901 8th St.
P.O. Box 4109
Moorhead, MN 56562
April 15, 2008
Mrs. Marcy Bork
116 West 2nd Street
Graceville, MN 56240
Dear Mrs. Bork:
My name is Kristen Huselid; I am a freshman at Concordia College in Moorhead, Minnesota. I
would like to begin by complimenting you on your work as an exceptional nursing director at
Grace Home. It is evident how much you care for each resident. Welcoming new ideas and
recommendations that will enhance the quality of living for the residents, you make many
positive changes in their lives. I am writing to you because you have the authority to implement
my proposal—an exercise program for the residents of Grace Home and Grace Village.
As a former employee of Grace Home, I am personally aware of the concerns at the facility. The
mobility of the residents is a matter of great importance to the entire nursing staff. Having
worked at Grace Home for two years, I have developed special relationships with the residents. I
have grown to love, respect and admire these residents and feel confident an exercise program
which will enhance their strength, balance, and energy.
This semester, I worked as an exercise club attendant at Eventide Catered Living in Moorhead.
My duties included: adjusting the equipment and machines to each resident’s precise
specifications, assisting residents onto the machines, and logging their individual
accomplishments—the distance traveled, the calories burned, and the duration of their workout.
This experience has opened my eyes to the obvious benefits, both physically and socially, of a
regular exercise program for the elderly. The residents have confirmed that they appreciate the
value of this program. Exercise has given them increased mobility—allowing them to carry out
daily tasks and activities with greater ease. Dottie, a participant in the exercise club
acknowledges having more energy, greater stamina, and increased well-being. “Exercise makes
me feel my best, and it sure beats playing bingo!” she says gladly.
My experiences as a Certified Nursing Assistant and as an exercise room attendant have given
me direct knowledge to personal concerns of the elderly. Many of the nursing home residents
with whom I have worked have entered the facility due to a serious fall. This has lead to
hospitalization, and in many cases, a down-hill spiral of healthcare issues (Brown). I believe a
simple exercise program can prevent and alleviate such incidents. As a part of the nursing staff, I
have seen first-hand how a single fall can drastically change a person’s life forever.
Worldwide, accidents which occur from falling are a major and increasing health problem
(Whitehead). Fractures due to fall-related injuries are extremely common in our growing, aging
population. Residents in nursing homes often become bedridden following fractures caused by
serious falls. The evidence that this problem is real can easily be seen by visiting any nursing
home. Falls to nursing home residents are not uncommon and are, therefore, a great concern to
nursing staff (Schoenfelder). Falls, in turn, may cause serious bone fractures that can be life-
threatening. The use of weight-bearing exercise may strengthen weak bones, and thereby,
decrease the risk of falling. Another problem many elderly people face with lack of physical
activity is the loss of agility and balance. This also contributes to an increased number of falls.
Participation in any types of exercise may reduce fall-injury risk; however, balance control is the
key requirement for successful mobility and fall reduction (Swanenburg).
With the continuing growth of elderly populations in our society, it has become a matter of
increasing importance to look for ways to maintain and improve the functional abilities of aging
people. It is no surprise that inactivity often increases with age, but this should not cause one to
become sedentary. By participating in a regular exercise program, residents can prolong their
independence and improve their quality of life (Hanna). Although remaining physically active is
one of the most important things that older adults can do for themselves, some seniors are
reluctant to exercise. Many seniors are afraid that exercise will be too strenuous or that physical
activity will harm them (Whitehead). However, exercise provides definite health benefits: helps
maintain the ability to live independently and reduces the risk of falling and fracturing bones;
helps aging adults improve their stamina and muscle strength; and helps maintain healthy bones,
muscles, and joints. Physical activity can also improve mood and relieve depression ("Physical
Activity and Health").
Inactivity is problematic for a number of reasons. For many adults, growing older seems to
involve an inevitable loss of strength, energy, and fitness, but this does not have to be the case.
