With gentle and flowing motions, Tai Ji Quan students follow along to the instructions from Yihua Zhou, ICHS Program Specialist, on left in white shirt and Kelsey Schultz, ICHS Occupational Therapist, during their twice-weekly class at ICHS Legacy House Assisted Living facility. Photo by Theo Bickel.

Sunlight is beaming into the activity room of the International Community Health Services (ICHS) Legacy House assisted living facility, where nine senior residents perform sweeping Tai Ji Quan (also known as Tai Chi) movements. Canes and walkers lean against the walls. Class began with everyone seated, but by now, everyone is standing and moving in unison.

Moving for Better Balance is ICHS’ newest Healthy Aging and Wellness Program and represents the innovative ways that staff have continued to advance health services in innovative, and accessible ways. The program is open to participants at no-charge in order to make it as accessible as possible.

ICHS’ Moving for Better Balance staff instructors lead lessons in participants’ first-language. With coordinated steps and controlled arm motions, participants are practicing an ancient meditative Chinese martial arts in a contemporary form, helping improve their balance and overall well being.

A visitor may mistake it as an exercise class, but the Moving for Better Balance program is much more than that says Andrea Lynch, ICHS Program Instructor. There are mental benefits too. “Tai Ji Quan movements increase in complexity over time,” says Lynch. “The brain is having to think about chewing gum and walking at the same time. You are having to use your brain in different ways while your body is moving in complex ways. You’re going against the impact of aging.”

Andrea Lynch, ICHS Program Instructor, leads a virtual Tai Ji Quan Moving for Better Balance session taught over Zoom meetings. Students tune in from across King County. Two ICHS staff members, Yihua Zhou and Flora Deng, serve as tech support and live translators of the instructions into Cantonese and Mandarin. Photo by Theo Bickel.

Open to participants age 55 and older, this structured program takes six months to complete. ICHS staff do close evaluations of participants before and after, measuring participants’ balance and dexterity. During the COVID-19 pandemic, the program was hosted via Zoom meetings so senior participants could join from their own homes.

If participants do not have technology devices to access class or don’t know how to use them, then Yihua Zhou, ICHS Program Specialist, consults with them to get them technical access and become comfortable navigating logging on.

The benefits go beyond exercise, says Zhou. The program is as much mobility exercises as it is a lifeline to social support for first generation Chinese American elders who face isolation. Having the opportunity for participants to virtually join in and meet other and make friends has been hugely beneficial.

Separate classes are held weekly in Mandarin and Cantonese. Over 100 participants are enrolled in these twice-weekly virtual classes where they join from their own homes Residents of ICHS’ Legacy House join in-person at the facility.

To stay healthy, stay active

According to the National Institutes of Health, only 15% of seniors age 65 to 74 engage in regular leisure-time physical activity. The number falls dramatically further to only 5% of people 85 and older.

Physical activity provides numerous health benefits for older adults and is key in managing health conditions like diabetes or delaying the onset of dementia. According to the CDC, getting enough physical activity could prevent 1 in 10 premature deaths in the U.S. and racial and ethnic minorities experience higher levels of inactivity.

ICHS has long sought to host low-barrier, culturally competent, in-language exercise classes and wellness programs at community locations. During the COVID-19 pandemic, ICHS swiftly closed the congregate senior meal program and in-person events out of concern for safety.

The COVID-19 pandemic and rise in anti-Asian hate crimes has exacerbated the mental and physical health impacts of isolation for many Asian seniors. A February 2022 report by the Asian American Federation found that 75% of older AAPI adults in New York were afraid to leave their homes as a result of anti-Asian violence.

This isolation and stark decline in daily exercise leads to worsening mobility and greater risk of falling according to researchers from the Journal of the American Geriatrics Society.

The best way of reversing this is to get back into practice of moving and practicing balance says Lynch. Trained as an occupational therapist, the Moving for Better Balance program effectively gets the mind active. “Our bodies are complex, and moving get harder as parts of our bodies go into disuse,” says Lynch. “[When performing Tai Ji Quan] all of our bodies’ sensors are going off, saying ‘I’m in balance, I’m out of balance.’ Blood pressure needs to rise. Blood pressure needs to lower.”

Newly accredited

On October 19, 2020, ICHS held its first accredited Tai Ji Quan: Moving for Better Balance program. Based upon the contemporary Tai Ji Quan (also known as Tai Chi) the program was designed by Fuzhong Li, Ph.D., a Senior Scientist at Oregon Research Institute, the program seeks to provide exercise and a “balance training regimen designed for older adults at risk of falling and people with balance disorders.”

Moving for Better Balance program classes are held across the country, at community centers and senior assisted living facilities alike. What makes ICHS stand out is the virtual components and the care that ICHS staff take in enrolling new participants.

Zhou, and now a new team member Flora, visit every registrant at their home for a safety evaluation. Do they have enough space to turn around? Are there tripping hazards like rugs or furniture? Do they have a sturdy chair they can move to hold onto during movements? They also check in with participants’ doctors to see if they are okay doing exercise, or experience issues with dizziness.

During every virtual call, Zhou or Flora join in to translate Lynch’s movements as well as observe participants to ensure no one has fallen at home while following instructions.

At first, many participants struggle with movements. “They get stronger,” says Zhou. “They just have to take a little bit, a baby step at a time. Just do the [movement] as much as you can. Maybe next time we can move higher.”

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