How to safely provide assistance

You may need to provide assistance to help someone:

• out of a chair, or a car seat
• into, out of, and turning in bed
• while walking
• get up off the floor

Doing these bending and twisting movements repeatedly while carrying the weight of another person can lead to back and shoulder strains. This is especially the case if you carry an action out too quickly, or if the person you are helping is slower, stiffer and needs regular help.

Think about the following things beforehand:

• Does the person you care for definitely need assistance? There may only be certain times of the day they need help because they are more stiff, slow, or unsteady.
• Don’t get into the habit of unnecessarily helping every time. They’ll stay stronger and more able the longer they can perform the movement themselves.
• Try giving your loved one instructions first, if possible. This is so they can try to do it themselves.
• Are you strong enough to help by yourself, or is there an assistive device or adaptation you can make use of? If you’re not strong enough, or feel that you can’t safely help, then you may need the support of other people, such as a paid carer.

Standing up from a chair

• Ask the person to bring their bottom forward in the chair, lean forward and push up using the chair arms.
• If you do need to help, avoid a position where you bend forward and twist. Ideally, stand at their side and help by supporting them through the lower back. Helping to push forwards and up into standing may give them the momentum they need rather than you pulling them up.
• Think about assistive devices. Use a slide sheet so the person you care for can slide their bottom forward without help, or a fixed frame for them to push up from.

If you’re helping someone to get into or out of a car, the principles of coming forward and pushing upwards are the same.

You can buy hand grips to attach to a car frame for pushing up on, or a hanging handle to pull up with. There’s also twisting sheets that can help someone to turn in the seat as their legs swing into or out of the foot well.

A physiotherapist or occupational therapist can help look at solutions like turning devices or a hoist if the person you care for develops further problems.

Walking

• Parkinson’s can affect how someone walks. Let your loved one know if they need to straighten up and take longer steps, especially on a downward slope. If their pace is slow, prompt them to increase their speed so the walk is more efficient and less tiring for them. Remember the heel should always hit the floor first.
• If they need occasional support, for example on uneven ground, then walk arm-in-arm. This is a good way to set the rhythm and pace of walking. Be mindful of how much weight you’re taking though. This will strain one side of your body, especially if they tire easily.

Some people with Parkinson’s may benefit from an assistive device such as a stick, walking frame or wheelchair. The right one will depend on whether it’s for indoors, outdoors, regular or occasional use, and if the person is comfortable using one.

Getting off the floor

It’s important you practice this as a movement before it becomes necessary to use it in an emergency.

• If your loved one falls and is embarrassed about it, your first reaction may be to help them up immediately. But it’s important to check they are not injured first. If the fall was because of low blood pressure, make them comfortable on with a pillow and blanket (if you have these available) until they feel better. If they’re not hurt, tell them to get onto their hands and knees so they can push up using their legs.
• If you need to help, pull a chair close to them so they can use it to get up, and stand close by in case they need support. You may need to pull up on their waistband to help them move onto their knees and then stand up.

If your loved one falls regularly, contact your Parkinson’s nurse or an occupational therapist, who can discuss devices and further advice on what can help.

Getting into, out of, and moving in bed

This is more of a problem at night when dopamine levels are low and when people are tired. This makes it harder to coordinate the arms, legs and body.

• To get into bed, tell your loved one how far back to place their bottom on the bed so when they raise their legs, their body is in the correct position.

  If they have problems raising their legs onto the bed, help them place one leg on so that it makes it easier for them to raise the other one.

  Some people can get onto the bed, but not move once they’re on the mattress. You could ask them to bend their knees, and move each leg across towards the middle. Then they need to lift their bottom, and finally their shoulders. This may need repeating several times, especially with a soft mattress.

• If the person needs assistance, it’s safer for you to get out of bed to help. Try practising the movements during the day, or when you are both less tired.

A physiotherapist or occupational therapist can help you look at solutions, such as rolling techniques.

Read more about physiotherapy or occupational therapy.