What precautions are commonly indicated for a patient with Parkinson's disease?

• A. Seizure precautions
• B. Falls and aspiration precautions
• C. Infection precautions
• D. Isolation precautions

Answer: (B)

Parkinson's disease often brings postural instability and dysphagia, so the main focus is preventing falls and preventing aspiration during meals.

Falls are common because gait becomes shuffling and balance is impaired, and rigidity with bradykinesia makes it harder to recover from missteps. To reduce this risk, keep pathways clear, remove tripping hazards, use good lighting, arrange furniture to allow safe movement, and employ assistive devices as needed. Use a gait belt during transfers, keep the bed low when possible, and have ready assistance for turning and getting in and out of bed.

Aspiration risk arises from swallowing difficulties. To minimize it, ensure the patient is seated upright during meals, ideally at 90 degrees, and maintain an upright position for a while after eating. Offer small bites and sips, allow extra time to chew and swallow, and consider modifying the consistency of foods and liquids (for example, soft or pureed textures and, if swallowing is impaired, thicker liquids). Minimize distractions during meals and monitor for signs of aspiration such as coughing or choking.

Seizure precautions, while important for patients with epilepsy, are not typically indicated specifically for Parkinson's. Infection and isolation precautions relate to contagious diseases, not the routine care of Parkinson's disease.