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 ADL (activities of daily living) 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 three-month commitment, and, because experience shows me that many older clients show some reluctance to commit to that time, 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 was working at a fitness facility that accepted Humana or other Medicare plans that pay fitness benefits. I would also present him with a health history questionnaire, and, because of his special health concerns and age, explain the importance of my speaking to 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.

At Jack’s initial appointment, I would go over his health questionnaire, and look for any additional red flags besides his weight, age, and vision impairment. I would consult with his physician as to the degree of this impairment, and how it affects his ability to use various exercise equipment. For the purposes of this paper, we’ll 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 attention to any mention of a history of heart disease, diabetes, certain forms of cancer (such as colon cancer), and high blood pressure. Not only would the history of heart disease and high blood pressure necessitate more frequent heart rate monitoring than would normally be used in an older individual, but the risk of all of these diseases could be 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 Strategy). 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 get an idea of Jack’s basic mobility. (Medscape)

My primary focus in strength training Jack would be to establish and increase basic strength and mobility. Using the circuits referenced on the chart on the final page, I would work with Jack starting with very light weights, to increase tendon and ligament strength without discouraging Jack. One consideration when training older adults is time and boredom; in my experience, many older adults wish to get in the gym, work out, 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 these alternating basic circuits to maximize his time, maximize his fat burning results, and avoid boredom and 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 the four times per week alternating upper and lower body circuits. On his weight training days, I would encourage Jack to “shake up” his typical walk by instead doing 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. Finally, in older adults in particular, flexibility is key. I would focus on stretches that do not require bending over (to prevent falling), but would spend at least five to ten minutes per session working on stretches that Jack could also perform at home while seated. During each session, I would frequently ask how Jack was feeling to make sure he was not pushing too far past his limits. With older adults, checking how hard they feel they are working on a scale of one to ten (perceived exertion) helps to prevent injury or worse.

Jack’s nutritional strategy would be key to long-term weight loss. I would begin by having Jack create a food diary for several days to get an idea 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 amount 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 spending their food dollar. (Cornell University). After assessing his intake, I would work with him on developing a 1,500 to 1,800 calorie per day diet. Because his exercise program is reasonable and his goal is weight loss, there is no need for him to consume considerably more on his weight training days; however, psychologically, my experience shows some flexibility will increase his adherence to his nutritional plan. Education is truly key when working with older adults. Showing Jack what a portion size is, 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 an ice cream cone are strategies that would allow Jack to consume lower calorie, more nutritionally dense foods without feeling deprived or feeling like he was on a diet (my experience has shown that many older adults consider “diet” to be a four letter word in more ways than one, an imposition on their golden years). Finding out and assessing Jack’s normal food intake would be a regular part of our sessions; during sets, we could talk about where he went out to eat, what he had, etc. Providing sample menus that cater to Jack’s lifestyle, including going over how to choose healthier options at restaurants, would be an integral part of his long-term weight loss.

In working with older adults, emphasis on the continued health benefits of exercise are key. These individuals have earned the right to enjoy their golden years, and they may rightfully dislike what they consider an imposition on their time. Continued reinforcement of how their exercise program is improving their quality of life helps to keep them motivated to remain fit for life.

Seated Leg Press

2 x 12

Seated Leg Extension

2 x 12

Seated Hamstring Curl

2 x 12

Seated Abdominal Compressions w. Band

2 x 12

Seated Biceps Curls

2 x 12

Seated Triceps Extensions

2 x 12

Seated Chess Press

2 x 12

Seated Leg Lifts (for abdominals)

2 x 12

Seated Leg Press

2 x 12

Seated Abduction

2 x 12

Seated Adduction

2 x 12

Seated Abdominal Compressions w. Band

2 x 12

Seated Shoulder Press

2 x 12

Seated Delt Fly

2 x 12

Seated Chess Press

2 x 12

Seated Twist w Body Bar

2 x 12

Works Cited

“Beating Mindless Eating.” Cornell University. 20 March 2011.

“Eight Functional Mobility Tests for Predicting Falls in Older People.” Medscape.com. 20 March

2011.

“Physical Activity and Older Americans: Benefits and Strategies.” Agency for Healthcare Research

and Quality. 20 March 2011.