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In order to care for someone with PD, it is important to understand the signs and symptoms of the disorder. Refer to the Parkinson's Disease page for this information.
If meeting a person with PD within the clinical setting (acute care or extended care) you are probably meeting them because they can no longer live independently. Many people with PD are cared for at home by spouses and family members, but as the disease progresses and as they lose their independence they need formal care. This will be an extremely difficult time for the client and their family.
Things to remember:
• PD can be very frustrating and embarrassing for the client
• The symptoms of PD can “change from minute to minute. This is because of the disease, not because a person is trying to be ‘difficult’” (Parkinson Society British Columbia, 2008, ¶ 2)
• Persons with PD may “feel trapped in their own bodies” (Parkinson Society Canada, 2003, p. 3)
• The client may need extra time to respond to you (They are not being unresponsive, stubborn or antisocial)
• Encourage socialization and participation in leisure activities
• Watch for signs of depression
• Speak with the client and family about their medication regime
• Provide ample time for meals encouraging the client to eat slowly
• Utilize specialized utensils and other aids to assist in activities of daily living
• Provide meals with adequate fibre and fluid to prevent constipation
• Encourage independence
• Talk with the client and their family to gain insight about the person’s condition, personality and activities of daily living
• Encourage the client and/or family members to attend support groups
• Recognize caregiver and professional burnout
• Consult with required interdisciplinary team members (e.g. physiotherapist, occupational therapist, dietician, speech language pathologist, social worker, pastoral care, spiritual care)
Medication
“Medication is the most effective treatment for Parkinson’s” (Parkinson Society Canada, 2003, p. 3) and “medication management is the most important part of controlling Parkinson’s symptoms” (Parkinson Society Canada, 2003, p. 3).
Each person with PD has specific symptoms that require specific medications. It can take years to establish a medication regime that is effective for the client. Every clinical setting has a different schedule for administering medications; however, to be beneficial for the client it is important that their medications are administered according to their established schedule. Also, in order for the medications to be effective for the client there must be a constant level of the medications in their bloodstream. It is very important that medications are given on time.
Clients with PD and their families “best understand their condition and responses to medications” (Parkinson Society Canada, 2003, p. 3) . Working with the client and their family will “ease your workload and improve their quality of life” (Parkinson Society Canada, 2003, p. 3).
Mobility
Exercise is very important for persons with PD. They may have posture and balance problems; therefore, there are some important things to remember when mobilizing a person with PD:
• Consult with the client’s physiotherapist. They are a valuable source of information regarding mobility.
• Freezing (difficulties beginning movements or suddenly not be able to move) can occur. This creates a risk for falls. When freezing occurs do not push or move the client. It will take time before they are able to move again.
• Encourage the client to lift the heel of their foot first to prevent shuffling and falls.
• Encourage the client to get up out of bed and chairs slowly. Ensure feet are placed under the knees while standing up.
• Do not have the client stand for long periods of time.
• Ensure that the client has good walking shoes (Rubber soles are not “recommended because they grip the floor and may cause tripping” [Parkinson Society Canada, 2003, p. 4])
• Utilize appropriate mobility aids (e.g. walker, cane)
At times client’s with PD may have more difficulties mobilizing than at other times. They are not being uncooperative, stubborn or unresponsive. These episodes can be related to their medication and the clients have no control over this.
For more detailed information for family caregivers and professional caregivers refer to Parkinson Society Canada Resources and Parkinson Society British Columbia.
Information from Parkinson Society Canada and Parkinson Society British Columbia. Please refer to Reference Page.
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