How OTs Help Someone With Parkinson’s

Occupational therapy helping Parkinson’s disease hand problems

Occupational Therapy is often used to help some early and later on-set symptoms of Parkinson’s Disease. PD is a neurodegenerative disorder that affects dopamine production levels in certain parts of the brain. It causes limb rigidity and causes a tremor or shaking in the hands; that is what the disease is best known for. How does OT help fight against Parkinson’s?

Occupational Therapy, combined with medication and Physical Therapy, helps Parkinson’s patients to recover their working skills lost due to symptoms. Also, OT helps prepare the patient’s home for any obstacles that could hamper them or cause an accident.

A Parkinson’s diagnosis is not a death sentence. Some could see only a small change in the quality of life; some complications could render the patient homebound and in constant need of medical attention. We’ll show you how working hard with your therapist will significantly improve your chances of maintaining your lifestyle.

How Occupational Therapy Helps Parkinson’s Patients

An OT’s job is to make sure that you can overcome the everyday obstacles affected by PD. Once you reach the later stages of the disease, you could see a noticeable difference in your gait or even your ability to stand upright. You should contact therapists after your diagnosis to combat these problems as fast as possible.

The focus of your therapy will be on making things that have become a problem easier to achieve or find an alternative that allows you to perform the activity. OT’s have tons of tricks in their bags that give them insight into Parkinson’s and what it does to your body. Listen carefully, as they are crucial to your wellness.

The things that an Occupational Therapist can help you with are:

  • Teach alternative methods – One thing that an OT excels at is teaching you how to do an everyday activity differently. They know several different ways to perform an action and can cater therapy to fit the patients’ exact symptoms. Daily things like brushing your teeth fall into this category.
  • Suggest appliances – There is a slew of items for the home that make dealing with your symptoms much more comfortable. Your therapist will know which ones will benefit you most and could even give you product information straight from the distributor.
  • Recommend changes for your home – Something that OT’s do that seems a bit odd at first is suggesting furniture choices. They know which pieces of furniture will be a danger and suggest other places to move them that keep them away from you. 
  • Learn coping mechanisms – Dealing with constant uncertainty and daunting new challenges can be challenging. Listen to your OT’s suggestions for coping with your diagnosis or any new problems that may arise.
  • Referral advice – The OT will be an excellent resource for advice on which doctors you should choose. They often have working relationships with doctors and physiotherapists and know who will be best for your specific set of issues.
  • Motivational Techniques – When a patient is down, no one should have more impact on their motivations than the OT. After having setbacks in treatment, they will continue to lead you into the fight against the symptoms of Parkinson’s. 

Highlighting what an Occupational Therapist does is not doing them any justice. They help patients adapt to new situations and prepare for eventualities with skill and grace. Choose an OT that has great credentials and a genuine passion for working with patients. You will be spending lots of time with them, choose with purpose.

Ways Occupational Therapist’s Improve Home Safety for Patients

Safety in the home is one of the most important things for you. The OT not only prepares you while working with them in the clinic but will suggest an array of items and gadgets for the home that will keep you on the up and up. Making subtle improvements is the best that can be done for you while you are away from their care.

An Occupational Therapist will suggest new furniture for the home. Chairs that are easier to sit in or have lifts can be purchased to make transferring to standing and seated much easier for you. They could also have a bed that allows you to raise and lower the head and feet, just like the beds in a hospital. 

The list of things that an OT evaluates during home safety are:

  • Balance
  • Coordination
  • Vision
  • Awareness
  • Strength
  • Attention

Once they know what obstacles are in the home and how you approach them, they can devise a strategy that places your furniture in useful out of the way places while keeping them out of your most traveled path. If moving and arranging furniture isn’t going to work for you, there are also home upgrade options.

Some upgrades will require that you make additions to your home and should all be done by a professional contractor. As your symptoms progress, you should stay away from heavy lifting and power tools as they could injure you and the people around you. 

