Steady on Your Feet
In the Living room
In the Bathroom
In the Kitchen
In the Bedroom
Coping With Parkinson's Disease
Medication
Special Problems
Physical Stress
Everyday Life
Traveling

Steady On Your Feet

If you've fallen lately, you're not alone. More than 11 million people over the age of 65 fall every year -- that's 1 of every 3 senior citizens. People with Parkinson's disease are especially likely to be among this group because the illness can affect their balance, posture, and the way they move. Falls can be a serious problem -- they are a major cause of injury, restricted mobility, and loss of independence.

The good news is that many falls can be prevented. The most important step you can take to prevent falls is to maintain as much strength and coordination as possible by following your doctor's instructions on taking your medications, eating properly, and exercising. The next step is to look around your home for hazards that could lead to a fall, and correct them. Here are some suggestions for creating a safer home environment:

• Use grab bars to get into and out of the tub
• Use a bath chair or stool in the shower
• Don't use throw rugs or wax on the bathroom floor
• Use a raised toilet seat with arm rails
• Buy soap on a rope, or put a bar of soap in a nylon stocking with one end tied to a towel bar

• Use a long-handled sponge/mop to wipe up spills
• Keep your floors smooth but not slippery
• Store your often-used supplies in easy-to-reach cabinets
• Avoid hard-to-reach wall phones; consider a cordless phone that can be carried from room to room, or a counter model

• Be sure that stairwells are well lit; consider nightlights for hallways and bathrooms
• Wear low-heeled, comfortable shoes with nonskid soles; don't walk around in socks, slippers, or stockings on bare floors
• Keep rooms and hallways free of clutter
• Make sure carpets, including those on stairs, have skidproof backing or are tacked to the floor

Above all, use common sense. If bending throws you off balance, try to avoid picking things up. If you are unsteady outdoors, use a cane to negotiate sidewalk cracks and curbs. If you fall but do not injure yourself, don't assume that you must restrict your activities. Too little activity can cause you to lose strength and coordination, putting you at greater risk for another fall. Instead, talk to your doctor about these and other steps you can take to reduce your risk of a more serious fall.

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In the Living Room

The living room is important, mostly because it's where we tend to spend a large part of our day when we're inside. To keep it a safe place for you, consider these tips:

• Arrange the furniture to give yourself enough room to move around and between pieces. Plan a route through the house that will always give you something to hold onto in case you lose your balance
• Try chairs with a straight back, armrests, and a firm seat to make getting up easier. You can even add a firm cushion to get the height that's right for you
• Install handrails on all staircases, especially outside. Consider adding other railings in hallways or other areas where you don't have something to hold onto
• Buy a device that adapts the small buttons of a standard phone to huge push buttons. It can make dialing a lot easier

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In the Bathroom

This may be the place where you could use the most help. Getting around the bathroom can be tricky, especially since floors, showers, and tubs can get very slippery when wet. In addition, most bathrooms are small and restrict your movement. Here are some helpful devices you can use to make your bathroom a safer place:

• Attach nonskid decals or strips to the tub or shower floor. You can even use a rubber mat. These can all help prevent falls
• Get rid of small bathroom rugs that are easy to trip over. Try a large rug that covers most of the floor or get wall-to-wall carpeting
• Install tub rails or grab bars throughout the bathroom. These will help you balance when getting in and out of the tub or shower
• Use a tub seat or shower chair to make bathing easier and to eliminate the risk of falling
• Purchase a raised toilet seat, attach arm rails to the toilet, or install a grab bar on the wall next to the toilet. These will all make sitting on and rising from the toilet easier

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In the Kitchen

The symptoms of PD can limit your strength and coordination and may affect your ability to perform certain tasks in the kitchen. But, there are dozens of useful aids that can be used to improve your safety and keep things moving.

