Chapter 3: how to keep going.

"Definitely NOT!" That's what 75-year-old Emma King told us when we asked her if she ever intended to stop exercising. Ms. King lives in Durham, North Carolina, and has taken long walks at least 4 or 5 days a week, for years. Recently, she took part in a study of exercise for older adults and added stretching to her weekly routine. "I can really tell the difference if I miss 2 or 3 days. I don't know what it would be like not to exercise," she said.

For many older adults, motivation to keep exercising and doing physical activities isn't a problem. They say that regular physical activity makes them feel so much better that it would be hard to stop.

Others say that, while physical activity makes them feel better, a little extra motivation helps them get going. For example, Georgia Burnette, 68, of Amherst, New York, told us that she used to put on headphones and listen to recorded books borrowed from the library to make her 40-minute walks more interesting. Now, she mall-walks for an hour, 5 days a week, with a friend. Having that companionship is a good motivator, says Ms. Burnette.

We have included this section on motivation because physical activity needs to be a regular, permanent habit to produce benefits like those listed in Chapter 1. So does staying motivated!

Recording your scores and watching them improve can be an excellent motivator to exercise, and we have included charts at the end of this booklet so you can do that. But don't get discouraged if you see that your scores have improved by only a few seconds or just one or two lifts of a weight. In terms of real-life benefits, those slight improvements are multiplied many times over as you include them in your everyday activities. You incorporate that extra little bit of endurance and strength into everything you do, and it adds up to a lot.

But no matter how enthusiastic you are about exercise, there may be times when you need extra motivation. It's common for beginning exercisers, especially those who are frail, to make fast progress at first. You might get discouraged when the improvements you were making taper off at times.

These leveling-off periods are normal. Often, they mean that it's time to gradually make your activities more challenging. If you have any doubts about whether you are doing the right things to progress, check the guidelines listed under each type of exercise in Chapter 4, or check with your doctor or a qualified fitness professional (see page 23).

When you need extra motivation, try the following:

* Ask someone to be your exercise buddy. Many older adults agree that having someone to exercise with helps keep them going.

* Follow Georgia Burnette's advice: Listen to recorded books or music while you do endurance activities.

* Set a goal, and decide on a reward you will get when you reach it.

* Give yourself physical activity homework assignments for the next day or the next week.

* Think of your exercise sessions as appointments, and mark them on your calendar.

* Keep a record of what you do and of your progress. Understand that there will be times that you don't show rapid progress and that you are still benefiting from your activities during those times.

* Plan ahead for travel, bad weather, and house guests. For example, an exercise video can help you exercise indoors when the weather is bad.

Let Us Acknowledge Your Efforts

When it comes to motivation, the first month is crucial. If you can increase your physical activity for a month and keep going after that, you will have passed a critical landmark. It's a good sign that you are on your way to making exercise and physical activity regular, life-long habits.

We want to give you credit for that. If you increase your physical activity for more than a month, send us the form at the end of this book. We will send you a National Institute on Aging certificate acknowledging your commitment.

Chapter Summary

Starting with one or two types of exercises or physical activities and a schedule that you really can manage, then adding more as you adjust, is one way of ensuring that you will keep exercising. You are also more likely to keep exercising if you feel you can do your exercises correctly and safely, feel that they fit into your schedule, and don't feel that they result in negative experiences, such as financial burdens or lost time.

Just knowing that physical activity can improve your health and abilities can be enough to keep you exercising, but you might need extra motivation sometimes. For those times, try exercising with a friend, listening to music, charting your progress, marking your calendar for exercise sessions, giving yourself exercise "assignments" ahead of time, and rewarding yourself when you achieve your goals.

Overall, your fitness should improve. If it doesn't, review the instructions on how to progress in Chapter 4.

If you stick with your exercises for more than a month, it's a good sign that you are on your way to making it a permanent habit. If you would like acknowledgment of your efforts, fill out the form at the end of this book, and we will send you a National Institute on Aging certificate.

