Mills Nutrition and Physical Activity Program Improves Mobility and
Self-Esteem in Wheelchair-Bound Elderly

Last year, Tova couldn't dress herself and needed the assistance of a physical therapist to go to the bathroom. Wheelchair-bound and without sufficient strength in her arms to get around, she required help just to leave her room at Beit Beyer – a nursing home and daycare center for the elderly. After nine months of exercise class through the Mills Nutrition and Physical Activity Program, Tova is now able to do all of these things on her own, and to stand for as long as half an hour at a time.

"The change for me has been dramatic," says Tova. "Before, I used to just sit a lot and it didn't feel good. This has pushed me – to stand, to walk – toward independence."

The funder and promoter of the program, biologist Professor Stanley Mills aimed to enhance the quality of life of the elderly through an enrichment program in nutrition and physical activity. The program was established in January 2003 by JDC-ESHEL (JDC's strategic partnership with Israel's government to develop services for the elderly), IDAN (the local association for the elderly in Jerusalem), government ministries, local hospitals and the Wingate Institute.

The Mills Nutrition and Physical Activity Program seeks to improve the overall health and fitness of elderly who are in day care centers, nursing homes, and other care institutions through the provision of exercise, a balanced diet, and a nutritional "overhaul" – which, in the case of Beit Beyer included replacing plastic ware with ceramic dishes and enticing silverware.

During this preliminary three-year pilot phase, the quality and effectiveness of the program are constantly being evaluated. The goal is to offer this program to day care centers, homes for the aged and other community centers across the country.

Tova is among the wheelchair-bound adults at Beit Beyer who participate three times a week in the project's exercise classes – in addition to their private physical therapy sessions – with the goal of enhancing their coordination, flexibility, and endurance. Candidates are screened by physical therapists to determine their eligibility, and divided into groups of four or five according to mobility level.

An occupational therapist builds personal programs for each participant and engages them in exercises designed to have practical applications in the participants' daily routines. Practice throwing and catching a plastic beach ball, for example, improves clients' coordination and, coupled with movements with a weighted donut that improve grip, increasingly enables them to hold a fork and feed themselves. Waving streamers enhances the functional (straight out) and lateral (to the sides) reach as well as general flexibility that are useful in patients' daily activities, including moving between their beds and wheelchairs and getting dressed.

Many clients stand during class with the aid of a special piece of exercise equipment – a vertical stand about waist-high that stabilizes the hip and knee joints to prevent a fall – allowing them to engage their leg muscles and move their upper bodies freely.

Since the introduction of the program in Beit Beyer last August, occupational therapists note marked improvement in the participants' self-image. According to Beni, a physical therapist and manager at the center, the exercise classes are a rare opportunity for many of the elderly to stand up, stretch, and look people in the eyes. "It is a matter of feeling dignified and seen as a person, not just an old person in a wheelchair."

For Tova, physical challenges have been a reality since she was fourteen. A tragic accident as a school girl – as the bus she was riding was hit by three cars – left her unconscious for three months and her lower body disabled. She nonetheless lived on her own for decades with limited mobility, relying on occasional help from her sister who lived nearby. After suffering a bad fall in her home last year, Tova's condition began to spiral downward and she came to Beit Beyer Nursing Home.

When she first began the exercise classes, Tova could also only stand for three minutes of each half-hour session. But her endurance has skyrocketed, and with it her self-confidence. "Now I stand for the whole half hour, and I also walk along the corridors holding the railing, and do so much more activity. I even feel lighter," she says.

The goal of the program has already been realized through clients such as Tova: to get them to use their muscles and become as independent as possible. Tova has recovered enough strength in her upper body to wheel her own wheelchair, so she is no longer reliant upon the staff to move around the premises. Speaking about her transformation, Tova is animated and her voice is full of life. "I feel free in every way."