Home Safety Tips for Parkinson’s Disease Psychosis

The symptoms of Parkinson’s disease psychosis (PDP), including hallucinations and delusions, can be disturbing for a loved one with this condition. Along with adjusting medications, "creating a safe, calm, and structured home environment can make a significant difference for people with PDP,” says Daniel Truong, M.D., a neurologist and the medical director of the Truong Neuroscience Institute at MemorialCare Orange Coast Medical Center in Fountain Valley, CA. Follow these tips to help safety-proof your home.

Add More Lighting

Hallucinations often occur in dim light at the end of the day, per research. Bright lighting in your home may help your loved one with PDP avoid seeing things that aren’t there (hallucinations), says Drew Cumming, M.D., a psychiatrist at Cleveland Clinic in Ohio. “In the dark, it’s easier for your brain to imagine things than if you’re in a well-lit room [with] more concrete things your eyes can focus on,” he adds. Dr. Truong recommends eliminating glares and reflections, too, as well as motion-sensor lights.

Don't Rearrange

“Minimizing changes at home can be helpful,” says Dr. Cumming. “Keep everything familiar." Consistent living spaces can help reduce disorientation, fear, and/or mistaking an actual, moved item like a coat rack for an imaginary person (known as an illusion), notes Ashley B. Pena, M.D., a neurologist at Mayo Clinic Hospital in Jacksonville, FL. She suggests removing tripping hazards, too. "Most PDP patients also have problems with walking and balance, so this is important.”

Install New Tech

A doorbell with a home camera system can help family and friends keep an eye on a loved one with PDP for added security. Tech support can be extra helpful at night, says Dr. Pena, when symptoms tend to be worse—and even more so if a caregiver is absent. The more a person with PDP is monitored during an active hallucination, illusion, or delusion, the better. “Sometimes caregivers will notice a specific trigger that they can address or remove” as a result, she says.

Play Gentle Music

“Visual hallucinations and auditory hallucinations are intensified when there’s not [much] stimulation,” says Dr. Cumming. Play "light music in the background ... to decrease the intensity of hallucinations.” Music was found to significantly suppress symptoms of psychosis in a meta-analysis in the Journal of Music Therapy. Researchers found that whether people actively or passively listened didn’t matter. And classical music didn’t help as much as other genres—so play whichever songs you love best.

Ask Pals to Visit

Having someone—or something—specific to focus on can help reduce hallucinations in PDP, says Dr. Cumming. So, inviting over a friend or family member to engage with your loved one can make a big difference. Close emotional bonds are better: Chatting with a bestie diminishes PDP symptoms more than interacting with lesser-known acquaintances, according to research. No one available today? An engaging object—like a book or puzzle—can have a similar stimulating effect, notes Dr. Cumming.

Secure Weapons

No one wants to plan for the worst, but if a loved one’s PDP episodes are severe, keep knives, guns, or anything else that could be used as a weapon stowed away, advises Dr. Cumming. “If delusions [a.k.a., false beliefs] get to the point where family worries that the person with Parkinson’s might kill them or if they start talking about hurting other people, that’s an emergency,” he warns. “They should be brought to an ER for psychiatric evaluation and have their access to these things limited.”

Hide Meds, Too

It’s a good idea to store some seemingly innocuous objects in a safe spot as well. Dr. Pena recommends keeping car keys and medications in a secure location to avoid accidental escapes or overdosing. “Anyone experiencing symptoms of psychosis needs their medications managed and dispensed by another person,” she says. It might seem overly restrictive. But “symptoms of psychosis can fluctuate greatly and are very unpredictable—so it’s important to have precautions in place,” Dr. Pena notes.

Keep Rooms Tidy

Reducing clutter can help the home feel predictable and help reduce visual misperceptions and/or injuries, per the Parkinson’s Foundation. “Maintaining a structured environment by minimizing sensory triggers like clutter can reduce hallucinations,” adds Dr. Truong. He recommends removing all décor that triggers hallucinations or illusions. Keeping walls blank can be the best way to go, he notes, just don't ditch calendars and photos. They can actually help your loved one orient themselves, he says.

Talk With a PDP Doc

Caregiving for someone with Parkinson's psychosis can be complicated. Ask your health care team if you’re not sure how best to keep your loved one safe at home. “Careful attention to physical safety, environmental triggers, and emotional comfort can help improve quality of life” for caregiver and loved one with PDP, says Dr. Truong. PDP symptoms often worsen, so "regular communication with health care providers is essential to adapt strategies as the disease progresses,” he adds.