Category: General

The Don’t of Weightlifting for Seniors

By: Brad Hankins

The trifecta of exercise is a movement practice (dance, yoga, pickle ball), a cardio practice (walking, swimming, biking), and a resistance practice (weightlifting, calisthenics, resistance bands).   All three, and especially the combination of the three, are vitally important in improving health, overall wellbeing and quality of life.  The questions for those of us a bit older is usually 1) how to safely begin 2) do I adapt exercise to fit me or the other way around and 3) how much of which type of exercise is enough. This month we are applying those questions specifically to weightlifting, and from the point of view of what we shouldn’t do when initiating a weight training program.

If you have followed this column, you know how pro-weightlifting I am for seniors. From my experience, weight training is a must for older adults.  Few exercise programs will do more to build strength, stamina and confidence, as well as improving safety and enjoyment of life. At the same time as older adults we must approach weight training with a high degree of respect.  If we do, weightlifting will become an enjoyable part of who we are, if we don’t, there is risk of frustration and injury – both of which we want to avoid.

Before we get to the don’ts let’s quickly run through the do’s. First, make an appointment with your health care provider to discuss beginning any exercise practice.  If you have a chronic health condition you will benefit from an exercise prescription from your provider which will determine heart rate limits, exercises to avoid due to orthopedic concerns and other safety parameters.  Second, make an appointment with an SSYMCA Personal Trainer for a health review (to include reviewing your exercise prescription), discuss goals and design an exercise plan that fits you and your current state of health.  Third, research which types of exercise interests you, what exercises will best help you reach your goals and how can exercise best fit into your day.   Fourth, consider a Personal Trainer at least for your first several weightlifting sessions to help set up the equipment to fit you, calculate beginning weight amounts, how to lift with proper form and how many repetitions and sets to do in the beginning.

Now the don’ts:

• At the top of list is don’t ego lift, in other words keep the weights low, use good form and keep your repetitions in the 10-12 range. How you lift the weight is more important than how much weight you lift, don’t let your ego convince you to lift more weight than is reasonable.
• Don’t rush through gym time, give yourself time to move through your exercises with adequate rest in between. Give yourself at least an hour and always start weightlifting sessions without feeling a need to rush.
• Don’t judge yourself against anyone else, you are on your personal fitness journey and the only yardstick is if you are meeting the goals you have set for yourself – don’t be intimidated by others.
• Don’t immediately start lifting dumbbells and barbells, instead begin on machines which are safer and allow you to work on form while increasing strength.
• Don’t begin power exercises (barbell bench, deadlifts – of any kind, barbell squats) without consulting a SSYMCA personal trainer. These are high risk exercises and though beneficial they can cause injury if not done properly.
• Don’t become frustrated with a particular machine or exercise. Often all it takes is a bit of adaption such as changing hand/foot position or moving to a different machine that will allow better compensation for shoulder or hip range of motion.
• Don’t think every day will be a strong day and give yourself grace on the days when you feel you have taken a step backwards.  The important thing is to still show up on the weaker days.  Give yourself more time, drop the weights a bit, cut the reps by two or three and purposefully move through the workout with energy you have that day.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

Cardio For Seniors

By: Brad Hankins

Fall is here, the perfect time of year for cardio!  Cooler days make for great outdoor workouts or bumping up the duration and/or intensity of your current cardio work.  Inside or outside, cardio should be part of your fitness trifecta to include movement and weightlifting.

Cardio exercise is any form of movement that raises, and sustains, your heartrate for a set amount of time.  The exercise can be running, walking, swimming, biking, or any one of the numerous machines at your Y such as step machines, elliptical trainers, bikes (to include biking labs) and treadmills.  Yoga, Pilates and Tai Chi are also great forms of cardio exercise. Keeping in mind that the keys to a successful cardio workout plan are 1) focused on a goal – either by time or distance and 2) sustained – staying in motion until you reach your goal exercise time/distance.

