More of our population than ever is over the age of 65:

And they’re living longer too:

What does this mean for Pilates professionals? How can we better serve an aging population, and what might that look like for our studios?

Specifically, how might we help our clients live independently, or age in place, longer?

Workshop goals:

My goal is for you to leave this workshop with confidence and competence working with older clients wherever they are in the aging process– whether early on or in decline, as well as how to treat aging bodies with dignity and care. With the skills you learn today, you’ll keep your older clients happier, healthier, and more independent… while also helping your book of business.

Your why:

Think about someone in your life who is over 65– a friend, family member or client. Who is that person? How might what you learn today help you program for them?

Programming tips for working with clients over 65:

• Bringing the body into better balance may not always look like progression. Maintenance is a worthy goal.
• Your job is not to heal or fix clients. Meet them where they are, and give them the work within your scope of practice.
• Walk the line between flexibility and rigidity when it comes to parts A, B and C. You may find yourself spending more time on Part C, or starting with Pre-Pilates. How can you maintain continuity and work the system with a client for whom the system may be increasingly inaccessible?
• Be prepared to change course with neutrality when an exercise, new or old, isn’t working.
• Or if an exercise is inaccessible, consider working the mount. When in doubt, leave it out.
• Focus on the transitions: that’s often where accidents happen. Some older clients may be light-headed when transitioning from supine to seated or to standing– be prepared to offer assistance or wait with neutrality.
• Challenge your thinking about props: when and where are they helpful? When and where are they distracting? Some clients may always work with a prop because you are working with an eye toward maintenance rather than progress.
• Take care of your own body. You may be doing more spotting or assisting with a client who needs support with balance or transitions. Keeping yourself strong and being aware of your own body in space keeps both you and your client safer.
• When in doubt, refer up or refer out. (Thanks, RLB!)
• Meet your clients with the dignity and care you’d like an instructor or professional to maintain when working with your own beloved older people– parents, grandparents, older friends or special clients.

Practical tips for working with clients over 65:

• Check your assumptions! Are you guilty of ageism? The medical standard quiz on facts about aging is here: https://www.studocu.com/en-us/document/pima-community-college/nursing-process-i/facts-on-aging-quiz/23122441
• Ask your client to update his or her health history form regularly, with an eye toward new diagnoses, medications or conditions… and any side effects thereof.
• Ask your client to update his or her emergency contact(s) regularly. Adult children move away, spouses pass away, peers relocate…
• You may be the only person who sees an older client’s legs, arms, or feet regularly. If you see something unusual– for example, an open wound on a diabetic client’s foot– say something.

• You may be a primary point of social contact for your client. Listen between the lines and, if and when appropriate, refer up or refer out. For example, “You’ve mentioned that you’ve mentioned that you’re sleeping poorly and are more tired than usual lately. Have you talked to your doctor about it?”  

How do I know when it’s time to stop working with an older client?

Many of your clients on the younger end of the aging spectrum will be able to fulfill all of the Instrumental Activities of Daily Living, or IADLs, and the Activities of Daily Living, or ADLs.

IADLs include cooking, cleaning, transportation, laundry, and managing finances.

You may be the first or only person who notices a slip in a client’s IADLs.

ADLS include ambulating, grooming, toileting, dressing, and eating.

If your client is losing the ability to perform ADLs safely and without assistance, it is time to refer up or refer out. There are several scales and assessments that professionals use to determine ability to perform ADLs or IADLs (Independent Activities of Daily Living). These assessments are outside of our scope of practice as Pilates professionals.