In the early stages of the disease - or when medication is effective - people with Parkinson’s can remain independent in most activities. A carer will not need to provide much assistance with manoeuvring, walking or turning. But as the condition progresses, despite optimal medication to control symptoms, there is usually a progressive loss of movement and the person you care for will eventually develop movement difficulties (for example when the effects of a dose of medication diminish, leading to ‘wearing off’, ‘on-off’ fluctuations and other movement symptoms such as freezing). It is at this point that your support could be required to help with movement.
Strategies to help with movement difficulties
When assisting with movement it is important for both of you that it is done safely, taking into account each of your abilities and limitations.
Parkinson’s is different for every individual and symptoms can vary from day-to-day and even hour-to-hour. Strategies, cues and cognitive movement methods can all help, but what works for one person may not for another, so make a note of what is most beneficial for you both. For examples of strategies that may be helpful see the Coping Strategies CD-Rom.
As well as assisting the person you care for, using cues or other movement strategies can help protect your back as they minimise the physical effort involved by encouraging the person to be part of the movement.
For other useful information on cueing and movement strategies see Falls, Freezing, Gait, Rigidity.
As Parkinson’s progresses cues may no longer be sufficient and the person you care for may become dependent upon you. At this stage, other interventions such as deep brain stimulation or continuous dopaminergic stimulation may be appropriate and only minimal help from you will be required.
However, if the stage is reached where maximum assistance is needed, then the following information might be helpful. Moving someone who is frail or unsteady can be a demanding and complex task, so it is important to understand the risks and to plan any manoeuvre carefully so as to minimise the chance of falling, slipping or damaging your back.
One of the most important principles of helping someone to move safely is to allow them to do as much as possible themselves, letting them control their movement as far as they are able. Avoid taking over or rushing, rather allow them to move in their own time and within their own abilities. If you think that you will be unable to safely help someone move on your own, then ask for assistance before you try
Equipment
A wide variety of equipment has been designed to assist with safely moving another person, for example:
- slide sheets to help roll, tilt or slide a person with minimal strain to yourself
- standing and turning aids
- electric recliner or riser chairs
- electric beds which allow the height of the bed and the elevation of the head position to be adjusted
- transfer boards for moving from one item of furniture to another
- stair lifts
- hoists.
An occupational therapist, physiotherapist, nurse or specialist back care advisor will be able to advise on specific everyday aids as well as appropriate techniques to help you and these can be tailored to each individual situation. Ask the professionals to demonstrate them or oversee you while you put techniques or equipment into practice so that they can guide and correct you. And if you don’t feel safe or comfortable doing what is asked of you then it is vital that you say so.
Always allow the equipment to take the strain where more than minimal exertion is required, as this means that your own health, particularly your back, is less likely to be compromised. It’s hard to be a good carer if you are injured!
Key points for safely helping someone move
- explain to the person what you are going to do before you start moving them
- talk about how they can help you, even if it’s just by relaxing and doing nothing at all
- decide on the correct position for the manoeuvre, such as on the person’s least painful side or so that you can see their face if this helps with communication
- make sure that you have plenty of space and no obstacles where you plan to move to
- stand as close as possible to the person you are going to move as this will reduce strain on your back
- place your feet comfortably apart so that you are well balanced and in a solid position, also ensuring that you can move forwards and backwards as well as side-to-side
- to reduce the risk of straining your back always bend at the knees using your thigh muscles to take the weight and avoid twisting or bending at the waist
- use roll, tilt and slide techniques instead of lifting wherever possible
- if the person you care for experiences muscular rigidity then it is advisable to flex the limbs before attempting to move them. This is particularly important if they have been lying or sitting in the same position for some time. For example if they have been sitting then flex the knees several times or if they have been lying down bend the legs.
Further information
The
following sources may be useful:
