Help Parkinson’s patients avoid falls

Falls can be a serious problem among patients with Parkinson’s disease because they experience changes in posture and movement. Also, Parkinson’s patients tend to walk in a slow, shuffling gait that may cause their feet to catch on uneven surfaces, thus throwing them off balance. Also, Parkinson’s patients commonly experience sudden drops in blood pressure when standing after sitting or lying down.

Trudy Hutton, coordinator of the American Parkinson Disease Association (APDA) Informa tion and Referral Center at St. Mary of the Plains Hospital in Lubbock, TX, offers these tips on how Parkinson’s patients may prevent falls. They are reprinted with permission from the APDA:

o When walking:

    • Wear good, sturdy shoes. Avoid crepe soles; they tend to get caught on carpet or uneven surfaces. A shoe repair shop can put leather soles on casual shoes such as tennis shoes so you can have the comfort of a casual shoe and the safety of leather soles.
    • Use the type of cane or walker that has been recommended by your physician or physical therapist. In some cases, a walker may be purchased with a seat for patients who tire easily.
    • If you use a walker, attach a bicycle basket or a pouch for carrying things so your hands remain free.
    • Keep your cane or walker (if you use one) near the bed at night.
    • Keep your hands free when walking in case you need to catch yourself. Wear clothing with pockets for carrying items.
    • Concentrate on standing straight to overcome stooped posture, which can cause you to lean forward and shift your center of gravity.
    • Concentrate on taking longer steps to avoid the short, shuffling steps that might throw you off balance.
    • Make an effort to pick up the feet with each step, rather than shuffling; this helps avoid catching your shoe on the carpet or an uneven surface.
    • When turning, allow yourself plenty of room; don’t try to pivot.

o Steps and stairs:

    • Install well-anchored handrails on both sides of stairs (even if there are only one or two steps).
    • Be sure stairs and steps are well-lighted.
    • Focus on stairs by counting steps and always hold on to the handrails.
    • If stairs are carpeted, make sure carpeting is short-napped and well-secured. If stairs are bare, make sure they are not slippery.

o Around the house:

    • Remove all throw rugs. These are easy to trip over.
    • Wall-to-wall carpet is a good choice, but choose short-napped and tight-twist carpets.
    • Keep clutter out of the normal pathways where you walk. Move all electrical cords so they are out of your path. Arrange furniture so you won’t trip over it.
    • Make sure chairs and sofas do not slip on the floor. If they do, place them against a wall to brace them.
    • Keep lighting levels consistent throughout the house to avoid false perceptions about floor levels.
    • Be sure all steps and stairs are well-lighted.
    • Use automatic night lights throughout the house to help you focus and keep your balance at night. Some lights are motion-sensitive: They turn on when there is any movement in the room.
    • Pulling or pushing on a heavy interior or exterior door can cause a loss of balance. Install a handle on walls adjacent to heavy or hard-to-open doors to give security of holding the wall handle while pulling the door open.
    • Automatic doors that open too quickly also can cause a loss of balance. Be careful.
    • Thresholds or door jams and inclines such as ramps can cause trips and falls from loss of balance. Be very cautious around them.
    • Put a phone within easy reach so you won’t have to rush to answer it. Cordless phones are a big help.
    • Get an answering machine for your telephone and set it to pick up on the fifth ring or longer. You can return calls at your convenience and not have to rush to answer the telephone.
    • If you get dizzy frequently, stay off ladders and do not stand on chairs.
    • Put things within easy reach so you won’t need a ladder or step stool to get them.
    • Do not wax floors.
    • Use an electric lift and tilt chair to make getting up easier. These may be covered by insurance with a doctor’s prescription.

o Bathroom hints:

    • Again, remove all throw rugs.
    • Remove glass shower doors and replace them with a shower curtain.
    • Install grab bars in the tub/shower area and next to the toilet. Be sure they are well anchored to the wall and not just attached to the side of the tub by clamps.
    • Install a raised toilet seat to make sitting and rising easier.
    • Watch for water spills on bare floors. Wipe up immediately.
    • Use a bath chair or stool in the shower or tub.
    • A handheld shower makes showering safer and is easier when using a shower stool.
    • Use nonslip strips or a mat in the tub or shower.
    • Use a soap-on-a-rope or place a bar of soap in a nylon stocking and tie one end to a towel bar. This prevents bending to pick up dropped soap.
    • Don’t lock the bathroom door. Be sure someone is in hearing distance when bathing.

o In the kitchen:

    • Wipe up spills promptly so you will not slip on them.
    • Use a long-handled sponge mop to wipe up spills to prevent having to bend over.
    • A dust pan attached to a wooden dowel or an old broom handle will allow pick up during sweeping without the danger of bending over.
    • Using a vacuum cleaner will prevent the need to use a dust pan at all.
    • Place frequently used items in a convenient place so you will not have to reach for them.
    • Tables and chairs with casters will roll easily and may slip out from under you and cause loss of balance or a fall. Remove all casters.
    • Long-handled tongs, available at medical supply stores, are helpful in reaching items stored overhead.