Parkinson’s Boot Camp Cleveland, Ohio September 6, 2014 Home Safety for Individuals with Parkinson’s Disease

University Hospitals Richmond Medical Center2 Presenter Brian Adams, MOT, OTR/L Manager, Rehabilitation Services UH Regional Hospitals Occupational Therapist with expertise in Neurological Rehabilitation, Seating and Positioning, Geriatric Rehabilitation and Home Assessment Certified Delay the Disease Parkinson’s Fitness Program Instructor

University Hospitals Richmond Medical Center3 UH Warrensville Outpatient and Neuro Rehab Outpatient Physical, Occupational and Speech Therapy program focused on the rehabilitation of individuals with chronic neurological conditions and neurological injuries 4480 Richmond Road in Warrensville Heights (216) for information or to schedule an appointment

4 Keeping Your Home Safe Most important aspect is fall prevention 90% of people with Parkinson’s will have a fall at some point Most falls are not serious, but there is no such thing as a good fall Falls are either caused by intrinsic factors (body) or extrinsic factors (environment)

5 Increased Risk for Falls in PD Postural changes-may cause forward tendency Shuffling steps Uncontrolled gait Vision changes Orthostatic hypotension Multiple Medications Constipation-vasovagal response

University Hospitals Richmond Medical Center6 Intrinsic Factors Prevention is Key

7 Intrinsic Fall Prevention Orthostatic hypotension –Always count to three before moving after a position change Multiple Medications –Review your medication list with your Primacy Care Physician and Pharmacist Constipation-vasovagal response –Push at your own risk!

University Hospitals Richmond Medical Center8 Extrinsic Factors Most Causes of Extrinsic Falls are Preventable

9 Extrinsic Fall Prevention Floors –Remove ALL loose throw rugs from the home –Clear walking paths from furniture and electrical cords that can be trip hazards –Keep all transitions as low as possible (tile to wood or tile to carpet) Steps –Assure handrails are on both sides and are sturdy –Good lighting on stairwells at all times of day –Go up with your “strong” leg and down with your “bad” leg

10 Extrinsic Fall Prevention Kitchen –Move commonly used items to a level that is easy to reach or leave them out –Hold onto a counter or other sturdy surface when reaching for something low or high –Quickly clean up spills to avoid slips Outside the home –Good lighting at all entrances –Repair uneven surfaces in steps and porches –Install sturdy handrails on stairs (even if only one or two steps)

11 Extrinsic Fall Prevention Bathroom –Always have good lighting at the walkway between the bedroom and bathroom –Place a non-slip mat in the tub/shower –Install grab bars inside AND outside of the shower Assure they are properly secured to a stud in the wall –Use a shower chair or bench to prevent fatigue and allow for safer entrance to the tub –Use a built up seat for the toilet with arms

12 Bathroom Equipment

13 General Safety Guidelines for Fall Prevention Keep a phone on your person at all times OR purchase in a Life Alert or similar system –New Phillips LifeLine fall detection system Wear proper, non-slip footwear at all times –No bear feet, slippers without backs or socks –Wear supportive hard-soled shoes Use mobility devices (cane, walker, wheelchair) AT ALL TIMES if recommended –No furniture walking or substituting for another device when in the house Pause for three seconds before moving after any change in position –Sitting to standing, lying down to sitting up, etc.

14 IF YOU THINK YOU ARE AT RISK FOR FALLS Talk to your doctor and get a referral for a Physical Therapy evaluation Advanced Vestibular/Balance Rehabilitation at Warrensville Outpatient Rehab and St. John Medical Center (Westlake) –Smart Balance Master Visit our table today for more information about the east side and west side programs

15 References Loftus, Sheree. "Fall Prevention Strategies for People Living with Parkinson's." - Parkinson's Disease Foundation (PDF). N.p., n.d. Web. 1 Sept Playfer, Jeremy R.. "Falls and Parkinson's Disease." Age and Ageing 30 (2001): 3-4. Print.

University Hospitals Richmond Medical Center16 Thank You.