Which of the following is important to remember when providing care to adults aged 80 older?

• Keeping active helps you stay physically and mentally strong.
• Aim for about 30 minutes of moderate-intensity physical activity on most days, but any amount of activity is beneficial — even just a few minutes.
• Strength and weight-bearing activities can increase bone density, helping to prevent osteoporosis.
• Consider exercising with a friend, and choose activities you enjoy, to help you stay motivated.

Whatever your age, you can enjoy the benefits of physical activity. There’s a host of health reasons to stay active and it doesn’t have to be ‘serious business’ — being active can be fun, especially if you can socialise at the same time. Exercise also helps keep your mind active and improves your quality of life.

Even a small increase in daily physical activity can reduce your risk of health conditions such as:

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Physical activity can also:

Conversely, spending a lot of time sitting down (being sedentary) may increase the risk of health conditions. So it’s a good idea to break up long periods of sitting with physical activity. Even a few minutes of walking or stretching is beneficial.

Can physical activity ‘slow down’ the ageing process?

Some types of physical activity, such as resistance training and flexibility exercises, can improve physical changes that come with ageing.

Most people lose some muscle mass, bone density and flexibility as they age. Chronic health problems can also contribute to weakness and frailty.

Physical activity has been shown to improve overall health, reduce the chance of chronic health conditions and reduce frailty. This means that staying active may help you live longer with a better quality of life.

How much physical activity do older people need?

You should aim for about 30 minutes of moderate-intensity physical activity every day. Moderate-intensity exercise should make you feel a bit breathless, but you should still be able to talk comfortably.

Incorporate different types of physical activity into your daily routine. This will keep it interesting and easier to stick to over time.

What types of exercise should older people be doing?

There are 4 main types of physical activity that are important for people of all ages.

Cardiovascular (‘cardio’) fitness activities help keep your heart and lungs healthy. This includes:

• brisk walking
• cycling
• swimming
• golf (without a gold cart)
• tennis
• aerobics classes
• dancing

Household chores such as gardening and cleaning can also be a great cardio workout. Low-impact activities such as swimming can be beneficial for people who find movement painful because of health conditions such as osteoarthritis.

You don’t have to do all of your activity in one session per day — you can spread it out. For example, 10 minutes of cardio 3 times a day, or 15 minutes twice a day

Strength activities help your muscles and bones stay strong. Strength training and weight-bearing exercise are especially helpful at increasing your bone density and reducing the risk of falls among people with osteoporosis.

Strength exercises include:

• weight training
• resistance training
• lifting and carrying (for example, groceries or small children)
• gardening (involving digging and lifting)
• climbing stairs

Aim to build strength exercises into your routine about 2 to 3 times a week.

Flexibility activities incorporate gentle stretching and bending exercises that help you move more easily. This might include:

• Tai Chi
• yoga
• dancing
• gardening
• lawn bowls
• mopping or vacuuming

Try to do some stretching exercises every day. You can even stretch while watching TV or waiting for the kettle to boil — you can follow the diagrams here.

Balancing activities help improve your balance, which can help prevent falls. They include:

• side leg raises
• half squats
• heel raises

Remember, physical activity can be varied and you can exercise outside of a gym or classes. There are also online fitness tools and programs you can use at home.

Even people who are less mobile or have a disability can find ways to keep active. Find an exercise program that is tailored to people at a similar age and fitness level as you.

If you’re struggling to find an activity that’s right for you, ask your doctor, exercise physiologist or physiotherapist for advice.

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How can older people start exercising safely?

Start gradually to give your body time to adjust to a new exercise routine. Try short periods of activity and, over a few weeks, build up to about 30 minutes of physical activity on most days. Even a few minutes of activity is beneficial when you’re starting out.

Wear comfortable clothes and supportive shoes. Drink plenty of water before, during and after exercising.

High-intensity (vigorous) exercise isn’t specifically recommended for older people, particularly those with osteoporosis since it can increase the risk of fractures. But if you’ve enjoyed vigorous exercise throughout your life you may be able to safely continue as you get older. Check with your doctor.