A list of upgrades an Occupational Therapist might recommend for the home are:

  • Entryway Expansion – Having an accessible entryway into the home is one of the first things needed. The OT will decide if there needs to be a ramp or if a set of handrails on the steps could be replaced. This also applies to access in the garage for exiting the automobile.
  • Reinforced Handrails – Having handrails at all points needed around the home is crucial for those that are experiencing a change in gait. As the pace shortens, you pick your feet up less, and any small thing, like a hallway rug, will become a hazard. Sturdy handrails are going to come in very handy around the home.
  • Large Bathroom – The room in the home that will require the most work will be the bathroom. An easy to use toilet and walk in shower is the most common installations. Take the time to choose what is best for you and your home. Safety is first and foremost, and the bathroom can be a dangerous area.
  • Easy to Access Kitchen – The kitchen will be another spot that OT’s will spend a lot of time inside. The kitchen should have a way for you to prepare meals without any danger of spilling hot liquids or starting a fire. The OT will give you a list of new appliances that could prevent risk in the home.
  • Chair Lift for Stairs – An OT will take the time to determine if you need a chair lift for an upstairs section of your home. These lifts are quite large and will require a professional installation. It is essential that many stairs have a lift as moving upstairs will be very hard on you later on. 

The home can be a treacherous place for you as the disease progresses. Things like loose steps or banister knobs could improve the chances of a fall or danger in the home. When the OT does their assessment, be sure to follow their guidelines, and the chances of a severe injury that require further therapy will fall dramatically.

Exercises Your Occupational Therapist Could Recommend for Parkinson’s Symptoms

The exercises that your OT gives you are there for a purpose and should be done routinely and to the best of your abilities. The exercise should challenge you and make you work towards strengthening your weaknesses. Don’t think that strolling on a treadmill or pedaling softly on a bike will work for this phase. Try and push yourself to see what limits, if any, that you may have.

One of the things that people don’t usually expect during therapy is to fail. OT’s will start the patient off with a diagnosis and work from bare bone to improve their quality of life. Expect to fail and repeat exercises as need. Don’t let little losses take your focus off winning the long game of staying independent and leading a long life. 

Therapists will concentrate on three areas of performance when they assign exercises. These areas are:

  • Everyday Activities
  • Using the Restroom
  • Large Body Part Exercises

Everyday Activities Concentrate on Making Life Easier for the Patient

Working on everyday items optimizes your movement patterns and allows you to perform them without as many hang-ups as you had initially. One of the biggest things about these everyday things is that they provide a foundation for the things that come after. Life will be about making adaptations from this point forward. Be ready to do what is needed.

As everyday activities are mastered, they should be added to other activities to create a system. This system should be performed regularly to improve the movements and make them become second nature. As tremors persist, there could be tools and devices that will help to accomplish some tasks. The practice is always vital when dealing with Parkinson’s.

Some of the areas that are trained with everyday activity exercise are:

  • Self-Care
  • Fall Prevention
  • Bed Mobility
  • Seated Transfers
  • Handwriting

Self-Care should be Practiced by Creating a System

Self-care for some Parkinson’s patients can be tiring and cause them to be off-balance. Your OT will help you practice by creating a system that places everything you will need for the day at a ready position. This positioning will increase the time that it takes and move along the process much faster than if you are going in unprepared.

One of the biggest complaints by patients is that they are stiff upon waking in the morning. If you are stiff, take some extra time to stretch while lying in bed and then move to the seated position before stretching the arms and legs. Once the blood is flowing, there should be some easement of symptoms, and self-care should continue.

Ways to Improve your self-care system in the mornings are:

  • Concentrate on the task at hand – While dressing or brushing your teeth, you should force your mind to think only about what you are doing. Allowing the mind to wander will increase the chances of failing the activity. Keeping positive is going to come in handy, and know that all obstacles can be overcome.
  • Sit down to use buttons – Looking down for several seconds can upset your equilibrium and throw you off-balance. Take a seat on the edge of a chair to work over your buttons. This will keep your feet firm on the ground and allow you to concentrate on making the buttons go into the holes.
  • Think it through – While dressing or shaving, you should thoroughly think about the process from beginning to end. Thinking about the process prepares the mind to perform it when the time comes. Be methodical and take into account the previous rule of concentrating on only this task.
  • One thing at a time – Build up the tasks one at a time. Don’t go into your therapy, thinking that everything must be accomplished on the first day. Concentrate on one thing at a time, and you will see tremendous improvements as the days go by.

