These days we hear and read a lot on the isolation of older people. Isolation means not only loneliness, but also insecurity and fearfulness. Not having someone to call on for help, days spent alone with no visitors, fearful of falls and unable to reach help….the list goes on.
What we need to know is how best to combat this isolation, to create some sociability and combat insecurity.
One successful method of contributing to sociability as well as to physical fitness is the Steady As You Go, familiarly known as SAYGO, exercise groups, which were the subject of a lecture in the Otago Polytechnic Professorial Lecture series.
The lecture on SAYGO was given by Associate Professor Linda Robertson, Her title was: Understanding the sustainability of peer-led community groups and the focus was to consider the reasons for the success of a particular lifestyle programme, Steady As You Go, and whether these reasons were transferable to other groups to assist in sustainability.
Her work both as a hands-on occupational therapist and lecturer on the same subject has been with older people, with the philosophy of empowerment through occupation.
The topic stemmed from research into a particular community-located physical fitness programme, organised and managed by Age Concern, Otago. This programme Steady As You Go, familiarly known as SAYGO, has now been in operation for more than 10 years and has expanded from the early groups to over fifty in Dunedin with an average of fifteen members each. Additionally it has been implemented in other places in NZ.
Obviously a popular and worthwhile programme, SAYGO has been developed from the Otago Falls Prevention Programme, with the content based on regular lifestyle patterns of movement. People are referred to a group by their general .practitioner. Such medical acknowledgement emphasizes the likelihood that the exercise group will provide physical benefits and improve physical wellbeing, over time. The essential words here are ‘over time’, because the regularity of the movements in these groups influences the improvement of physical wellbeing.
Associate Professor Robertson compared SAYGO with other lifestyle groups such as the Stanford Lifestyle Group, the Driving Cessation group and the DESMOND group for people with type two diabetes. These groups also use peer leaders to assist in the facilitation of the groups but are short term and run for a defined period of time. SAYGO is unique in that the intention is to imbed these groups in the community for an indefinite period of time.
Her thesis suggests that there is a model underpinning the sustainability of the SAYGO group which can be promulgated with other groups to ensure sustainability. This model, she asserts, is based on an underemphasized/unrecognised set of elements in a model of group management. By making these elements visible, it is possible to transfer them to other community groups, to ensure the success of these groups.
She identified such elements to be: management; locale; regularity; ‘peer’ leadership.
She identified these as being a model related to a community of care; meeting human needs as well as a focus on individual motivation which was spelt out succinctly by WHO (World Health Organisation). WHO stated that people’s lifestyle changes will happen when:
*it is within their ability to do so
*They have the resources to implement change (physical, psychological and social capital)
*The changes are perceived as being of benefit to them
*The benefit outweighs the cost of effort in overcoming barriers
The philosophy of Age Concern Otago, who also is the initiator of the SAYGO is central to the success of the programme. A central premise is that of valuing older people, and of supporting local initiatives. They have also invited researchers to test the assumptions that for those who participate regularly in these groups will be less likely to have falls. An exciting feature of these groups is their ability to attract members to stay engaged with the groups for long periods which also ensures that the members remain connected in their communities. As one research project noted, the social l elements were the glue that held it all together.
Locale is important: each group is sited in its own community and the use of a local church or community hall makes the group both visible and accessible to members of that community.
The groups are regular weekly events. Same time, same day, same place!
And they are led by ‘peers’, otherwise people who have experienced the group context themselves, and who are willing and capable of leading such a group.
This makes the groups economical; it also makes creates a context of connectedness, since every group member is also a member of the local community.
Peer leadership in fact could be one of those major factors in sustainability of such lifestyle groups, in that these peers offer knowledge of the group experience combined with knowledge of their community. Such peer leaders provide their own experience in dealing with group involvement and interactions; they also are an immediate link with others who can assist with different questions and issues, such as perhaps further health problems, problems with housing and heating, nutrition. The list is endless, and many are the problems discussed during the groups which are answered either by group members or by the leader, and often over a cup of coffee later.
Fun and friends
What should be mentioned as being an important element of the Steady As You Go meetings is the sociability fostered by the peer leader.. As well as on the spot problem-solving there is the general enjoyment reflected in the friendliness amongst group members.
Fun is good! As Associate Professor Robertson pointed out, enjoyment of these exercises sustained the enthusiasm and attendance of the group, which not only helped their physical well-being, but also involved sociability, and as various quotations from her research showed: ‘It’s something to get up for and go to.’: ‘I get to know people, and I meet them in the supermarket, and in the community.’ And another, ‘ It makes me feel I belong to a group of friends.’
Funding – Important!
SAYGO is clearly an important model for alleviating loneliness in older people, ensuring some connectedness, and strengthening and supporting their wellbeing.
The funding, which has been divided between ACC and the Ministry of Health came to an end on 30th June 2017 and the temporary funding is about to finish on1st October 2018 . This funding has been for Age Concern staff member wages, car and travel to classes, overseeing leaders and developing resources. Participant donation ensures the venue hire. Needless to say, Age Concern is continuing to look for funding to ensure the quality of this programme continues, since, as Assoc. Professor Robertson says, one of the main aspects of its success is the regularity and continuity of a responsible organization, and Age Concern with its focus on the wellbeing of the older person, is undoubtedly such an organization. Its past success in organizing these programmes, many of which have been in operation for twelve years, and their spread. There are now fifty groups in Dunedin and a spread throughout New Zealand, showing, how popular the programmes are. Research by Associate Professor Robertson and Dr Beatrice Hale has testified too to the social value of these programmes.
For any group or organisation keen to initiate programmes to encourage social connections as well as focussing on other issues for older people, the model which Associate Professor Robertson has identified provides exceptionally important techniques for initiating and maintaining other such programmes.
As such, the value of this work needs to be more widely recognised.