llt tutor weekend1 later life training tutor weekend november 2009 llt directors update

LLT Tutor weekend 1

Later Life Training Tutor Weekend

November 2009

LLT Directors Update

LLT Tutor weekend 2

Later Life Training

Director’s update

• New developments at Later Life Training

• The policy context of our work – UK Recommendations– Physical activity policy– Active Ageing

• Zambezi Challenge!

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New developments at LLT

• Office / Website development

• Partnership with Northern Fitness & Education

• Stroke module

• Work with people living with dementia

• Preparation for Chair CPD

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Office / Website Development• Office

– Kirsteen Riddell now works 2 days a week– Full server and offsite storage

• Website– Old site – thanks to Seb Chastin, online revision of all

anatomy and physiology, all falls epidemiology and evidence base for intervention. Some video clips on exercises themselves. Still needs something on exercise programming and implementation.

– NEW SITE being redeveloped by Steve Richardson – should be in place in the new year

• Unique passwords with access to online training specific to course type – ability to do revalidation online if necessary

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Partnership with NFE

• Contract Signed Nov 2009– Using LLT Tutors, same pay rate– Might be tougher on expenses so beware!– DMc will train up NFE tutors – DMc in charge of tutoring courses – nearest tutor gets

first choice– LLT get licence fee from all courses

• NFE start Fitness CBE Jan 2010• NFE start H&SC CBE Mar 2010• LLT to complete any courses already paid for

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Stroke Module

• Still in discussions but expected Dec 2009 signing of contracts– LLT pay QMC/UoE 15% royalty– Sara W heading up tutor training and early course

administration and organisation– Course is already on REPS L4– Sara W to re-jig course so delivery similar to PSI –

Stroke specialist physio will be employed locally for some lectures

– Expect to run 4 courses first year and slowly expand

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People living with dementia

• Highlighted last year and following discussions we are currently planning to draft and pilot

• CPD course for CBE + Otago

• CPD course for PSI

• Awareness raising for local agencies on physical activity and exercise

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Consequently ………..

• We need to be (very) aware of and understand 4 key documents

• All available on TUTOR area of LLT website

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Key document 1 - Department of Health Prevention Package (2009)

• Forms the Department of Health’s main contribution to the government’s ageing strategy - Building a Society for All Ages.

• The package:• brings together information on existing health

‘entitlements’ including sight tests, flu vaccination and cancer screening;

• promotes best practice around falls prevention and effective fracture management; (PSI and OTAGO)– Skelton and Dinan authors on Exercise Document

• Also introduces measures to improve access to affordable footcare; eyecare; intermediate care services

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Key document 2 National Stroke Strategy (2007)

• 10 point action plan• 20 Quality Markers

QM10. High-quality specialist rehabilitation

Marker of a quality service

“People who have had strokes access high-quality rehabilitation and, with their carer, receive support from

stroke-skilled services as soon as possible after they have a stroke, available in hospital, immediately after transfer from hospital and for as long as they need it”.

- Mobility and movement


Key Document 3 – The Dementia Strategy (2009)

• Three Key components– Improving public and

professional awareness of dementia

– Early diagnosis and intervention

– High quality care and support for people with dementia and their carers

• Similar documents in Scotland, Wales and Northern Ireland


Key document 4 - NICE Guideline on Mental Health and Physical Activity

4 recommendations• Occupational therapy• Physical activity• Walking schemes• Training

NICE Guidance for Occupational therapy and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care

(NICE 2008)


Importance of documentation• These provide the policy direction that underpin

LLTs work with commissioners• These shape the agenda that practitioners are

working to• These conditions (falls, stroke, mental health

and dementia) are at the heart of LLT instruction, adaptations

• Increased prevalence with increasingly older societyAs LLT tutors, we need to understand process,

purpose and content of documentation and be able to interpret

There are many more !


Context of physical activity promotion with the older population

• New UK wide recommendations out for consideration among all 4 UK Govt Departments

• Physical Activity – Strategic Development across UK

• Active Ageing as a key focus


UK Wide expert recommendations on physical activity and older people

• England, Wales, Scotland and NI all had PA recommendations, wording slightly different. Some old (2001), some new (2008).

• Experts brought together to review recent changes to US and Canadian guidelines and draft new UK-wide recommendations

• These brought to wider consultation at conference in Marlow in October 2009

• Next steps – Web Consultation (e/o Nov)


• The UK guidelines should – maintain the focus on stating the amount of activity in terms of “5

sessions x 30 minutes of moderate-intensity physical activity per week” and note that this is equates to a volume of 150 minutes of moderate intensity per week.

– note that there are multiple ways of accumulating the total of 150 minutes, and “5 x 30” is one way.

– recognise that the volume of physical activity associated with the prevention of different chronic diseases may vary but the evidence is currently insufficiently precise to warrant separate guidelines for each specific disease because in part the evidence may be equivocal and also it is likely to cause confusion.



• The UK guidelines should – recognise the health benefits of moving from ‘no activity’ to ‘low

levels’ of activity, particularly for those who have been very inactive and older people with physical and disease limitations.

– recognise that higher volumes of activity (> 150 minutes) are associated with increased health benefits

– for older adults should place greater emphasis on moderate-intensity rather than vigorous intensity activities and should be based on lower absolute but similar relative intensity

– retain a statement recognising that activity can be accumulated through shorter bouts of at least 10 mins or more of moderate intensity exercise.



