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Helping older clients with their depression

Although depression is not considered a normal part of aging, this illness is common among
older adults. According to the American Association of Geriatric Psychiatry 15% of adults ages
65 and above experience symptoms of depressions that cause them distress and make it
difficult for them to function.

Depression also influences the physical and mental health of older adults, say researchers from
the University of Washington. Their study of the healthcare costs associated with depression
shows that mature adults with significant depressive symptoms had healthcare costs about 50%
higher than older individuals without depression. According to the researchers, this increase
was seen for every component of healthcare costs and was not accounted for by an increase
specialty mental healthcare.

Currently depression is the fourth leading cause of premature death and disability worldwide
and is expected to become the second leading cause by 2020, according to the World Health

Many studies in the last decade have looked at the effects of exercise on depression. This
research has found that exercise enhances self-esteem, improves mood, reduces anxiety
levels, increases the ability to handle stress and improves sleep patterns. In addition, a recent
study suggests that exercise many be an effective antidote to major depression.! !
Investigators from Duke University Medical Center tested exercise against an antidepressant in
156 outpatients ages 50 and older who met the criteria for a major depressive disorder. The
team discovered that both treatments had about the same ability individually (or combined) to
reduce or eliminate symptoms. Exercise also did a better job of keeping symptoms from coming
back after the depression lifted.

Being a Personal Trainer puts you in an excellent position to help older adults who might be
suffering from depression. You can help depressed clients feel better by helping them through
physical activity and through giving them your full undivided attention.

Physical activity breaks down emotional barriers, freeing older adults to express their feelings or
talk about the distresses in their lives. It’s important for you to be fully engaged and listen when
your clients feel safe enough to open up more in their conversations with you. If you listen
authentically and with clear intention you’ll draw your mature clients out and encourage them to
express their emotions.

You can promote these interactions by selecting exercises that help you maintain good eye
contact. For example, avoid using any exercise at the moment in which your eye level is higher
or lower than the clients, such as lying on the floor. This particular position can discourage the
free flowing interaction between the individual and you. Constantly assess your position,
adjusting it when necessary by standing or kneeling to keep eye-level contact.

Here is a list of helpful ideas for listening to older adults.

1. Stop talking. Resist giving advice and limit your talking. You can’t listen while you talk.!
2. Empathize. Try to put yourself in the older adults place so you can see or understand the
person’s perspective.!
3. Don’t give up too soon. Be patient, don’t interrupt.!
4. Concentrate on what the client is saying. Actively focus your attention on words, ideas
and feelings related to the subject.!
5. Look at the person. Focus both eyes intently on ONE of the client’s eyes, rather than
shifting your focus from eye to eye. You’ll be amazed at what you will see and learn.!
6. Leave your emotions behind. Try to push your worries, fears and problems outside the

By using the right exercise intensity levels, you will help break down barriers and crate open
communication between you and your clients. Then, with your best effort and intention, you can
engage them with your full attention, utilizing this two pronged approach helping your clients feel
less depressed, better about themselves and better able to think more clearly about issues at

Paul Holbrook, MA, CSCS
FAI Advisory Board Member
Owner, Age Performance

When did we stop listening to our bodies?

Every human has an internal wisdom which guides and directs us. Our belief systems are like computer programs. When we are old enough to hear and see, we begin to program ourselves. We believe anything our role models tell us, even if what they tell us goes against our own feelings or bodily impulses. For example, if the child is hungry and tells the caregiver, and the caregiver says, “How could you be hungry, you just ate,” the child’s computer programming will take in that information and register that the child’s bodily impulses are incorrect. This is one way we lose our mind/body connection. We begin to live in our heads and totally reject contradictory messages communicated by our physical bodies, which, paradoxically, happens to be the most innately wise part of our entire being. Our body wisdom is shaped by our experiences and our bodies are the vehicles we use to travel the path of life.

Our wisdom tells us if we are doing the right things for the right reasons. Is this a pain we should work through or does it indicate to modify or stop? If we listen and act accordingly, we will know much more about our health. We tend to concentrate on specific athletic endeavors as opposed to a variety of activities that create a balanced body. This comes from following fitness fads, competitions, or body dysmorphic disorders.