The benefits of cardio exercise are numerous, regardless age or gender.  For those of us a bit older one of the biggest benefits is improved cardiovascular (CV) health https://pmc.ncbi.nlm.nih.gov/articles/PMC10068966/#ABS1 .  All 30 trillion (not a misprint-trillion) cells of your body are dependent on energy supply through arteries and waste disposal via veins. The heathier, meaning more pliable and non-restrictive, our arteries and veins are the better our cells function.  Better functioning cells means a slower aging process, decreased weight, better brain function and cognition as well as a decreased risk of CV related issues such as heart attack and stroke.

To help set your exercise goal first consider target heart rate.  To calculate target heart rate, subtract your age from 220 then multiply by 80%. For me this looks like 220-71=149. 149×0.8=119 beats per minute.  Target heart rate is as the name implies, the heart rate to sustain over your exercise period.  If you have a history of heart, vascular or lung disease, or any metabolic health conditions such as diabetes or high blood pressure please consult your medical provider for an exercise prescription before beginning or increasing cardio exercise.

Next to consider is breathing rate, which is measured by your ability to talk in complete sentences while exercising. Your target heart rate should equal the ability to talk in complete sentences without gasping or breaking sentences into two or three word bursts.  If you are exercising at your target heart rate and find it difficult to talk, please stop exercising until you consult your medical provider.

With your target heartrate known, next is to set an exercise goal.  This can be distance, say from your house to the third fire hydrant down the road and back, or a total exercise time with 15-20 minutes being a good first goal.  The object being sustaining your target heart rate over the exercise time, except for a two to three minute warm up when you begin exercising.

How much cardio exercise is enough?  The AMA, Cleveland Clinic    https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20057916 and others suggest 150 minutes of cardio per week with the larger goal being 300 minutes a week of total exercise.  If this seems daunting, start with a time/distance within your current ability.  If that is 10 minutes, or to the end of the block and back that is great! The most important thing is that you are out the door and on the way to improving your health.

One of the best things about cardio workouts is that you probably already have everything you need to get started. A membership at the South Sound YMCA gives you access to a wide variety of classes, equipment, and personal trainers who can help you plan and achieve your cardio goals. In fact, all you really need is a comfortable pair of shoes, some exercise shorts or pants, and a T-shirt. And let’s not forget, we live in the Pacific Northwest, which, in my opinion, offers the best outdoor cardio environment in the world.

Please let us at SSYMCA how we can help you begin a cardio program or support you in reaching new goals.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

The Importance of Sleep for Older Adults

By: Brad Hankins

Sleep is important at any age, think back to when you had a newborn and neither of you slept more than an hour or two.   As we age sleep shifts from being more about rest and recovery to an important part of our physical and mental wellbeing https://www.nia.nih.gov/health/sleep/sleep-and-older-adults .

All adults require basically the same seven to nine hours of sleep each night.   However, as we age multiple factors can affect the amount and quality of sleep.  The first sleep change is we typically go to bed earlier and rise earlier than younger adults.  This is, by itself, is only problematic if your bedtime is out of sequence with others in your house who’s evening activities may keep you awake or only lightly sleeping.  The bigger issue is quality of sleep, i.e. REM vs non-REM sleep.

The two major types of sleep are rapid eye movement (REM) and non-REM. Both are connected to patterns (waves) of electrical activity in your brain. Non-REM sleep is when your brain in is quietest while REM sleep is when brain activity more resembles being awake and is when dreams usually occur. REM and non-REM sleep occur in cycles, usually three to five each night. REM sleep helps you store memories while non-REM sleep improves focus and energy.

Sleep is a complicated body function involving brain chemicals, feedback loops in your nervous system, brain function and overall health.  Homeostasis https://my.clevelandclinic.org/health/articles/homeostasis, or our body’s self-regulating mechanism, helps our sleep patterns by allowing us to be more physically and mentally balanced both day and at night.    Brain chemicals and hormones play a big role in the sleep cycle, especially melatonin, a hormone your body releases as it gets dark outside and makes you feel sleepy.  Chemicals such as adenosine are at play here as well, with the overall path to improved sleep being a better balance of these chemicals and happier homeostasis.

