|What is Parkinson's Disease?
Parkinson’s disease (PD) is a progressive, neurological disease that
mainly affects movement but can also affect cognition. Parkinson’s disease results from the destruction of nerve cells in a part of the brain called the basal ganglia.
Different parts of the brain work together by sending signals to each other to coordinate all of our thoughts, movements, emotions, and senses. When we want to move, a signal is sent from the basal ganglia to the thalamus and then to the cerebral cortex, all different parts of the brain. Nerve cells in the brain communicate by using chemicals. A chemical (neurotransmitter) called dopamine is produced in a group of cells called the substantia nigra and is essential for normal movement. When the cells die, they can no longer produce and send dopamine, so the signal to move doesn’t get communicated. By the time a person starts to experience motor symptoms of Parkinson’s, they’ve already lost approximately 50% of their dopamine producing cells. People may experience non-motor symptoms from loss of other neurotransmitters up to ten years before motor symptoms are noticed.
All persons with Parkinson’s do not develop the same symptoms, and any symptoms that do develop may change over time as the disease progresses. People will experience both motor and non-motor symptoms. Typically, PD motor symptoms start on one side of the body, and over time may progress to both sides. Often, one side is more affected than the other. The primary symptoms most commonly associated with Parkinson’s disease are:
- Tremor: Not all persons with PD develop tremor, but this is a common symptom. The tremor is described as a “pill rolling” action of the hand/fingers, usually most pronounced at rest, and may lessen with action, or movement. Tremor often starts on one side of the body—usually with the hand—but may also involve the arms, feet, legs, and chin.
- Rigidity or stiffness: In addition to making movement difficult, stiffness can also cause muscle aches. This symptom often is initially attributed to arthritis or pain syndromes, and persons often seek medical attention for “frozen shoulder” symptoms or “tennis elbow” and other orthopaedic complaints.
- Slow movement (bradykinesia), loss of movement (akinesia): Symptoms present with a decreased arm swing on one side, or decreased ability to perform usual motor tasks at usual speeds. Those affected can lose the ability to make normal facial expressions, appearing “mask-like” to the person they are talking with. Family and friends may comment that the person smiles less or appears disinterested when in fact they are unable to make the facial muscles move in ways to help express what they are feeling.
- Balance and walking problems: Initially persons have difficulty walking at normal speeds or may find it difficult to fully lift a leg, causing the foot to “drag” behind the other foot. Or, they may take unusually small steps to move forward or use several tiny steps to turn around. Eventually postural problems result in a stooped torso with a noticeable shuffling gait. The resulting body imbalance can cause the person to stumble or experience near falls. The person may no longer instinctually reach their arm out to “break” their fall, putting them at greater risk for injury. Most people do not develop postural problems until many years after they have been diagnosed. Some individuals also experience episodes of “freezing” when they cannot move for several seconds or minutes. This is most common when they are approaching a doorway or other contained or small space.
When you're a caregiver for someone with Parkinson's disease
, some days you'll need to help them with daily tasks. Other days you just need to give them enough time to do them on their own. This checklist can make life easier for both of you.
- Make it easy for them. Try an electric toothbrush if their hands or fingers are stiff from Parkinson's. If you help with flossing or brushing, try not to touch the back of their tongue, to prevent their gagging. Keep a small towel handy if drooling is an issue.
- An electric shaver may make shaving easier. After shaving, have them use lotion instead of aftershave, which may be too harsh.
- For safety and comfort, use the shower, if possible. Tub baths can be a falling hazard.
- While they are bathing, have them sit on a shower stool, use a hand-held showerhead, and hold a grab bar.
- Wrap them up in an absorbent terry cloth robe after bathing. Then they don't have to dry themselves off with a towel.
- Make sure clothes are easy to put on, such as pants with elastic waistbands, bras that hook in front, and tube socks instead of dress socks. Skip pantyhose and clothes that pull on over the head. If favourite clothes have buttons, replace them with Velcro.
- Avoid shoes with rubber soles. They can cause tripping.
- Make dressing simple. Lay out clothes ahead of time, in the order they like to put them on. Offer dressing aids like buttonhooks or long-handled shoehorns.
- Let them dress themself as much as possible. Suggest that they sit down and dress on the side most affected first.
- Serve fibre -- like whole grains, bran cereals, fruits, and vegetables -- to prevent constipation, a common Parkinson's issue. If they are used to a low-fibre diet, add fibre slowly.
- Serve a calcium-rich food at least three times a day to prevent osteoporosis. This is a special concern with a person with Parkinson's, because falls that can lead to fractures are more likely. Dairy foods like cheese and vitamin D-fortified milk and yogurt are good choices.
- The Parkinson's drug levodopa is absorbed best on an empty stomach. Protein can decrease its absorption. So, space out proteins so they are served after they take their medicine, which may be every 3-4 hours.
- If they have trouble swallowing, fix moist, soft foods. Avoid foods that crumble easily, like crackers. Thick drinks, like protein shakes, are also easy to swallow. If eating is tiring, fix smaller meals more often.
- Don't let their symptoms discourage participating in activities. Specially adapted tools are available to help with things like holding a paintbrush. Their occupational therapist can also suggest strategies. If some hobbies become too hard, like playing a musical instrument, go to a concert or listen to music instead.
- Try relaxing activities to reduce stress, which can make symptoms worse. Listening to music and relaxation guided imagery may help ease tremors. You can learn guided imagery from books, CDs, or DVDs.
- Besides the daily exercise that their doctor probably suggests, urge them to exercise their face muscles, jaw, and mouth. Sing or read out loud (using big lip movements) or make faces.
The hands-on daily tasks of caregiving can be hard for both of you. But they also bring you together. As much as possible, focus on your client can do. Taking part in their own care and enjoying hobbies will help them enjoy life more.
Below are some useful websites if you would like to learn more about Parkinson’s
ONE TOUCH HEALTH
• MyHomeCare uses One Touch Health app for all rosters & bookings, client care plans, documentation and also as a platform to communicate with staff. Each staff member has an individual log in and password
• No time sheets required – logged shifts are sent straight to payroll via app. Your up to date roster is available on your phone.
• All care plans and relevant client documentation available on One Touch Health App
• Staff can highlight concerns by using the important message tick box option on the notes section. It is important that you record your tasks and care provided in the notes section daily for each client. If you have any issues using the system, please contact your local team who will be happy to help!
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