What should I do when my parent with Parkinson's disease suddenly "freezes"?
Because of her Parkinson's disease, sometimes when my mother is walking, she "freezes" and gets stuck, unable to move forward. This happened one time when we were in a bookstore together. Is there anything I can do to help her when this problem strikes?
Getting stuck in place tends to happen when people with Parkinson's disease are anxious or feel rushed, or when they're navigating small passageways like going in and out of elevators or through a doorway. It's embarrassing and awkward for them.
One bit of advice is to resist physically or verbally tugging on your mother. Spouses do this all the time -- take the person's hand and pull her along. Or sometimes verbally or through eye contact, the spouse nudges the patient to "come along." None of these approaches are helpful or effective.
So never rush your mother, because the freezing will go away spontaneously. Sometimes, just sitting down for a minute (if she's in a place where that's possible) will relieve the problem. Another trick is to place your foot on the ground in front of her and tell her to carefully step over it -- this could break that freeze. You might want to have a doctor demonstrate this before trying it.
Freezing is a forward-motion problem, so your mother can also try rocking side to side. Or, counting one, two, three, four, and walking to that marching beat may work. You can count out loud along with her. Another good verbal trigger is to say, "Try lifting your knee up, Mom." And by not thinking about walking forward but just about lifting the knee, she may then be able to break the pattern.
It's best to talk with your mother ahead of time about the ways you might help when she freezes. What would she like you to do? Give a verbal cue like "knee" to remind her to raise her knee, or "march" if a regular beat is her best way to get going? This way, you have an agreed-upon system in place and she'll have some control over how you help.
My mother oftentimes "freezes" and I found that a gentle hand on her lower back breaks the freeze and she is able to resume her stride.
My husband freezes while I am helping with his pants. We get the left leg in then he can't move the right leg. I tap his leg and this helps most of the time.
We went to our Parkinson's physical therapy group the day this item appeared--the physical therapist says some experts think the freezing sometimes happens when the brain/body suddenly can't process a need to shift weight. She said the lifting of the knee as in marching in place is very helpful--to get movement re-started first, and then shift weight afterwards.
My Mom freezes too. I find that if I tell her to pretend she is going up a step. Then she remember to lift her foot up. Turnig is also a problem when she is walking because she can't pivot. We try to walk in a big circle insted of turning sharply. It is interesting that she can back up very quickly, but forward is much more difficult.
I am a PD patient that has problems with freezing. When I freeze, my wife will snap her fingers or project a laser beam in front of me. Either of the methods have a beneficial impact.
I have noticed that when we are walking and my Mom starts to talk she stops walking. She needs to realy stay focused on just walking.
Parkinson's disease is not for multi-taskers. For my husband the problem of focus became worse when there were narrow spaces to navigate. Although I could get him to move forward with a tap on the back, the arm, the leg, I thought it is better for him to find his own key to unfreezing.
"Move Forward" or "walk forward" became one phrase I would ask him to repeat when he had this problem while recovering from a bout of uremic poisoning and dehydration brought on by anxiety over urinary problems which turned out to be prostate rather than PD.
I love the laser pointer idea because it makes the person independent of reliance on others. For those PwPs who use canes, there are some rather pricey laser pointer canes which will do this. There are also separate laser pointers which will attach to a cane.
The key to verbal cues and using a laser pointer is practice, practice, practice. Take advantage of brain plasticity to learn a new task. This is especially important for people who live in houses with more than one floor or who are out in public frequently. The risk of falling or being shoved is serious.
We were lucky to have found that being persistent with his doctors led to a treatment for the root cause of the physical and cognitive issues. The herbal supplements he had been taking had been neglected in his anxiety over an unrelated issue...proving that everything is eventually related by only a few degrees.
Most people don't look for the solutions until the problem has reared its nasty head. Since PwPs often incorporate exercise into their daily regimen...or should...the time to prepare is now. Find those key words and practice them with a walking forward (or better yet) marching forward and turning exercise. That way they will be in the mental bank when they are needed.
My husband find the marching definitely helps when he freezes - but its fascinating that just the sound of my voice can also help him to click into movement - and he will really rush forward. For public moments he finds using a stick (we have a wonderful one designed by Trevor Bayliss with a torch, an alarm and a wind up battery - really helps to keep him steady.
Freezing was one of the first indicators we had of Mama's PD. We talked with her doctor about it and he prescribed levodopa (I hope I spelled this correctly). The improvement was remarkable. Within a week, she could stand and walk with no hesitation at all. Her family and assisted living facility caregivers all noticed the results. After time, the drug wasn't so helpful but it was wonderful in the interim.
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When levodopa alone is no longer as effective, it may be time to discuss adding carbidopa to the mix to improve the delivery system across the blood brain barrier.