The body begins to compensate for various reasons including, over tight muscles, weak muscles, over rotation, limb length changes, etc. Continual compensation leads to dysfunction and more compensation. Anatomical dysfunctions can interfere with the body’s ability to perform both physical and mental tasks. When there are postural changes, the whole kinetic chain is interrupted and the whole skeletal system is affected.
These misalignments also affect the performance of other body systems, including the cardiovascular, digestive and respiratory systems.

When developing program design both clients and trainers need to understand a systematic approach using a four stage progression model which will ensure proper body mechanics and correct kinetic chain firing.
Stage one evaluates stability and the ability to maintain or control joint movement or position without compensation. This is achieved by synergistic actions of the components of the joints and the neuromuscular system without compromising joint mobility.
Stage two evaluates mobility and the range of uninhibited movement around a joint. This is achieved by the synergistic actions of the components of the joint and the neuromuscular system without compromising joint stability. There are 5 fundamental movement patterns which include: bend and lift, push, pull, rotation, and one leg movements.
Stage three incorporates loading using traditional programming to achieve muscular strength and endurance. This phase should not be implemented until phase one and two are achieved.
Stage four addresses skill-related components of fitness which help improve the functionality of performance and include: agility, balance, reaction time, coordination, speed, and power.

Dianne McCaughey, PhD
FAI Advisory Board Member

Strategies for Successful Aging

In the process of working on my doctorate in gerontology, I discovered, rather than studying physical health, I was more interested in understanding and evaluating the mental, emotional and spiritual health of people who were getting up in age. I collected and analyzed data to learn more about the participants’ experiences with their life crises, how they responded to a particular crisis, coped with the crisis or learned from the crisis, and how they had applied this learning to their later lives. By understanding the importance of these other areas you will become more effective working with mature clients.

Our satisfaction with life and our self-esteem are on average as high in old age as they are at any other time in adulthood. As we age, our earlier expectations of life change and more and more come to match our current realities. We become in some ways wise, mellow and more able to enjoy the present moment.

As people grow older and have fewer years left, they become more concerned about enjoying the present and less concerned with activities that prepare for the future. Less time, attention and energy are devoted to casual acquaintances, long-term marriages grow closer, and partners enjoy each other more and spend less time trying to improve, impress and dominate each other. Ties with family and old friends grow closer while social networks shrink in size. Surveys show that our fear of death typically peaks in our fifties but lessens as we age. Older individuals are less fearful of death, more likely to accept it because they know they have lived a full life.

Life changing processes in human development have been studied for years. Erik Erikson was one of the pioneers of this research, and he believed adults continue to grow and mature throughout their entire lives, not just the early years. Erickson believed wisdom is the end result of any healthy crisis resolution and is evident in a person’s proverbially seeing the glass half full rather than half empty. Wisdom has been considered from the earliest of times the pinnacle of human development because of its positive qualities and its helping us to understand the life we have had, the life we have, and life in general.

Taking Action
Believing that one’s efforts can influence an outcome increases the likelihood of the person’s actually selecting goals to act upon, investing the necessary time and energy in achieving those goals, and experiencing a personal sense of well-being. The basis for healthy growth in all stages is that as long as people try, they can succeed. A wise person weighs the known and unknown and resists overwhelming emotion while taking appropriate action. Successful aging was found to be an end result for those who had coped well, found an opportunity and proactively dealt with their stressors. Personalities that were more confident had positive beliefs, assertive behaviors, and, in the end, enjoyed themselves more. Not taking action, on the other hand, or deflecting responsibility for their actions prevented individuals from learning, from introspective analyses, and frustrated the potential of their futures.

Action must be taken for learning to occur. Real change takes place from the inside out. Once individuals begin to recognize the ineffective methods they have used in their lives to cope with the stress of challenges, they can begin to correct the faulty methods and make positive changes. Those who choose to take control of their lives take action. They work on things they can do something about.

Each of us must take the initiative and responsibility to make things happen. And making things happen keeps us from seeing ourselves as victims and helps us to move from reactive to proactive behaviors. In this way, purposefully reconnecting with the self enriches a person’s life experience and helps people learn to be their real-selves. In fact, data from my research concluded that being one’s real-self was a desire that three-fourths of the participants acted upon after their first crisis. They learned that to be truly happy, they had had to follow their hearts, to be themselves, and they learned that real joy in life did not come from their trying to be what everyone else wanted them to be.

