Balance through ballet.

In any nursing home or long-term care setting, the words "I've fallen and I can't get up" are not comedic advertising buzzwords. They are a serious--often devastating--cry for help. But the risk of falls can be reduced. Aging doesn't automatically equate to lost muscle tone, reduced range of motion, or poor balance. The key is to keep moving.

At Heritage Park, a CCRC located in Fort Wayne, Indiana, we offer our residents an ingenious program called Benevolent Ballet--Fall Prevention for the Elderly. This program is enjoyed by both men and women. It takes female residents back to their youth when graceful jetes, arabesques, and pirouettes were a part of their little girl dreams. Although very few people ever set foot on a professional stage, dance, in general, remains a lifelong vehicle of self-expression, which is why some of our male residents have joined the group. They, too, have an appreciation for the grace and, possibly, the athleticism necessary for a dancer to interpret the mood and movement suggested by the music. After all, when these folks were younger, dancing was their entertainment.

Developed in 1995 by Sheila Lehner in consultation with geriatric experts, Benevolent Ballet is designed to help the elderly protect themselves from the risks of failing. To learn more about the concept and if it would work at Heritage Park, I contacted Lehner and arranged to attend one of her training sessions. An instructor in classical ballet, Lehner says that anyone can learn to conduct the exercises--no previous dance experience is required. Fall risk in the elderly is reduced through a set of exercises--set against a backdrop of beautiful music--that is designed to improve balance, strength, posture, and coordination. At the seminar, we practiced the exercises, steps, and movements, along with specialized teaching techniques. Elders face many challenges and we were shown ways to empathize with and motivate them.

Benevolent Ballet is geared for the active senior through advancing Alzheimer's, but we have modified it as a sit-down exercise program for residents of our nursing center and memory care units. Its primary premise is to create an awareness of one's body. Through the prescribed exercises (arm stretches, leg movements, sways, and more), residents become reacquainted with what their bodies can and will still do. They learn how to maintain good posture and body alignment, to which staff cues them when ambulating. In addition, residents learn how to center their body weight, much as a dancer does. Another component of the program is getting residents tn transfer their weight in a swaying motion from hip to hip as they do when they walk.

Along with transferring their weight and graceful arm extensions, our "dancers" combine those movements with leg lifts, side kicks and, like classically trained dancers, foot positions. Choreographing these movements enhances the exercise experience by combining music with movement. Only one movement is practiced at a time, and nothing new is added until the first step is mastered by everyone. At that point, a new stretch or exercise is introduced that builds on the previous movement, and so on. This sequencing is then set to music and the residents, even the cognitively impaired, perform their dance.

Music plays a pivotal role in maintaining resident interest and enjoyment; our residents respond to the moody, expressive New Age melodies of Jim Brickman. His music speaks to them on a dramatic, emotional, and personal level. One-half hour before assembling, we begin playing Brickman selections as a cue for participants to assemble in the activity area. While waiting to begin, the residents sit and listen, connecting with the music and the mood.

Over time, as the group became comfortable with Benevolent Ballet routines, a dramatic new element was added: scarves. Before we begin, a basket with an assortment of scarves in fluorescent shades of pink, lime green, orange, and lemon yellow is passed around the room and each resident chooses one or two. Sometimes the choice is made to match that day's outfit and other times, perhaps, the color reflects a resident's mood. This sounds like a little thing, but for the elderly, who generally aren't given many choices, it's quite meaningful.

The scarves are now a permanent part of the routine; after making their selections, the participants instinctively begin to wave them up and down and in arcs to limber up their wrists and arms. This routine evolved from when we first introduced the scarves. The activity aide and I were so busy helping each resident select a scarf that, when we finished and were ready to begin the session, we got quite a surprise. Our graceful female dancers were wearing the scarves tied around their heads, knotted around their waists, or around their shoulders as a shawl! It was actually very sweet to see because, rather than becoming confused, they immediately put the scarves to their accustomed use. After letting the residents know that we were planning to use the scarves in a new way, they quickly learned to incorporate the flowing colors into their dance routine to make it more dramatic and expressive. Now, when they assemble, they immediately move into their warm-up routine. By adding the scarves, I've found that the residents put something extra into their movements.

Before Benevolent Ballet, exercise was just that--exercise. It didn't inspire or reward. Now, residents make an extra effort to stretch farther or kick higher or hold a pose longer, because it adds to the dance. I'm very impressed with this exercise program because it offers more than just the physical benefit--the residents derive emotional and psychosocial benefits, as well.

Residents build self-esteem through individual and group accomplishments. Even a person who had a stroke can participate. If, for instance, a person's right side is compromised, movement is then focused on what the resident can do with the left side. When it's done successfully, the joy of accomplishment shines on the resident's face. She or he disregards her or his limitations and focuses on retained abilities.

We've found a tremendous difference in the overall carriage of our residents. Prior to Benevolent Ballet, they walked bent over with hesitant strides. Now their gait and sense of balance are improved. They are less wary of falling than before, and when they are reminded to stand straight, they call upon the techniques they learned in class to do so. This is also a bonding program for the residents; being part of a group makes them feel whole. After every session, each person is congratulated and thanked for participating.

Although there has not been an official performance of Benevolent Ballet, many visitors and staff enjoy watching the dancers' accomplishments in the activity areas. In the future, I hope to videotape their dances so that the dancers can see the beauty, style, interpretation, and grace they bring to them.

Other than the initial training and purchasing the scarves this is a very affordable program that provides vital exercise, while transporting residents back to a time when grace, rhythm, and beautiful music were the touchstones of their lives.

For further information, contact Heritage Park Memory Care Facilitator Cindy Shepherd at [phone] or fax [phone]. To learn more about Benevolent Ballet, visit www.geocities.com/ benevolentballet. To comment on this article, please send e-mail to [e-mail].