In the UK, 1 in 37 people alive today will be diagnosed with Parkinson’s Disease. The prevalence is higher in men than women and increases with age. Anyone diagnosed before the age of 50 is considered to have young or early onset Parkinson’s disease, there can be a family history in these cases. The symptoms tend to mirror those with later onset, progression can be slower, but side effects from medications can be more frequent.

The most common symptoms of Parkinson’s disease are a shuffling gait and a tremor, but others can include an impact on memory/cognition, loss of facial expression and general motor control.

In the case study below* we try to provide an illustration of the impact Parkinson’s disease can have, and how home modifications can maximise independence and reduce risk.

Carol began to experience tremors in her hands when she was 61 years old. It affected her ability to prepare meals and to write legibly. At first, she ignored the symptoms thinking they would go away. However, she began to experience some changes with continence and altered balance.

Her family noticed that her voice was quieter, and they had to ask her to repeat herself often. She went to her GP and was referred to the neurology team, she was diagnosed at 63 years old with Parkinson’s disease.

Occupational Therapy was requested to assist Carol to assess, support and assist her to plan her daily occupations within her home. They considered what she was able to do independently, discussed things that were becoming difficult and explored activities that were likely to become more problematic over time.

Considering home design and future proofing her home was important for Carol; she had a full family life and wanted to always remain in the family home.

We addressed accessibility, ensuring that she was able to get in and out of her house and ensured she could get around her home independently. Ramps, widened doorways, open plan living and smooth, anti-slip flooring were recommended to reduce incidences of freezing gait, and hazards which could cause slips, trips, and falls.

Safe access to the first floor of her house was also addressed with plans for a stair lift. A home lift was discussed to maximise future proofing, but it was not something Carol wanted to consider at that time.

Carol was extremely keen to maintain her personal hygiene, including managing cleaning after using the toilet.  She was determined that she didn’t want her husband and children to assist her in any way but acknowledged that due to her peripheral tremor this was already becoming a challenge. Carol already had an en-suite wet room which was large enough to accommodate appropriate seating if required in the future, but she had started to experience rigidity and bradykinesia which was impacting toilet hygiene. We recommended a Closomat Palma Vita, a wash and dry toilet that maintained her fierce desire for independence, and long-term dignity. It was also acknowledged that in the future an Aerolet vertical or tilting toilet lift could be used to further manage disease progression.

We advised Carol to make changes in the kitchen, reorganising her cupboards so that everything was accessible, changing the handles to compensate for reduced dexterity, and having easy controls on appliances made meal preparation easier. She chose to make this a family activity too, asking her loved ones to join in and undertake some of the tasks meant she could avoid some of the riskier activities such as chopping vegetables when her tremors were particularly bad, and made for a social occupation within her home. We encouraged her to consider some seating in the kitchen for when she experienced poor balance.

Carol really wanted to continue to sleep in her bed with her husband. Choosing the correct height bed with discreetly placed grab rails enabled her to maintain transfers safely and independently. During the night, when her medication had worn off, she would struggle to turn herself in bed, often waking her husband to assist her to roll onto her side. We successfully used the base of a double in-bed satin sheet system which enabled her to initiate the turn independently, whilst her husband slept uninterrupted on the cotton side of the innovative fitted sheet.

By choosing accessible thoughtful home design and re-thinking some activities within the home, we were able to assist Carol in maintaining so much of her independence within her family home. Ensuring that those occupations that were particularly meaningful for her and her role within her family could continue for as long as possible.

Closomat’s solution:

The Palma Vita wash and dry toilet:

The Closomat Palma Vita can be adapted for people with restricted mobility by adding the appropriate accessories, at initial installation and later, as needs change.

The heart of our toilets is the washing and drying experience: the most effective available in the UK.

The warm water washing is followed by thorough warm air drying – so you are left with the ultimate feeling of cleanliness and freshness.

Aerolet Toilet Lifts:

If you have balance or leg-strength issues and can’t go to the toilet unaided, then an Aerolet toilet lift could be just the help you need. We know how challenging it can be if you are having difficulty getting on and of the toilet. And we also understand that for some people this can be a difficult subject to talk about and to seek help with.

Supplied in either ‘tilting’ or ‘vertical’ action, a Toilet Lift reduces a resident’s risk of falls and injuries, enhances their dignity and independence, and decreases reliance on carers. It does this by replicating the natural motion of standing up and sitting down. Gently raising and lowering the user accurately into position over the toilet as required whilst enabling their feet to remain in contact with the floor, maintaining balance.

*Name used for illustration purposed only.