Westcare UK

Pacing

(Pat O'Hara)

 

Contents:

Balancing rest & activity | Principles of pacing | Setbacks | An example of pacing | Summary

Balancing Rest & Activity

Vicious Circles

"Why can't I stop before I over do things? Do I respond to distress with denial"

"What am I afraid of? Do I respond to distress with withdrawal"

Principles of pacing

Prioritise - Ask yourself the following questions.....

• Does it all need to be done today?
• Can I get someone to help me?
• Does it all need to be done at all?

Plan - Ask yourself the following questions.....

• Can I break the job down into different stages?
• What do I need to carry out the job?
• What basic activities does each stage individually involve (e.g. Walking, sitting, standing etc...)

Pace - How do I pace my activities?

Find a baseline for each activity

WHAT IS A BASELINE?

This is a level at which an activity can be performed regularly, on a good or bad day. This level can then be increased gradually as your stamina and exercise tolerance improve.

HOW TO FIND YOUR BASELINE

Choose an activity - For example, Walking:

• Time how long you are able to walk comfortably at different times during the day. Then take the average of these times and HALVE it.

• THIS is your baseline for walking

• The same method can be used for sitting, standing or carrying out a task

Key Points:

• Take regular rests and change position frequently
• Do not set targets/goals too high
• The aim is to succeed not fail!

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Setbacks and what to do about them

There will be times when your symptoms may be worse for a few days or even longer.

When this happens, you may have trouble maintaining your activity levels. How long the set-back lasts and how it affects you will depend on the way you deal with it

• ACCEPT that temporary flare ups or set-backs may happen
• PLAN : Cut back on activities and exercise. Use more relaxation and rests, but don't stop altogether.

There is no 'Best Way' that will work for everyone. Remember we are all individuals!

When to stop:

Don't wait until you are exhausted!

STOP before you start to feel tired or when your pain increases.

REMEMBER some muscle pain may be healthy pain, i.e. just aches and pains from unaccustomed exercise

Pace it don't race it:

• Increase activity levels gradually, set your targets low and increase gradually
• Review your progress regularly and adjust your pacing accordingly
• Remember, if you are having problems achieving your goals you may have set them to high or you may be working on too many at once

A little and often:

A little and often is better than large chunks of either physical or mental activity

Pace:

• Pace physical and mental activity throughout the day with rests in between.
• Goals should be sustainable, realistic and achievable

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An example of pacing activity

Mrs X  lives at home with her husband and two grown up sons. She has a part time job two days a week as a checkout operator in a large supermarket.

 

She does all the washing and ironing for her family, all the shopping and preparation of all the evening meals.

As well as this, she enjoys knitting and gardening.

Mrs 'X' was finding that on the days when she worked at the supermarket and tried to do the ironing and evening meal preparation, her pain was aggravated so that she would spend most of the next day lying down.

This is how Mrs X would pace herself:

1) Make a list of all the things you have to do

• Preparing evening meal
• Washing
• Ironing
• knitting
• Gardening
• Shopping
• Work (2 days a week)

2) Prioritise the tasks

• Work (2 days a week)
• Prepare a cold meal on days when working
• Do the weekly shopping at the weekend when help from family is available for driving and carrying
• do the washing and ironing little and often

3) Pace the activities

Note:

The task of preparing the evening meal could be broken down and planned

• On work days, prepare a cold meal rather than cook a hot meal
• Ask a family member to set the table ready for meals
• On work days ask for help with washing & drying up afterwards

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Summing up

Main points:

• Try and identify a set-back early

• REVIEW events leading up to set-back. Try to identify cause

• RESET your baselines - You may need to review your baselines - are you being over optimistic

• Cut back on activities NOW. Increase rest periods until symptoms settle again

• Gradually pace up and increase activities

• PLAN for events like Christmas, family celebrations - enjoyable, but they all involve more physical and mental effort and energy

• REMEMBER relaxation. Don't over do activities, use rests in a structured way

Maintenance Plan:

Pacing & planning

This should be done daily and weekly to get a good balance of activity/rest/relaxation. Pace activities throughout the day. Don't do them all in the morning or one day! Vary activities and positions.

Deal with set-backs or lapses

Use them as a learning situation. Build on them to cope better the next time.

Take credit for your achievements!

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