Helping Patients to Adapt Their Life at Home

Parkinson’s is a progressive disorder of the nervous system that affects movement and develops gradually over time. While the most well known symptom is a tremor, Parkinson’s also commonly causes stiffness or slowing of movement, slurred speech and impaired posture and balance.

Because the disease develops gradually, it is important to keep track of any changes in the patient and then making the appropriate adaptations to their home or daily living process. It is important to take into consideration a gradual decline in health and abilities, as there is no cure for Parkinson’s. But by adapting the home environment, it will make it easier to deal with the challenges of Parkinson’s as well as making everyday routines such as eating, bathing and dressing, easier.

Here are some ideas to give or help patients and their family caregivers to adapt their home for living with Parkinson’s

Facilitate Movement

Consider the use aides such as canes, walkers or wheelchairs.
Help the family caregiver by educating them how to open pathways between rooms and remove or safely place obstacles.
- Floor Rugs: People with Parkinson’s typically develop a shuffling gait that can lead to trips or falls. If the patient does not want to remove a rug, make sure that it is tacked down.
- Lamps: Both standing lamps and table lamps should be placed so they are not easily tipped over. Also, make sure that a person seated in a wheelchair can easily turn a lamp on or off without discomfort.
- Furniture: Like lamps, they should be placed far enough apart to be wheelchair accessible, or roughly 5 ½ feet apart to allow a wheelchair to complete a 360-degree circle without hitting anything.
- Home Decorations: Floor vases, statuary objects and side tables should be placed well out of the main walkways.

General Safety and Accessibility

Beware of sharp edges. The family caregiver should cover edges of countertops and other surfaces with cushioning.
Have the family caregiver consider removing locks from bathroom doors.
Non-skid mats in the bathtub/shower and around the sink and bathtub/shower should be used to reduce slips and falls.
To eliminate confusion in the later stages of Parkinson’s when cognitive abilities are impaired, consider using paint or tape to color water faucets red or blue to denote hot and cold.
Place bar soap inside a nylon stocking and tie it to a grab bar. Those suffering from Parkinson’s may have difficulty grasping objects and this will help them use their soap.
Make sure that toilet paper, facial tissue and other personal items accessible without the patient having to reach for them.
Make sure all furniture is stable throughout the house and that a patient in a wheelchair locks the wheels before movement is attempted.
Because it may be hard for a patient with Parkinson’s to use normal doorknobs, the family caregiver may consider installing door pulls or utility handles that will allow for easier access throughout the home.

Room by Room

Bedroom: The family caregiver should remove wheels/rollers from the bed frame or lock them in place to keep the bed stable.
Kitchen: This room should be made accessible and as user-friendly as possible for the patient. Pieces of fabric or rope tied to drawer handles and cupboard pulls can make for easier access. When possible, leave items between chest and waist level to avoid the need for reaching or stooping for dishes, silverware or even food in the fridge.
Bathrooms: Depending on the need of the patient, the family caregiver can install grab bars beside toilets, sinks and in the bathtub/shower.

Simplifying Daily Living

Some patients with Parkinson’s eventually develop dementia or confusion. Such things as the sound or feel of running water may frighten them. When assisting them with bathing, give the patient time to adapt to the situation and to understand what is happening. Start with less sensitive areas of the body, such as the hands and feet, assisting with washing as needed.
Simple tasks such as brushing their teeth can become a frustrating endeavor for someone who shakes badly. Adaptive handles for toothbrushes, hairbrushes and combs as well as special cups and glasses are available from medical suppliers.
Dressing a patient with Parkinson’s may take an increasing amount of time as motor skills and strength decrease. When possible, buttons or zippers should be replaced with Velcro tabs. Loose fitting clothing is easier and more comfortable to get in and out of. But the most important thing to remember when helping a Parkinson’s patient to dress is to go slow and take plenty of time.
“Freezing,” or extreme rigidity and almost complete loss of movement is a common symptom of Parkinson’s. When this happens, the caregiver or loved one should tell the patient to pretend that they are stepping over an object on the floor or encourage them to rock very slowly from side to side to help get them moving again.
Heating pads can help to relieve aching muscles and mineral ice does wonders for stiff joints.
Have the patient squeeze a rubber ball for short periods of time throughout the day to reduce tremors and to keep hands and fingers strong.
Encourage exercise to whatever degree possible to keep muscles, tendons and joints strong for as long as possible.
Consider the use of specially designed eating utensils with padded or built-up handles. When a family caregiver helps feed their loved one, this process should not be rushed. Foods may also need to be pureed or finely chopped in order to facilitate eating. Bowls, rather than plates, make it easier for patients to scoop food.
Encourage sipping of liquids throughout the day and while eating as medications may cause dry mouth. As the disease progresses, patients often choke or cough while eating and drinking. Drooling is often a sign of a decrease in the swallowing reflex and special care and attention should be taken to ensure the patient’s safety while eating. At this stage, a caregiver should be present during all meals.
As cognitive ability declines, caregivers should avoid over-stimulation and break tasks down into manageable parts. While you should encourage the patient to remain as independent as possible, an increasing amount of attention should be focused on safety and making daily living activities easier for the patient.
As Parkinson’s progresses, communication becomes more difficult. Continue to encourage communication and allow plenty of time for a response as well as verbalized requests.

Caregivers have the opportunity to make life much easier for a patient suffering from Parkinson’s disease. Remember to not expect too much from the patient and be aware of their boundaries and limitations during the various stages of the disease process. By planning ahead, a caregiver and loved ones may be able to anticipate issues before they negatively affect the patient.

Care Tips for Patients with Parkinson’s