As a district nurse for over twenty years I have mainly cared for older people in their own homes. The  challenge with an ageing population is supporting older people to self-manage their healthcare and stay well through exercise.

This is my neighbour John and his dog Archie. John is 82 years old, and though he can’t walk the Eildon hills anymore, he still manages to take Archie out for short walks down the street. Archie gives him a reason and motivation to get out and about.

There is an abundance of evidence on the benefits of outdoor activity.

Research at the James Hutton institute identifies multiple, inter-related barriers that reduce the opportunities for older people to participate in outdoor activities: poor health, immobility, limited social relationships and fragility.

The Green Gym

As health professionals how can we engage with patients and their families to make green prescribing, and the use of our great outdoor ‘green gym’, a real choice?

We can’t do anything about our Scottish weather but we can use green prescribing as an additional choice to the traditional hospital based exercise care pathways for falls and post-op rehabilitation.

Interventions need to be offered which suit people’s ability and preferences. They don’t need to be based solely around exercise and can be seen as an option to alleviate social isolation, the profound loneliness many older people feel. Research by geriatrician Dr Carla M. Perissinotto at University of California has linked loneliness to physical illness and early death, a real health challenge for Scotland, with so many elderly people living alone.

Scottish Government policy is focused on supporting older people to live well within their communities. Social work integration has given us a real opportunity to evaluate our communities and the services we provide.

Co-production

This is Dorothy and Norrie walking by the union canal in Linlithgow. They are both 81 years old. They enjoy gentle walks and working in their shared allotment. Norrie says the allotment helped prevent recurrence of the depression he has previously had following bereavement.

Co-production brings local people in communities together, coordinating action between public sector health and social care providers and the voluntary sector.

This coordination creates opportunities for social connections and enables choices to suit all needs and abilities, such as walking groups, allotments, men’s sheds and bowling. It can also take into account barriers to outdoor activity such as transport issues.

Co-production provides the opportunity for sustainable solutions which can address the social issues of ageing and bring communities together with inter-generational activities.

Our challenge is to find ways to make green prescribing a real choice and an alternative to our traditional hospital based care pathways.

This post was written by Deirdre Moss, Associate Improvement Advisor, Healthcare Improvement Scotland. You can follow Deirde on Twitter @deirdre_moss