SV15 - Supervision of Older Persons

Purpose

To provide guidance on the supervision of older persons in unstructured activity at an aquatic facility.

Defining Older Persons

Although the World Health Organisation (WHO) defines ‘older age’ or ‘elderly’ as being aged 65 years and over, Royal Life Saving employs a slightly broader definition to capture those aged 55 years and over. This expanded definition was employed due to the concerning large number of drowning deaths occurring among those aged 55 years and over.

The WHO Heidelberg Guidelines (1997) identify three groups of older people along the health-fitness gradient: the physically fit-healthy; the physically unfit-unhealthy but independent living; and the physically unfit-unhealthy and dependent individuals. Within each of these categories, people may be either sedentary or physically active.

Risk Factors in Older Persons

Older Australians (that is those aged 55 years and over) make up a significant proportion of the total number of drowning deaths that occur in Australia every year. On average, 87 people aged 55 years and over have drowned in Australia every year for the past 10 years. The 114 drowning deaths recorded in this age group in 2012/13 is the highest number of drowning deaths ever recorded in this age group 5.

From these simple observations, it becomes apparent that factors contributing to the drowning death of older Australian has many diverse contributing factors and requires an aquatic facility to implement a broad ranging program to deal with them which should include but is not limited to:

• Policies
• Engagement and Public Education and skill development
• Parent/Guardian and Lifeguard Supervision
• Clothing and Personal Protective Equipment
• Facility Design

Policies

The owner or operator of an aquatic facility should encourage older people to notify staff at the entrance if they have any pre-existing medical conditions, or consume any medications that may increase their risk of drowning. Facilities are to determine those conditions which would require notification but may include epilepsy, cardiac conditions, dementia and general frailty.

Owners and operators of aquatic facilities should consider the use of older people as instructors for any courses aimed at older people. Sourcing volunteers from local organisations aimed at older people such as the University of the Third Age (U3A), Probus, Rotary and local RSL clubs may be a viable option.

Owners and operators of aquatic facilities should consider for induction, training and ongoing professional development for all staff on the needs and specific requirements of older people that particularly focuses on barriers to aquatic participation and strategies for overcoming or reducing such barriers.

Public Education and Skill Development

Owners and operators of aquatic facilities should encourage older people to undertake regular health checks, including prior to undertaking any aquatic activity.

Aquatic Facilities should promote themselves as safer spaces for older people to test out their current fitness and skill levels prior to engaging in aquatic activity in open water environments with changeable conditions and that may not have a lifeguard on hand.

Owners and operators of aquatic facilities should be mindful of public transport options for travel to and from their facility and perhaps work with local council to encourage further support for older patrons in accessing their local aquatic facilities.

Owners and operators of aquatic facilities should consider opportunities to partner with local council and other community transport options that may be available to older people in the local area near the aquatic facility.

Owners and operators of aquatic facilities should give consideration to forming partnerships with community groups aimed at older people or aged care and retirement villages in the local area to encourage increased patronage among older people of the aquatic facility.

Owners and operators of aquatic facilities should consider the age of instructors and staff. A diverse workforce and age appropriate instructor for any classes or courses aimed at older people will be an appealing factor for inducing participation among this age group.

Facilities to promote participation in a Grey Medallion course as a way to develop essential water safety and lifesaving skills.

Owners and operators of aquatic facilities should consider the timing of any program aimed at older people. These should be at times deemed suitable such as mid-morning on weekdays (10am onwards).

Owners and operators of aquatic facilities should be mindful of the need for flexible delivery for any program aimed at older people, to satisfy a range of skill and fitness levels. Courses aimed at older people may be best delivered over a number of weeks to ensure that participants can build up their skills and fitness gradually.

Owners and operators of aquatic facilities should utilise promotional resources at their facility and within the broader community to promote aquatic activity not only as a means for low impact exercise but also as a means of social interaction with peers.

Owners and operators of aquatic facilities should consider providing group activities aimed at older people in a cohort process – such as through local community groups to encourage greater participation and counter lack of motivation as a barrier to aquatic activity among older people.

Owners and operators of aquatic facilities should promote aquatic activity for older people and highlight the social and non-competitive nature of aquatic activity.

Owners and operators of aquatic facilities should consider providing drowning prevention information to older people, in the same way they provide information on child drowning prevention strategies and learn to swim information.

Owners and operators of aquatic facilities should promote programs aimed at older people such as the Grey Medallion, highlighting the benefits, not only to participants but also to people within their care, such as skills in supervision, CPR and safe rescue skills which are of particular use when caring for grandchildren.

Older Australians should be encouraged to undertake CPR and first aid courses.

Supervision

Owners and operators of aquatic facilities should assess the implications older persons with pre-existing medical conditions undertaking swimming or aquatic activity alone.

Owners and operators of aquatic facilities should give consideration to the availability of defibrillators.

Facility Design

Owners and operators of aquatic facilities should be mindful of water temperature when trying to engage the older population. Consideration to be given to increasing temperature (within a healthy range as per State and Territory Regulations) at times when older people are more likely to attend the facility or during programs aimed at older patrons (e.g. aqua aerobics)

Owners and operators of aquatic facilities should give consideration to the temperature of change rooms when trying to ensure aquatic facilities are appealing to older people.

References

• World Health Organisation. Definition of an older or elderly person. Secondary Definition of an older or elderly person. http://www.who.int/healthinfo/survey/ageingdefnolder/en/.
• Australian Water Safety Council. Australian Water Safety Strategy 2008-11. Sydney, 2008.
• Australian Water Safety Council. Australian Water Safety Strategy 2012-15 Australian Water Safety Council, 2012.
• World Health Organisation (WHO). The Heidelberg Guidelines for Promoting Physical Activity Among Older Persons. Journal of Aging and Physical Activity, 1997(5):1-8.
• Royal Life Saving Society - Australia. Royal Life Saving National Drowning Report 2013: Royal Life Saving Society - Australia, 2013.
• McCrindle M. Australia in 2020: A Snapshot of the Future: McCrindle Research, 2013.
• Bergamin M, Zanuso S, Alvar BA, et al. Is water-based exercise training sufficient to improve physical fitness in the elderly? . European Review of Aging and Physical Activity 2012;9(2):129-41.
• Elbar O, Tzedek I, Vered E, et al. A water-based training program that includes perturbation exercises speed of voluntary stepping in older adults: a randomized controlled cross-over trial. Archives of Gerontology and Geriatrics 2013;56(1):134-40.
• Martin-Valero R, Cuesta-Vargas AI, Labajos-Manzanares MT. Evidence-Based Review of Hydrotherapy Studies on Chronic Obstructive Pulmonary Disease Patients. International Journal of Aquatic Research and Education 2012;6(3):235-48.
• Verhagen AP, Cardoso JR, Bierma-Zeinstra SM. Aquatic exercise and balneotherapy in musculoskeletal conditions. Best Practice and Research Clinical Rheumatology 2012;26(3):335-43.
• Jorgic B, Milanovic Z, Aleksandrovic M, et al. Effects of deep water running on older adults. A Systematic review. Healthmed 2012;6(9):3219-27.
• Queiroga AC, Peden A. Drowning Deaths in Older People: A 10 year analysis of drowning deaths in people aged 50 years and over in Australia, 2013.
• Franklin RC, Mathieu E. Older Australian Aquatic Safety. Sydney: Royal Life Saving Society - Australia, 2006.
• World Health Organisation. WHO Global Report on Falls Prevention in Older Age Geneva, 2007.