Sticking With It: What Works

According to the U.S. Surgeon General's report, you are more likely to keep doing physical activities if you:

* think that, overall, you will benefit from them

* include activities you enjoy

* feel you can do the activities correctly and safely

* have regular access to the activities

* can fit the activities into your daily schedule

* feel that the activities don't impose financial or social costs you aren't willing to take on

* have few negative consequences from doing your activities (such as injury, lost time, or negative peer pressure)

In other words, set yourself up to succeed right from the start. Choose realistic goals, learn to do the exercises correctly and safely, and chart your progress to see your improvement.

Finding A Qualified Fitness Professional

Most older people can exercise just fine on their own, without advice from a fitness instructor. Some have special needs and may want to consult a professional. If you decide to seek advice, how can you tell whom to trust? Anyone can call himself or herself a fitness professional, and many people do--but that doesn't always mean they have the training to help older people exercise safely and effectively.

Instructors who aren't trained to work with older adults, specifically, might not be aware of their needs. For example, they might not know that certain conditions or medications can change older people's heart rates or that people with osteoporosis risk spine fractures if they do some types of forward-bending exercises incorrectly.

A number of professionals are familiar with the special physical needs of older people. Doctors who specialize in sports medicine are highly qualified to help you exercise the right way. So are professionals who have a college degree in exercise physiology. They can help you start an exercise program tailored to your needs, build it up to your best possible level, then show you how to continue safely on your own.

Physical therapists also are qualified to design exercise plans for older people, especially those who have conditions affecting their muscles and skeletal systems, or nervous-system conditions that affect their muscles. Some physical therapists take special training for a certification in geriatrics.

The American College of Sports Medicine (ACSM) also trains and certifies people to work with older adults. The ACSM is made up of health professionals and scientists with an interest in fitness. ACSM-certified fitness instructors work in a variety of settings; for example, you might find them leading hospital-based exercise programs for older adults, working with older people in exercise studies, or working as personal trainers.

Cardiologists can advise you on how to improve your cardiovascular system through endurance exercise. Orthopedic doctors can help you understand how to prevent injuries to your muscles, bones, and other structures.

Many hospitals and health plans now have wellness centers that offer exercise programs. Some colleges and universities hold special exercise classes for older adults or conduct studies on exercise for older people. It's likely that the fitness instructors hired by these organizations are carefully screened and are qualified to teach you how to exercise correctly. Try calling them to find a fitness professional in your area.

If you do consult a fitness instructor, ask for his or her credentials. Any instructor who is qualified to work with older people is likely to be proud of his or her credentials and will be happy to share them with you. Also ask about expense. Costs vary, and insurance plans differ as to what kinds of services they will cover.

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Making It Work

There are lots of ways to increase your physical activity. Exercising at home is just one of them, and we feature it here because it's within the reach of most older people. Or, you might decide to follow Phyllis Wendahl's example, instead, and do something different.

Ms. Wendahl is 85 years old and lives in the small town of Bothell, Washington. On the phone, she sounds much younger. She is a widow and lives on her Social Security income, and, like many older adults, she won't let her kids spoil her as much as they would like to. She would rather do things on her own.

That's why, when she was scouting around for a fitness club where she could use strength-building equipment, she bargained the owner down to a monthly fee that she felt she could afford--$25 a month for unlimited use.

"Look, I know that not everybody is as bold as I am about that kind of thing," Ms. Wendahl told us. Nonetheless, she has some advice for older adults who are thinking about going to a fitness center: "They don't need to feel self-conscious about going to the club. The owner of my club holds me up as an example now."

Ms. Wendahl said that she has always been active, but never as much as she is now. She began doing aerobic exercises in her 70s, moved on to water aerobics, and most recently to strength-building and stretching 3 times a week. She lives on her own and drives herself wherever she needs to go. After 6 months of endurance and strength exercises, measurements showed that Ms. Wendahl was able to perform household tasks--carrying groceries, making her bed, and transferring laundry--more quickly. She could also carry more weight.

"It has just done me a world of good," she said of her physically active lifestyle. "My family is so thrilled and proud of me," she added.

She wants older adults who read this book to know that, when it comes to exercise and physical activity, "there's always something within someone's capabilities. There's no reason older people need to be sitting in a rocking chair."

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