PORTFOLIO Reducing Falls in Older Adults A Qualitative Exploration of an Intergenerational Tai Chi Class Thomas Miller New Mexico State University Author contact: thomascmiller@outlook.com Mary Alice Scott Department of Anthropology, New Mexico State University Author contact: mscott2@nmsu.edu Anthropology & Aging, Vol 38, No 2 (2017), pp. 29-37 ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 This work is licensed under a Creative Commons Attribution 4.0 International License. This journal is published by the University Library System of the University of Pittsburgh as part of its D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press. Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 29 Reducing Falls in Older Adults A Qualitative Exploration of an Intergenerational Tai Chi Class Thomas Miller New Mexico State University Author contact: thomascmiller@outlook.com Mary Alice Scott Department of Anthropology, New Mexico State University Author contact: mscott2@nmsu.edu Falls in the older adult population are a critical public health concern, particularly in New Mexico where mortality due to falls is three times higher than the national average. Following National Center for Injury Prevention and Control recommendations (NCIPC 2008), an interdisciplinary team of researchers at New Mexico State University's Falls Research and Healthy Aging Laboratory has implemented a tai chi-based intervention to reduce this disproportionately high rate of falls-related mortality. The lab includes kinesiologists, physical therapists, and a medical anthropologist as well as their undergraduate and graduate students. During the spring semester of 2015, the lab began offering a tai chi course at a local community center as part of a pilot study evaluating the effectiveness of this intervention strategy for a U.S-Mexico border population. The team conducted a qualitative analysis of participants’ experiences of the tai chi intervention. The 15-week program included two hour-long classes per week. The intervention paired kinesiology student-instructors with older adult participants in the class, creating intergenerational dyads that supported participants physically, socially, and mentally. Our interviews suggest that participation in the class improved participants' confidence in performing activities of daily life. Additionally, working one-on-one with university students enhanced the instructional experience and motivated participants to continue attending class. The research team conducted short interviews with nine participants (approximately 1/3 of the class) at the beginning, middle, and end of the course to document their experiences with the class. Most participants articulated the physical benefits they gained from the class including increased body awareness, sustained engagement in low impact exercise, and improved balance. Arnold (NB: all names used are pseudonyms) who has taken several tai chi courses, stated “you have to keep doing this; I have experienced no falls since February 2014. Even when stumbling I am able to recover beautifully.” Hayleigh described why she continues to participate: “for my wellbeing, and for being more active and mobile. By coming in and doing the exercise that we are set up to do, it allows us to open up the aching muscles and bones.” Many individuals expressed a desire to participate in future opportunities to reduce their fall risk and maintain regular physical activity. http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 30 In addition to their positive experience with the actual physical activity taught in the class, participants also discussed their positive experience working with undergraduate students as their teachers. Three interviewees compared this class to other exercise classes, noting that in other classes instructors often moved too quickly and did not provide sufficient guidance or one-on-one assistance. Interviewees appreciated the individualized instruction by students. Bridgette stated that without one-on-one instruction she felt “like an octopus," and noted, "It's helpful to have someone direct my arms the way they need to be." Arnold appreciated the personalized exercise plans that students provided. These plans drew on students’ emerging expertise in kinesiology as they progressed in their undergraduate training. Finally, Bernice felt that the class was “a wonderful learning experience.” Working with the students was particularly important for her: “You know, they learn, we learn, we all learn together. It creates a really nice environment as opposed to going to a gym – not a fun experience in a gym.” Bridgette, Arnold, and Bernice appreciated the intergenerational experience of working with students who took the time necessary to teach the exercises, gaining access to academic knowledge to support ongoing exercise outside of the class, and learning alongside the student-teachers. There is substantial evidence that the physical activity that is part of participation in tai chi classes reduce falls risk (Li et al. 2004), but we know less about how the specific qualitative experience influences sustained and effective participation. Our research participants suggest that certain methods of instruction function better than others. In particular, participants enjoyed the mutual teaching- learning relationships they developed with undergraduate students. This intergenerational practice - which Cook and Bailey (2013) define as "a practice that brings people together in purposeful, mutually beneficial activities which promote greater understanding and respect between generations" - draws on the strengths of both the young people and the older adults involved. The undergraduate students bring their developing skills as teachers, while older adults bring their experiences of physical activity, falls, and preventive practices. Intergenerational relationships may support greater efficacy of exercise programs among older adults, echoing other research that has identified positive effects of intergenerational relationships in other community settings (Springate 2008; Underwood and Dorfman 2006). All participants experienced improved physical ability, including greater strength, increased flexibility, and heightened bodily awareness. However, participants also emphasized their interactions with the student-teachers in the class. We suggest that these relationships, even if temporary, contribute to reducing falls risks as participants gain strength, flexibility, and confidence. The intergenerational relationships that developed during the class increased participants' willingness to engage in activities that pushed the boundaries of older adults' perceived physical limits. Through focused, individualized practice, participants built motivation to continue engaging in physical activity, particularly future classes involving undergraduate students as teachers. http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 31 REFERENCES Cook, Glenda and Catherine Bailey. 2013. 'Older Care Home Residents’ Views of Intergenerational Practice. Journal of Intergenerational Relationships 11(4): 410-424. DOI:10.1080/15350770.2013.837802 Li, F., P. Harmer, K. Fisher, and E. McAuley. 2004. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls In Older Persons. Medicine & Science In Sports & Exercise 36(12): 2046-2052. http://www.ncbi.nlm.nih.gov/pubmed/15570138 National Center for Injury Prevention and Control (NCIPC). 2008. Preventing Falls: How to Develop Community- based Fall Prevention Programs for Older Adults. Atlanta, GA: Centers for Disease Control and Prevention. Springate, Iain, Mary Atkinson, and Kerry Martin. 2008. Intergenerational Practice: A Review of the Literature (LGA Research Report F/SR262). Slough: National Foundation for Educational Research. https://www.nfer.ac.uk/publications/LIG01/LIG01.pdf, accessed on July 26. Underwood, Heather L. and Lorraine T. Dorfman. 2006. A View from the Other Side: Elders’ Reactions to Intergenerational Service-Learning. Journal of Intergenerational Relationships 4(2): 43-60. DOI:10.1300/J194v04n02_04 http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 32 Photo by Morgan Taylor http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 33 Photo by Morgan Taylor http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 34 Photo by Morgan Taylor http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 35 Photo by Morgan Taylor http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 36 Photo by Morgan Taylor http://anthro-age.pitt.edu/ Anthropology & Aging Vol 38, No 2 (2017) ISSN 2374-2267 (online) DOI 10.5195/aa.2017.141 http://anthro-age.pitt.edu Miller & Scott | 37 Photo by Morgan Taylor http://anthro-age.pitt.edu/ PORTFOLIO Reducing Falls in Older Adults A Qualitative Exploration of an Intergenerational Tai Chi Class Miller & Scott | 29 Reducing Falls in Older Adults A Qualitative Exploration of an Intergenerational Tai Chi Class