Home exercise cuts healthcare need among elderly

­­­A simple home exercise program for older people could dramatically lower their reliance on healthcare services, according to the results of an Australian-first trial.

In the 18-week trial, trained personal care workers supported clients of government-funded community aged care providers to exercise regularly and safely in their own homes.

Lead researcher Dr Tim Henwood said the active@home trial saw a steady reduction in healthcare service utilisation among the 37 participants, down by 47 per cent by the end of the trial.

“In evaluating the active@home trial, we observed a 19 per cent reduction in the number of participants classified as frail,” Dr Henwood said.

“To our knowledge, this is the first time anyone has attempted a personal care worker-led exercise program for aged care clients delivered in the home,” he said.

“This trial has shown that cost-effective, in-home exercise opportunities can be embedded into existing aged care services for older people, who would otherwise continue on a trajectory of physical decline.

“Another positive is that active@home requires a bare minimum of exercise equipment and this helps remove a barrier that can prevent older people from exercising.

“During the trial, we found participants were able to adhere to the exercise program for at least five days a week on average.

“Among other benefits, we noted improved balance among participants, better leg strength, more ability to do things for themselves, with personal testimonials suggesting decreases in the signs of depression and anxiety,” he said. 

The active@home trial was a joint initiative of Burnie Brae Ltd and Brisbane North PHN’s community aged care consortium.

Brisbane North PHN Chief Executive Abbe Anderson said the trial results were exciting, but needed evaluation on a much larger scale.

“The active@home trial is a perfect example of how consortia can share information and resources to enhance service delivery and support better health outcomes,” Ms Anderson said.

“We’ve proved this can work in Brisbane North. It’s now up to others to take this innovation to the next level, with a controlled study involving more participants,” she said. 

The personal care workers involved in the trial were drawn from 11 service providers and were already providing personal care and domestic assistance to the trial participants.

Burnie Brae CEO Kevin Rouse said accredited exercise physiologists designed and delivered the training module that personal care workers completed before the trial began.

“Personal care workers were taught the best technique for each activity and also how to modify the activity to suit client abilities and avoid adverse events,” Mr Rouse said.

“They were also trained to administer the Short Physical Performance Battery (SPPB) test, which provided a baseline by which we could measure participant progress.

“Medical consent was obtained for each participant prior to enrolling them in the program,” he said.

Mr Rouse added that active@home is aligned with the ‘reablement and wellness’ approach that underpins contemporary thinking in aged care, focused on enabling older people to improve their functional independence, social participation and quality of life.

“Access to reablement and wellness activities was a key recommendation to come from David Tune’s Aged Care Legislated Review, which was tabled in Federal Parliament on September 14 this year,” Mr Rouse said.

“It was also the subject of a major aged care industry conference on August 30 in Melbourne, where the PHN delivered a presentation on the active@home trial.

“This type of intervention fits exactly within the reablement and wellness paradigm and it deserves further investigation,” he said.

To view videos about the active@home program on YouTube, go to: https://goo.gl/cvqQot.