Not all patient’s with Parkinson’s experience “freezing” (a temporary inability to move); but in patients who are prone to freezing episodes, FALLING is a risk.
(Freezing does not only occur when walking, but can also be observed when eating, lifting a cup, or trying to remember something.)What triggers a freezing episode?
It’s unpredictable, but freezing usually happens when something interrupts the usual flow of movement or normal sequence of events—it can happen during walking, eating, lifting a cup—or trying to remember something . . .
Patient’s who experiencing a freezing episode literally feel “stuck” to the floor or to their chair.
Some of the typical triggers for a "freezing" episodes that occur while walking include:
- Walking towards doorways, chairs, or around obstacles
- Turning or changing directions, especially in a small space
- Entering an elevator
- Becoming distracted by another task or conversation when walking
- Crowded, cluttered spaces or a highly patterned floor
- Parkinson’s medication wearing off or not working very well
- Walking from one texture of flooring to another (for example: going from smooth floor to carpet, or vice versa)
Many patients who experience "freezing" may notice that different tricks (or "cues") can help them "unfreeze." Here are some ideas to consider:
· Remain calm, take a deep breath, and think it through.(No one should prod or pull the patient—they could fall.)
· Concentrate on shifting the weight to one leg—THEN take a step.
· Change direction: step sideways first, THEN go forward
· Shift the focus to another movement (raise an arm, point to the ceiling, etc.); THEN restart.
· Say: “One, Two, Three—STEP”: THEN restart (or start humming a rhythmic tune)
· Carry a laser pointer—shine it in front of the foot and step on the light—this is a “restart cue” (there are actually special canes made with lasers embedded for Parkinson’s patients.)
· Tape the floor of trouble spots in the room (corners or furniture or door thresholds) as a visual cue (step on or over the tape).
· March in place when coming to a halt at a trouble spot to keep moving and avoid a "freeze."
· Step over an imaginary line to take the first step.
Check out these links for more information about "Freezing" in Parkinson's Disease (or just learn more about Parkinson's in general:
Freezing in Parkinson's (pdf version from the UK Parkinson's webpage)
"Caring for Your Patient with Parkinson's" (This is a very nice, concise booklet for caregivers OR for family)
"Cueing for People with Parkinson's Disease" (Tips for helping someone "unfreeze." A publication of the RESCUE Project, Northumbria Univ. in the UK
Parkinson's Disease Foundation (Order publications or learn online at this comprehensive, educational site)