Quality sleep helps protect against disease and keeps our brains, heart and lungs healthy. Restful sleep also improves our ability to create new memories, helps us solve problems quickly, improves decision making, and improves our general mood and life outlook.  While not getting enough sleep, or sleeping poorly, can affect our health and increase the risk of diabetes, heart disease and high blood pressure as well as increasing fall risk,

What can help both the quality and quantity of sleep? Please consider the following suggestions:

• First, ask your medical provider to review your medications for side effects that may affect your sleep. This not only the individual medications but the interactions of two or more medications when combined.
• Avoid caffeine late in the day. This varies greatly from person to person and most of us know what that time of day is. However, be wary of evening caffeine in the form of chocolate, beverages and sneaky snacks.
• Establish a sleep schedule by going to bed and waking the same time each day, including when traveling and on weekends.
• This can be a tough one, avoid napping in the evening or late afternoons. Naps are good, there is nothing wrong with naps, but consider limiting them to 10 to 20 minutes and no later than 3:00 PM.
• Time your last meal of the day to no closer than two to three hours before bedtime or limit your last meal of the day to a specific time, say no later than 6:00 PM.
• Limit screen time before bed. This can be another tough one but try experimenting with small steps such as no screens in bed and/or no screens 30 minutes before bed.
• Limit alcohol to three hours before bedtime – even in small quantities.
• Ensure you room is comfortable for sleeping, this includes the amount of light, temperature and ambient noise. Many products are now available to help regulate bed temperature, generate white noise (or block it), or reduce/block light coming through windows.
• Exercise regularly, but not within three hours of your bedtime.
• Establish a bedtime routine that includes a brief brain wind-down such as reading a book or listening to music.

If insomnia or interrupted sleep is a consistent issue, please consult your medical provider.  Many medical conditions including sleep arena and hormone imbalances (such as high thyroid levels) can contribute to a poor night’s sleep.  Many of these conditions are easily addressed, if your provider has a sleep history to review.  Keeping a sleep diary for several weeks will help your provider establish a diagnosis.  Include in your diary; the times you went to bed, the times you woke up during the night, if you had night sweats or night terrors, the times of your last meal of the day, and if you had caffeine or alcohol during the day/evening.

A good night’s sleep is foundationally important, how we spend the night directly relates to how we spend our day.

 

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

 

Hydration for Older Adults

By: Brad Hankins

What better month than July to explore hydration. The most common hydration question I am asked is how much fluid should I drink?  The answer is it depends – on a lot of things.  A basic rule of thumb  https://www.ncoa.org/article/how-to-stay-hydrated-for-better-health/  is to divide your body weight by 1/3 and that will be the minimum number of ounces of fluid you should drink in a twenty-four-hour period.   For me that is 68 ounces, 8.5 cups or a little over 2 liters per day.  At age 51 and above The National Academy of Medicine recommends 13 cups (3 liters) of fluid per day for men and 9 cups (2.25 liters) for women every 24 hours. Again, these are minimum recommendations for a normally health older adult.

Please notice I am using the term “fluid” and not limiting fluid to just water.  Most liquids and some foods count https://health.clevelandclinic.org/drink-up-dehydration-is-an-often-overlooked-health-risk-for-seniors toward your daily intake.  The outliers are alcohol and high levels of caffeine which are diuretics and reduce fluid volume in the body.  So, juice, milk, coffee (in moderation), soup and even popsicles count (keep an eye on sugars if you are diabetic or have other metabolic conditions). Foods such as cucumbers, tomatoes, apples, bell peppers, watermelon and celery are also high in fluids. And, both meat and fish are high in fluids as well.  I get quizzical looks when adding meat to the fluid list but consider marine mammals such as seals cannot drink sea water and get their fluids through fish and other marine life they eat.

