“If you fall, do not get up right away. Get your feet in order. Your hands, too. Then think about what and where your next move is going to be when you are ready to get up, and if there is anyone around to help you. Tell them to let you be for a minute or two, then you will be glad to let them know when they can help you up.”
—JO N., PWP
Unfortunately, because of the nature of Parkinson’s and how it affects balance and stability, people with this disease are prone to falling, and falls become more and 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, discussed in the previous chapter. People with Parkinson’s might also experience falls as a result of orthostatic hypotension (postural low blood pressure) and problems with vision. If you do fall, you should always seek medical attention. A doctor will need to evaluate any wounds or trauma and treat injuries immediately so as to limit potential complications.
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.
Ways to help prevent falls in your home
• Make your bathroom floors slip-resistant.
• Install grab bars and a raised toilet seat in the bathroom.
• Install handrails on both sides of stairways.
• Remove hazards such as scatter rugs, cluttered electrical cords, and unstable furniture.
• Install a personal alarm system to call for help when necessary.
Ways to reduce the frequency of falls
• Make sure you take your medication as prescribed. Reducing motor symptoms as much as possible will help prevent falls.
• Don’t get distracted while walking! Even talking can contribute to falls, as multitasking may be hard for the Parkinson’s brain.
• To increase muscle strength, stability, and balance, try an exercise and physical therapy program that is tailored to your needs.
• Wear appropriate footwear to help you move around more easily and increase your stability (ladies, put away your heels!). Mom found walking around barefoot was best for her while in the house.
• 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.
If your loved one with PD is in a care facility, you may want to consider use of the following for additional help in preventing falls.
• Vitamin D and calcium supplements
• 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, use of physical or pharmaceutical restraints has not been found to help prevent falls. In fact, there is some evidence to support an increased risk of injury from a fall with the use of restraints.75