Exercise, Health and Ageing - a GP's Perspective

Rupert Manley

GP, Stennack Surgery, St Ives

Last 20 years........

Fire fighting service → Prevention

BP cholesterol diet exercise smoking cessationchronic disease management

…...Micromanagement of senescence

General Practice

Pressures........

Spiralling workload

Financial constraints

Cultural – food & drink - ?screens

Lifestyle as health intervention

Health Benefits of Exercise

Cardiovascular disease / Stroke Hypertension Diabetes Depression, stress and anxiety Fractures / osteoporosis Falls Dementia Cancer

Factors influencing exercise levels – early years

- Genetic

- Cultural – parental habits - school curriculum, environment - shift to virtual living

- Environmental- sports facilities- availability of open space- built environment – foot paths

- Health - obesity

Factors influencing exercise levels - middle years

- work-life balance

- social contacts

- child care

- health – obesity

- musculo-skeletal

- mental health

- cardiac & respiratory

Factors influencing exercise levels - later life

- all the above

- health plays an increasing role

- cognitive decline and dementia

- housing

- social contact

Poor health

Loss of fitness

Low self esteem

Social withdrawal

Lack of exercise

Cycle of inactivity

Health

Medication Surgery

Physiotherapy

More ExerciseFitness

Self esteemSocial engagement

Counselling

Escape from the cycle of inactivity!

Health & Wellbeing

Exercise Fitness

Self esteemSocial engagement

facilitation

Lifestyle as an intervention

The community as a health resource

Sports clubs

Support groupsVolunteering opportunities

Hobby and interest groups

GP - patient

LEAP

Knitting group

Art class

Green Gym Carer support groups

Writing group

Play reading group

Sure StartBadminton club

Surfing lessons

Allotment group

Cookery group

Fresh Start Walking group

Hospital Friends Save the Children

Day Centre

AA

MIND

Mindfulness course

Penwith PioneerProject

Exercise classes

GP - patient

LEAP

Knitting group

Art class

Green Gym

Carer support groups

Writing group

Play reading group

Sure Start

Badminton club

Surfing lessons

Allotment group

Cookery group

Fresh StartWalking group

Hospital Friends Save the Children

Day Centre

AA

MIND

Hospital referral

Diabetes Nurse

Physiotherapy Echocardiogram

X-Ray

ECG

Psychiatrist

Counsellor

Surgeon

Medical reportUltrasound

Chiropodist

24 hour BP

Blood tests

CADA

PCT

Medication review

Practice meeting

Computer beakdown

MRI

NICE

Sick note

Jaundice hotline

Inquest

Post mortem

MI

EEG

RACPC

Appraisal

Wellbeing Facilitator

at Stennack Surgery

Penwith Community Development Trust

Process

- Referrals from GPs and Health workers

- Consultation with client to assess needs, aspirations & barriers to participation.

- Aim is to enable clients to identify what works for them and to engage in community activity to improve health.

The Elderly

- often burdened by ill health

- house-bound

- socially isolated

- same spiral of inactivity

- falls

Age UK – Penwith Pioneer Project

Pilot in Newquay – reduced unplanned admissions by 40%

Aim

To have a guided conversation with 1000 vulnerable elderly to identify social solutions to health and social care problems.

Find out what the person's aspirations are

“ I would like to go to the garden centre once a week”

Try to find a simple solution – volunteers

Getting out – improved self-esteem and motivation

….....and perhaps a little more exercise!