3 Physical activity in the caring role

Despite the known benefits of physical activity to physical and mental health, in the 12 months to November 2019, almost 1 in 4 women and 1 in 5 men were classified as ‘inactive’ (i.e. being physically active for less than 30 minutes on average per week) in the UK (NHS Digital, 2020). Furthermore, physical inactivity has been cited as the fourth largest cause of disease and disability in the UK (Public Health England, 2014).

At the time of writing, no research reports on the actual prevalence of physical activity across the caring population in the UK (Horne et al., 2021), although 54% of carers report to have reduced the amount of exercise they do because of caring (Carers UK, 2017). Data examining carers over the age of 55 years indicates a concerning picture with a clear difference evident between the physical activity levels of the caring and non-caring population in this age group (Carers UK, 2020; Figure 3).

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Figure 3 Comparative physical activity data of over 55-year-old carers to the whole population (Carers UK, 2020)

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Graph titled ‘Activity levels by caring status’.

The y-axis shows percentages in increments of 10, starting at 0% and going up to 60%. The x-axis identifies Carers 55+ and the Whole population 55+, each is split into three categories: total inactive, toal fairly active, total active.

The graph shows the following data:

• Carers 55+, total inactive: 46%
• Carers 55+, total fairly active: 40%
• Carers 55+, total active: 14%
• Whole population 55+, total inactive: 33%
• Whole population 55+, total fairly active: 13%
• Whole population 55+, total active: 54%

Figure 3 Comparative physical activity data of over 55-year-old carers to the whole population (Carers UK, 2020)

It should be highlighted that the inactivity levels shown in Figure 3 are not the result of carers not wanting to be physically active. 81% of carers of all ages report that they are not able to do as much physical activity as they would like (Carers UK, 2019). However, given the physical and mental health impacts of caring discussed in Session 1, Activity 2 and the proven benefits of physical activity, it is particularly important for carers to be physically active, making it vital to explore any potential barriers to this.

Activity 4

Timing: Allow approximately 20 minutes.

Watch Video 2 below. As you watch, consider your own physical activity levels and the correlates that might influence this. If you are a carer, reflect on any barriers that you face. If you are not a carer, think back to the case studies in Session 1 – what might be the barriers to physical activity that they face?

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Transcript: Video 2

DR JO HORNE:

Despite the extensive benefits of physical activity on both health and wellbeing, approximately one-third of the adult population failed to engage with the recommended levels. Typically, these individuals cite a lack of time, a lack of energy, and a lack of motivation as their primary reasons for inactivity.

However, there are a wide range of other factors that can impact an individual's exercise behavior. Biddle et al, 2021, recognise six major categories or correlates of physical activity which can have a bearing on an individual's exercise behaviour.

First are socio-demographic correlates, such as socioeconomic status, gender, and age. For example we know that males and children usually report higher levels of physical activity than females and adolescents, and those from lower socioeconomic groups may not have the resources to engage in some types of activity.

Second are biological correlates such as fitness or body fatness. Lack of fitness and feeling conscious of weight are reasons why individuals may be concerned about starting an exercise program, as the prospect of visiting a gym can be daunting due to a lack of confidence and can even lead to feelings of anxiety.

Thirdly are psychological correlates such as confidence and attitude. Lack of confidence associated with lack of fitness and from other biological correlates can lead to an individual having low motivation levels to exercise.

Next are behavioural correlates, which are other behaviours associated with physical activity, such as smoking or diet. Previous experience of physical activity is a positive correlate to physical activity in later life, in part due to an individual already having self-efficacy in that domain. Whereas smoking and poor diet are negatively correlated with physical activity.

Then we have social correlates such as social support and family interactions. Lack of support from friends and family or mixing with people who are not physically active is a fundamental barrier to become inactive as this isn't seen as usual behaviour within the individual social group. And finally are environmental correlates, such as cycle paths and weather conditions. Poor access to places in which to be active is a frequently noted barrier to exercise. For example, living in an area with limited facilities.

End transcript: Video 2

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Video 2

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Discussion

When reflecting on your own physical activity levels and influencing correlates, you might have identified a number of barriers that you, or one of the case study carers, might face. For example, when considering social correlates, it might be that those around you (or the carer) might not be physically active which might not encourage you (or the carer) to be physically active.

Dr Jo Horne (who narrated Video 2) and colleagues (2021) reviewed the research literature to examine the barriers and facilitators to physical activity of carers based in the UK. The findings of the review highlighted the following barriers:

• increasing age
• not wanting to leave the caree alone
• the caree being unable to take part in activities
• health conditions
• fatigue
• lack of time
• difficulties in changing the routine for the caree.

You might have identified some of the barriers on this list when reflecting on your own physical activity levels or that of the case studies from Activity 2 in Session 1.

The facilitators to physical activity in carers found in the research are discussed in the next section.

Despite the challenges that a carer could face to be physically active, the evidence of the benefits for being active is strong. The next section looks at considerations for carers to become more physically active.