The recent announcement by Jefferson Healthcare that current participants in the Exercise for Health program may be placed back on a waiting list has left some gasping for air.

The program provides exercise regimens for the physically infirm who are closely monitored by healthcare professionals.

No changes will be made until June.

But Julia Cochrane — who suffers from chronic emphysema and has been in the program for the past 15 years — said she is displeased with the change.

“They are saying we are selfish because we are keeping the spaces to ourselves and are not moving on,” she said. “Well, we are dying. None of us are moving on. We are dying because we have chronic diseases. There is nowhere to move on for us.”

Christine Ardoin — who suffers from emphysema and allergic asthma and has been a member of the class for the past few years — is also disappointed in the change.

“I was on a waiting list for a couple of years, but I was also going through preliminary therapy at the time,” she said. “I do object to being placed at the bottom of a waiting list I have already waited on.”

The hospital’s Wellness Center does offer a full complement of unmonitored exercise programs designed to encourage and challenge fitness in a multitude of ways, according to a hospital handout.

The new programs focus on strength, balance, aerobic fitness and mobility. These classes do not require provider referral and are filled on a “first-come, first-served” basis.

Being more inclusive of the community

The change will shorten the length of the waitlist as participants cycle through to community-based or Wellness Center classes, said Mitzi Hazard, Jefferson Healthcare director of rehab and wellness.

The change also will allow more community members to take advantage of the exercise programs, Hazard added.

“At some point the format had changed so that the people who were in were grandfathered in for life,” she said. “What that did was block anybody else from being able to access the program.”

That frustrated patients and their healthcare providers who could not immediately benefit from the program, Hazard said, because the class was booked.

“It meant we were serving 130 people instead of serving the entire community,” she said. “We have people who are finishing up with cardiac rehab, pulmonary rehab and physical therapy after strokes and hip fractures” and need access to the program.

The change means a more egalitarian approach for all parties, Hazard said.

“Everybody (will have) the benefit of the expertise of the people who are working in the program in terms of how to monitor yourself and gauge your body’s response to exercise. Those are the things they should be learning in there.”

The changes were made gently, Hazard said.

“Of course we are always concerned about their feelings, but there has been overwhelming concerns about the feelings of people who aren’t able to get into the program,” she said.

Informed of change

Participants were notified of the change during a March 25 meeting in the hospital’s Victor J. Dirksen Conference Room, Cochrane said.

“We went to the meeting and they told us that in June that we would have to have a doctor’s letter that tells us that we are supposed to be in this program,” she said. “We are going to have to get a doctor’s referral, again.”

As of September, the current participants are being asked to leave the program, Cochrane said.

“We will be put on the bottom of the waitlist — if we choose to — and to take part in something like a Tai Chi class. Tai Chi class is laughable. It is not what we need.”

Ardoin said she won’t do Tai Chi because she is physically barred from doing so.

“I have done yoga in my life. I am not strong enough to do Tai Chi. But, they are also not offering any staff. I need to monitor oxygen and respiration.”

Cochrane said many of the participants are in dire need of the personal care provided through the program.

“We need the machines, we need the person taking our oxygen (levels) or our pulse to be aware of who we are and what are physical status is.”

If the levels dip too low, the healthcare providers on scene send participants straight to urgent care for treatment, something they may not know to do otherwise, Cochrane said.

“The classes they are trying to send us to provide none of that,” she said.

Seeking alternatives

Greg German — who suffers from congestive heart failure and has participated for the past 1.5 years — said he is now forced to find an alternative.

“It will eliminate probably the only real avenue I have to exercise,” he said. “I have a few months to rethink what my plans will be and I am hoping I can get back to walking, at least.”

Cochrane, who has been in the program for the past 15 years, said current members should not be booted, but the program expanded.

“What the hospital should be doing is looking at best practices and expanding the program,” she said. “If you’ve got more people than can fit in the program, fine expand it.”

The issue, Cochrane said, is that participants such as Ardoin and herself will never get to a point where they can exercise independently without the close supervision they have enjoyed in the program.

German said he was blindsided by the announcement.

“We have been kind of expecting in the background there would be some changes,” he said. “I have no problem with those people coming into the program, I am trying to understand why the hospital can’t increase the program instead so there are more people taking it.”

Hazard said resources limit expansion.

“The program is impacted,” she said. “There is not a huge space for it and so … the burden that is on us in terms of what we owe to the community is that people should have equal access. I think our responsibility is not to just have a gym for people to exercise. Our responsibility as a healthcare center is to teach people to exercise, to give them the tools, to empower them and engender a desire for physical activity.”

Cochrane and Ardoin see no such benefit, they said, because now an important avenue of wellness preventing their diseases from progressing more quickly will be removed.

The program “keeps me from getting worse as quickly,” Ardoin said. “With emphysema it is a progressive disease. The more exercise you get the easier your blood oxygen exchange works in your muscles.”

Cochrane said the program had left her lung doctor “delighted.”

“I have not deteriorated hugely, which I could have,” she said.

Losing friends

German said the exercise portion could likely be replaced, but that the social benefits of attending the program with peers who have become friends and a support system of sorts is irreplaceable.

“That was something that was important to me,” he said.

Cochrane agrees.

“This is our social contact,” she said. “Sometimes this is the only time participants leave their house.”

Hazard said the hospital is concerned with the welfare of the current participants.

“It is one of the reasons we have given them basically six months to make a plan,” she said. “They have not only been given this chunk of time up until June to kind of make the most of the program and to determine where they are going to go, but then they are given an additional three months.”

Hospital staff did that to give participants plenty of time to look at other programs around the community, Hazard said.

The participants were given a list of other similar community programs they could choose to join, Hazard said.

“We encourage them to join those other exercise programs with their social networks and their friends,” she said.