While the majority of the participants believed that each day should be lived to the fullest, they all expressed it in different ways. Some suggested that living each day to the fullest is a way of practicing gratitude for the life they have. Others indicated that even after the earlier crisis, their awareness of the value of living each day to its fullest became more clear.

But, to change requires flexibility. Deepak Chopra indicates that flexibility can reverse biological aging and that flexibility comes from letting go of attachments and being resilient when facing inevitable challenges in life. The crisis itself may not be forgotten, but the sense of urgency to change is remembered. Healthy forgetfulness involves moving on, but only after the appropriate changes have been made. If there is no change, there is no moving on.

After a crisis occurs, and the coping is completed, and time passes, individuals have choices. They come to a crossroad at which they must choose between continuing life as it had been or moving on to what the future promises.

Virtually all research data suggests that moving on with one’s life is the appropriate action to take once the value of embracing change has been established. There was a letting go of some kind for all who wish to be the most complete version of their true selves, and there is a period of grieving for what is left behind or let go of, but those who move from the past to the present eventually acquire hope for the future.

Successful aging is a result of a balanced exchange of energy between the individual and the social system in which the individual finds himself or herself. Almost all older persons living in private homes engage in some form of productive activity. Freud indicated that love and work are essential to successful living. Sadly, many retired elders have lost their sense of purpose and productivity and feel cynical, bored and empty. The definition of work is larger than the job and thus suggests work is not governed by a paycheck or a time clock. Work might include weeding a garden, baking bread, teaching a skill, or volunteering in one’s community.

Having a purpose in life has been found to create a passion for life and gives meaning to life. Older individuals who still believe they can improve themselves need a sense of creative tension that cancels out the lack of challenge and depression that has been found to cause disease. Thus, the key to successful aging is to redefine our purpose and move from a self-centered world to an altruistic world of caring for fellow human beings. The challenge is to find that kind of caring that creates a sense of aliveness and purpose in us, to find what stimulates us to continuing growing and developing our better selves.

Satisfaction with one’s life was found to be predicated on our sense of having achieved our goals, be they socioeconomic status, employment or self-actualization. Yet, many healthy and happy elders had to re-create their definition of success from security, advancement and retirement to greater commitments to family, community, nature and spiritual growth. To make a contribution is one of the most popularly cited reasons for why people choose their work, and the reward for giving to something larger than themselves is not only valuable to others but also invaluable to the giver. It is not enough to be kept busy, study participants reported, but that their work had to be directed toward some pragmatic end, to help others or themselves, in order for the work to have meaning.


Self-worth and confidence are components of well-being and personal happiness. Successfully moving through crises, learning life’s lessons and acquiring the wisdom necessary to create an improved self, increases our sense of well being and happiness and leads to a healthy sense of self-worth.

Growing old is an enriching experience that involves our appreciation of our personal significance and our coming to terms with losses and changes. Personal growth is just that, a maturation of the self, which evolves or is spirited on in many ways, through introspection, the altering of values and perspectives, and action. By committing ourselves to being our best selves, we help ourselves and everyone around us.

By knowing why you are, and who you are, you can begin to make yourself into the person you want to be.

Dianne McCaughey, PhD
FAI Advisory Board Member

Aging Wisdom

Current research indicates there are three types of wisdom: cognitive, affective and reflective. The cognitive dimension is related to our understanding of the deeper meaning of life, our responding to the desire to know truth and comprehend the underlying significance of events. The affective dimension is related to our sentiments and actions toward others and tends to increase our sensitivity to what is going on around us. Affective wisdom also enhances our empathetic love and our desire to eliminate apathy and cruelty toward others and therefore promotes a reduction of self-centeredness and other negative personality traits. Reflective wisdom is manifested in our practice of self-reflection and introspection. This awareness of self stimulates the perceptive processes necessary for us and others to acknowledge and understand our own and others’ intentions and conduct, decreases self-absorption and blaming, and increases our ability to understand different perspectives and make positive situational value shifts. Additionally, reflective wisdom helps us to accept our limitations and become aware that there are many ways to see and interpret a phenomenon, even while seeking an ultimate truth. Thus, in the end, because it promotes the development of both cognitive and affective wisdom, reflective wisdom is the most important form.