Having a few miles on the odometer means we can become dehydrated easier than in our 20’s and 30’s.  There are many reasons for this, with a decline in total body fluid being toward the top of the list.  If you recall from previous posts, our muscles are our water tank and as muscle mass declines with age our ability to store water literally shrinks.  More muscle equals more stored water which equals more fluid reserves when challenged by heat, exertion, injury or acute health conditions – especially those resulting in vomiting and diarrhea.  Yes, you need to lift weights.

Another age-related dehydration issue https://www.healthline.com/health/symptoms-of-dehydration-in-elderly is decreased thirst response.  Simply put, with age we become more dehydrated before feeling thirsty.  This is because our thirst center, located in our brain’s hypothalamus, becomes less responsive as we age.  In turn this makes it important to drink/eat fluids over the course of the day – don’t wait until you are thirsty.  We can balance our hydration level by being aware of the need for morning and mid-day drinks and taking in more fluids with meals and snacks.  A suggestion is as soon as you are out of bed, before coffee or food, drink one or two cups of plain water.  This is because as we sleep our brain dehydrates through our breathing, and as our brain is very fluid dependent the extra water first thing in the morning gives it a boost.  Also consider a cup or two of water with your second cup of coffee in the morning and with your tea or soda in the afternoon.

Early signs of dehydration need to be responded to quickly by resting and drinking more water.  These signs include dry or sticky mouth, dark yellow urine, decreased urination, headache, muscle cramps, dizziness and fatigue.  Be especially aware of these symptoms during hot and/or humid weather and increase your fluid intake as temperatures and humidity rises to help prevent the symptoms from occurring.

When exercising, the best hydration plan is to be fully hydrated before stepping into the gym.  This means drinking 15-20 ounces (2 to 2.5 cups or a half liter) of fluid in the hour prior to exercise.  During exercise 10 ounces (approx. 1 cup) of fluid for every 20 minutes of exercise.  And after exercise slowly drinking a liter (approx. 4 cups) of fluid with a fibrous snack such as a banana (to slow water absorption), will ensure you are fully rehydrated and ready for the day.

Sports drinks, or electrolyte replacements, are usually not necessary when exercising for an hour or less – water works exceptionally well https://extension.unh.edu/blog/2023/09/hydration-are-electrolyte-drinks-better-water   .  However, sports drinks do have a place such as after strenuous exercise in warm weather, e.g. 10k run or a day of summer mountain hiking. They are also beneficial during an illness when experiencing prolonged sweating, diarrhea or vomiting.  People with hypertension need to be aware of the high levels of sodium and potassium in these drinks which can increase blood pressure.  Electrolyte drinks are not meant to be consumed throughout the day as if they are water but do have their place in certain circumstances.

In summary:

1. Rehydrate early each day and remind yourself to stay hydrated over the course of day (at least 2-3 liters over 24 hours).
2. Ensure you are hydrated before exercise (1/2 liter), hydrate during exercise (1/2 to 1 liter) and slowly rehydrate after exercise (1 liter ).
3. Be aware of the early signs of dehydration and respond quickly with additional fluids and rest as they appear.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT

 

Navigating The American Health Care System as An Older Adult

By: Brad Hankins

Consult Your Primary Care Provider Before Making Changes to Your Medications, Diet or Beginning/Changing an Exercise Program

I have spent 43 years in the American healthcare system, as a clinical Nurse, clinic administrator and hospital COO.  When I entered healthcare in 1982 records were kept on paper, a patient chart was a few pages thick and hospital admissions were published in local newspapers.  Things have changed.

Over the course of my career one of the biggest changes I have witnessed is healthcare moving from a human service provided and governed at the local level to the rise of regional and national for profit health care systems such as HCA and Tenet. Though most hospitals remain non-profit, approximately 36 percent are now for profit up from less than 10 percent in 1982.

I have also been witness to near unbelievable transformations in technology, from MRI and PET scanners to robotic assisted surgery and recombinant DNA medications.  Technology has not only improved the quality of healthcare but also safety and accessibility.  However, it has come at a literal cost.

