than adjusting the volume to suit our needs. There are many tools available to both the trainer and the client such as YouTube and Google that can help us troubleshoot any issues and provide videos of the solutions.  Don’t hesitate to utilize one, or both for information.

3.  You've got the lights, the camera and now the action:  Now it's time to get moving!  Make sure the camera is adjusted so that you can be seen and heard clearly.

Good luck!  I hope that everyone is staying safe and healthy during these "quarantine days"!

You can find exercise videos and more information about Emeritus Health and Balance University at:
Website:
https://www.emeritushealthfitness.com/

YouTube:
https://www.youtube.com/channel/UCFZBCssysteSE_QDxsKa58w?view_as=subscriber

Facebook:
https://www.facebook.com/EmeritusHealthFitness/

Recently, I was interviewed by Kimberley Fowler about the steps assisted and indepedent living facilities are taking to prevent residents from falling.  We discussed several topics including common myths associated with senior falls, what should families look for when placing a loved one and how Balance University is making an impact by providing education on fall prevention for residents and empoyees!

Here are some of the questions I was asked.

Learn more about Kimberley by clicking the link below.

How assisted and independent living facilities are designing their communities to prevent senior falls.

1. Why are seniors at a higher risk of falls than other segments of the population? 
As we age, the synapses (space between two nerve cells) in our brains become further apart thus slowing our recognition and reaction time as a result.  Neurotransmitters, such as acetylcholine, norepinephrine and dopamine are responsible for carrying those signals that tell our legs, feet and body to correct itself before we reach a point of “no return” and fall, across these synapses.  This is the same thing that happens when playing golf, tennis or pickle ball and the wind is really blowing and whipping around.  The game just became that much harder.  But there is HOPE!  With consistent practice in proprioceptively enriched environments, your balance can improve significantly.  There are factors that can impact the rate and overall capacity of improvement such as neurological disorders, neuropathy and macular degeneration to name a few.
2. Are there any common myths associated with senior falls that you think should be addressed?
One issue that bothers me is the cloud of embarrassment the seniors tend to feel when they fall.  This becomes a problem when seniors choose not to tell anyone that they have fallen.  I see this a lot with those that live at home, either alone or with a spouse.  The typical concern is that a family member or members will “gang’ up on them and try to convince or force them to move into a place they do not want to be.  Also, the potential move would take a spouse, who has become a caregiver, away from and leading to the separation of the couple.  In most cases, the most frustrating component of this issue is the fact that they can so something to improve their balance, but when nothing is said, no answers are sought which leads us further down the road in the wrong direction.
3. In what ways are assisted living communities making accommodations to reduce the risk of falls that you’ve seen or know about?
I know that many, if not all at this point, assisted living communities offer balance classes to their residents.  Also, I have seen quite a few, newly built facilities with fitness centers that are staffed by certified personal trainers.  This is great to see!  Strength training and group fitness classes are a great way to improve balance, flexibility, improve osteoporosis and positively impact the cardiovascular system.
4. How does your program work and what are the benefits of your program for the assisted living communities that use it? How does your program help these communities reduce the risk of falls?
Balance University includes the four pillars that are necessary to address when it comes to improving one’s balance.  Leg and core strength, postural exercises, improving flexibility and balance exercises.  BU has created the Position Of Confidence (POC) which creates a safe and stable foundation in a proprioceptively enriched environment.  This just means that an individual is in a position where they are stable but just slightly unstable.  This is done in order to improve neuromuscular efficiency, another key to improving one’s balance.  As you can see, improving balance is a multi-faceted issue that Balance University has recognized and guides students in a step by step manual.  Assisted living facilities can utilize the program in a few different ways.  They can offer classes on a weekly basis that follows the exercises in the guide/book throughout the 10-week program.  Residents can purchase the program and follow the 10-week program in the comfort of their own home.
5. As families and seniors tour assisted living communities, what things should they look out for that may indicate the community is proactive when it comes to reducing the risk of a fall?
If I were looking for a facility for a family member, there are a few things I would look for that would indicate that this particular facility was being proactive in their approach to fall prevention.
1.  Is there a fitness facility available?  And if so, is there a staff of certified personal trainer(s) or physical therapists to ensure the safety and proper use of equipment.
2.  Does this facility offer balance classes?  If so, what are the credentials of the instructor?  What specific program are we following to ensure improvement?
3.  Does the facility offer lectures/classes to educate residents on how to prevent falls throughout the year?
4.  Are there grab bars and other fall preventive steps taken in the bathrooms of each residence?  70% of all falls occur in the bathroom, so we want to make sure that steps have been taken to make the bathroom a safe place.  Also, if a fall were to occur, is there a system available that would alert staff that a fall has taken place?
5.  Has the staff taken any type a balance course so that they are knowledgeable about exercises to improve balance and methods to prevent falls?

