Parkinson’s Disease is a neurological disorder where the brain cells responsible for the production of dopamine, (a chemical which helps to control movement) become damaged or die.

Parkinson’s disease is progressive and degenerative, meaning that the symptoms worsen over time, and slightly more likely to be diagnosed in men from the age of 50.

The main symptoms, affecting the person’s movement:

  • Tremors: Normally first noticed in the hands, the individual will experience involuntary shaking or trembling.
  • Muscle stiffness: Affecting range of movement and rigidity, making changing positions and normal occupation difficult.
  • Speech: Problems with slurred speech or reduced volume when speaking and facial expressions can be altered, making communication challenging.
  • Initiating movement and postural instability: Walking and balance are affected, and the person can be prone to “freezing” and falls.

These symptoms along with several others and a plethora of potential side effects from pharmaceutical treatments can present a collection of many symptoms as unique as the person living with the condition.

The symptoms present the person with Parkinson’s disease with many functional and occupational challenges, often impacted on by the built environment.

When contemplating house design for an individual with Parkinson’s there are key areas that need to be addressed.

Person in a wheelchair entering through a doorway.


Accessibility

As it is a condition which affects mobility, accessibility is crucial when considering house design and future proofing. Take care considering the flooring options, as a change in flooring colour/pattern or surface type can encourage what is known as ‘freezing’ at real or perceived thresholds.

Having wide doorways and hallways will help to allow for walking aids, walkers or wheelchairs.

Changing steps for ramps or step lifts at the entrances will allow for easy wheeled ingress or egress for the individual, but be careful not to assume that ramping is safer or easier than wide steps that accommodate a walking aid and the person. For autonomous access there are keyless or wireless door entry systems, for those who have poor fine motor control or those in powered wheelchairs.

Internal access is equally important, considering an open plan space or widening internal doors can do much to improve the flow of mobility. Flooring needs to be safe, anti-slip and if there are carpets, these ideally need to be short pile and in good repair. The typical shuffling gait can mean that the person is at risk of tripping, so seamless flooring is ideal.

Access to all of the rooms/facilities within the home is also key when considering home design as is futureproofing it for an individual with Parkinson’s disease. If there are stairs to negotiate, they can over time become an area of risk. Alternative means to access the upstairs rooms, needs careful consideration.  Graded adaptations, from bilateral banisters through to stairlifts and home lifts are all options in removing barriers to independence.

Smiling elderly lady assisting her husband with a walking aid in their home.


Furniture and assistive equipment

Ensuring the individual has the right equipment and furniture at home is essential to independence and wellbeing. A supportive chair and bed with clear access to them is a must. They should be set at an appropriate height, to make transfers easy. Adjustability with armrests, grab rails, lateral supports, cushions and mattresses will give the furniture longevity to support the person’s posture, independence and skin integrity as their needs change.

Bed mobility can be a particularly difficult occupation for a person with Parkinson’s disease. Their medication often dissipates over night making turning and changing position in the night challenging and transfers during the night more problematic.

Smart appliances and motion sensor lighting can also make a significant difference for those individuals where the disease has progressed and movement is more limited.


Bathrooms

The bathroom is no different when it comes to accessibility, with statistics demonstrating that it is one of the most high risk areas within the home.

Thought needs to be given to how the person engages with the environment in order to meet their occupational demands. Balance, stiffness and tremor can affect the individual’s range of movement and ability to use traditional methods of maintaining toilet hygiene; considering a wash and dry toilet such as the Palma Vita would facilitate much needed autonomous, dignified occupation. Transferring on and off the toilet, as with all sit to stand transfers, can be challenging which mean options such as the Aerolet, which assists with either a tilting or vertical lift could make the difference between requiring carer assistance or independent transfers.

A spacious level access shower with rails and room to accommodate for suitable seating would enhance safety and independent access, whilst allowing for assistance with showering if the time arose. Shower controls that a person can reach whilst sitting, ergonomic controls and easy ergonomic tap handles in the shower and on the handwash basin should be included in good design. Adjustable half screens would allow for carer access too, without them getting soaked!

However, don’t dismiss bathing if it’s meaningful to the person.  Specialist baths are available which support safe transfers into and out of the water, and being submerged can have a positive impact on muscular spasms.


Kitchen

Being able to autonomously access water, a hot drink or a hot meal for someone with Parkinson’s disease can become more challenging as the condition progresses.

Initially it may just be thinking about non-slip flooring, a place to sit for stability or rest, and large, easy to use controls on appliances. However, access to worktops, cupboards and shelving for those in wheelchairs need to be organised.

Lowered counters, pull out shelves, or even height-adjustable cupboards can make this occupation stress free and safe. Induction hobs heat and cool quickly reducing the risk of accidental burn injuries; considering broader handled utensils and lightweight crockery and cookware will support independence for longer.

A place to eat in the kitchen or means to transport food and drink should be included in design.


Outdoor spaces

If the individual is lucky enough to have outdoor spaces, designing these with accessibility in mind is worth doing. Clear smooth, wide pathways and raised beds can make the space inclusive. Being out in a garden, in nature, can really boost well-being and should be incorporated into home design where possible.

A thoughtful home design can vastly improve the quality of life for individuals with Parkinson’s disease. By considering all aspects discussed, we can create safe, fully accessible environments that enable rather than disable, promoting autonomy and comfort for those living with Parkinson’s disease.