• If you have the wall space, install a pegboard you can easily reach. Use it to hang up the utensils you use most often
• Place a rubber pad or wet dishcloth under bowls and pans to keep them stable
• Use an electric can opener and jar opener. They reduce frustration and improve safety
• Try a wooden cutting board with raised edges to prevent food from scattering when you cut it. Attach suction cups to the bottom of the cutting board to prevent it from sliding
• Collect floor sweepings with a long-handled dust pan. This will keep you from having to bend to the floor
• Purchase aluminum pots and pans if you have limited strength. Long pot handles allow room for both hands when lifting

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In the Bedroom

To begin, try to avoid clutter. Keep floor areas free of shoes and other objects, and give yourself easy access to your bed, dresser, and closet. To make it easier for you to get in and out of bed, consider the following:

• Keep your bed about knee height. If your bed is now too high, have a carpenter shorten the legs. If it's too low, try using a thicker mattress or mattress padding
• Mount a wooden or metal triangle (called a trapeze) over the head of the bed. This can help you change your position, and you can find one at most surgical supply stores
• Place a sturdy cardboard box under the sheets at the foot of the bed. This will keep your feet and legs free of the sheets so it's easier for you to turn over
• At the head of the bed, put wooden risers under the legs or place a foam cushion under the mattress. This will make it easier for you to sit up and rise from bed
• Install a railing on the wall about 10 inches higher than the level of the bed. Make sure the bed is placed against the wall below the railing. You can use the railing to help you get out of and turn in bed

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Coping With Parkinson's Disease

As a patient with Parkinson's disease, you understand the impact it can have on your daily activities and your overall lifestyle. This web site discusses some of the challenges Parkinson's patients like yourself might face on a daily basis, and offers a number of potentially helpful solutions. It was compiled with the help of Parkinson's patients from around the country, so it gives you helpful tips to make each day a little easier from people who understand your unique needs.

Remember that it is important to try and continue your normal daily activities as much as possible. Certain tasks may become difficult, but stick with it until you find the best way to overcome these obstacles. You'll find that keeping a positive attitude and going about a daily routine can be just as important as staying on your medication in helping you to manage your Parkinson's disease for the long term.

Parkinson's patients can be affected both emotionally and physically, yet because they differ in age and physical condition, it is difficult to pinpoint any specific problems shared by every patient. There are, however, universal challenges that most patients experience to varying degrees. Many patients may experience a sense of fear and/or isolation, trembling, or fatigue. These problems can cause difficulties and anxieties that influence daily living. The following suggestions are included to help you maintain your independence and psychological well-being.

• Maintain a positive attitude in both occupational and social situations
• Keep friends and coworkers informed of your status, and accept their help only when needed, in order to help maintain your independence
• Do important tasks on a priority basis to achieve a sense of accomplishment and purpose
• Join local Parkinson's disease organizations and support groups

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Medication

The medication your physician has prescribed for the treatment of your Parkinson's disease has important benefits in the overall management of your condition. However, there are also important considerations that must be taken into account with your medication, either prescription or nonprescription. Following are some helpful hints to make taking your medication easier.

• To make sure you get the full benefit of your medication, do not pull apart capsules
• Drink a lot of water with your medication -- 6 to 10 glasses a day is a good amount
• Keep a written diary of medication, benefits, symptoms, and any side effects
• Set an alarm clock to remind you of your next dose
• Perform physical activities just after taking medication to help with digestion and absorption
• Warm baths may facilitate the action of your medication
• Consult your doctor before changing or stopping any medication, and inform him/her of any side effects that you think may be caused by any of your medication

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Special Problems

Patients with Parkinson's disease experience unique problems that may cause certain anxieties or fears. Added to the normal stresses of everyday life, these problems may become a heavy burden for patients. Following are some suggestions to help cope with these problems and the anxieties they can cause.

Freezing

• Step over something to get yourself started again -- having someone put his/her foot in front of you so you can step over it can be very helpful
• Slowly rock from side to side to get moving again
• Counting to yourself when you walk may help to ease the process

Drooling and Salivation

• Suck on hard candy, lozenges, and sourballs, or chew minty chewing gum to help control salivation
• Drink through a straw to strengthen the muscles of the lips, mouth, and throat

Sleeping

• Objects such as a stationary pole or a trapeze bar can be installed to help you rise from bed
• Try sleeping in a reclining chair instead of a bed to eliminate sleep problems
• Turning in bed is easier with satin sheets and silky pajamas
• If your jaw slams shut while sleeping, use a mouth protector to help stop tongue biting

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Physical Stress

The muscle, neurological, and chemical changes your body experiences with Parkinson's disease can result in various physical stresses. These include tremors, cramping, and difficulties caused by extreme temperature. Following are some suggestions for coping with these stresses.

