People with Parkinson's disease and their caregivers often have a lot of questions about what to expect — and what they can do to make living with the condition easier and safer. At Temple's Movement Disorders Program, we've talked to many caregivers who want to know what changes they can make at home to help their loved one with Parkinson's, both immediately after diagnosis and as the condition progresses.
Parkinson's disease affects mobility and coordination. Its symptoms include tremor, slowed movements, loss of balance, and changes in the way a person walks — a smaller, shuffling gait is typical. As the disease progresses, these symptoms, along with non-movement symptoms, such as vision changes and fatigue, can make it harder to stay mobile, even at home. And because Parkinson's disease affects a person's balance skills and protective reflexes, it puts patients at risk for falls.
Our patients' caregivers often ask how they can make their homes easier to navigate — and reduce the risk of falling. They may worry that extensive and expensive alterations will be needed. We tell them that thoughtful modifications can go a long way toward protecting your loved one and helping them feel more confident getting around at home. And when we talk to experienced caregivers, they tell us they've found that simple changes can make significant differences.
We like to break the most effective changes into four steps — plus one bonus tip.
1. Rearrange and secure furniture.
First, take a look at how your home is arranged and check for tight spaces that could be difficult for your loved one to navigate. This step is especially important if they use a mobility device, such as a walker or wheelchair.
Once you've identified possible problems, reposition the furniture in those areas to create wide walking paths that provide enough room for a mobility device to easily turn around. If your loved one uses a wheelchair, placing furniture items about 5.5 feet apart will give them enough room to turn around.
Take a look at the individual pieces of furniture, too. Check that they are sturdy and aren't at risk of tipping over if your loved one were to grab on to it for balance. Use furniture anchors to secure any wobbly items.
Pay special attention to chairs, in particular. The best seating options are ones that remain stable (in other words, they don't swivel), have sturdy arm rests, and have a seat height that's easy for your loved one to stand up from. If there are wheels on any furniture, remove them or lock them in place.
2. Adapt your bathroom to reduce the risk of falls.
Slippery surfaces, low lighting, and the need to get on and off the toilet or in and out of a bathtub make the bathroom the most common site of falls at home, and people with Parkinson's are at increased risk. We advise caregivers to make bathroom fall prevention a high priority.
While you may need the help of a handyperson, we highly recommend installing grab bars near the toilet, tub, sink, and shower. Choose bars that are secured to the wall with screws. Do not choose bars with suction-cups as they won't support a person's full weight in a fall. Towel racks and toilet paper holders aren't safe alternatives either; when grabbed for support, they could pull free from the wall and cause a fall.
We also strongly recommend removing any bath mats that slide or bunch up. Instead, place a non-slip mat at the entry to the shower or bathtub.
Two more pieces of adaptive equipment can make bathing and using the toilet safer as your loved one's Parkinson's disease progresses. Adding a seat riser to the toilet can make sitting down and standing up easier. And a tub transfer bench can help your loved one get in and out of the tub without having to step over the tub edge. It also gives them a comfortable place to sit while they're showering or bathing. Choose one with back support.
3. Make cabinets and doors accessible with hardware swaps.
Our patients tell us that tremors and reduced grip strength can make cabinet handles and doorknobs hard to use. To help people with Parkinson's stay independent, we recommend swapping out small cabinet knobs with large handles or pulls, which are easier to open. To make doorknobs easier to handle, add bulky grips or replace them with levers. Many caregivers find that they're able to manage these swaps themselves, but if not, a handy family member or friend should be able to assist.
These changes are helpful throughout the house, but they’re particularly effective in kitchens, which tend to have a lot of cabinets. While hardware swaps can make cabinets and cupboards easier to open, the kitchen poses additional challenges for people with Parkinson's. Balance issues make opening the oven or refrigerator more difficult or increase the risk of falls when reaching for a high shelf or bending to a low one.
Tying ropes or fabric to the handles of appliances, such as a refrigerator or dishwasher, can help. To reduce the risk of falls, store frequently used items in easy-to-reach locations — if at all possible, between your loved one's waist and chest height.
If your loved one uses the stove, store items like pots, pans, and spices near it — but not over it. Reaching for objects stored over the stove can lead to burns.
4. Remove throw rugs and address other tripping hazards.
Throw rugs tend to bunch or slide — and that can lead to serious falls. When you're adapting your home for a person with Parkinson's disease, it's crucial to remove them. Keeping electrical cords tucked away from walking paths is also important.
We encourage caregivers to give extra thought to possible risks on steps and staircases, since they can be particularly tricky for people with Parkinson's to navigate. Steps should be clutter-free and have non-skid surfaces. We often recommend putting brightly colored tape at the top and bottom steps to make them easier for Parkinson's patients to spot, too.
Handrails can make stair-climbing considerably less intimidating. So it's worth installing a rail on at least one side of the staircase, if possible. Handrails that sit 2 to 3 inches from the wall will be easiest for your loved ones to grasp.
If your loved one isn't able to use their walker or cane on the steps, invest in multiples and keep one at the bottom and one at the top of the staircase. Carrying unused mobility aids up and down the stairs can increase the risk of a fall. Multiple mobility aids can make life easier for caregivers too.
Bonus tip: Adjust lighting
Adequate lighting can go a long way toward making spaces brighter and more accessible. When your loved one can clearly see their surroundings, they'll be less prone to trips, bumps, or falls. Anecdotally, some caregivers also find that good lighting seems to be a mood booster for loved ones.
Start by adding more lighting to any dark or shadowy areas around the house. Place lamps in spaces where your loved one can easily turn them on and off. Many patients find that touch lights or lights that respond to sound are simpler to manage. It's also worth placing bright nightlights in the hallway, especially the path to the bathroom.
Finally, keep flashlights by your bed and in other easy-to-access areas around the house so you'll have good visibility if there's a power outage.
Ask an expert
We've found that the changes above are helpful to many caregivers as they modify their homes for a person with Parkinson's disease. But if you're looking for ways to address a specific challenge, consider reaching out to the Temple Movement Disorders Program. Our neurologists, occupational therapists, and other experts take a comprehensive approach to help people with Parkinson's disease preserve their independence and quality of life. To connect with our program, call 800-TEMPLE-MED (800-836-7536) or schedule your appointment online.
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