Senior Fitness Training Plan: Weight Loss & Mobility for Older Adults

Introduction and Initial Consultation

Jack presents a number of physical challenges that will influence his training, namely his age, his weight, and his impaired eyesight. While all of these factors are important considerations in designing his training program, the key factor to remember is that despite his limitations, helping Jack lose weight and decrease his body fat percentage will aid his mobility and his ability to perform activities of daily living (ADL) well into his older years. The fact that Jack already walks several times a week demonstrates a commitment to fitness; including strength and flexibility training and varying his aerobic routine will allow him to maximize fat reduction results while increasing strength and stamina in his daily routine.

At my initial consultation, I would ask him for a three-month commitment. Because experience shows that many older clients display some reluctance to commit to that timeframe, I would be sure to explain that this was a marathon, not a sprint, and help him set realistic expectations for his fitness goals. I would also establish my fees and ask about his insurance if I were working at a fitness facility that accepted Humana or other Medicare plans that pay fitness benefits. I would present him with a health history questionnaire and, because of his special health concerns and age, explain the importance of my speaking with and receiving a release from his physician prior to beginning our program. I would set an initial appointment with Jack and plan a comfortable, private time and location to perform some basic fitness tests.

Health Assessment and Physician Clearance

At Jack's initial appointment, I would review his health questionnaire and look for any additional red flags beyond his weight, age, and vision impairment. I would consult with his physician regarding the degree of his vision impairment and how it affects his ability to use various exercise equipment. For the purposes of this paper, we will assume his vision impairment would not be severe enough to impede his use of exercise equipment and that he could see well enough to maneuver in a gym environment with a trainer's guidance.

During the consultation with Jack's physician, I would pay close attention to any history of heart disease, diabetes, certain forms of cancer (such as colon cancer), and high blood pressure. Not only would a history of heart disease and high blood pressure necessitate more frequent heart rate monitoring than would normally be used with an older individual, but the risk of all of these diseases could serve as a powerful motivating force in encouraging Jack to continue his exercise program, as exercise has been shown to decrease these risks (Agency for Healthcare Research and Quality). Finally, after obtaining physician approval, I would measure Jack's circumference, body fat, and weight. I would also perform two basic mobility tests — the sit-to-stand test and the half-turn test — to establish a baseline understanding of Jack's mobility (Medscape).

Strength Training and Aerobic Programming

My primary focus in strength training Jack would be to establish and progressively increase basic strength and mobility. Using the circuits referenced in the chart at the end of this paper, I would work with Jack starting with very light weights in order to increase tendon and ligament strength without discouraging him. One important consideration when training older adults is time and boredom; in my experience, many older adults wish to get into the gym, complete their workout, and get out to enjoy the rest of their day.

To avoid boredom and keep Jack's workout time to a minimum while still achieving strength and fat-loss results, I would use alternating basic circuits to maximize his time and fat-burning results while reducing frustration. I would begin with weight training three times a week using an upper and lower body circuit and, after six to eight weeks, transition to four times per week with alternating upper and lower body circuits. On his weight training days, I would encourage Jack to vary his typical walk by instead completing two or three sessions weekly on a recumbent bicycle. Given Jack's weight and age, a recumbent bike would minimize stress on his joints while adding variety to his aerobic routine.

Nutrition Strategy and Long-Term Adherence

Jack's nutritional strategy would be key to long-term weight loss. I would begin by having Jack keep a food diary for several days to get an accurate picture of his normal intake. Prior to beginning the diary, I would coach Jack on the importance of measuring portion size. Research shows that the majority of overweight people underestimate the number of calories they are consuming, in part because they underestimate how large their portions are; this is particularly true in older adults who believe "more is better" when it comes to getting value from their food dollar (Cornell University).

After assessing his intake, I would work with Jack on developing a 1,500 to 1,800 calorie per day eating plan. Because his exercise program is moderate and his primary goal is weight loss, there is no need for him to consume considerably more on weight training days; however, my experience shows that allowing some flexibility will improve his adherence to the nutritional plan. Education is truly key when working with older adults. Showing Jack what a correct portion size looks like, and advising him on making wise choices — such as choosing whole grain bread over white, olive oil over butter, and yogurt or a low-calorie fat-free popsicle over ice cream — would allow Jack to consume lower-calorie, more nutritionally dense foods without feeling deprived or as though he were on a diet. Many older adults consider the word "diet" to be an imposition on their golden years.

Finding out and regularly assessing Jack's normal food intake would be an ongoing part of our sessions. During sets, we could talk about where he went out to eat and what he ordered. Providing sample menus that cater to Jack's lifestyle — including reviewing how to choose healthier options at restaurants — would be an integral part of his long-term weight loss plan.