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Cueing Strategies for Parkinson's


Parkinson's disease impacts the ability to perform movements that are usually done without conscious thought. As the disease progresses, your loved one's movements will become smaller and less automatic. Parkinson's can also result in inaccurate perception of movement size and quality, so your loved one may not fully recognize these changes.


You can use cues to help your loved one move more easily. Simple cues can make the brain less dependent on its automatic systems and "reroute" messages, so movement improves.

One of the most important things to remember is that your directions and reminders need to be kept short. Long explanations or instructions are often harder to follow for someone with Parkinson's disease. Use these simple phrases to cue movement:

  • "Stand tall" if posture becomes too flexed​

  • "Big steps" to decrease shuffling when walking

  • "March" when turning to keep knees high

Since Parkinson's impacts automatic movements, standing tall and taking big steps, for example, may not happen automatically. You will likely need to repeat cues on a regular basis.


​Often, as care partners we may feel like we sound like a broken record. We ask ourselves, why can’t they remember to do these tasks that should come second nature? Well, that’s Parkinson’s disease. Without your cues as Parkinson’s progresses, your loved one’s brain is not connecting the dots for movement.


Other important reminders as care partners comes when going from a standing to seated or seated to standing position. Often, many people with Parkinson’s will forget where to hold on to their walker – you may need to prompt them for where to put their hands. Additionally, when assisting in the bathroom, you may need to coach them on sitting slowly down on the toilet – avoiding them crashing thinking the hard surface is their recliner.


Giving these cues constantly may become frustrating to some. Our tone and manner in which we give them needs to be positive, short and friendly. When giving cues, your loved one still may not respond correctly. It is important that you anticipate that, and try to avoid crashes or falls using safety measures and tools, such as walkers, gait belts or perhaps even poles or grab bars that have been mounted near the areas your loved one uses most often.


It’s important to keep you safe too. Don’t let your loved one grab on to you. This may be a natural instinct for them, but it is important that they not take you down with them if a fall occurs.


Ask the doctor for a referral to a physical therapist who can tailor cueing strategies to your loved one's individual needs, and an occupational therapist who can help you set your home up for greater safety measures. There are many ways to help with walking challenges, such as freezing episodes. Being your loved one’s advocate in prompting with these cues can be very helpful to get them moving and most importantly, moving safely.

Sources:

Parkinson's Foundation. Page 54. Cueing Strategies. Practical Pointers. Chapter 3. Caring and Coping. A Care Partner's Guide to Parkinson's Disease. "Booklet."


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