Don’t stop or slow down without first checking with your doctor — you might just be advised to keep it up, or modify your activity slightly as you get older.

If you have stopped being active because of a health condition or recent surgery, talk to your doctor before resuming your fitness program. In some cases, your doctor may refer you to a physiotherapist or exercise physiologist for advice.

Physical activity should involve some effort, but shouldn’t cause pain. If you experience pain or other symptoms such as dizziness or heart palpitations when you exercise, stop the activity and see your doctor.

If you are experiencing severe chest pain or shortness of breath, call triple zero (000) and ask for an ambulance.

How do I stay motivated to keep active?

Even when you know that physical activity is beneficial, it can be hard to get started and stay motivated. You could:

• choose activities you enjoy
• switch to another activity if you find yourself getting bored
• invite a family member or friend to join you
• use reminders, such as post-it notes on the fridge
• plan ahead — schedule activities in your diary or calendar and allocate regular times for exercise
• use a diary or activity tracker to record your activities to help keep you motivated

Myths about physical activity and older people

‘Older people can’t go to the gym.’

Fact: Gyms are not just for younger people. Many older people enjoy working out at gyms or attending exercise classes, many of which are tailored to seniors.

If it makes you more comfortable (and you're retired), you could go to the gym during off-peak hours. You could also request a tour or introductory training session with a qualified personal trainer. It’s also important to remember that physical activity can take place anywhere.

‘Frail people can’t exercise.’

Fact Most people can find enjoyable ways to safely stay active, even if they have health problems or are frail. Physical activity can actually help you become stronger and less frail. If you are struggling to find an activity that is right for you, ask your doctor, exercise physiologist or physiotherapist for ideas.

‘I’m too old to start exercising.’

Fact: It’s never too late to become more active and enjoying the benefits of physical activity. Improving your fitness and mobility, even at an older age, will boost your physical and mental health, and quality of life.

Resources and support

Last reviewed: December 2021

The varied needs of older patients may require different interviewing techniques. The following guidelines can help you obtain a thorough history of current and past concerns, family history, medications, and socioeconomic situation.

These suggestions are less time-consuming than they may appear. Some involve a single investment of time. Other health care professionals in the office or home may assist in gathering the information. You may want to get a detailed life and medical history as an ongoing part of older patients' office visits and use each visit to add to and update information.

General suggestions

You may need to be especially flexible when obtaining the medical history of older patients. Here are some strategies to make efficient use of your time and theirs:

• If feasible, try to gather preliminary data before the session. Request previous medical records or, if there is time, mail forms that the patient or a family member can complete at home. Try to structure questionnaires for easy reading by using large type and providing enough space between items for people to respond. Questionnaires to fill out in the waiting room should be brief.
• Try to have the patient tell his or her story only once, not to another staff member and then again to you. For older patients who are ill, this process can be very tiring.
• Sit and face the patient at eye level. Use active listening skills, responding with brief comments such as "I see" and "okay."
• Be willing to depart from the usual interview structure. You might understand the patient's condition more quickly if you elicit his or her past medical history immediately after the chief complaint, before making a complete evaluation of the present illness.
• Try to use open-ended questions that encourage a more comprehensive response. If the patient has trouble with responding, be prepared with yes-or-no or simple-choice questions.
• Remember that the interview itself can be beneficial. Although you see many patients every day, you may be the only person your patient is socially engaged with that day. Your attention is important. Giving your patient a chance to express concerns to an interested person can be therapeutic and can build trust.

Elicit current concerns

Older patients tend to have multiple chronic conditions. They may have vague complaints or atypical presentations. Thinking in terms of current concerns rather than a chief complaint may be helpful. You might start the session by asking your patient to talk about his or her major concern, "Tell me, what is bothering you the most?

Ask questions

Ask, "Is there anything else?" This question, which you may have to repeat several times, helps to get all of the patient's concerns on the table at the beginning of the visit. Sometimes, an older patient will seek medical care because of family members' or caregivers' concerns.

