The UK’s National Institute for Clinical Excellence has issued new guidelines for health professionals on how to encourage older people to engage in more physical activity as a way to boost their mental health; one suggestion is for GPs to encourage their older patients to join local walking schemes and tell them how walking benefits mental wellbeing.

The guidelines, which were released on 22 October, are aimed at doctors, health care staff, occupational therapists and physiotherapists and give advice on occupational therapy and physical activity interventions to promote the mental health of older people in primary care and residential care.

By 2020, one in five people living in the UK will be over 65. While many older people lead happy independent lives, for some people advacing age is accompanied by declining mental health. NICE says there are many reasons for this, for instance less financial security, physical illness, attitudes of society, where people live, lack of access to support services, and having to take care of others.

Decline in mental wellbeing should not be seen as a natural part of getting older and we should raise society’s expectations, and those of older people for mental wellbeing in later life, said Dr Gillian Leng, Executive Lead for the guidance, and NICE Deputy Chief Executive, who explained that the new guidelines show:

“Ways in which mental wellbeing can be promoted in older people and is anticipated to be the first of a range of NICE public health guidance on the health and wellbeing of older people.”

Although the last 50 years have seen people living longer and getting wealthier, there is evidence that many older people live with low levels of wellbeing and satisfaction with life, said Professor Catherine Law, who is Chair of the Public Health Interventions Advisory Committee (PHIAC) at NICE and Professor of Public Health and Epidemiology, University College London Institute of Child Health.

Reports shows that 40 per cent of older people who visit their GP and 60 per cent of those in residential care have “poor” mental health, said Law.

“All people coming into contact with older people, including health and social care professionals, have the potential to promote and maintain physical activity, health and independence, factors frequently mentioned by older people as important to their mental wellbeing,” she added.

Chief Executive of the College of Occupational Therapists, Julia Scott, said the College welcomed the way the new guidelines acknowledged the role that occupational therapists play in helping older people maintain mental wellbeing.

“The document highlights how participating in everyday activities really does enable older people to restore, maintain and improve their health and well-being. Engagement in meaningful activity is core to the philosophy of occupational therapy practice,” said Scott.

The new guidelines recommend that:

  • GPs, nurses, local health officials, leisure centres, and voluntary organizations working with older people should encourage older people to join walking schemes and find out about the benefits of walking for mental wellbeing.

  • Professionals like occupational therapists who support and care for older people should offer group and one to one sessions that encourage older people to identify and practise new daily routines that help them maintain and develop their mental health.

  • Professionals like physiotherapists who are qualified and trained to teach people how to exercise properly should help older people and their carers to devise community-based physical activities that are suitable to each individual, such as dancing, walking and swimming.

  • All professionals who care for older people, such as managers and staff in care homes, support workers, home help staff, and people in the voluntary sector should receive basic training in occupational therapy, wellbeing promotion and communication skills so they can encourage and support older people to take up physical activities.

Gordon Lishman‚ Director General of Age Concern in England‚ said the charity welcomed the new NICE guidelines which show there are lots of simple and inexpensive things that the health service can do to promote the mental wellbeing of older people.

“Older people can benefit hugely from exercise‚ yet there is a common myth that as we get older we should slow down,” said Lishman.

“Exercise is not only good for the heart‚ it’s good for the mind too. Walking‚ gardening and dancing are all great activities to do and don’t have to be too strenuous,” he added.

Sources: NICE, Age Concern.

Written by: Catharine Paddock, PhD.