The frail health and loss of function we associate with aging, such as difficulty walking long
distances, climbing stairs, or carrying groceries, is in large part due to physical inactivity. When
it comes to our muscles and physical fitness, the old adage applies: "Use it or lose it." Moderate
physical activity can help improve the health of most aging adults or those who have diseases
that accompany aging. An inactive lifestyle can cause aging adults to lose ground in four areas
that are important for staying healthy and independent: strength, balance, flexibility, and
endurance. Researchers suggest that exercise and physical activity can help aging adults
maintain, or partly restore, functions in these four areas. Even frail, older adults can prolong their
independence and improve their quality of life by becoming more physically active
(Schoenfelder). By focusing on physical exercise, which may incorporate strength training,
individuals are working and strengthening their muscles and keeping their bodies healthy and
It is never too late to become physically active. No one is too old to enjoy the benefits of regular
physical activity (Hanna). In fact, older Americans have much to gain by becoming more
physically active. The elderly are at higher risk for health problems which can be prevented by
being active. In addition, physical activity can be an important part of managing problems that
might already be present, such as diabetes, high blood pressure, or elevated cholesterol. Finally,
physical activity can improve the ability for a person to function well and remain independent in
spite of health problems. Few factors contribute as much to successful aging as having a
physically active lifestyle.
My proposal for an exercise program includes two aspects. This program is tailored to each
resident’s fitness level. The first level is very basic and can be used by most residents, including
those sitting in chairs. Residents can use small barbells of varying degrees of weight to increase
balance, flexibility, and strength. This proposal is simple and inexpensive. Grace Home and
Grace Village could easily provide small hand-held weights found at any local retailer.
This level of exercise, incorporated with daily walking, will provide residents with a primary
fitness program. Working with Melissa Sigler, a room at GraceVillage could be utilized for
residents to use this equipment. Nursing home staff can easily be trained to use simple exercise
programs (Schoenfelder).With supervision, this room could be available to residents at a
designated time during the day. The attendant will encourage participants to set personal goals
and record their increments of success. Residents will experience a pride of accomplishment
when they have met their goals. The residents can receive numerous benefits by daily
participation in physical exercises. In a short period of time, residents will see positive results
from exercising, which will instill confidence. Therefore, the discouragement factor of failure is
eliminated—which in turn, encourages the residents to continue their exercise regimen.
If you wish to add an intensive exercise program, I would like to propose the purchase of a
NuStep®. This is an excellent piece of equipment for the elderly because it has ten work levels
to accommodate everyone—regardless of fitness level (Johnston). Residents of Eventide’s
exercise club were extremely enthusiastic about this equipment. The NuStep® records the
number of steps taken during the workout, allowing residents to observe their progress. In a
social atmosphere, residents take part in playful challenges, uplifting and encouraging one
another. Camaraderie is established by the participants in the exercise club. Grace Home and
Grace Village can apply for available grants to help finance equipment and supplies necessary to
provide for this exercise program. I believe organizations within our community will be
accommodating and will actively seek to offer their assistance in providing their time and
resources to make this program available. Many families in our community have relatives
residing in Grace Home and Grace Village. They are supportive of new ideas and programs
which will benefit their loved one. By making this opportunity available to Grace Home and
Grace Village, we are offering residents the ability to have an active, healthier lifestyle.
The residents of Grace Home have been an important part of my life for the last two years. I care
deeply about them and am concerned for their physical, emotional, and social well-being. By
providing an exercise program for them, I feel their quality of life will be drastically improved.
An exercise program will provide both short- and long-term health benefits. I believe that
providing an exercise program for the residents of Grace Home and Grace Village is an
investment in a healthier future. If you have any questions about implementing my proposal,
please feel free to contact me.
Brown, Annette Piotrowski. "Reducing Falls in Elderly People: A Review of Exercise
Interventions." Physiotherapy Theory & Practice 15.2 (1999): 59-68.
Hanna, Ibrahim R., and Nanette K. Wenger. "Healthy Aging." American Family Physician 71.12
Johnston, Brian. "NuStep TRS 4000 Recumbent Cross trainer." NuStep. 2008. NuStep. 3 Apr
Larson, Dottie. Personal interview. 17 Mar 2008.
"Physical Activity and Health." Centers for Disease Control and Prevention. 26 Mar 2008.
Department of Health and Human Services. 28 Mar 2008
Schoenfelder, Deborah Perry, and Linda M. Rubenstein. "An Exercise Program to Improve Fall-
Related Outcomes in Elderly Nursing Home Residents." Applied Nursing Research, 17.1
Swanenburg, Jaap, et al. "Effects of Exercise and Nutrition on Postural Balance and Risk of
Falling in Elderly People with Decreased Bone Mineral Density: Randomized Controlled
Trial Pilot Study." Clinical Rehabilitation 21.6 (2007): 523-34.
Whitehead, Craig H., Rachel Wundke, and Maria Crotty. "Attitudes to Falls and Injury
Prevention: What are the Barriers to Implementing Falls Prevention Strategies?" Clinical
Rehabilitation 20.6 (2006): 536-42.