The main concern may not be the first one mentioned, especially if it is a sensitive subject. If there are too many concerns to address in one visit, you can plan with the patient to address some now and some next time.

Encourage the patient (and his or her caregivers) to bring a written list of concerns and questions.

Discuss medications with your older patient

Side effects, interactions, and misuse of medications can lead to major complications in older people. It is crucial to find out which prescription and over-the-counter medications older patients are using and how often. Older people often take many medications prescribed by several different doctors, such as internists, cardiologists, urologists, or rheumatologists.

Remember to ask about any alternative treatments, such as dietary supplements, complementary remedies, or teas that the patient might be using. Remind patients that it is important for you to know all the over-the-counter medicines, such as pain relievers or eye drops, they use.

Suggest that patients bring a list of all of their medications—prescriptions, over-the-counter medicines, vitamins, supplements, herbal medicines, topicals, liquids, injectables, and inhalants—along with how much and how frequently they take each medicine. Or, you could suggest that they bring everything with them in a bag. Find out about the patient's habits for taking each medication, and check to be sure that he or she is using it as directed.

Check to see if the patient has (or needs) a medical alert ID bracelet or necklace. There are several sources, including MedicAlert Foundation International.

Gather information by asking about family history

The family history is valuable, in part because it gives you an opportunity to explore the patient's experiences, perceptions, and attitudes regarding illness and death. For example, a patient may say, "I never want to be in a nursing home like my mother." Be alert for openings to discuss issues such as advance directives.

The family history not only indicates the patient's likelihood of developing some diseases but also provides information on the health of relatives who care for the patient or who might do so in the future.

Knowing the family structure will help you to know what support may be available from family members, if needed.

Ask about functional status

Understanding an older patient's usual level of functioning and knowing about any recent significant changes are fundamental to providing appropriate health care. They also influence which treatment regimens are suitable. The ability to perform basic activities of daily living (ADLs) reflects and affects a patient's health.

Depending on the patient's status, ask about ADLs such as eating, bathing, and dressing and more complex instrumental activities of daily living (IADLs) such as cooking, shopping, and managing finances. There are standardized ADL assessments that can be done quickly and in the office.

Sudden changes in ADLs or IADLs are valuable diagnostic clues. If your older patient stops eating, becomes confused or incontinent, or stops getting out of bed, look for underlying medical problems. Keep in mind the possibility that the problem may be acute.

Consider a patient's life and social history

If you plan to continue caring for an older patient, consider taking time to learn about his or her life. A life history is an excellent investment. It helps to understand the patient. It also strengthens the doctor-patient relationship by showing your interest in the patient as a person.

Be alert for information about the patient's relationships with others, thoughts about family members or co-workers, typical responses to stress, and attitudes toward aging, illness, work, and death. This information may help you interpret the patient's concerns and make appropriate recommendations.

The social history is also crucial. If you are aware of your patient's living arrangements or his or her access to transportation, you are much more likely to devise realistic, appropriate interventions. Ask about where he or she lives; neighborhood safety; eating habits; tobacco, drug, and alcohol use; typical daily activities; and work, education, and financial situations. It helps to find out who lives with or near the patient.

Understanding a person's life and daily routine can help you to understand how your patient's lifestyle might affect his or her health care. To this end, determine if the patient is an informal caregiver for others. Many older people care for spouses, elderly parents, or grandchildren. A patient's willingness to report symptoms sometimes depends on if the patient thinks he or she can "afford to get sick" in view of family responsibilities.

House calls by a health care professional are an excellent way to find out about a patient's home life. If that's not possible, try to learn some details about the patient's home life during the interview: “Do you use oil or gas heat? Do you have steep stairs to navigate? Do you own a pet? Can you get to the grocery store or pharmacy on your own? Are you friendly with anyone in the neighborhood?”

Learning about your patient's home life will help you understand aspects of his or her illness and may improve adherence to treatment.

Also, be sure to ask if anything has changed since the last visit. For instance, you'll want to find out if your patient still has the same living arrangements or experienced some type of loss.

For more information about obtaining a medical history