What is the "Position Of Confidence" (POC)?  The POC is the very first position, or stance that I ask folks to try in Balance University, so that I can evaluate just how well, or poor, their balance may be.  The Split Stance, or known as "SS" in the Balance University program, is a great and safe way to introduce proprioception to a client.  Proprioception is a fancy term for "stable, but unstable environment".  So, if I stand on one foot, for many of us, that means that we will be a bit stable but mostly unstable in that particular position.  Proprioception is a key element to improving balance because it introduces the EXACT environment that enables better balance.  If you stand in the SS position, you may notice that your feet are wiggling side to side, as if you are standing on a block of ice trying to balance.  Believe it or not, this is a good thing!  However, please understand that we are all at different levels and the SS may not present much of a challenge to few, however, it can be quite the challenge to most.  Those of you that are not challenged much SS position, then try standing on one foot.  Even the most athletic folks must work a bit to stand on one foot whether they admit or not.

The point of focus with the POC position is to find that point in the SS that you feel 95%-100% confident that you will NOT fall.  This position will look different for everyone.  Some folks will have their feet really close, as though they are standing with their feet side by side.  Others may be able to move their feet further apart and have them placed more  narrow to create the POC.  Why is this important?  The POC will become a reference point as we move through the BU program and create the beginning of better balance, mobility and independence.

Tim Tebow is a great example as to how the POC will improve your confidence and balance.  Tim is a phenomenal athlete and quarterback.  Did you know that only .1% of all football players that play football in high school will become professional football players and play in the NFL.  One of the main reasons Tim Tebow is not playing Quarterback in the NFL is because of how long it takes him to get the ball out of his hand and throw the football.  If you will look at the pictures above, you will see the difference between Tim's motion and how low he drops his arm.  Then take a look at Aaron Rodgers and how low Aaron's arm is located during the throwing motion.  The differences may be subtle to some, however, in the game of football, seconds and inches can mean the difference between being open as a receiver or a being covered by a defender or defensive back. 

How many time do you think Tim Tebow has thrown a football this way?

When Tim sees an open receiver and wants to throw the football to them, do you think he is thinking, "elbow up, move arm back, drop arm, take a step back with the left foot, uh oh.... here comes a 367lb. lineman to tackle me!... RUN... ok... get set, drop arm, thumbs under.... etc."  ABSOLUTELY not!  Here's what happens, Tim sees an open receiver and he fires away!  In order for this to happen, the CEO (brain) receives a message from his eyes that tells him to flip the "throw the ball NOW switch".  This "switch" activates a series of muscle contractions from the feet, neck, shoulder, arm, core and legs that allows Tim to throw the ball without thinking about contracting each of those muscles individually.  In other words, Tim is not focused on his throwing motion, he is focused on making a determination on which receiver he should throw it too!
Why? 
Tim has thrown the ball this way his entire life and he has been able to develop and create a pattern or "button" for the CEO (brain).  He has created muscle memory that allows his CEO (brain) to flip a switch and the symphony of muscle contractions begins without much thought.  So, how many times would Tim need to throw the ball correctly in order to change his muscle memory and motion to mimick Aaron Rodgers motion and get the ball out of his hand much more quickly? 
The answer:
Tim would need to throw the ball correctly as many times as he has thrown the ball incorrectly, to get it right and establish a new pattern and "button" for the CEO to press.
 
The only way to improve one's balance is through consistent and repetitive work in proprioceptive environments just like the POC.  Balance University teaches it's students the correct way to establish neuromuscular efficiency and the correct patterns needed to create better balance.  There is not a secret movement or "magical" exercise, however, there is certainly a right order to the exercises needed to create a more balanced and independent person.

I want to prevent folks from falling, better known as "fall prevention", rather than deal with the repurcussions that follow like hospital and doctor visits!