Fitness for Mind and Body – Interval Training to Maintain Skills
by Gretchen M. Ashton, CFT, SFT, SFN, SSC, NBFE,
PAC Certified Independent Consultant
Sometimes the clock ticks and ticks as slow as molasses, and other moments fly by so fast we wonder where an entire day went. When caring for people living with dementia (PLwD) we often notice a different sense and experience of time, particularly when performing tasks and skills. If we do tasks ourselves, it typically goes much faster and easier, but we sacrifice the best relationship building tool available – hands-on interaction with PLwD. When we accomplish tasks by assisting PLwD with their skills, it will most likely take longer, much longer. It is time well invested though. Everything we do now and how we do it affects future care either positively or negatively. So, how do we get everything accomplished that needs to be completed each day while caring for PLwD and preserving skills for as long as possible? After all, the race is against dementia not against time.
One way to create balance is to apply the concept of interval training. Interval training gained popularity through the sport of running. It is utilized by new runners transitioning from walking to running, or by advanced runners wanting to increase distance, speed, and efficiency. The exercise involves repeating timed intervals of walking with timed intervals of running, either fast or slow, until the goal is accomplished. These training programs are developed through planning, with purpose, incorporate practice, require patience, and rely on persistence. Each program is unique to each participant. Initially, intervals may alternate in one-minute increments. As performance improves, and for increasing distance, speed, and efficiency, intervals extend to three minutes and longer, and training progresses.
How to apply interval training to care:
1. Allow extra time for everything, extend schedules, and include fewer to dos each day.
2. Decide ahead of time which skills are the most important to maintain and incorporate those intervals of interaction into the routine. Make time to be flexible.
3. Give PLwD advance notice to help them prepare for interactions and activities. Even if it seems there is no relative response, there is often still an internal process PLwD can work through if they can anticipate what is next.
4. All things considered, it is quite possible that aggressive behavior and resistance are learned responses related to time constraints and previous negative hands-on interactions. The same with withdrawn behavior. This is when one-minute intervals work great. Try something for one-minute, wait for one minute, try again for one minute, wait for one minute, and if necessary, walk away for one minute. This may take extended practice over days and weeks, but transitions will come with planning, purpose, practice, patience, and persistence.
5. Create intervals in the day to alternate periods of time for tasks that the PLwD cannot perform at all, with skills activities that can be performed by the PLwD. Break up the day to keep it interesting. Long intervals of doing nothing can cause PLwD to become dependent on others in nearly every aspect of care.
6. Make the skills real. For example, activities of daily living, personal hygiene, chores, food preparation, or hobbies the PLwD can relate to. Don’t dumb down the skills activities.
7. Demonstrate skills so PLwD can follow. Show rather than speak. Move at a moderate pace and use words of encouragement in response to a correct action, rather than explaining what to do. Listening and moving may be too much to do at the same time for PLwD.
8. Go for a walk or run and apply interval training. A healthy lifestyle helps us win the race against dementia. It keeps the mind and body active. Preserving and maintaining function for PLwD and care partners is essential to maintaining skills, performing tasks, and building relationships.