Transcript What is Parkinson`s?

Parkinson’s
Disease:
Comprehending
the Challenges
and the Choices
According to the National
Parkinson Foundation, after
Alzheimer’s disease,
Parkinson’s is the most
common neurodegenerative
disease.
The Parkinson’s Disease
Foundation reports that as many
as one million Americans suffer
from Parkinson's, which is more
than the combined number of
people diagnosed with multiple
sclerosis, muscular dystrophy, and
Lou Gehrig's disease.
Approximately 40,000 Americans are
diagnosed with Parkinson's disease
each year. This number does not
reflect the thousands of cases that go
undetected.
The chances of being diagnosed with
Parkinson’s increase with age, but an
estimated 15 percent of patients are
diagnosed before the age of 50.
What is Parkinson’s?
● Parkinson's disease belongs to a group of
conditions called motor system disorders.
These disorders are the result of a loss of
dopamine-producing brain cells.
► Parkinson’s usually impacts people over the age of 50.
Early symptoms of Parkinson’s are subtle and occur
gradually (although for some the symptom progression
is faster).
What is Parkinson’s?
● As our bodies and brains age, it is normal for all
of us to slow down; however, the four major
symptoms of Parkinson’s are not a normal part
of aging:
► Rest tremor of a limb (shaking with the limb at rest)
► Slowness of movement (bradykinesia)
► Rigidity (stiffness, increased resistance to passive
movement) of the limbs or trunk
► Poor balance (postural instability)
How is Parkinson’s diagnosed?
● Diagnosing Parkinson’s involves a variety of
tests, some of which rule out several other
conditions.
► There are currently no blood or laboratory tests proven
to help in diagnosing Parkinson’s.
■ Therefore, diagnosis is usually based on medical
history and a neurological examination.
► The disease can be difficult to diagnose accurately.
■ Doctors sometimes request brain scans
or laboratory tests in order to rule out
other diseases.
How is Parkinson’s diagnosed?
● Diagnosing Parkinson’s involves a variety of
tests, some of which rule out several other
conditions.
► When at least two of the four major symptoms are
present, and especially if they are more evident on one
side of the body than the other, a Parkinson’s diagnosis
is usually made, unless there are atypical features
suggesting an alternative diagnosis.
The first signs of Parkinson’s
might be…
● Mild tremors – this is the most recognized
symptom that usually causes people to seek
medical help
● Difficulty getting out of a chair
● Speaking too softly
● Handwriting is slow and looks cramped or small
The first signs of Parkinson’s
might be…
● Losing track of a word or thought
● Feeling tired, irritable or depressed for no
apparent reason
● The very early stages of Parkinson’s may last
for an extended period of time before more
classic and obvious symptoms begin to appear,
such as constant trembling
As a caregiver, you might notice
early on that your loved one…
● Lacks facial expression and animation (known
as "masked face")
● Does not move his or her arms or legs normally
● Seems stiff, unsteady or unusually slow
A number of other symptoms
may accompany Parkinson’s…
● Some are minor; others are not. Many can be
treated with medication or physical therapy. No
one can predict which symptoms will impact an
individual patient, and the intensity of the
symptoms varies from person to person and
includes:
► Difficulty with swallowing and chewing
► Speech changes
A number of other symptoms
may accompany Parkinson’s…
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Urinary problems or constipation
Skin problems
Sleep problems
Dementia or other cognitive problems
Sudden drop in blood pressure when the person stands
up from a lying-down position
Muscle cramps and sustained muscle contractions that
cause forced or twisted positions
Pain
Fatigue and loss of energy
Sexual dysfunction
Distinct Parkinson’s Symptoms
● As Parkinson’s symptoms become more
pronounced, walking, talking and completing
small tasks can become more difficult.
► The shakes and tremors associated with Parkinson’s
may also interfere with daily activities.
► Utensils pose a particular challenge.
► Holding objects to read also becomes increasingly
difficult.
