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How to help with falling issues of a Parkinson's Disease patient?

A fellow caregiver asked...

How do I deal with the falling issues of a Parkinson's Disease patient?

Expert Answer

Graham A. Glass, MD, is the co-founder of PEAK Neurology and Sleep Medicine, LLC with multiple locations across Alaska. Previously, he was deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center PADRECC and assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

Falling is a very difficult problem in Parkinson's disease, as a patients' sense of balance is not helped by any of the medications that we use to treat PD. If the patient is falling because their legs freeze up and then they fall forward, we will often be able to help by increasing the medication dose. That being said, if the problem is more of a balance issue we strongly encourage physical therapy as well as moving to the appropriate gait assistive devices (walker etc) to ensure safety. We never want to decide that a person should have been using a walker after a bad fall has taken place and try our best to be pro-active in this. I wish there were more that we could do to help with balance in PD, but like problems with swallowing and speech, we really struggle, as the medications do very little if anything to help.