Physical limitations shouldn’t stand in the way of living well.

No one exercise fits all.

The first rule is there’s no hard-and-fast rule. Jean Abustan, director of therapy at Hughes Health & Rehabilitation in West Hartford, Connecticut, says every long-term nursing home resident has different strengths and limits. While some move briskly, others require assistance to walk or use a wheelchair. So before deciding if water aerobics or tai chi or light weights is a good fit, take personal factors into consideration. Abustan advises any nursing home resident first be evaluated by a doctor and a physical therapist or occupational therapist – taking medical conditions into account – to determine what exercises might be appropriate. “The important thing is that they move safely and make it a routine,” she says.

Doing nothing isn’t safe.

Some loss of muscle strength with advancing age is inevitable, says Wojtek J. Chodzko-Zajko, a spokesman for the American College of Sport Medicine, and an exercise scientist whose research is focused on physical activity and aging. “But most of the decreases we find are due to physical inactivity and sedentary lifestyles,” he says. Slowing down can raise one’s risk for everything from taking a serious fall to having a heart attack. Fortunately, staying on the move can help protect against health hazards, including the loss of muscle and strength. “There’s good research evidence that those declines can be prevented and also ameliorated through physical activity,” Chodzko-Zajko says.

Choose your own adventure.

The surest path to quitting an exercise routine is letting someone else pick it for you. “In the past, we’ve tended to have experts tell older people what they should do, and that has been associated with relatively low adherence levels,” Chodzko-Zajko says. “Because they’d not [been] considering what it is that the older person likes, or what it is that they want to achieve.” Today, evidence-based activity programs usually start by asking what a person wants to do. Align goals with personal preferences, whether it’s taking things at your own pace on a stationary bike or mixing physical activity with socializing in group classes.

Be balanced.

Dr. Shelley Bhattacharya, a geriatrician and an associate professor with the University of Kansas Medical Center, says though not every nursing home offers it, Pilates is certainly growing in popularity among nursing home residents. The relatively low-impact exercise can also boost balance and strength. Tai chi – a type of martial art combining deep breathing and relaxation with gentle movements – may also help with balance. However, for some adults who have balance limitations already, Pilates may be more appropriate, Bhattacharya says. “I would cater to each individual person,” she says. Much like tai chi, she adds that Pilates is great for working on flexibility, range of motion and hand-eye coordination – “fantastic assets that every older adult can benefit from.”

Take a seat.

For some, simply standing may prove a tall order. “For those that aren’t able to stand for prolonged periods of time, you can always do the chair exercises,” Bhattacharya says. “Chair yoga is something that’s growing in popularity.” She recommends this seated version because it maintains the benefits of yoga – including breathing exercises and upper body strengthening – without requiring a person to stand for prolonged periods of time or balance on one leg. “If one is unable to do that or if they can’t be on the floor, then being in a chair is much more feasible [and] much more accessible.”

Get wet.

Swimming is a fantastic exercise for people who have joint conditions, Bhattacharya says; these conditions, like arthritis, become much more common with age. Swimming has no impact on your joints, she says, and it strengthens the core as well as leg, hamstring and quad muscles, and does the same for the back. Also great for core strengthening and well-tolerated and easy on the joints: water aerobics, Bhattacharya says. “It hits all your major muscle groups, yet it’s a no-impact exercise.” Water aerobics have also been shown to increase cardiovascular health and provide a way to ease back into activity for people who have been relatively sedentary. That said, very few long-term care facilities have ready access to swimming pools, but if transportation to a wellness or fitness facility is available, by all means take advantage!

Don’t rack the weights.

Aerobic exercise and strength training serve as important complements to overall wellness, and experts say it’s important to resist the urge to neglect one or the other as a person ages. For some, strength training might involve using elastic or resistance bands, or resistance training in a pool or whirlpool, Abustan says. For others receiving skilled nursing care, it could mean lifting free weights. “We want them strong,” she says. The combination of strength with balance can help prevent falls, which are more common in older adults and can be physically debilitating.

Take it in stride.

Being active needn’t be complicated. For those who want to go sans equipment, and who are physically able, walking can be highly beneficial, experts say. Bhattacharya notes, however, that finding a place to walk can be challenging for nursing home residents who aren’t able to come and go freely. But some nursing homes, like Hughes Health – which has programs that encourage walking, and where certified nurse assistants will walk with residents – make accommodations. “The biggest thing would be that … it’s never too late to start an exercise program,” Bhattacharya adds. “Your body will always reap the benefits.”