Distinct Parkinson’s Symptoms
● Although symptoms may begin on one side of
the body…
► As Parkinson’s progresses, the disease eventually
affects both sides of the body.
► Even after the disease involves both sides of the body,
the symptoms are often less severe on one side than on
the other.
Seek medical attention if a
change in a loved one’s
behavior is noticed.
Is there treatment for
Parkinson’s?
● At present, there is no cure for Parkinson’s, but
a variety of medications can provide dramatic
relief from the symptoms.
● In some cases, surgery may be appropriate if
the disease doesn't respond to medication.
Is there treatment for
Parkinson’s?
● Obtaining assistance from a home care agency
can provide caregiver respite or allow a
Parkinson’s patient to remain at home if a family
member is not available for care.
People who receive treatment
often experience improvement
in their overall medical
condition and realize a better
quality of life.
Patient Challenges
● In addition to adapting to their body’s new
behaviors, patients may also have a difficult
time adjusting to the new psychological
challenges they are presented with:
► Persistent high levels of anxiety
► Intrusive thoughts
Patient Challenges
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Body self-absorption
Hypersensitivity
Social withdrawal
Inability to tolerate frustration
Anger
Depression
Contributed by Mariann Di Minno, RN, MA, and Michael J.
Aminoff, MD, DSc, of the Parkinson’s Disease Clinic and
Research Center at the University of California, San Francisco
on Parkinson’s progression and presented by The National
Parkinson Foundation.
Understanding the Five Stages of
Parkinson’s (according to WebMD)
● Stage 1: During this initial phase of the disease,
a patient usually experiences mild symptoms.
These symptoms may inconvenience the
day-to-day tasks the patient would otherwise
complete with ease. Typically these symptoms
include the presence of tremors or shaking in
one of the limbs.
► At this stage, friends and family can usually
already detect changes in the Parkinson's
patient including poor posture, loss of
balance, and abnormal facial expressions.
Understanding the Five Stages of
Parkinson’s (according to WebMD)
● Stage 2: In the second stage of Parkinson's
disease, the patient’s symptoms are bilateral,
affecting both limbs and both sides of the body.
The patient usually encounters problems
walking or maintaining balance. The inability to
complete normal physical tasks becomes more
apparent.
Understanding the Five Stages of
Parkinson’s (according to WebMD)
● Stage 3: Stage 3 symptoms of Parkinson's
disease can be rather severe and include the
inability to walk straight or to stand. There is a
noticeable slowing of physical movements in
Stage 3.
Understanding the Five Stages of
Parkinson’s (according to WebMD)
● Stage 4: This stage of the disease is
accompanied by severe symptoms of
Parkinson’s. Walking may still occur, but it is
often limited, and rigidity and bradykinesia are
often visible. During this stage, most patients
are unable to complete day-to-day tasks, and
usually cannot live on their own. The tremors
and/or shakiness that take over during the
earlier stages, however, may lessen or
become non-existent for unknown
reasons during this time.
Understanding the Five Stages of
Parkinson’s (according to WebMD)
● Stage 5: The last or final stage of Parkinson’s
disease usually takes over the patient’s physical
movements. The patient is usually unable to
take care of him or herself and may not be able
to stand or walk during this stage. A patient at
Stage 5 usually requires constant one-on-one
nursing care.
Making Life Easier for Those with
Parkinson’s.