• The UK guidelines should – acknowledge shorter bouts of activities that may not last the

minimum required bout of 10 minutes (for example activities including walking up and down stairs) will add to total activity and may help sedentary people get started.

– retain the recommendation that physical activity is undertaken regularly across the week (such as 5 or more times per week) because of the evidence of acute effects on biomedical markers and because it can encourage regular activities undertaken as part of daily lifestyle such as active travel through walking and cycling.



• The UK guidelines should – for adults and for older adults include a specific

recommendation to undertake muscle strengthening activities involving the major muscle groups of the body on two or more days per week.

– for older adults include a specific recommendation on the benefits of physical activity involving balance training on two or more days per week for the prevention of falls in those adults at risk of falls.

– for adults and for older adults recognise the benefits of physical activity in improving flexibility but no specific quantification or recommendation on type, frequency, duration or total volume should be attempted as there is insufficient evidence.



• The UK guidelines should – continue to acknowledge the role of physical activity

in both the prevention of poor mental health; reductions of symptoms of poor mental health (such as depression and dementia) and improvement in mental well being (such as mood, self-perception and sleep); the guidance should continue to indicate that these benefits are possible from the minimum currently recommended dose of activity of 5 x 30 mins (or 150 mins/week equivalent) of moderate-intensity physical activity.




• Implications ? – Most likely confusion amongst professionals

• Most who work with older people and physical activity do not have exercise science background

• They do not understand basic concepts e.g. aerobic activity, strength, power, balance

• These may shift the balance back towards exercise away from physical activity ?

• Obsession with “Gentle Exercise”


Physical activity policy for older people ?

Physical activity – prevention

DOH/DCMS

Ageing policy

Independence

DWP

Conditions and treatment

DOH


Physical activity and older people– strategic development ?

• DOH Be Active - Be Healthy – a plan for getting the Nation Moving (2009) but dominated by 2012 and Olympic Legacy Plan which excludes older people

• Scotland – Physical Activity Strategy – References to older people - No specific

actions but 2014 Commonwealth Games Legacy Plan includes older people

• Wales and Northern Ireland, lower priority


Building a Society for All Ages (DWP 2009)

• Staying Active and Independent• Health checks 40 – 70 and tailored advice

(vascular risk assessment)• 46 NGBs of Sport to develop community sport

including 50 + • Increase access and mobility e.g. access to

museums, Concessions for travel• Increase activity of Fitness Industry ?• Scotland Strategy for an Ageing Population

“All Our Futures 2007”


Treatment and conditions

• National Service Frameworks (CHD, Stroke, Falls, Mental Health

• Transferring into specific strategies

• Generic and specific Care Pathways

• NICE and SIGN Guidelines

(DOH)


Active Ageing in the UK

• 8th World Congress on Active Ageing - Glasgow - 2012

• The next 3 years will be very exciting

• A major opportunity for LLT to engage

• Active Ageing Manifesto• Active Ageing Weeks• http://www.wcaa2012.com/


Active Ageing Manifesto

• End product of WCAA 2012

• A vision statement supporting active ageing

• Produced through the Active Aging Community Centre virtual network

• A tool for advocacy, policy and action


Active Ageing Weeks

• Across all 4 countries

• Based on Games Legacy plans

• National and local programmes celebrating physical activity

• Activity promotion events, PR and promotion linked to public education, strategy development and partnership


Key elements of Active Ageing Weeks

We can do more (better ?) than offer volunteering

• Celebration and Festival• People coming together• Participation and engagement• Promotion and challenges• Linked to sustainable opportunitiesDesigned to demonstrate Active Ageing


Opportunities to celebrate

The possibilities are endless !• Competitions e.g. Olympage Games• Walk Out Days• MOGA events• Danceathons• Splash !• Public education and debates

And what else ?


Olympage Games – Sheffield care homes (2008/9)

• 20 Teams competing• 6 events• Teams of 6 – 8

(participants + carers)• Unruly supporters in

team kit !• Medals, certificates

and prizes• Lots of cheating as

well !


Sheffield 2009


Walk out days

• National Walk Out Day (Finland)

• For those who need assistance and encouragement to walk out

• Walking with Buddies• Walking with purpose• Based on Walk with Me

training !


MOGA events

• Most Outrageous Group Activities

• How many people

- all together or

- at the same time ?

The Guinness Book of ?


Public Education and Debates

• Test, expose or challenge the academic !

• Is it too late for me !• Science and ageing• Brain health – how ?


Potential applications - 1 Themed weeks

• Get up and Go - (1st choice - focus on new strength, balance recommendations ?).

• The Great Outdoors • Wild and Wet• Out and about• Dance On


Active Aging Community Centre

• Human Kinetics supported

• Interactive world wide virtual Active Aging Community

• Research, practice, programmes

• Support for Active Ageing, Physical activity and exercise professionals


Other issues/activities

• Change 4 Life to include adults (- 74)

• CSP Move for Health (older people Autumn 2010)

• Gender equity in health

• Changes in NVQ structures

• Cuts in public sector spending (already begun but April 2011)

• “Worth a look”


Worth a Look !

A selection of key documents relating to

Active Ageing and Health promotion


And finally !!!

Thank you

For all you do for and with Later Life Training

llt tutor weekend1 later life training tutor weekend november 2009 llt directors update

Documents

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tutor training

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choice llt

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llt directors update

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