Exercise for institutionalized older adults and transitional care between residential care and the home

Abstract

The management of institutionalized older adults should be based on a person-centered care model aimed at preserving functionality, autonomy, and quality of life. This population exhibits a high prevalence of fragilty, sarcopenia, multimorbidity, and functional limitations, conditions associated with an increased risk of dependency, hospitalization, and mortality. Among the most common chronic diseases is type 2 diabetes mellitus (T2DM), which is associated with functional decline, loss of muscle mass and strength, an increased risk of falls, and reduced quality of life.

In this context, physical exercise represents a fundamental therapeutic intervention and is currently recognized as a key component of the concept of “exercise as medicine.” Scientific evidence strongly supports multicomponent exercise programs that combine resistance training, balance exercises, aerobic endurance, and flexibility training. These programs have demonstrated significant benefits in mobility, functional capacity, fall prevention, metabolic control, and overall quality of life.

Long-term care facilities provide an ideal setting for implementing exercise programs tailored to the characteristics, needs, and goals of each resident. However, the benefits achieved during institutionalization require continuity beyond the residential setting. The transition from the facility to the home environment, and subsequently to community-based physical activity resources, is a crucial strategy for preventing physical deconditioning and maintaining the gains achieved during care.

Throughout this process, interdisciplinary collaboration is essential. Physicians, physical therapists, exercise professionals, occupational therapists, nutritionists, nurses, and other healthcare providers contribute to functional assessment, exercise prescription and supervision, fall prevention, education of family members and caregivers, and coordination with community resources.

In conclusion, the systematic integration of physical exercise within a person-centered care model and a continuity-of-care framework helps preserve functional capacity, reduce dependency, and promote healthier aging among institutionalized older adults.