This might also be a good time to look at your mother's dietary regimen. Timing of meals (especially protein) and levodopa intake can affect the functuning of the l-dopa. Allow at least 30 - 45 minutes from meal completion to taking l-dopa in any form.
If your mother is already taking Sinemet (levodopa-carbidopa) it may be time to add a COMT inhibitor, entacapone to the mix - it is also known as Stalevo. Comtan does not cross the BBB but does increase the serum levels of l-dopa.
Please consider her exercise routine and nutritional supplements. This might also be a good time to begin medical massage as a weekly therapy.
My husband has PD, diagnosed in 2006 and already in advanced stage since then. Recently he purchased an In-Step walker which has a base shaped like a horseshoe with several small wheels and has a laser beam that projects across the stepping area to help with freezing when needed. I noticed the beam works best for him at night when light is dimmer and beam stronger. His meds have never helped much with any symptoms, now quite a bit of imbalance and leaning to the right. Between freezing and sleepiness, he needs a verbal cue for everything- including eating. Interestingly, he still does quite well at his computer and instantly remembers names and places... those bridges are still connected!
This probably sounds ridiculous but our doctor suggested it and we've found it to work really good. But when she freezes, take a rest for a couple of seconds then say, "Okay, 1, 2, 3, GO!" and for some reason she always goes! It's strange, but it works for us!
My husband has Parkinson. He has not gotten into the freezing area as of yet. However, we were told if he would hum that it would help him.
Humming; saying 1,2,3 or move forward; a gentle tap from another, rolling the eyes or whatever. If it breaks the freeze and in some the panic, go for it. Most importantly, experiment to find what works and then let everyone who might be around the PwP know the effective cue. What is important is to learn to break the freeze in order to avoid a fall.
When my father used to freeze, we would have him take a step backwards and it seems to get him started forwards again. It sounds weird, but it worked every time.
Along with the tips others have suggested, I offer this one. When my mother would get "stuck", her doctor recommended that she imagine a line on the floor at her feet, and that she should step over that line. Now, I just remind her to step over the line. It's all it takes to get her going.
Now that she needs a walker, she has U Step walker. It has gone a long way to keeping her mobile and independent. This walker has 5 caster wheels and does not take much effort to push. It travels well over all surfaces, except probably grass and rocks. Most importantly, it can be fitted with a laser light. By pushing a button to activate the light, a red laser light shines across the floor between two of the wheels of the walker. With the laser light on, when my mother gets stuck, she just automatically steps across the light to get going.
In addition, this walker is designed so that an individual can use it by holding either the padded U shaped handlebar or the hand grips, similar to a bicycle. Also one can sit on a padded seat to rest if needed; pushing the U shaped handlebar back offers an instant backrest for the seated person. Under the padded seat is a basket, which can be used to carry things. It can easily be folded down for transport.
The company that makes this U Step walker has a website. Just type in "U Step walker" into the search bar. Medicare will cover the walker, but not the cost of the laser attachment, if they have not reimbursed you for a walker within the last 5 years. You will need to submit a prescription for the walker from your physician if you want to be reimbursed by Medicare.
My daughter was with me the first time I froze and it was at the top of an esculator. She whispered in my ear "its okay come with me", and she took me to a chair to sit. She whispered in my ear "are we ready?" and up I got and did not hesitate to freeze, like before. Now it takes a gentle nudge or a whisper in my ear to get me going again.
When I freeze I try to calm myself down and try to relax and then instead of taking a normal step I slide one foot forward and keep sliding my feet to walk. It feels like I am gliding across the floor and there is no more freezing. More details about this on freezingofgait.yolasite.com.
My daughter puts her foot in front of mine and I try to step over it. She makes a game of it, wiggling her toes and challenging me to step. I've also used a cane with a red laser on it that creates a red line on the floor when pressed down that I then step over.
My father had a terrible time with freezing. A change in flooring regardless of a change in levels, or even a change in a pattern of floor caused him to freeze, as did the doorways. His problem too was he would be focused on getting where he wanted to be so when the feet freeze his upper body was usually still leaning forward. His multi daily falls scared the mess out of us, but for some incredible reason he never broke a bone. He also had the problem of not being able to turn well. He did his own therapy by walking up and down steps with handrails multiple times daily. The steps did not cause freezing. The nuro gave him a new sodium something patch that was being tested for treating walking difficulties, and for the very short Time he used it it did seem to help some. ( He was found later on to have cancer and that is what took him away from us before he could really see the results of the DBS and other treatments. The after surgery "honeymoon" was great, and the patches did seem to help) it is so true that to grab their arm or otherwise help does not seem to be productive and caused my dad to lose his temper.
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