Making Everyday Places Safer

When this may help: When attacks can arrive without warning, change the surroundings and the way an activity is done to reduce avoidable harm. [Clinical safety and occupational-therapy guidance; direct attack prevention unproven]

---

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For the Person With FND

Change the task, not just your confidence

A hazard is something that could make a fall more likely or its consequences worse: a loose rug, a stair edge, a hot pan or a sharp corner. Removing a hazard may reduce harm even when it does not change the attacks themselves. You do not have to discover a trigger before asking for a safer environment. [1]

Proportionate planning means matching the change to the actual risk and the activity you want to keep. It is neither a promise that a room can be made risk-free nor a requirement to stop ordinary life. Falls and injuries deserve attention in FND as in other conditions. [2][3]

Start with one regular activity

Choose something you do often, such as washing, making a drink or getting to the bathroom. With an occupational therapist or the relevant team, consider where you stand, what you carry, what you could strike and how help would reach you.

Possible changes include well-fitting footwear, clear routes, secure floor surfaces, appropriately fitted rails and an assessed seated option for a standing task. Stairs and bathrooms need their own review; a loose chair or a towel rail is not a substitute for a suitable support. [1][2]

For example, making a drink while seated and arranging for someone else to carry it may make participation possible with less risk from a fall while holding hot liquid. That is an illustrative adaptation, not a setup suitable for every kitchen or person.

Include activities outside the room

Discuss stairs, heights, bathing, lone activities and getting help outside the home. Work out which activities need assistance or a different method while risk is being assessed. Sudden loss of control also calls for individual advice about driving and the applicable local requirements; do not use driving as a test of recovery. There is no universal restriction period supplied by this page. [2][4][5]

A phone or personal alarm is useful only if it can be reached and used. Think about where it will be during the activity rather than leaving it across the room. [1]

Review what the change actually achieves

Ask whether the activity is safer, easier or more available. If a precaution prevents you from doing anything worthwhile, discuss another way to meet the need. That does not mean removing necessary protection to practise confidence. When attacks cluster or another symptom worsens, temporarily increase support and review the pattern.

After any fall, use the injury-response plan. A familiar diagnosis is not a reason to overlook a new injury. [1]

---

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Family, Friends, and Other Supporters

Ask before rearranging the person’s space. Familiar placement can help with access, so explain changes and check that essential items remain reachable. Practical help carrying a hot drink may be more useful than a repeated warning to “be careful.”

Avoid imposing a blanket ban on activity. Bring specific concerns to the care team and look for a supported way to preserve the activity where possible.

---

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Assess environment, footwear, transfers, sensation, balance, pain and the consequences of a sudden collapse during the particular task. The 2026 motor-FND falls study supports broad assessment; its associations do not prove which intervention prevents functional drop attacks. [3]

Distinguish a hazard modification from psychological exposure. Removing an actual fall hazard and addressing disproportionate restriction are different decisions. Agree a review date, required assistance and a fallback arrangement. [2][6]

---

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

The proposed changes are general safety and access adaptations. A safer environment can be a worthwhile outcome without reducing attack counts. Neither the motor-FND observational study nor occupational-therapy consensus establishes a drop-attack-specific prevention programme. [1][2][3]

Evidence reviewed: September 24, 2026. Examples are educational illustrations, not patient quotations or tested protocols.

Citation	Full citation and stable record	Support and limits	Figure
1	NHS. Falls. Reviewed March 6, 2025; accessed September 24, 2026. Source. FND-CIT-0216	General falls safety and care guidance; not an FND trial. Transfer and activity advice needs adaptation to the person and any injury.	—
2	Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(10):1037–1045. https://doi.org/10.1136/jnnp-2019-322281 FND-CIT-0011	FND occupational therapy consensus: activity and access planning; not direct evidence that equipment or an individual adaptation prevents drop attacks.	—
3	Mohammadi Z, Keyvanfar A, Higgins R, et al. Falls in Functional Neurological Disorder: Prevalence, Risk Factors and Clinical Implications. European Journal of Neurology. 2026;33(6):e70665. https://doi.org/10.1111/ene.70665 FND-CIT-0085	Cross-sectional tertiary-clinic study of motor FND: falls and injury burden, not a drop-attack-specific treatment trial or proof that an associated factor causes falls.	—
4	Bennett K, Diamond C, Hoeritzauer I, Gardiner P, McWhirter L, Carson A, Stone J. A practical review of functional neurological disorder (FND) for the general physician. Clinical Medicine. 2021;21(1):28–36. https://doi.org/10.7861/clinmed.2020-0987 FND-CIT-0001	Practical clinical review: positive diagnosis and coexisting conditions, not a drop-attack treatment trial.	—
5	Stone J. Functional drop attacks. Neurosymptoms.org. Accessed September 24, 2026. https://neurosymptoms.org/en/symptoms/fnd-symptoms/functional-drop-attacks/ FND-CIT-0061	Specialist education and practical ideas; not controlled treatment evidence. Typical descriptions must not be used to rule out serious injury.	—
6	Revell ER, Gillespie D, Morris PG, Stone J. Drop attacks as a subtype of FND: a cognitive behavioural model using grounded theory. Epilepsy & Behavior Reports. 2021;16:100491. https://doi.org/10.1016/j.ebr.2021.100491 FND-CIT-0060	Qualitative interview-and-diary study of seven people; a proposed cognitive-behavioural model, not proof of a cause or treatment benefit.	—

---

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —