AARP Hearing Center
Key Takeaways
- Older adults may avoid movement because of pain, fatigue or fear, and pushing them can lead to power struggles.
- Gentle, enjoyable strategies — like social activities and fun outings — help make movement feel natural.
- Small, consistent steps, supported by patience, humor and positive reinforcement, can boost confidence and motivation.
As people get older, the use-it-or-lose-it phenomenon kicks in strongly, especially for mobility, balance, strength and other aspects of physical fitness. Adult caregivers often realize this, but sometimes it’s an uphill battle to get sedentary parents or other care recipients to stop sitting while they read or watch TV and get moving.
“We see this a lot, and it’s a difficult thing to overcome,” says Dr. Tori D. Gartmond, a geriatrician at the Patricia Bauman Center for Integrated Geriatrics Care at New York’s Montefiore Health System. The best approach, she says, is to “put yourself in the shoes of an older adult and meet them where they are.”
The first step is to consider why they may be reluctant to move more. It could be because they’re depressed or perpetually tired. Or maybe they’re in constant pain and they’re worried about exacerbating their pain by moving. Perhaps even that they’re afraid of falling.
On a very basic level, it also could be that they “don’t actually believe they’re going to lose it if they don’t use it,” says Barry J. Jacobs, a clinical psychologist in the Philadelphia area and coauthor of The AARP Caregiver Answer Book. “Don’t assume they put stock in what doctors and physical therapists are telling them. They may be skeptical about advice they may be given.”
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In addition, a study in a 2023 issue of the journal BMC Public Health found that a sedentary lifestyle among adults ages 70 to 97 is often based on their conscious choices, such as choosing to spend time reading in a seated position. For many of these adults, being able to make a conscious choice to be sedentary creates a sense of freedom and gives them a feeling of accepting their body.
Indeed, for many older adults, there may be a desire to assert their autonomy. They may firmly believe, This is still my life, and I get to choose how to live it. I don’t want to push myself to do things I don’t want to do, according to Jacobs.
Regardless of the underlying reasons for their sedentary behavior, “you don’t want it to become a power struggle,” Jacobs says. “The caregiver’s approach needs to be gentle and soft, with a certain amount of cajoling and humor.”
Here are creative strategies caregivers can use to help a loved one move more, without being overbearing or even using the word “exercise”:
Introduce temptation bundling.
The idea is to encourage an older adult to engage in a particular enjoyable activity — such as listening to a favorite podcast or audiobook or watching a certain TV show — only while using a stationary bike or elliptical machine, says Katy Milkman. She is a behavioral scientist and professor at the Wharton School at the University of Pennsylvania and author of the book How to Change: The Science of Getting From Where You Are to Where You Want to Be.
This makes the physical activity more enjoyable and creates a built-in reward for doing it, which can lead to positive associations and motivation to continue.
“One of the things caregivers can do is make the movement not seem like exercise or work,” says Robyn Culbertson, a board-certified clinical specialist in geriatric physical therapy in Columbia, South Carolina, and a spokesperson for the American Physical Therapy Association. “It’s about finding something they enjoy so it doesn’t seem like work.”
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