Parkinson’s Disease Self-Care: Tips for Maintaining Independence

When you're living with Parkinson's disease, taking care of yourself can look a little different than it used to. But that doesn't mean your condition has to keep you from doing the things you enjoy. Along with proper medical treatment, the right self-care strategies can help you manage your symptoms, stay active and independent, and make everyday life a little easier. Here's what to know about caring for yourself with Parkinson's disease.

Why Does Self-Care Matter With Parkinson's Disease?

You might think of "self-care" as taking bubble baths or getting a massage. But it's not just about relaxing. In fact, self-care refers to any habit or routine you've put in place to manage your health, protect your mobility, and preserve your independence. "Parkinson's symptoms might require you to make adjustments and do things differently, but you can and should still do the things you love"—it's all part of self-care, says Rebecca Gilbert, M.D., Ph.D., the chief mission officer at the American Parkinson Disease Association in New York City.

When you live with Parkinson's disease, self-care might involve:

• Adopting behaviors that allow you to continue doing as much as you can on your own
• Eating well to promote more energy
• Following the treatment plan developed by your medical team
• Managing your stress and energy levels
• Staying physically active

The self-care strategies that work for you may not be the same as ones that work for someone else with Parkinson's disease. And they can evolve over time as symptoms change. What matters is that you do the things that help you feel your best.

Exercise and Parkinson's Self-Care

Exercise supports mobility, strength, balance, and overall quality of life when you have Parkinson's disease. "Exercise early in the disease has the potential to delay progression of the disease which can make a big difference in a person's quality of life," says Daniel M. Corcos, Ph.D., a professor of physical therapy and human movement sciences at the Northwestern University Feinberg School of Medicine in Chicago and research director of Parkinson's Elevated, a philanthropic program that uses movement to proactively treat the condition. "Later in the disease, exercise maintains physical function, bone health, and mental health."

A good exercise program for Parkinson's disease has four elements, according to the Parkinson's Foundation and the American College of Sports Medicine. These include:

• Aerobic exercise. Brisk walking, running, cycling, swimming, and dancing are all activities that elevate your heart rate. Do these at least three days a week for 30 minutes at a time.
• Strength-building exercise. Lifting weights, using resistance bands, or performing body weight exercises all count toward strength-building. Do these exercises two to three times a week (on nonconsecutive days) for 30 minutes at a time.
• Balance exercises. Tai chi, yoga, and Pilates help improve balance. Do these at least two to three days per week.
• Stretching. Get the tightness out of your body with yoga, tai chi, or other stretches that you learn from a physical therapist. Stretch at least two to three days per week, or daily if possible.

If you're new to exercise or your Parkinson's disease is causing balance issues, see a physical therapist who specializes in neurologic conditions. Together, you can put together a workout plan that's effective, fun, and safe, notes the American Parkinson Disease Association.

When to Exercise With Parkinson's

There's no hard and fast rule about when to work out with Parkinson's disease. It's best to exercise at the time of day when you know your medication will be the most effective. Since your meds help support smoother muscle movements, being active during these moments (known as "on" periods) will make exercise feel easier and more doable. You'll be able to push yourself a little harder, too. Try to save your "off" times (when medication is wearing off) for activities that don't involve as much physical effort, recommends the Michael J. Fox Foundation.

While it's always best to listen to your body, you might find that exercising during your morning "on" period works best. A small study published in Parkinsonism & Related Disorders using real-world mobility data found that a morning dose of mainstay Parkinson's medication levodopa was tied to greater increases in walking activity compared to afternoon doses.

Managing Parkinson's Medications

Medication timing doesn't just matter for exercise. It also keeps symptoms well-controlled throughout the day, helping you avoid unpredictable "off" periods, says the Parkinson's Foundation. So be sure to take your meds consistently and on time.

"When a person with Parkinson's takes a dose of levodopa, the levodopa passes into the brain and is converted into dopamine which controls Parkinson's disease symptoms. As time passes, the dopamine level in the brain begins to fall, requiring another dose of medication to be taken before symptoms return," Dr. Gilbert explains.

Certain tools can make it easier for you to stay on track. Pill organizers, setting alarms on your phone, using a medication timing app, or just creating a written schedule can all help, suggests Johns Hopkins Medicine.

And speaking of medications for symptom management, pay attention to how your symptoms change over time and whether certain factors (like stress or activity) seem to have an impact. You can write them down in a journal or even on your smartphone. However you track, having a log of your symptoms makes it easier for you and your doctor to notice changes to your PD that call for adjusting your meds, the Parkinson's Foundation says.

