People living with Parkinson’s experience falls from the balance issues that arise as the condition progresses.
The fear of falling and associated loss of confidence may be as disabling as the actual falling and severely affect your quality of life.
Avoiding falls is essential because of the risk of serious injuries.
Understand the Causes of Falls to Reduce Your Risk
Oftentimes a fall will cause no injury or a mild one, however, sometimes a fall can cause moderate to significant injury. Falls and fractures are a leading cause of hospitalisation for the elderly.
Falling and loss of balance are common problems for people living with Parkinson’s. These problems develop over time as the condition progresses. For some people falling may be a daily occurrence and may even occur several times in one day.
Learning to identify fall hazards and how to walk safely will help reduce the risk of falling.
Possible causes of falls
There are numerous factors which increase the risk of falling in Parkinson’s. Many of these are associated with impaired movement. These include stiff and rigid muscles, dystonia, postural instability, and stooped posture, slowed movement, freezing, a shuffling gait and muscle fatigue.
Other non-motor factors that can result in falls include vision problems, sleep disturbance and urinary urgency.
Medications taken to manage Parkinson’s and other conditions may increase the risk of falling. Parkinson’s medications often result in dyskinetic movements which can cause falls. In addition, they may cause orthostatic hypotension which results in light headedness and dizziness when changing positions, such as rising from a sitting position. Confusion and drowsiness can result from medications and will increase the risk of falling.
Improper shoes, pets, poor lighting, uneven flooring, uneven ground, and pathways may also cause falls.
Prevention of falls
Understanding which factors are contributing to falls is important since each is treated in a different way. A discussion with the GP or treating medical specialist will identify any medical causes of falling.
The postural instability of Parkinson’s may be responsive to increases in certain medications.
Sometimes episodes of freezing of gait and gait festination can be reduced with increases in medication as well. Bothersome dyskinesias can be treated by adjusting your medications or starting new ones.
Generally, types of exercise are being used as a fall-preventative method. Referral to a physiotherapist and/or an occupational therapist can address the physical and environmental causes of falling.
These health professionals can assist with teaching the safest and easiest way to get up following a fall.
Improving home safety
Get a home safety assessment by an occupational therapist or visit stopfallsathome.com.au website for an online version of a home self-assessment. Some things that you can do to reduce tripping hazards:
- Reduce clutter to eliminate trip hazards
- Remove rugs, furniture, and other potential obstacles to walking
- Create unobstructed walkways throughout the home
- Ensure good overhead lighting, particularly at steps
- Use night lights where necessary, especially near bathrooms for night time access
- Consider installing handrails at steps and grab rails in bathrooms (minor home modifications could be funded by NDIS or My Aged Care)
- Apply strips of tape to floor in areas where freezing of gait occurs
- Avoid rolling chairs
Improving walking safety
Get a mobility assessment by a physiotherapist. They can provide advice and show you how to walk and turn safely.
- Use music or a metronome to walk to a beat
- Focus on taking long strides and swinging arms
- Focus attention when turning and do so slowly
- Maintain a regular exercise program to improve calf muscle strength and balance
- Wear supportive footwear
- Use walking aids to maximise stability if prescribed
Improving visual problems
- Eye problems are common in Parkinson’s. Being active, keep moving and looking around, exercising and socialising is important to eye health. It can boost blinking and minimize dryness.
- Maintain regular eye checks. Take care when wearing multifocal glasses, especially on stairs. Two pairs of glasses is recommended.
- Medication management
- Some medications can interact and contribute to falling.
- Always take medications on time as prescribed by your treating specialist.
- Ensure the GP and treating specialist are aware of all medications taken (prescription and non-prescription).
What to do if a fall occurs
- Remain calm
- Do not attempt to move quickly
- Feel and look for any signs of pain or possible injuries prior to planning how to get up
- Use a heavy piece of furniture to help you get up
- If injured (or there is a fear of injury) try to stay as comfortable as possible
- Call for help using your chosen technology, if you are unsure you can get up alone, crawl or scoot to a phone and call for help.
Technology and falls
Many personal alarm systems can also be funded through My Aged Care CHSP or NDIS, and hence, the cost isn’t out-of-pocket.
However, the devices can also be purchased privately through providers. Wear a medical alert bracelet and consider purchasing technology that has AI to detect falls:
- pendant alarm system
- smart watch with falls technology
- phone apps.
Your Care
Your GP can arrange for bone density testing, which is done via a quick and painless x-ray scan. If thinning of the bones or osteoporosis is detected, medications can be prescribed to improve this, which can prevent a fracture should a fall occur.
Ensure that you have someone who can check in on you if you live alone.
Councils may have supports for eligible disability or older residents to maintain their independence in their home and within their community.
You should also be able to contact your support worker.
Carers and family members should avoid lifting someone who has fallen. This can result in the risk of injury to the carer or the person with Parkinson’s.
Assist the person to help themselves, for example, bringing a chair to them so they have a means to lift themselves.
Call 000 if the fall is severe and you need help.
If falls, particularly falling backwards, occur early in your diagnosis it may point towards atypical parkinsonisms.
See Eye problems and Parkinson’s, Atypical parkinsonisms information sheets.
