MOBILITY,

ADL & LEISURE IN

ELDERLY

NINIK NURHIDAYAH, S.Pd., SST.,M.Kes

 MOBILITY
• Penuaan dan kekuatan otot
– Loss of number & size of muscle fibers
– Increase connective tissue & fat within the muscle
– Effects on :
• Strength
• Flexibility
• Reaction time
• Functional Performance
Strength Assessment in The Older
Adult

• Modify the methods in assessing older

adult
• Because of pain , joint deformities,
limitations in endurance & flexibility
 RECOMMENDATIONS :
Strength training geriatric patients
1. Simple directions, gesture, PROM
2. May gain strength slowly
3. May gain less absolute strength
4. May have less adaptability to stress, more
injuries , increased cramps
5. Decreased oxygen consumption:
Perhaps may fatigue easily
 Lanjut recommendations….

6. Short and graded exercise , but apply the overload

principle
7. Use variety of muscle contractions : isometric,
isotonic, isokinetic, concentric, eccentric
(memanjang)
8. Monitors skin, respiration, & pulse rate in response
to exercise
9. The talk test : do not over exercise the aged person
so that he/she cannot talk during the exercise
 POSTURE
• Alignment of body parts in relations to one
another at any given moment
• Static process, affect by gravity & neural
control mechanisms constantly  shift in
weight & body alignment
 Age-related changes in the axial skeleton :

1. Head forward position scoliosis

2. Increased dorsal kyphosis
3. Flattened lumbar spine
BALANCE & COORDINATION : requires the integrations of multiple muscle
group & nerve pathways
 SELF-CARE

• GENERAL PHYSICAL HEALTH :

1. Number of illness or conditions
2. Days spent in bed
3. Self-ratings of health
4. Physician visits
5. Hospitalizations
• Basic Self-Care /ADL
– Bathing
– Dressing
– Going to the bathroom
– Getting in or out of a bed or chair
– Walking outside the house or apartment
– feeding
 IADL
• Preparing meals
• Shopping
• Managing money
• Using the telephone
• Doing light housework
 SOCIAL SUPPORT
• Informal : family, friends, neighbors
– Services : meals on wheelchair, care giver
• Formal : day care, panti jompo
• Depend on the ENVIRONMENT
– Nursing home resident :
• Low level of social interaction
• Lack of close relationships
 Retirement communities :
interaction among neighbors is high

• Psychosocial resources & coping strategies :

Elders who capable of communication had
larger social networks
• Coping strategies :
deal with stressful life events: change in
functioning  confront older people
Coping skills to deal with stressful in
elderly :
1. Confrontive coping : aggressive efforts to alter
the situations
2. Distancing : efforts to detach oneself
3. Self control : Regulating one’s own feeling
4. Seeking social support
5. Accepting responsibility by acknowledging one’s
role in the problem
6. Escape-avoidance
7. Planful problem solving : deliberate problem –
focused efforts to alter the situation
8. Positive appraisal through efforts to create
positive meaning focused on personal growth
ENVIRONMENTAL DESIGN
• Physical & architectural features of
group-living settings can influence the
well-being of elders
• Housing modifications
– Handrails
– Ramps
– Grab bars
– Adaptations to accommodate sensory
deficits
LEISURE ACTIVITY IN ELDERLY

NINIK NURHIDAYAH,
SPd.,SST.,M.Kes

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Leisure Activities

• Pada lansia aktivitas leisure dapat

berupa sebuah pengalaman bukan
hanya sebagai aktivitas
• Leisure ini merupakan pilihan bebas
bagi lansia
• Memungkinkan lansia untuk
melepaskan dari aktivitas
sebenarnya

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 Elemen Leisure
• Kontrol
• Motivasi
• Pelepasan (disengagement)
• Absorbsi

Keempat elemen tersebut saling berinteraksi secara

kompleks antar individu dengan pengalaman dan
lingkungannya

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 Kontrol
• Merupakan fenomena yang komplek saat individu
terkendali selama aktivitas atau keadaan dimana
dia bebas memilih apa yang akan dilakukan dan
dengan siapa dia melakukannya

• Dikontrol juga berarti kemampuan untuk

menentukan hasil dari suatu aktivitas

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Kebebasan Memilih

• Kebebasan memilih biasanya merupakan hal

yang paling penting dalam mendefinisikan
suatu aktivitas sebagai pengalaman atau
leisure

• Kebebasan memilih merupakan kriteria yang

paling mudah untuk membedakan leisure
dan bukan leisure

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 Motivasi :
Havighurst’s menyatakan bahwa leisure berhubungan dengan
motivasi yang berbeda pada orang yang berbeda pula.

Disengagement (pelepasan)
: bila lansia ingin mendapatkan pengalaman leisure,
harus dapat melepaskan diri sementara waktu dari
paksaan
Absorbsi
: menurut beberapa ahli didefinisikan sebagai alur,
keterlibatan individu dalam aktivitas yang menjadi
karakter leisure

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