28. Preventing Falls

“The advice I had from our occupational therapist was to have a walk-in shower installed and grab rails fitted in the bathtub for my husbands’ safety.”

JOY, PARKINSON’S CAREGIVER

Unfortunately, because of the nature of Parkinson’s and how it affects balance and stability, people with this disease are prone to falling. Falls become more common as the disease progresses. In fact, up to two-thirds of people with Parkinson’s experience falls each year (compared to a third of the general elderly population).

Falls in PD occur mostly when turning or changing directions and are often related to a freezing episode. People with Parkinson’s might also experience falls as a result of orthostatic hypotension (postural low blood pressure) and problems with vision.

There is no single solution to preventing falls in PD, and because they become more and more common as people age, the main focus should be on preventing frequent falls and minimizing injury.

As a caregiver, one big thing you can do to help keep your loved one from falling is to make your home safer. Tips on how to do this were mentioned in chapter 25 on home safety for people with Parkinson’s.

Here are some more specific tips to help with fall prevention.

•  Ensure that your loved one takes their medication as prescribed to reduce the severity of motor symptoms.

•  Help your loved one stay focused while walking by avoiding distractions. Even talking can contribute to falls, as multitasking may be hard for the Parkinson’s brain.

•  To increase muscle strength, stability, and balance, have your loved one try an exercise and physical therapy program individually tailored to their needs.

•  Make sure your loved one is wearing appropriate footwear to help them move around more easily and keep them more stable (ladies, put away your heels!). Mom found that walking around barefoot was best for her while in the house.

•  Encourage your loved one to always keep one hand free to grab onto surrounding objects and/or break the force of a fall if need be.

•  Consider withdrawal of psychotropic medications.

•  Always seek medical attention, even after a minor fall, to identify the full extent of injuries and have them treated immediately to limit complications.

If your loved one with PD is in a care facility, you may want to consider the following for additional help in preventing falls.

•  Use of vitamin D and calcium supplements

•  Use of hip protectors

Studies have shown that there is no evidence to support the effectiveness of interventions to reduce falls among people with cognitive impairments. In addition, using physical or pharmaceutical restraints has not been found to prevent falls. In fact, there is some evidence to support an increased risk of injury from a fall with the use of restraints.20