Parkinson’s disease at home: medicines on time, falls and swallowing

Parkinson’s disease is managed in the small details of a day: the time each pill is taken, the rug in the hallway, how a meal is eaten. Those details shift as the disease changes. This note covers the daily routine at home, from the National Library of Medicine’s guidance, plus how to protect the medicine schedule during a hospital stay and where families can get help.^1,2

The short answer

• Take Parkinson’s medicines as directed, and don’t stop any without talking to the provider.¹
• Remove tripping hazards, keep the hallways lit, and put grab bars by the tub, shower and toilet.¹
• Eat small, frequent meals sitting upright, and stay upright for 30 to 45 minutes after.¹
• In the hospital, speak up for medicines on time, every time.²
• The Parkinson’s Foundation helpline answers questions for free, in English and Spanish, at 1-800-473-4636.³

Medicines on time

Take each medicine as directed, and know ahead of time what to do if a dose is missed. Don’t stop any medicine without talking to the provider first.¹ Phone alarms or a pill organizer with the times marked can help keep the schedule.

Watch for side effects, including hallucinations, nausea, vomiting, diarrhea and confusion. Some Parkinson’s medicines can also lead to risky behaviors, like compulsive gambling. Tell the provider about any of these.¹ Keeping medicines straight after the hospital explains how to keep one correct list.

Moving and preventing falls

Regular exercise helps with muscle strength, balance, sleep and staying regular. Pace the tasks that are tiring or take concentration.¹ To make the house safer:¹

• Remove throw rugs and loose cords, and fix uneven floors.
• Keep hallways well lit.
• Install grab bars by the tub, shower and toilet, and use a slip-proof mat in the tub or shower.
• Ask a physical therapist about walking aids and how to set up the home.
• Reorganize the home so everyday things are easy to reach.
• Keep a cordless or cell phone close by.

Preventing falls at home goes room by room.

Therapists can help with skills like cooking, eating and dressing, and with swaps like Velcro in place of shoelaces and buttons.¹

Eating and swallowing

Parkinson’s can make chewing and swallowing harder. MedlinePlus suggests:¹

• Eat small, frequent meals.
• Sit upright for meals and for 30 to 45 minutes afterward.
• Take small bites, and choose thicker or softer foods.
• Avoid talking while eating.
• Call the provider about choking or coughing while eating.
• Try milkshakes and other thick drinks, soft foods that are easy to chew, or blended food.

For people who qualify for home health, Medicare covers speech-language pathology at home, which includes help with swallowing and speech.⁴

Constipation

Keep a regular bowel routine, drink more fluids, eat plenty of fiber and stay active. Ask the provider whether any of the medicines could be causing it.¹

Mood

Feeling sad or depressed can happen. Talk about it with friends or family, and ask the provider about seeing a professional.¹

Staying well

Get a flu vaccine every year, ask the provider about a pneumonia vaccine, and get the COVID-19 vaccine, which is recommended for people with Parkinson’s. Ask the provider whether driving is still safe.¹

Hospital stays

People with Parkinson’s can have trouble getting their medicines on time in the hospital, so the Parkinson’s Foundation urges families to make the need clear: medications on time, every time.² It also suggests carrying Parkinson’s identification for emergencies and keeping a hospital go-bag by the door.² Put the current medicine list, with the exact time each dose is taken, in that bag, and ask the hospital team to match those times.

Therapy at home

For people who qualify for home health, Medicare covers physical therapy, occupational therapy and speech-language pathology at home.⁴ With a disease that changes over time, the goal may be keeping abilities more than regaining them, and Medicare can cover skilled therapy for that too.⁵

When to call

Call the provider about changes in symptoms or problems with medicines, trouble moving or getting out of a bed or chair, new confusion, pain that’s getting worse, a recent fall, choking or coughing while eating, or signs of a bladder infection.¹

Help for the family

The Parkinson’s Foundation helpline is free and staffed by trained information specialists, in English and Spanish, Monday through Friday from 9 a.m. to 7 p.m. Eastern time, which is 6 a.m. to 4 p.m. in California. The number is 1-800-473-4636.³