April is Occupational Therapy Month: Parkinson’s Disease, Falls and Occupational Therapy
Each year, millions of people 65 years and older, slip, trip and fall in and around their homes and less than half tell their doctor. According to the U.S. Centers for Disease Control and Prevention*:
1 in 4 Americans aged 65+ fall each year
Every 11 seconds, an older adult is treated in the ER for a fall, every 19 minutes, an older adult dies from a fall
In 2015, the total cost of fall injuries was $50 billion. Medicare and Medicaid shouldered 75% of these costs. It is expected to increase to $67.7 billion by 2020.
What About Parkinson’s and Falls? People living with Parkinson’s Disease (PD) are at a higher risk for falls due to the motor symptoms, including stiff muscles, freezing, and balance impairment. Research estimates that people with PD are at twice the risk of falling as often as their peers. Falls can be mild, causing only bumps and bruises, or they can result in significant damage, causing increased disability and a reduced quality of life. The fear of falling in people living with PD is real and impacts both the patient and their caregiver or care partner. (Parkinson’s Foundation 2017). The result of falls is multifactorial in nature, influenced by personal, environmental and activity-based factors. Personal factors include such things as illness, behaviors, capabilities, medications, and a fear of falling. Environmental factors are hazards within the home, the stability of the shoes they wear, and the availability and use of mobility devices. Finally, specific activities can place someone at risk for a fall when the demands of the activity exceed their abilities. Older adults make one of two main mistakes that increase their chances of falling. Some overestimate their abilities and take too many risks. Others are so concerned about falling that they cut back on activities they actually can do and lose leg strength and balance.
How Can Occupational Therapy Help? Occupational therapists are skilled at evaluating and addressing influences from the person, their activity roles and routines and the environment to maximize independence for older adults. There are several steps one can take to prevent falls:
Assist in helping the patient make an honest inventory of their risks and limitations: • Length of disease duration • Certain medications and timing • Freezing episodes • Posture, gait or balance • Poor vision • Cognitive impairment
Make suggestions for home modifications: Parkinson’s home safety checklist: https://b9p3b5u6.stackpathcdn.com/wp-content/uploads/2018/06/Parkinsons-Home-Safety-Checklist-Davis-Phinney-Foundation-2018.pdf
Assist patient to develop a routine to exercise regularly: Focus on exercises that emphasize not just balance and concentration, but aerobic, flexibility and strength-building exercises are also beneficial. Encourage patient to join a Parkinson’s exercise group to hold one accountable to go and participate.
Work with a physical or occupational therapist. They can help develop an exercise routine, help find ways to continue day-to-day activities and help develop coping and management skills.
Teach patient to practice balance techniques • Consciously lift your feet when walking • Widen your base • Swing both arms when walking • Avoid pivoting movements • Change positions slowly • Use a walking aid • Wear proper footwear • Avoid multitasking
Occupational Therapists use a variety of assessments to evaluate a patient with Parkinson’s Disease and assist them with overcoming neuromuscular impairments, cognitive deficits and difficulties with performing activities of daily living. Occupational Therapy is only one of the stepping stones to helping one live with Parkinson’s. By knowing the challenges and what lies ahead for these patients and their loved ones, OT’s can show patients how to maintain, live well and improve their quality of life with Parkinson’s disease.
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