Occupational therapy

If you have Parkinson’s, you may find it more difficult to do some of the everyday tasks and activities that you used to do easily.

Guidelines say that people with the condition should see an occupational therapist who has experience of working with people with Parkinson's soon after being diagnosed. They understand that being able to perform daily activities can be crucial to your health and sense of wellbeing and can:

• show you different ways to do a difficult task more easily, or give you advice about using strategies, techniques, gadgets, or equipment and new technologies where you need them.
• recommend practical changes, such as rearranging your furniture at home to make it easier to move around an awkward area.
• suggest ‘cues’ that may help you perform activities and complete tasks more easily. A cue is a way to help someone complete a task by offering them a prompt.
• help you develop strategies to cope with tasks that may become a problem in the future.
• help you make choices by providing information on the various resources, services and benefits that are available to help you maintain family life, work and leisure interests.
• make referrals to other services and organisations that offer treatment, support or help. They can also provide contact details and information so that you and your family or friends can get in touch when you want to.
• give you advice about issues such as driving and accessing other forms of transport, or how to get practical help to allow you to keep meeting work or family commitments. They can also tell you how to apply for a Blue Badge parking permit.

Tremor

If you have a tremor, this can affect everyday tasks, such as buttoning a shirt or applying make up.
An occupational therapist can advise you on different ways to manage your tremor. They may also suggest exercises to help improve your hand function.

Fatigue

You might experience fatigue with Parkinson’s, and get physically and mentally tired more quickly. Your occupational therapist may ask you to keep a diary. This is so you can record what tasks make you tired and if there are times of the day when you feel more tired. They can help you plan, pace yourself and get gentle exercise and rest throughout the day. They can also suggest ways of putting a good sleep routine in place.

Communication

People with Parkinson’s can experience problems with communication, including changes in handwriting.
Occupational therapists can give you strategies help with this, including avoiding distractions while you are writing, or paying attention to each letter you form as you write.

They can also support you to start or continue using a computer and other technology to help you handle day-to-day correspondence or suggest organisations that can provide training.

Anxiety

If you have Parkinson’s, you may experience anxiety. This might be due to changes in chemicals in the brain, which control and regulate your mood, or because of concerns you have about living with a long-term condition. For example, it may stop you joining in with activities because you are worried about falling, or eating and drinking in public.

Some people with Parkinson’s experience anxiety that happens when they’re ‘off’. When a person takes their medication, their symptoms will improve. But these symptoms can sometimes come back before the next dose is due, causing a person’s condition to fluctuate. This is called ‘wearing off’.

An occupational therapist may be able to help you find strategies to deal with anxiety. They can also refer you to a mental health specialist if necessary.

Occupational therapists are employed in a variety of settings. You can usually contact an occupational therapist through your GP, your social services or social work department, or health and social care trust, to see if it is possible to arrange for an occupational therapist to visit you at home.

You can also ask your GP, specialist or Parkinson’s nurse to try to refer you to a rehabilitation unit if you need to see other professionals too, such as a physiotherapist or speech and language therapist.

You can also pay for private occupational therapy. To find a private occupational therapist in your area, you can contact the Royal College of Occupational Therapists.

During your first meeting, an occupational therapist will ask you about your work, home and family life, your roles and responsibilities, and the types of activities that you need or want to do.

They'll ask you what your main priorities are, your usual lifestyle and what may be stopping you from carrying out daily routines. An occupational therapist will also consider the effect of any other health issues on your day-to-day life.

The occupational therapist will work with you to create an action plan. This normally includes goals you want to achieve over a number of sessions. A friend, family member or carer can be involved in sessions if you wish. Sessions can take place in your home, outside or at your place of work.

If needed, sessions can be used to help you choose and organise equipment or adaptations for your home or place of work. They can also be used to practise a specific technique, such as getting on and off your bed.

If your treatment is carefully managed and you have plenty of support, it’s possible to continue working when you have Parkinson's for many years, depending on the type of job you have and how your symptoms progress.

If you are finding practical tasks difficult at work, an occupational therapist can do a workplace assessment and suggest reasonable adjustments to help you carry on working. They can also talk to your employer about their responsibilities and act as a link between you, your employer and other services, who may be able to help. Your employer might have their own occupational health service you can use.

You should not buy any equipment, such as reclining chairs or mobility scooters, without speaking to your occupational therapist first, even if the person selling the equipment claims to understand the needs of people with Parkinson’s.

If an occupational therapist thinks you could benefit from using a piece of equipment, they may be able to provide basic items on loan, free of charge. Independent information and advice on choosing equipment is also available from the Disabled Living Foundation. 

You might be able to get a wheelchair from the NHS or health and social care service. An occupational therapist can refer you to the relevant service in your area for an assessment.

Help with funding for adaptations

Occupational therapists can advise and help arrange funding for minor home adaptations if you need them, such as fitting grab rails or hand rails by steps and stairs.

If you need advice about more expensive home adaptations, such as stairlifts, or accessible bathing facilities, you should speak to an occupational therapist based in a social services department, or the health and social care services of a local authority. They may advise you on any funding available. However, major home adaptations, such as installing a level-floor shower (wet room) are often subject to means testing.

Find out more about possible grant funding for major adaptations.

• Disabled Living Foundation
• Royal College of Occupational Therapists