Practical Strategies to Make Daily Tasks Easier

One of the frustrating things about Parkinson's disease is how symptoms like bradykinesia, or muscle slowness, can make everyday tasks harder, from preparing your breakfast to buttoning your shirt. Often though, small adjustments can make these tasks more manageable.

Start by giving yourself enough time to complete a task without rushing. "Parkinson's can make movements slower and smaller, and trying to do several things at once can make some activities more difficult. Breaking a complex activity into smaller steps and focusing on one step at a time can make everyday tasks more manageable," says Amy Morse, DPT, a doctor of physical therapy and owner of the Live Able Collective, a coaching program for people with neurological conditions in Atlanta, GA.

Also, try to do the activities that are meaningful to you as much as you can instead of having someone else take over, Morse recommends. The more you practice specific tasks, the more you'll be able to maintain your ability to do them, she explains. As the old saying goes, when you rest, you rust!

With those general rules of thumb in mind, here are some more specific strategies for daily self-care.

Dressing and Personal Care

Make getting ready easier with these simple tips from the Parkinson's Foundation:

• Choose pieces that are easy to put on, like elastic waist pants, front-closing shirts or dresses, and shoes that can be slipped on or have Velcro closures or elastic shoelaces.
• Do a few stretching exercises to limber up before getting dressed.
• Find a firm, steady chair and take a seat while dressing. Don't sit on the bed; you could lose your balance.
• If one arm or leg has more stiffness, put that limb into your sleeve or pant leg first.
• Try adaptive tools like a button hook, dressing stick, zipper pull, or sock aid helper.

Eating and Meal Preparation

Kitchen work can be less of a chore with the right tools and planning and organization strategies. Start with these recommendations from the Parkinson's Foundation and the Michael J. Fox Foundation:

• Choose utensils with handles that are easy to grip. If you can't find a product that works for you, try attaching tube pipe insulation from the hardware store around handles for extra grip.
• Drink from cups with a lid or two handles if you have tremors.
• Place items you use most often at waist height where they're easiest to reach.
• Prepare ingredients while seated. Chop vegetables or assemble a sandwich sitting at the table, or bring a chair over to the kitchen counter.
• Select lightweight pots and pans for easier lifting.
• Stick with simple, one-pot meals to reduce your need to multitask.
• Try an adaptive cutting board, which has raised edges to keep food from falling off the sides.
• Use a plate guard to make it easier to get food onto your fork or spoon.

Writing, Phone Calling, and Household Tasks

Whether you're putting pen to paper or punching numbers into the phone, there are ways to assist yourself with tasks that involve fine motor dexterity, per the American Parkinson Disease Association, the Parkinson's Foundation, and the University of Colorado Anschutz:

• Avoid carrying items while navigating stairs or managing a mobility device.
• Enable the accessibility settings on your smartphone.
• Pace yourself by doing one household task at a time and taking breaks in between.
• Sit upright with your elbows, hips, and knees at 90-degree angles when writing or using the computer for better muscle control.
• Try adaptive writing equipment like a slant board or a weighted pen.
• Work during your "on" times and rest when you need to.
• Use larger pens or pencils and lined paper or try voice-to-text tools.

Fall Prevention With Parkinson's

Because Parkinson's disease affects your gait and balance, avoiding falls at home (or anywhere) is a top priority. In addition to getting injured, "the fall could possibly result in an ER visit, hospital stay, or surgery," says Dr. Gilbert, adding that complications from a fall can add up quickly. "This can interfere with medication timing, contribute to simultaneous infection, precipitate hallucinations, and increase confusion."

You can reduce the odds of falling while performing basic movements, per the Parkinson's Foundation, with these tips:

• Get backup. Use a wearable medical alert device so you can call for help if you fall.
• Monotask. Keep it simple. Focus solely on walking when you're going from point A to point B. Keep your hands free.
• Reduce hazards. Place things you need within easy reach, so you don't need to bend low or reach high.
• Steady your stance. Planting your feet wide apart and taking bigger steps makes you more stable.
• Take your time. Move slowly and carefully when standing up, sitting down, or turning.

Know that you don't have to go it alone either. If you're concerned about your fall risk, a physical therapist can help you. "They can identify individual risk factors and develop a personalized exercise program to improve balance, strength, walking, and the ability to safely navigate everyday activities," Morse says.

Do You Need Mobility Support?

A mobility device may allow you to be more independent if balance issues are limiting your activity or making it harder for you to get around safely. Options like walking poles, canes, walkers, rollators, and wheelchairs can all offer support, depending on your individual symptoms and needs.

