Putting the Function in Functional Reserve: Helping Older Adults Thrive, Live, & Learn
By Anthony Ruggeri
Director of Senior Living Partnerships
Three years ago, my wife and I decided to sign up for our first half marathon. We had run a 5K and 10K the year before, but 21K — the equivalent of 13.1 miles — seemed like quite the jump. It was going to be difficult, but with the right training regimen, we were hoping to get ourselves ready to tackle the challenge.
Have you ever noticed how difficult an initial workout can be after taking some time off? It probably took a handful of sessions before you became comfortable and willing to push yourself to the next level.
For us, the more we trained, the easier it was to find the extra energy required to get through each run. As the distance gradually increased, we were able to keep up with the physical and mental demands. That extra energy supply is a physiological phenomenon called functional reserve. According to a study titled Functional reserve in functionally independent elderly persons; functional reserve is defined as the difference between the maximum physical or mental capacity of a construct and the minimum necessary to perform daily functioning.
Impacting Older Adults
The importance of functional reserve for older adults cannot be overstated. Most people who are familiar with the term think of it as intense aerobic exercise, such as cycling or running. However, it applies to much more than that. People have a set functional reserve for almost any activity. For the majority, it is not something we need to worry about because we have the necessary energy stored to complete the most common, everyday tasks. However, for the older adult population, the reality of not having enough energy to complete activities of daily living (ADLs) comes to fruition consistently every single day.
In addition to helping one perform ADLs, perhaps the grander importance of functional reserve is the assistance it provides with strengthening the immune system. This helps the body fight against sometimes deadly illness, such as the flu, or recently, COVID-19.
As one of the more vulnerable populations, older adults need all the support they can get. Why not start by building a strong foundation of abundant functional reserve? In a 2005 article written by David F. Goldspink, he states that “reserve capacity of the heart is a major determinant of an individual’s ability to remain active and cope with daily stresses and illnesses. Long-term participation in endurance-based activities helps to preserve cardiac reserve and has both direct and indirect beneficial effects on vascular smooth muscle and health preservation within the cardiovascular system.”
This, of course, speaks to FR of the heart, but it certainly impacts other organs and skeletal muscles in the body. David goes on to say, “in a culture where inactivity has become an accepted part of life we still need to explore in greater detail the benefits of habitual physical activity and use this information as a community-based educational tool to help prevent or delay cardiovascular disease, obesity, arthritis and the frailty associated with old age.”
Functional Reserve in Senior Living
Surely, functional reserve may offer benefits in performing ADLs, fighting illness, and improving one’s overall quality of life. The question that senior living operators need to ask is how and what can older adults do to build up FR? What are some activities or healthcare options that can help lead them on a path to happier and healthier golden years? Most senior living communities have resources to provide exercise classes for their residents. Taking regular walks around the inside or outside of the community certainly helps, but what if residents have difficulty walking, or participating in classes? A medically driven intervention may prove to be a better option.
Today, many senior living operators have modernized their wellness models to include physical, occupational, and speech therapy as a proactive component within a resident’s continuum of care. If a resident is sedentary due to de-conditioning, or simply has a fear of falling which prevents them from leaving their apartment, their condition can continue to deteriorate without rehabilitation intervening. It is an unfortunate cycle. One that I witnessed with my grandfather, who refused therapy for years until he ended up relying on a motorized scooter for mobility even within his apartment.
If residents aren’t participating in activities, events, or exercise classes in the community, it’s most likely not because they would rather sit in their room and keep to themselves, often, this behavior can be attributed to lack of functional reserve. Not only is their physical ability and functional well-being diminished, but also their confidence and mental health to actively participate and try new things.
Putting Valuable Resources to Work
Now, more than ever, the adequate functional reserve is necessary for all seniors to live better, longer. It is the responsibility of family, caregivers, and professionals to advocate for movement, exercise, and the utilization of physical and occupational therapies to keep older adults happy and healthy, allowing them to thrive in their living environment and beyond.
There are tools out there to help delay the deterioration of functional reserve. They need to be put to use. Just like my wife and I trying a half-marathon for the first time, older adults want opportunities to face new challenges. They want to explore, learn, and live with purpose.
- González, Paul Medina, Cofré, Rodrigo Muñoz, & Cabello, Máximo Escobar. (2016). Functional reserve in functionally independent elderly persons: a calculation of gait speed and physiological cost. Revista Brasileira de Geriatria e Gerontologia, 19(4), 577-589. https://doi.org/10.1590/1809-98232016019.150136
- David F. Goldspink (2005) Ageing and activity: their effects on the functional reserve capacities of the heart and vascular smooth and skeletal muscles, Ergonomics, 48:11-14, 1334-1351, DOI: 10.1080/00140130500101247