Led by Age Concern Otago, SAYGO and Tai Chi are two programmes that aim to provide a variety of opportunities for fitness, fun and falls prevention for local older people.
To begin with definitions: SAYGO stands for Steady As You Go, and is a fitness/falls prevention programme based on the Otago Exercise Programme (OEP), University of Otago School of Physiotherapy ‘Train the Trainer’ programme and mindfulness principles; while Tai Chi, an ancient martial arts discipline is a proven falls prevention practice.
Steady As You Go has recently been the subject of one of the Otago Polytechnic Professorial Lecture series where Associate Professor Linda Robertson demonstrated its essential elements as a model of community group sustainability.
The history of this long-standing community programme was retailed to me by Margaret Dando, QSM, of Age Concern Otago. She says:
SAYGO programmes at the beginning were ten-week courses, based on the Otago Exercise Programme, and were organised with paid Age Concern Otago instructors.
Funding initially was from the Ministry of Health, then ACC suggested increasing the funding of these courses to Age Concern Otago. This combined funding created a full-time position and Margaret was employed in 2002 to start and manage classes in both Otago and Southland. The objective was to increase the number of classes across Otago and Southland and develop sustainability of the classes beyond 10 weeks.
Structurally, the SAYGO courses have Margaret as overall Coordinator and groups are trained for 10 weeks by a paid instructor. In Dunedin, to kick start the programme, Physical Education students were employed and proved to be excellent initial 10 weeks instructors. In rural townships a local person was employed to promote and instruct 10 week classes.
Over this initial 10 week period, volunteer Peer Leaders from within the groups are identified. These Peer Leaders continue to run the classes after the paid instructors complete their 10 weeks. Margaret then provides these groups with the very necessary on-going support to sustain them. In these early days not all the classes continued. Some fell by the wayside. The technique of finding Peer Leaders and sustaining the group was not an overnight process, Margaret said emphatically.
Currently there are 50 SAYGO classes throughout Dunedin and another 16 over Otago.
Supporting the classes involves training peer leaders and developing resources. Originally training was provided by the “Train the Trainer” programme from the University of Otago School of Physiotherapy. This expanded the variety of exercises available in the Otago Exercise programme. All 10 week instructors and Peer Leaders undertook this training. Over time, Margaret used these exercises and others to develop an audio recording the classes could follow. This recording described the exercises and was timed to allow exercises to be practised slowly and mindfully. Ankle weights are used to assist in strength training. It also included falls prevention tips and prompted social cohesion within the group. Once this audio recording was developed Margaret began training Peer Leaders and 10 week instructors herself.
Margaret organises one day workshops for new Peer Leaders are expected to know how to practice the exercises safely, to be observant of each group member, to ensure the venue is safe and encourage their classes, especially new participants. Established Peer Leaders have annual half day refresher workshops. To support the classes, Margaret also visits each class at least once each six months.
Margaret has also trained SAYGO Coordinators to establish peer-led classes by other Age Concerns in Oamaru, Ashburton, Christchurch and Canterbury, Wanganui, Taranaki, Tauranga, Thames and Hawkes Bay. Now Age Concern New Zealand is leading this two day training to establish peer-led SAYGO through Age Concerns all over New Zealand, with Margaret as the Master Trainer.
Initially funding allowed 16 groups to be started per year over Otago and 8 over Southland. Age Concern Otago employed coordinators in Alexandra, Balclutha and later Wanaka to also establish classes as far afield as Ranfurly, Cromwell, Roxburgh, Clyde, Kaitangata and Milton. Later when classes became more numerous, funding was changed to a model to support classes rather than establish them. Participant donation pays for venue hire.
At present, there is a query about funding. The funding, which had been divided between ACC and the Ministry of Health came to an end on 30th June 2017 and temporary funding is about to finish on 1st October 2018. This funding has been for Age Concern staff member wages, car and travel to classes, supporting Peer Leaders and developing resources. Needless to say, Age Concern is continuing to look for funding to ensure this high quality programme continues.
What happens in the classes?
When you join a class, recommended by your general practitioner or a friend, what is the first thing that happens? Margaret puts you through your paces, to check your abilities to join in the class.
Then you join the class, and you become involved in the exercise. There is a CD-recorded reminder of each exercise; the Leader ensures everyone can take part and do so as accurately as possible, and that no one is overdoing the exercises.
The exercises vary from seated exercises and standing exercises to encourage a range of motions, and assist with flexibility, to hand-eye coordination exercises which help stretch neck and shoulders, and ensure good steady eye movements.
Walking exercises range from general stepping out, to marching, to high-steps, ‘duck’ walking (and I’m quoting here from my own Peer Leader), to walking sideways, backwards and ‘in curves’.
Funny? Yes indeed! Fun – definitely. When performed in company these exercises can be friendly competitive and fun!
Despite the basic seriousness of the exercises, which aim to reduce falls, the fun is an important part of the group’s hour together. The regular meetings, the exchange of news and views which always happens when neighbours meet, and the friendly acknowledgement of the performance of the exercises by group members, create a happy spontaneous atmosphere of enjoyment.
Indeed, a resounding YES is the only answer. Not only for fitness and falls prevention but also for fun and friendship, and let’s add another ‘f’ – financial! The results of these groups in reducing falls has been noted in several research theses and projects. People tell Margaret stories of how helpful the exercises have been.
Again funded by ACC for some time, and as important as Steady as You Go are the Tai Chi exercise groups. Slow, regular, thoughtful, mindful – Tai Chi helps people by making them aware of their bodies and of their movements. There is a vast history of Tai Chi, formidable to read and take on board, but what we need to know here is that Tai Chi core training involves two main features. The first emphasizes a straight spine, abdominal breathing and a ‘pushing hands’. Margaret demonstrated how she teaches people using walking frames or trolleys to straighten their spines as they move. That helps their movement and their breathing, she said.
Like SAYGO, Tai Chi insists on regularity, and a natural range of motion. Accurate and repeated practice is intended to retrain posture, to encourage good breathing, and to encourage good circulation. It also helps flexibility of joints.
And again, like SAYGO, Tai Chi groups have been encouraged, initiated, managed and sustained by Age Concern Otago.
It’s no wonder that Margaret is not only well-known for her work but also rewarded!