Why do care homes fail to get residents moving?

Enid Irving headshot

By Enid Irvnig

Enid Irving is an ‘Expert by Experience’ for Age UK. As such,
she car­ries out work for the England inspec­tion body,
the Care Quality Commission

My job is to visit many care homes and talk to the res­id­ents at some length, report­ing my find­ings to the CQC (Care Quality Commission) Inspectorate. The care homes I see are extremely var­ied, most are clean, warm and, on the whole, cheer­ful. Yet there is one thing miss­ing in prac­tic­ally all of them: move­ment. Both men and women sit all day with an eye (but not much atten­tion) on a massive TV screen. Sadly there are some who sit, uncom­mu­nic­at­ive, with heads rest­ing upon their chests. The day is long.

I ask about exer­cise – even simple phys­ical games — and usu­ally I am told that there are some, but none that I or any of the col­leagues I meet have ever wit­nessed. Occasionally a care-​giver tells me that once a week they will organ­ise a soft-​ball throw­ing game, dur­ing which no one actu­ally gets up from their chair. But even this is rare.

Often these care homes have lovely gar­dens, almost com­pletely unused simply because these oth­er­wise fairly healthy old people are los­ing the abil­ity to walk! I find this deeply shock­ing. A twice-​weekly ses­sion of move­ment — in the lounge, if need be – would cer­tainly improve the hap­pi­ness, not to say phys­ical abil­ity, of the res­id­ents.

Many have come into res­id­en­tial care from homes where they were already sit­ting all day long, so they might be res­ist­ant to such a plan. But if exer­cise were intro­duced as part of the gen­eral routine that every­one par­ti­cip­ated in, I see no dif­fi­culties. Energy, appet­ite and more vital­ity would fol­low. Self-​reliance would grow and fre­quent fall­ing might be over­come when con­fid­ence and bal­ance were restored.

For many older people, a bug­bear is ser­i­ous con­stip­a­tion, brought on by eat­ing and then sit­ting hunched up in an arm­chair all day. It fol­lows that walk­ing, and move­ment of any kind could alle­vi­ate this.

The cost of res­id­en­tial care is colossal — £1,000 a week is typ­ical. Care-​home own­ers would protest that a physio or exer­cise instructor, even hired only twice a week, would cost far too much for them to con­tem­plate. I do some­times won­der whether it actu­ally suits the own­ers bet­ter to keep their res­id­ents pass­ive and depend­ent.

I was recently invited to a plan­ning con­sulta­tion meet­ing, in which a local coun­cil was seek­ing the views of older people about a new care-​home devel­op­ment in the area. The budget ran to mil­lions. What facil­it­ies would we, as poten­tial future res­id­ents, expect and want? I mildly sug­ges­ted includ­ing a swim­ming pool. The response was a deaf­en­ing silence. You can bet there will be a very large TV, though.

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