According to Parkinson’s Hope,
these simple home improvements
can create a more “Parkinson’s
friendly” home:
Simple “Parkinson’s Friendly”
Improvements
● In the bedroom, avoid space
heaters and electric blankets
as they are potential fire
hazards and include:
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a firm chair
a footstool
a bedrail
a nightlight
Simple “Parkinson’s Friendly”
Improvements
● In the bathroom, utilize:
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a shower chair
rubber mat(s)
handrails
a nightlight
Simple “Parkinson’s Friendly”
Improvements
● In the kitchen, clean spills
immediately and employ:
► a rubber mat
► accessible counter space for
use while seated
► an electric jar opener
► a food processor – for
chopping, since tremors can
make using a knife
dangerous
► self-closing cabinets
Simple “Parkinson’s Friendly”
Improvements
● In the office, avoid
extension cords and make
use of:
► a firm chair
► a large button phone
Simple “Parkinson’s Friendly”
Improvements
● In the garage, minimize
clutter and incorporate:
► a cordless phone in case a
fall occurs and help is
needed
► handrails
Simple “Parkinson’s Friendly”
Improvements
● Outside, repair pavement
cracks, pick up
tools/hoses, install extra
lighting and consider:
► handrails
► a ramp
Advice
● First-hand advice from a daughter of a
Parkinson’s patient, according to My
Parkinson’s Patient:
► Hand rails—“We put banisters in key locations
throughout the house. They were very tasteful and
helped to steady Dad. Once he even pulled himself up
from a fall using one of the hand rails.”
Advice
► Walkers, Wheelchairs, and Canes—“They make life a
little less of a struggle.”
► Shirts—“When it became difficult to dress Dad, and
especially when he became bedridden, we cut his shirts
up the back, from the bottom to about 3 to 6 inches
below the neckline. We slipped the shirts easily over his
head, and this gave a dressed look for when family and
friends visited. Dad preferred this to hospital gowns.”
Caregiver Tips
● Parkinsonshope.com provides the following
tips for caregivers:
► Assist with daily activities and therapies by encouraging
the patient to stay active with simple exercises, like
walking or gardening.
► If balance is a problem, ask the patient’s doctor about
seated exercises.
► Check with the patient’s doctor to find out if
other group activities or exercise programs,
such as yoga or massage, may be beneficial
for the patient.
Caregiver Tips
► If the patient is involved in physical therapy, speech
therapy, or other exercise programs, try to assist the
patient with his or her exercises.
► Create a safe home for your Parkinson’s patient.
► Help with the patient's treatment program.
► Support the patient in eating a healthy diet by
encouraging the patient to enjoy a balanced diet rich in
whole grains, fruits, vegetables, and calcium.
► As a caregiver, learn basic first-aid techniques.
Words of Wisdom
● Words of Wisdom from the Michael J. Fox
Foundation for Parkinson’s Research on
Caregiving:
► Every close relationship has an element of caregiving.
► You should not need special medical training to take
care of your loved one except during advanced stages
of his or her disease.
Words of Wisdom
► Early on, loved ones will need understanding and
emotional support.
► Along the way, you will be helping with the tasks of daily
life that may become difficult or impossible for your
loved one.
► One exception: If the Parkinson’s patient has trouble
swallowing food, it may be useful or even life-saving to
learn how to use the Heimlich maneuver to dislodge
food stuck in the throat.
Finding Support
● The National Parkinson Foundation sponsors
support groups throughout the United States for
people and families living with Parkinson’s
disease. Contact your nearest NPF Center of
Excellence for a list of support groups in your
area.
● Call ElderCare at Home for more
information on how we can assist
a Parkinson’s patient to live
comfortably at home.
Finding Support
● Take care of yourself. Your health is important
to you and to the patient! Get enough rest, eat a
healthy diet, and engage in regular exercise.
● Try talking about how you’re feeling with a close
friend, family member, or counselor. Observing
a patient go through the stages of Parkinson’s
disease can be stressful.
You have options.
● Many people with loved ones suffering from
Parkinson’s are unaware of the options
available to them—like in-home care. People
have choices when it comes to Parkinson’s
care. Loved ones can remain safe and
comfortable—at home.
● Call ElderCare at Home for more information.
► West Palm Beach . . . . . . . . . 561.471.3122
Delray Beach/Boca Raton. . . 561.367.9676
Toll-Free . . . . . . . . . . . . . . . . 800.209.4342
► www.eldercareresourcecenter.com
Resources:
● My Parkinson’s Info
● National Institute of Neurological Disorders
and Stroke
● National Parkinson Foundation
● Parkinson’s Disease Foundation
● Parkinson’s Hope, parkinsonshope.com
● WebMD