The ever-increasing cost of medical technology has been one, but far from the only, cause of escalating healthcare costs.  The aging of the American population and associated demand for healthcare services also has increased costs of staffing, education, buildings and information infrastructure.

As the American healthcare system has grown so has its regulatory oversight as well as billing/reimbursement processes.  Both of which play their own role in increasing costs while at the same time helping ensure the quality of, and payment for, healthcare services are at par across the nation.

With all that said, most health care consumers feel that access, quality and cost of care is getting worse, not better. As I write this in May of 2025, there does not appear to be a clear national path through this escalating quagmire of increasing costs, decreasing access and stalled quality of care.  Doubtless, what we are currently experiencing in our healthcare systems will be with us for the foreseeable future.

At the same time, please be assured the vast majority of American healthcare workers and providers are skilled, dedicated and focused on service to others. However, they are limited by the systems they work in.  As patients and healthcare consumers how do we successfully navigate our current national and local healthcare systems while maintaining a high level of self-advocacy and results?

I suggest recruiting your own healthcare team, with you as team manager. First, you probably have professional resources available you don’t fully use, pharmacists are an example. They are an excellent consulting/educational resource, they provide injections/vaccinations and are strong advocates.  You need a pharmacist on your team, preferably one at a local pharmacy who knows your name.

If you attend exercise classes or work with a personal trainer you also have these professionals readily available as team members.  Typically group exercise leaders (yoga, dance, Pilates etc.) and trainers are well versed in the body’s response to exercise and stress and are often underutilized as consultants.  Build a consulting relationship with your exercise instructor or trainer, ask them questions and you will be surprised at the value they bring to your team.

A readily accessible medical provider is a must-have team member, with options available from in person to online. Considering today’s access issues, I suggest finding an urgent care clinic that works well for you.  Granted you will probably see a different provider each trip, but if the clinic suites you overall, and you go there routinely for minor health issues, e.g. lingering colds, sore throats etc., they will become important immediate care team members.

A medical provider who helps manage your general health is mandatory, especially if you have chronic health conditions such as diabetes or high blood pressure. This may be an MD, DO, Nurse Practitioner, or Physician Assistant that 1) you trust 2) communicates clearly 3) follows up thoroughly/quickly and 4) develops a successful track record of listening to your needs and responding appropriately at each visit.  You may have already been their patient for 25 years or you may be currently searching for the right provider, the point is to have a general medical provider on your team who consistently has your best interest at heart and fulfills their obligation to you in a way that meets your expectations and needs.

Specialists are also team members, Neurologists, Orthopedists and Nephrologist being examples.  If you are not satisfied with a specialist referral, ask your general provider for a new referral.  This may slow access as the new referral is processed but can gain time on the recovery end by assuring you have a specialist who successfully meets your needs.  Specialists are important team members and their communications with your general provider is an important part of being on your team – always ensure they send medical records to your general provider.

There are also growing numbers of independent health care professionals who are available either face to face or online.  Dieticians, Nurses, Exercise Specialists and Nutritionists are some of the professionals who can be added to your team as consultants and advocates.  These services are available on an as-needed basis but are being used more frequently as permanent team members to help navigate care, give professional advice/education, and provide advocation or help develop good self-advocacy skills.

As team manager it is important to have your health care information and data readily available.  I recommend becoming your own health records manager.  As you add team members, access specialty care or find yourself visiting providers outside your general healthcare system 1) sign up to the patient portal of each clinic or provider 2) download and print your healthcare information from all providers [including your general provider] as it becomes available 3) keep these records at home 4) ensure your general provider has copies of any record outside their system by either delivering printed copies or sending electronic copies.

There are many paths to becoming a good self-advocate and healthcare navigator, these are only my suggestions. However, from years of seeing navigation success and failures I feel an organized team approach gives broad continuity of care and provides access to information from multiple sources to be used in thoughtful decision making.  All together an organized team-based plan will help ensure your voice is heard and your healthcare needs are met in a safe, efficient manner.

I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.

Brad Hankins RN, CPT