Incorporating function and physical activity across all settings

The majority of older adults do not engage in regular physical activity. In surveys of community dwelling, among older adults age 75 and above, one in three men and one in two women engage in no physical activity. These rates are even lower among those who are hospitalized or institutionalized in nursing homes or assisted living settings. Moreover, those living in institutional settings demonstrate a decline in function that exceeds what would be expected based on disease states. Limited activity and functional decline place older adults at risk for pain associated with contractures, pressure sores, and decreased sense of wellbeing and overall quality of life. We propose a Function Focused Care approach that encourages caregivers to engage older adults in function and physical activity during all care interactions. This approach can be implemented using a fourstep approach and practical, cost-neutral approaches. This chapter delineates the ways in which to implement Function Focused Care across all settings, describes outcomes associated with this approach, and provides ways in which to overcome the setting-specific challenges.