Transcript Home Safety - University Hospitals

Home Safety for Individuals with Parkinson’s Disease
Parkinson’s Boot Camp
Cleveland, Ohio
September 6, 2014
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 Center
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UH Warrensville Outpatient and Neuro Rehab
UH Warrensville Outpatient and Neuro
Rehab
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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) 765-2830 for information or to schedule
an appointment
University Hospitals Richmond Medical Center
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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)
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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
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Intrinsic Factors
Prevention is Key
University Hospitals Richmond Medical Center
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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!
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Extrinsic Factors
Most Causes of Extrinsic Falls are
Preventable
University Hospitals Richmond Medical Center
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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
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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)
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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
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Bathroom Equipment
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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.
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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
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References
• Loftus, Sheree. "Fall Prevention Strategies for
People Living with Parkinson's." - Parkinson's
Disease Foundation (PDF). N.p., n.d. Web. 1
Sept. 2014.
http://www.pdf.org/en/fall09_fall_prevention
• Playfer, Jeremy R. . "Falls and Parkinson's
Disease." Age and Ageing 30 (2001): 3-4.
Print.
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Thank You.
University Hospitals Richmond Medical Center
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