April is Parkinson's Awareness Month. Sadly, the prevalence of Parkinson’s Disease is on the rise in Australia due to our ageing population.
Today, an estimated 10 million people worldwide are living with this neurodegenerative disorder, and more than three million people die of the disease each year.
What is Parkinson’s disease?
Parkinson’s disease (PD) is a disorder of the brain that affects the transmission of messages to the muscles. When a person has PD, there is damage to the part of the brain that produces dopamine, an important chemical that allows the muscles to operate properly. The causes of PD are not entirely understood. Scientists continue to learn about genetic and environmental factors.
What are the symptoms of Parkinson’s disease?
Tremor. The most common symptom is trembling or involuntary movement of hands, arms, legs or face; the person may appear to be “rolling” something between their fingers.
Rigidity. The muscles are tense and contracted. It’s hard to move the arms and legs, and this effect may be painful. Handwriting may become cramped and harder to read.
Slowness of body movement. The person might experience a slow, shuffling gait, sometimes alternating between slow steps and more rapid ones.
Balance problems. Postural instability makes it hard to sit up or stand up straight, and raises the risk of falling.
Difficulty chewing and swallowing. The muscles that help us eat may be affected, which can lead to drooling, choking and pneumonia.
Speech difficulties. Speech may be slow and expressionless. Facial mobility also is affected, so the person may seem to be expressionless.
Nonmotor symptoms. Some symptoms of PD do not involve movement. A person may experience depression and other emotional changes, sleep disruptions, thinking or memory problems, and other personality changes.
How is Parkinson’s disease diagnosed?
There currently are no definitive tests to confirm the diagnosis, which is instead based on observation of the person’s symptoms and on their medical history. The doctor may order laboratory tests and brain scans, but those are to rule out other diseases that might be causing the symptoms — neither helps in diagnosing PD.
It might take a while for the doctor to arrive at a definitive diagnosis. Each case of PD is a bit different. Symptoms differ and can vary over time — a patient might have some better days, some worse, and days when one symptom is more noticeable than others. It is likewise difficult to predict the course of the disease in an individual patient. According to the National Institute of Neurological Disorders and Stroke (NINDS), although some people with PD experience only minor motor disruptions, others eventually need to use a wheelchair and become bedridden.
Further complicating diagnosis, other neurological disorders also cause similar movement problems. These are referred to as parkinsonisms, and include certain brain diseases, stroke, abnormal fluid on the brain, head injuries, or the effects of drugs and alcohol.
Medication and other treatments for PD will not help if a patient has one of these other conditions — and vice versa. So, a correct diagnosis is very important, even if the answer isn’t readily clear.
Can Parkinson’s disease be cured or treated?
As of yet, there is no cure for PD. But treatments can reduce symptoms significantly.
Treatment is individualised to each patient, and might include:
- Medications. A variety of drugs can provide dramatic relief from symptoms of PD. NINDS says that most commonly, patients are given medications that increase (or mimic) the level of dopamine, the brain chemical that control movement. Other drugs ease the various symptoms of PD. Determining the best medications can take time and ongoing adjustment of drug and dose. It’s important that people with PD take these medications as recommended and promptly report troublesome side effects.
- Surgery. Many countries have approved a therapy called deep brain stimulation (DBS), in which electrodes are surgically implanted in the brain, and a control device is implanted elsewhere — similar to a pacemaker for the heart. The device sends electrical pulses that stimulate the area of the brain that controls movement, and can improve certain symptoms such as tremor, reducing the need for medications.
- Rehabilitation therapies and specialists. Physical therapy can help people with PD improve their strength and flexibility. Occupational therapy helps them learn new, adaptive ways of doing things. Speech-language therapists help improve speaking, chewing and swallowing. Dietitians can recommend a healthy, adapted eating plan. Driving rehabilitation specialists help people with PD drive more safely, or find alternative transportation.
- Lifestyle changes. Many studies show that exercise is a top way to help people with PD maintain their muscle tone and flexibility. It also can help with gait problems and swallowing, and enhances a sense of well-being. Gym workouts, walking, swimming, dancing, tai chi and even gardening have all proven to be beneficial. Exercise classes specifically modified for the needs of people with PD are available. People who have PD should get a “prescription” for appropriate exercise from the doctor.
The role of family and friends
Your role might include:
- Support during the diagnosis process and establishing treatment. Confirming that your loved one has PD and determining the best treatment strategy will require several appointments with the doctor and specialists. Your support helps ensure that your loved one gets their questions answered, understands the doctor’s instructions, and keeps follow-up appointments.
- Encouragement and support for treatment. The medical regimen for PD has a lot of components. Adding to that, your loved one might be dealing with other health conditions, as well. You’ll likely continue to help your loved one remember their appointments, as well as taking medications as directed and following other recommendations.
- Day-to-day life. As the disease progresses, your loved one may need assistance with daily activities and staying active and connected in the community.
- Transportation. Many people with PD can continue to drive for some time. But if physical and mental changes and/or the side effects of medications mean your loved one is unsafe behind the wheel; you may be called upon to provide rides or help your loved one access appropriate public transportation.
- Emotional support. Dealing with PD can take a toll on a patient’s emotions, leading to depression and anxiety. PD can cause a change in a person’s thinking and emotions, and their ability to communicate. Your support can help your loved one cope; individual or family counseling can help.
Family caregivers face challenges
As they’re helping their loved one manage PD, family often lose sight of their own health and well-being. They might be juggling work duties and other family responsibilities with their loved one’s care. And often they are dealing with emotional pain of their own. As their loved one’s condition changes, spouses and children evolve into the caregiver role. PD also changes the way patients communicate, so family must learn new ways to connect.
Fortunately, our healthcare system is recognising the important role of family caregivers. If you are a family caregiver, learn about support resources that can help, such as a caregiver support group (in person or online), and federal, state and local support services. Talk to other family members and friends about your loved one’s needs and how they can help. You can’t do it alone!
Home care is a great support resource
A caregiver can provide:
- Assistance with personal care, such as bathing, dressing and grooming.
- Grocery shopping and preparation of meals, according to the doctor’s instructions.
- Supervision and encouragement for exercise.
- Transportation to doctor appointments, the pharmacy, and anywhere the client wants to go.
- Reminders about appointments and medications.
- Companionship to help clients avoid social isolation and depression.
- Respite care for family caregivers, allowing them to recharge their emotional batteries and take care of personal tasks and their own health.
The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor about the diagnosis and treatment of Parkinson’s disease.
From all of us here at Right at Home,
In good health.
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As a home care provider, Right at Home Australia provides support and homecare and assistance for the elderly and for people suffering with illness so they can remain at home together with their loved ones through recovery or maintain an independent life if living with a disability. Our care services fall into several categories of home care for seniors, adults living with a disability and post-operative care including services for those with special care situations caused by complex medical conditions. Right at Home is a 'My Aged Care' government approved, home care provider for levels 1 – 4 and have a comprehensive portfolio of care services that ensure your loved ones get the care they need. Right at Home also provides care through the NDIS disability scheme. Our number one priority is the safety of our staff and clients, and we follow strict hygiene and safety protocols.
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