Ots Make Fall Prevention a High Priority

An OT can help in the later stages of Parkinson’s since your balance and gait could be substantially impaired. There are only so many ways to prepare surfaces against falls. As a caveat to prevention, a heavy dose of learning what to do after a fall is essential as sometimes falls will be unavoidable.

There are fall alarm systems and jewelry that can be worn to send for help after a fall, but nothing is going to help, like putting yourself in more and more complicated situations and learning how to get yourself out. Working with an OT is designed this way, scalable lessons that can be built upon, to provide safety and confidence for the patient.

Ways to reduce your chances of falling are:

  • Concentrate on the movements – Like with the other exercises, you should concentrate on one action at a time. Take a single step and then focus on the next and so on until you are comfortable with your pacing and movements.
  • Test a walker before committing – Your OT will help you choose a walker that will help maintain balance and improve your chances of surviving a fall. Don’t choose something that is too low and causes you to stoop as you move. Find something that fits your height and is not going to force long strides in your gait.
  • Use tools for carrying items – Carrying items could be something that isn’t possible at this stage in your illness. Concentrating on carrying an object and not dropping it could be too taxing on your system; choose something to aid in carrying any items you might need to move.
  • Find the beat – When you are stumbling, concentrate on walking to a steady rhythm. This beat will improve your gait and force you to make strides as the music plays. Having a steady march will decrease your chances of falling and help you fight off the disease’s sluggish effects.

Working Towards Bed Mobility is Essential for Parkinson’s Patients

Something that could be a precursor to a Parkinson’s diagnosis is an inability to move around in the bed on your own. Being unable to move at night and frequent trips to the bathroom often lead you to an appointment with your doctor. A few simple things to consider while you are in bed will help to improve your mobility.

Your OT will work up a set of exercises that teach you how to tackle this significant problem. They will set up a series of moves that teach you to shift yourself around enough to get your feet in a position to stand. Therapists work with you in the clinic so that there are fewer obstacles to tackle at home.

Some cues to help you work on bed mobility are:

  • Learn to roll over – This sounds like a trick for your new puppy, but actually, it will teach you how to move your body to get out of bed. Having a process will allow you to think through the moves and engage the correct muscles at the appropriate time.
  • Get used to the ‘three sections’ – One of the most useful terms for teaching someone to move from the bed is the three sections analogy. Think of your body as three sections, head, waist, and knees, and move them one at a time until you move across the sheets.
  • Work towards the bridge – Arching your back is a great way to create some movement and work towards leaving the mattress. Alternate picking up the hips and arching the back will make a walking pattern and help with stiff muscles as well. 
  • Practice using the bed rail – Once a handrail has been installed, it will be essential to practice using it. If the arms and shoulders are over stiff, it could be challenging to reach and pull enough to leave the mattress. Pair the bed rail with the other movement patterns, and you should be in good shape.

Outside of transferring from seated to standing and using the toilet, learning how to move in the bed is one of the most essential things your OT can work on. It gives you back your independence that could be lost with leg tremors or rigidity in the lower extremities. Stick to the plan, and the results will follow. 

Seated Transfers are Equally Important to Practice and Master

As weak and unsteady as your legs could be, they must be trained to move from every seated position to standing. This is hard because the shifting of weight to different parts of the foot can become unsteady as Parkinson’s progresses.

The Occupational Therapist will work on teaching you how to move from seated to standing. At the same time, it sounds easy; learning how to do this will martial all of your strength and concentration. If you suffer from leg rigidity practicing the moves will ease the symptoms and strengthen weakened muscles. 

Cues to follow when transferring from a seated position are:

  • Use the front of the seat – Shifting the weight to the front of the chair puts you in a great position to fire the legs and stand. It also allows you to get an excellent footing on the floor and build a good balance base.
  • Breaking the stuck feeling – There are times during the sitting process when you feel helpless. This is a point where your body has more weight or leverage in a position that keeps you in the chair. Learn to fight through this feeling by being capable of moving your body to offset this leverage.
  • Use the chair’s aid – Chairs will be an excellent place to find spots for leverage to move. By turning around in a chair, you can use the chair’s arms or back to steady yourself or even pull upright.

