Steady Together Fall Prevention Program in the Home

According to the Parkinson’s Foundation (2023, April 28), 60% of persons with Parkinson’s Disease (PwP) will experience falls each year. Most falls occur while turning, bending forward, standing up, initiating walking, and trying to avoid obstacles.Falls can cause significant disability and loss of independence. Risk of hip fracture is four times higher among PwP. PwP are likely to fall due to problems with balance, posture, freezing gait, leg weakness, fear of falling, cognitive impairment, and difficulty moving in the home (Heyn et al., 2023). Of note, fear of falling impacts a PwP’s quality of life as they may avoid engaging in valued activities (Rider et al., 2023). Frequently avoided activities among this population include walking in dimly lit and unfamiliar places, walking on different surfaces, lifting and carrying objects, walking in crowded places, recreational and leisure activities, and going up and down stairs. Most falls by PwP occur indoors, mostly at home (Foongsathaporn, et al. 2016). Strong evidence exists that home modifications and training in the home conducted by occupational therapists as part of a multicomponent intervention program are effective in improving function of people with a wide variety of conditions (Stark et al., 2017). Comprehensive home modification interventions that include (1) assessment of a person’s abilities, (2) assessment of the home environment and occupational goals, (3) an intervention plan to remediate barriers, (4) implementation of or support for the implementation of the plan, and (5) training of the client or caregiver to complete his or her daily activities using environmental support are more effective than less comprehensive interventions (such as checklists or assessments completed by those who are not OTs).