Falls are one of the largest contributors to our healthcare system in Australia, accounting for 43% of hospitalisations in 2018.
The risk of falling, including slipping, tripping or stumbling, increases as we age and is more likely to occur in your home. Falls can lead to injury, the need to undergo surgery and potentially death.
Due to the hallmark motor symptoms of Parkinson’s, the risk of falling can be moderately high, particularly if you experience postural instability (affecting your balance), muscle rigidity (stiffness in the muscles when moving), bradykinesia (reduced speed of movement) and tremor.
Hannah Tavian
Occupational therapist
We’re here to help
Although we can’t predict a fall, we can look at mitigating the risk. As an occupational therapist (OT), our role is to work with you to identify any tripping hazards which you may come across throughout your day.
This could include tripping on furniture items throughout your home, losing your balance in the community, falling out of bed, or becoming dizzy after getting off the toilet.
Contributing factors
The factors which can contribute to a fall include:
- the management of your medication
- your ‘on’ and ‘off’ periods
- the type of equipment you use to ambulate
- your nutrition and hydration
- the environment (noises, lights, sound, etc)
- your physical mobility.
To promote your mobility, we recommend having a consultation with an exercise physiologist to look at putting together a program to promote your physical endurance and therefore build your strength to minimise the risk of having a fall.
An occupational therapist can also help you to explore a range of assistive technology such as walking aids and wheelchairs, plus a range of internal and external strategies to promote independence.
Here is a list of strategies that you can try at home to reduce your risk of falls:
Intrinsic cueing
- Mentally rehearse a movement prior to attempting it
- Describe movements to yourself in an ‘internal dialogue’ to counteract shuffling
- Adopt a positive attitude, using “I will” statements as you prepare for a difficult action or task.
Reducing falls
- After lying/sitting for a while, rise slowly and in stages to avoid feeling light-headed
- Before getting up, march your legs on the spot for a few paces to begin warming up the legs and start the walking action
- Rise from your seat carefully and pause to concentrate on feeling well-balanced before walking off
- Focus on one thing at a time, try not to talk while you walk
- Walk in arcs where you have room to avoid pivoting.
Staying mobile (anti-freeze)
- The weight shift method: STOP and shift your weight to one foot before attempting to step off and continue walking
- Auditory methods: If you freeze, try counting out aloud, “1, 2, 3, STEP”, in a clear and commanding tone to restart your movement
- Visual methods: If it’s safe, your support person can put their foot in front of you and cue you to “step over my foot”
- If your support person is not around, you can try visualising an obstacle (such as a log) and telling yourself to step over the obstacle.
In the community
- Pause and plan your routes in advance, have a look around for any possible barriers and identify a route to avoid these if possible.
Visual-spatial strategies
- When reaching for an item, check the distance by finding a surface first
- When reading, use a plain coloured card to mark off an area being read, and sit at table while reading to keep pages’ stable
- Be sure to rest your eyes regularly by taking breaks and looking elsewhere rather that staring at one object or area.
Other tips
- Don’t try to do too many things at once.
- Concentrate on one thing at a time to avoid straining your attention
- If you freeze in bed, try to think BIG, reaching over with your arm before rolling.
You may want to consider using equipment to reduce your risk of falling. This could include a walking stick, walking frame with wheels, a wheelchair (powered or manual) or a mobility scooter for the community.
Please consult an occupational therapist before purchasing any assistive technology to ensure the equipment is appropriate and suitable for you.
Call our support line on 1800 644 189 to book an appointment with one of our occupational therapists for more information.