Handwriting can be a Difficult Area to Improve Upon

When the fingers and hand muscles begin to tremor, handwriting could be something that is not easily done. Using adapted pens and fingerings could allow you to better grip the pen and even allow you to write a few words.

Picking up small objects, like puzzle pieces and Legos, forces the patient to concentrate on the tips of their fingers. This works well for handwriting and eating, which is another area that will require significant effort. Working on small motor skills improves your ability to do many ordinary things, and strong hands could save your life in a fall situation.

Some things to concentrate on when working on your handwriting are:

  • Gripping the pen – The grip is often the most challenging thing for PD patients to use. When the fingers don’t cooperate with a small grip, you can always opt for pens with a more significant grip area or use an attachment to make the pen fit your grip.
  • Use an easy writing pen – Choose a pen with gel ink or something that writes evenly and smoothly. With a pen that sticks, the hand can veer off into wild tangents and could go wherever the hand takes it. A smooth writer will keep the lines you are concentrating on working and going where they are supposed to.
  • Lined paper is key – Using paper with lines will help you concentrate on keeping the writing on the same level. This also gives you something to use as a guide when you are writing.

Occupational Therapy Instruments to Improve Feeding

Eating is one of the things most affected by tremors associated with Parkinson’s. An Occupational Therapist will prescribe exercises and regimens to keep the tremors to a minimum, but having assistive devices available to use is always a good idea. They can further diminish the tremors and will make eating and preparing food much more manageable.

Using assistive devices will help in all parts of working in the kitchen. The OT will have a list of items necessary for the kitchen, but they will also recommend ways to improve safety while preparing the meals. Each selection they make will be beneficial to you and not only improve safety but ability as well.

Some assistive devices that could be recommended by an Occupational Therapist are:

  • Adaptive Cutting Board – A cutting board that can be used one-handed or has a press mechanism will be a great help for you. They also have a lip placed on the edge of the board that will keep food from sliding off while you chop. This also works to protect the fingers, which are prone to accidents.
  • Built-Up Utensils – When tremors are present, having a larger handle on your forks and spoons makes gripping them much more manageable. The increased bulk of the handle also means that it is less likely to slip from your grip. Take advantage of any tools that the OT recommends and use them as often as possible.
  • Suction Plate – When the hand tremors, it could shake food and even the plate around the table as you try to eat. Having a suction plate that has a lip around the edge is crucial to preventing this from happening. Also, a dish that will not move helps you feed yourself and gives you independence.

Learning to feed yourself restores an enormous sense of independence. When you rely less on people, you begin to see that any task you set your mind to is within reach. Take time and focus on what you are doing while you prepare and eat your food. The time spent will reap the rewards in the later stages of the disease.


Using an Occupational Therapist will improve your quality of life after a diagnosis of Parkinson’s, and they will provide you with essential data about your situation. Not only will the OT be a way to learn exercises for your disease, but also as a way to cope with your diagnosis and be a sounding board for questions or concerns.

The therapist will give you ways to increase the viability of doing everyday activities on your own and show you that living with Parkinson’s doesn’t mean a loss in quality of life. Take their advice to heart, and your journey with Parkinson’s won’t be filled with pain and anxiety.

Content Disclaimer

The information contained above is provided for information purposes only. The contents of this Blog article are not intended to amount to advice, and you should not rely on any of the contents of this Blog article. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this Blog article. OccupationaltherapyBlog disclaims all liability and responsibility arising from any reliance placed on any of the contents of this Blog article. 


I'm a Neurological Occupational Therapist and Founder of HT Neuro Rehab an Holistic & Person-Centred Adult Rehabilitation in London. I"m fully registered with the Health and Care Professionals Council (HCPC) and the Royal College of Occupational Therapists (RCOT). I have founded HT Neuro Rehab to provide clinical Occupational Therapy services to adults with neurological conditions, brain injuries, major trauma, upper limb retraining and rehabilitation, Prolonged Disorders of Consciousness (PDoC) and Functional Neurological Disorders (FND). My practice provides support, training, and guidance to both the patient and their families and caregivers. My goal is to enable each patient to achieve their personal ability, mobility, and independence goals while cultivating a long-term support network that is capable and prepared to engage in the rehabilitation journey.

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