It can sometimes be tough to judge for yourself if you've reached the point where it's time for mobility support. According to Morse, these are some of the signs to watch for:

• Feeling less confident when you walk
• Frequent loss of balance or falls
• Increased fear of falling
• Reaching for walls, counters, or furniture for stability
• Relying more heavily on your partner or caregiver when walking

These things don't necessarily mean that you need a cane or walker. "Instead, they are signs that a mobility and fall-risk assessment by a neurologic physical therapist may be helpful," Morse says. A physical therapist can evaluate your balance, walking, strength, freezing and everyday mobility to decide whether exercise, movement strategies, an assistive device, or a combination of approaches would best support safe and independent mobility.

Making Your Home Safer and Easier to Navigate

Many Parkinson's disease-related falls happen at home, when you're trying to get from room to room or carry out an everyday task, according to a recent Movement Disorders Clinical Practice paper. Don't let that frighten you. There are steps you can take to make your living space more Parkinson's-friendly.

Here are some things that the Parkinson's Foundation and the Michael J. Fox Foundation recommend:

• Create wide walking paths. Arrange furniture so there's as much space to maneuver as possible, especially if you use a mobility device.
• Make sure furniture is stable. Seating, especially, should be sturdy and not swivel.
• Remove tripping hazards. Get rid of rugs and move power cords out of the way. Keep steps free of clutter.
• Take extra care with the bathroom. Most falls happen here, so pay special attention in here. Install grab bars and add a non-slip mat in the bathtub or shower. Make sure the toilet has an elevated seat and arm rests or install a grab bar that's easy to reach.
• Use bright lighting. Add lamps and nightlights as needed so you can see well in dark or shadowy areas.

Consider reaching out to an occupational therapist if you need more guidance. They may be able to come to your home to evaluate your space for fall hazards and give you specific recommendations for making the area safer, per the American Parkinson Disease Association.

The Role of Sleep and Nutrition in Self-Care

Adequate sleep helps your brain recharge so you can fire on all cylinders during the day. But quality shuteye can be harder to come by when you have Parkinson's disease. "People with Parkinson's disease may have poor sleep due to sleep disorders associated with the condition, as well as motor and non-motor symptoms that impact sleep," Dr. Gilbert says.

While there's not always an easy fix, you should let your doctor know if sleep is a struggle. Adjusting your medication routine could help, as can certain lifestyle changes (like being active and limiting caffeine), and addressing any underlying sleep issues like sleep apnea, the Parkinson's Foundation says.

Make an effort to fill up on wholesome foods, too—think fruits and vegetables, whole grains, lean proteins, and healthy fats. While a recent Nutrients paper notes that the research on how diet may impact Parkinson's disease is mixed, a healthy eating pattern will help you feel your best overall. "Good nutrition is also essential for maximizing quality of life by ensuring intake of important nutrients and calories to help a person with Parkinson's disease stay strong," says Dr. Gilbert.

In some cases, certain changes to your eating habits might make medications like levodopa more effective, like taking your dose on an empty stomach and avoiding taking iron supplements at the same time as your levodopa, per the Michael J. Fox Foundation. Talk with your doctor before making any changes to your diet or medication plan.

Care for Your Mental Well-Being

Parkinson's disease doesn't just impact your motor skills like walking. The changes to your dopamine levels that occur with this condition can have a direct impact on your mood, too, per research published in the journal Pharmacological Research. Altogether, it may come as no surprise that anxiety or depression affect up to 50% of people with Parkinson's disease, the Parkinson's Foundation notes.

"Anxiety can fluctuate throughout the day along with dopamine levels, with anxiety experienced most acutely during 'off' periods," notes Dr. Gilbert, who adds that many people with Parkinson's disease find symptoms get worse when they're stressed.

Stress-relieving practices like deep breathing, yoga, or meditation can help you feel calmer and keep symptoms steadier. And if you need another reason to add regular exercise to your Parkinson's disease self-care routine, it's a legitimate mood booster.

All that said, self-care strategies alone aren't always enough to manage mood swings. If that's the case, let your doctor know. They may recommend talking with a mental health professional, adjusting your Parkinson's disease medications, or adding another medication like an antidepressant to help you feel better.

Bottom Line on Parkinson's Self-Care

Medication is the mainstay for Parkinson's disease treatment, but proper self-care techniques can make symptom management more effective, while offering practical ways to stay active, independent, and engaged in the things you enjoy.

From exercising daily to taking your medications on schedule to making your home safer, small changes can make your everyday life easier. Get started today by taking things one step at a time. And if your needs change over time, don't hesitate to work with your care team to find new strategies that help you live well with Parkinson's disease.

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