Wisdom is thought to be a reliable indicator of successful aging, and this wisdom cannot be taught but is obtained only through personal involvement and the willingness to be transformed through personal life experiences, self-reflection, self-awareness and the evolution of one’s inner-self.
Age provides us an opportunity to explore and develop a reflective mode of thinking that includes contemplating the meaning of life, coming to terms with our past by striving for self-fulfillment and spiritual advancement as we prepare for our inevitable end. Wise elders do not begrudge the loss of people or things over which they have no control, but instead treat their own weaknesses with humor as they navigate the natural currents of later life.
Wisdom creates opportunities for transitions that may be disorienting and painful, but also creates pathways to growth and discovery as well as connecting individuals to the deeper meanings of their lives. The purpose of the transition is to help us learn our own personal stories about life so as to avoid repeating our own mistakes and to pass this learned wisdom on to the next generation.
As mentioned earlier, stimulating a person’s will to initiate needed changes frequently takes difficult times. Yet, after looking at a problem from a new and different angle or point of view, we can begin to anticipate challenges and move forward toward solving problems. This change in perception fosters renewed reflective thinking and continues to further our evolution toward wisdom.

In a Harvard study, participants were asked to share what they believed were the benefits of pursuing wisdom and to identify rules of living well they had gathered during their lifetimes and to note what they would consider valuable to pass on to the next generation. Some of their suggestions included:
Be happy into old age
Be confident
Search for meaning
Live life because it is worth living

Older adults rate their problems as less stressful and have learned that problems happen and that blaming themselves or others for those problems is a waste of time and energy. These older adults adapt, move forward and simply manage the problem. And these adaptive strategy changes appear to be very important for good mental health in later years.

In interviews of over one hundred older adults, all of these adults reported being grateful for the benefits as well as the challenges and lessons of their past. They accepted the positive and the negative, which led to greater patience, humility, tolerance, understanding and compassion. Wisdom, according to them, is a virtue that results from the successful resolution of challenges encountered during their respective stages of development and is apparent in our coming to terms with our past as well as our present. Clearly, wisdom comes with age as a result of transitioning from who we found ourselves to be and what we do to make ourselves into the people we want to be. Striving for stasis or attempting to keep things as they are is self-defeating. As one participant reported, change is inevitable and “When you have plans, God laughs.”

Dianne McCaughey, PhD
FAI Advisory Board Member

Functional Longevity Exercises

Here is some great information you can repost to your list of older clients or on your blog or even print out and post in your facility!

When it comes to increasing physical function for a long time which exercises are the best?  I’ve assembled some of the top functional longevity exercises that I could come up with.  These are the same types of functional longevity exercises that I use in the Never Grow Old Fitness Formula – a follow-along exercise program for mature adults.  But first let me give you a few common characteristics of high-quality functional longevity exercises.

Functional Longevity Exercises:
1.         Challenge many aspects of physical function such as strength, balance, endurance, coordination, proprioception and stability

2.         Use many muscles and limbs simultaneously

3.         Focus on completion of a task rather than training a specific muscle

4.         Are easy on the joints

5.         Use a variety of equipment options

6.         Are rarely performed in a seated position (unless standing is not possible)

So here are some of my top functional longevity exercises for you to try:
•          Power Stand (stand up from a chair as fast as possible and lower back down slowly)
•          Lunge with reach to toes (both hands)
•          Side lunge with reach toe (opposite hand to toe)
•          Standing 1 arm row with tubing
•          Standing 1-arm chest press with tubing
•          Standing diagonal lift with DB (or medicine ball)
•          Plank Series (front, side, back)
•          Obstacle Course
•          High-Intensity Interval Training (cardio)

If you want to not only live a long life but also able to have a high functioning body in order to enjoy all of those extra years then try out these functional longevity exercises for yourself.  If you are already an avid exerciser but you perform the basic strength training movements on exercise machines at the gym then I dare you to try these functional longevity exercises instead.

Ready to start a Functional Longevity Exercise program?  Then click here!

Cody Sipe, PhD


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