From Fear of Falling to Standing Again: How Seating and Rehabilitation Support Helped Rebuild Confidence

After a fall, recovery is not always straightforward.

For one woman living with Parkinson’s disease and dementia, a fall in December resulted in shoulder fractures, a hospital admission and a return home with a hoist, live-in carer and four-times-daily care package.

In the months that followed, she became largely bed-bound or chair-bound. Her daughter contacted Therapies on Thames because she was concerned about her mother’s posture, comfort and loss of mobility.

A referral had already been made to wheelchair services for a tilt-in-space chair, but the waiting list was eight months. The family wanted to understand what could be done sooner.

The Situation When We Arrived

When our therapist arrived, the woman was sitting in a recliner chair.

At first glance, it may have appeared that her mobility had significantly declined. She was being hoisted for all transfers, was anxious during movement and had not regained functional mobility after returning home from hospital.

However, the assessment showed there was more to understand.

She was alert and able to engage. She had good functional movement in her upper limbs and good lower-limb strength on observation. This suggested that the issue was not simply physical weakness.

The therapist identified that fear of falling was likely playing a significant role.

Her live-in carer explained that she had previously loved spending time in the garden, but had not been able to do this for months. During rolling and movement, she would become anxious, grip staff tightly and appear visibly distressed.

Rather than viewing this as resistance, the therapist recognised behaviours consistent with a fear response following her fall.

When Fear of Falling Affects Mobility

Fear of falling can have a major impact on recovery, particularly after a painful or frightening fall.

During bed transfer and rolling, our therapist observed protective behaviours and visible anxiety. These signs helped build a clearer picture of why she had become so dependent on hoisting.

In some cases, fear of falling can look very similar to physical inability. This can be especially complex when someone is also living with dementia or Parkinson’s disease.

If fear is not recognised and supported in the right way, a person may have fewer opportunities to stand, move safely, rebuild confidence or take part in everyday routines.

In this case, the assessment helped show that there was still functional ability present, but she needed the right seating, reassurance and graded rehabilitation to access it safely.

Why Seating Was So Important

The recliner chair was not giving her the support she needed.

She was sacral sitting, with poor postural endurance. She was also unable to tolerate a standard wheelchair, as she would stoop forward and struggle to maintain trunk control.

This made suitable seating a priority.

A tilt-in-space chair was clinically appropriate because it would provide better postural support, improve comfort and help her spend more time safely out of bed. It would also support participation in daily activities, rather than leaving her limited to bed or unsuitable seating.

A Timely Seating and Rehabilitation Plan

After completing a full seating assessment and taking wheelchair measurements, our therapist discussed the options and rationale with her next of kin.

A tilt-in-space chair was arranged within 72 hours.

This prompt action helped avoid a further period of poor positioning, discomfort and reduced opportunity for movement.

Alongside the seating intervention, Therapies on Thames started an ongoing physiotherapy plan focused on confidence building, graded exposure to movement, sit-to-stand practice and safe return transfers.

The approach was gentle, practical and guided by what she could tolerate.

Progress Within Days

Within days, there was clear progress.

With physiotherapy support, she was able to stand with a zimmer frame. Care staff were also able to support return transfers safely and appropriately.

Her posture and comfort improved in the new seating, and she became more engaged and less anxious during movement.

The assessment and early intervention helped reframe the situation. Her mobility had not simply disappeared. With the right support, seating and rehabilitation plan, she was able to begin rebuilding confidence and function.

What This Meant for Her Family and Care Team

For the family, the assessment provided reassurance and a clearer plan.

They could see that her loss of mobility was not necessarily permanent, and that fear, positioning and confidence were all important parts of her recovery.

For the care team, it also helped improve understanding of her needs. Instead of seeing hoisting as the only safe option, staff were able to recognise the role of fear-based immobility and the importance of graded rehabilitation.

This supported safer, more confident handling and helped reduce unnecessary reliance on hoisting.

Why This Case Matters

This case highlights why early therapy input after hospital discharge can be so valuable.

A person may appear to have lost mobility, when in reality they may be frightened, poorly positioned, unsupported or not being given the right opportunities to move safely.

Fear of falling can have a powerful effect on confidence and independence. When it is recognised and addressed, rehabilitation can begin to move forward in a more meaningful way.

With timely seating assessment, appropriate equipment and physiotherapy-led rehabilitation, months of decline began to shift within days.

The outcome was about more than standing. It helped restore comfort, confidence and the possibility of taking part in everyday life again.