• Leg cramps can be relieved with nightly massages
• Muscle spasms can be relieved with warm baths or hot water bottles
• Mild abdominal cramps can be relieved by eating a popsicle, slushy drink, or Italian ice
• Mineral ice can alleviate sore joints caused by changes in weather
• When tremors begin, try lying on the floor, face down, and relaxing your body for 5 to 15 minutes
• Squeeze a small rubber ball to reduce hand tremors

NOTE: If any of these or other symptoms persist or become worse, be sure to consult your physician.

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Everyday Life

For many patients, Parkinson's disease can affect several aspects of their daily lives. Following are suggestions for overcoming some of the general difficulties and anxieties of everyday life.

Perseverance

• Stay out of bed as much as possible
• Stay mentally active and alert -- read, listen to music or books on tape, or socialize
• When you become tired or frustrated with a task, take a 15- to 20-minute break

Dressing

• Wear slip-on shoes, or use a long-handled shoe horn to put shoes on
• Avoid clothes with small buttons. Instead, choose clothes with stretch waistbands or Velcro®¹ fasteners
• Try sitting on a commode to dress; it provides a good height to reach both shirt and shoes

Writing

• Use large print instead of script, and try using a weighted pen or pencil
• Instead of writing, try typing letters, notes, or other materials

Standing

• Try bending slowly and touching your toes before rising from a chair
• Stand still for a few seconds after rising to regain your equilibrium

Sitting

• Add 4 inches to the height of your chairs for a more comfortable position -- try using a phone book or a firm pillow, making sure that it's stable
• Sitting on a satin pillow will enable you to rise easier

Gripping

• Install pull-handles in your bathroom for added support
• Use electric devices for oral hygiene, such as an electric toothbrush or water pick
• Wrapping wide black tape around objects can give you a firmer, more controlled grasp

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Traveling

Traveling to visit family or friends should be a joyful, exciting experience. But, for Parkinson's disease (PD) patients, the anticipation of a lengthy trip can also be the cause of anxiety. Here are some suggestions from Dr. Dwight McGoon, a PD patient and physician, that can help ease your worries about travel and make your trip more enjoyable.¹

Car Travel:

• Use common sense if you drive. For a driver with PD, a trip that involves highway or city driving may not be as safe as driving short distances to and from home.
• Share the driving with your spouse or caregiver.
• Beware of driving while sleepy. Many PD patients experience drowsiness from their anti-Parkinson's disease drugs, particularly after eating. If you are going to be driving, take a nap earlier in the day and avoid eating for 2 or 3 hours before departing.
• Travel medicated. Although some PD patients may see a car ride as an opportunity for a brief drug holiday, unmedicated travel can have undesirable consequences. Being unable to move about, loosen up, or work off a muscle cramp can make the time spent in a car miserable. Even more distressing, without medication, PD patients may experience urinary dysfunction, including sudden, compelling urges to void when the bladder is only partly filled. Needless to say, on a long car ride it would be better to avoid such difficulties if possible.

Air Travel:

• Request a wheelchair, if necessary, to the gate and at your destination by calling the airline or your travel agent a few days before your flight.
• Ask for early seating to get a few extra minutes to board and get comfortable before your flight.
• If you are on a restricted diet, special meals can be ordered. Ask the airline or your travel agent for more information.

Train Travel:

• Wheelchair lifts and seats that can be removed to accommodate wheelchairs are installed on most Amtrak® trains. Ask the ticket agent where they are before boarding.

And Don't Forget To:

• Carry a flask of water for taking pills when you are away from home.
• Organize your medications. Set aside the drugs you will need while in transit in a carry-on bag or your purse. Do not keep pills on the dashboard or other areas in a car that are exposed to heat vents or direct sunlight. If you have questions about storing your Parkinson's disease medications during your trip, consult your doctor or pharmacist.

Above all, plan ahead. Think through what you need to pack for your trip, including personal comfort items such as rubber-soled mesh shoes for the shower and easy-grip scissors. A checklist can help ensure that you don't forget anything essential. Also, allow extra time when traveling and for activities once you reach your destination. A leisurely, unrushed pace is one of the best ways to guarantee that your vacation trip will be as stress-free and pleasurable as possible.

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