Where to Begin?
Convincing people of the benefits of exercise is an essential first step. Many persons with early-stage Alzheimer's are worried about becoming a burden to their families. Explaining that exercise can help keep them healthy and make care giving easier on their loved ones can be a strong selling point.
Obtain a thorough physical exam by a physician, preferably one that believes in the health benefits of exercise. Such an exam may reveal cardiac, musculoskeletal, or other problems that may impose restrictions on the type and intensity of exercise to be undertaken. If this is the case, request a referral to a physical therapist or cardiac-rehab specialist to work out a beginning regimen that is suitable for the individual.
Ask the person's physician to reinforce his or her exercise recommendation by writing out a prescription that can be shown to the individual periodically. Such an instruction carries more weight than suggestions from a caregiver. Find media articles that cite the benefits of exercise in improving memory or preventing and slowing the effects of Alzheimer's. For example, a CNN Web site that reports a study done at Case Western Reserve University found that regular exercise may reduce the risk of developing Alzheimer's Disease (www.cnn.com).
That study, by Arthur Smith and Robert Friedland (1998), retrospectively examined the exercise habits of 373 people - 126 with Alzheimer's and 247 healthy people. They found that persons with Alzheimer's Disease had lower levels of physical activity earlier in life. (This could be a good selling point for involving son and daughter caregivers in a joint exercise program with their parent(s)).
The key to motivating people to persevere in any program of lifestyle change is social support. Alcoholics Anonymous and other similar organizations depend on one-to-one support and group encouragement to keep its members abstinent. The clinically proven Ornish diet and exercise program stresses the importance of social support in maintaining adherence to lifestyle changes and preventing heart attacks and other serious diseases.
Fitness club membership lists are filled with names of people who rarely come to work out after an initial "honeymoon" period. Many home treadmills, exercise bikes, and other fad equipment are unused after this initial period. Exercise programs for persons with disabilities that are successful, such as the osteoporosis and Alzheimer's studies at the University of Arizona, the exercise programs for persons with developmental disabilities and multiple disabilities at the University of Illinois at Chicago (Rimmer et al., 2000), are all characterized by the presence of exercise "buddies" or program monitors that provide ongoing supervision and encouragement.
Use yourself, a valued friend, a hired caregiver, or a student volunteer as an example and monitor and make exercising a joint social activity. Better yet, find another Alzheimer's-affected couple and go together. Set short-term achievable goals, such as a 1-minute increase in time on the treadmill and/or bike every two weeks until 30 minutes is reached, or steady increases in RPMs, miles per hour, pounds lifted, or repetitions achieved. Reward progress along the way with stars on a chart, a special T-shirt or badge, a frozen yogurt treat, or, as one Alzheimer's Disease caregiver does, with lunch at Taco Bell. Avoid promises of long-term results, like weight loss, that may not show evidence of progress for a long time.