Care for Advanced Parkinson's Disease

Provided by Holly Chaimov, Parkinson's Resources of Oregon. For more information call 503-594-0901 or visit their website at www.parkinsonsresources.org.

Parkinson's is a chronic, progressive neurological illness. Frequently changes and decline occur at such a slow pace that families are caught unprepared when their loved one loses their ability to live independently.

Symptoms of advanced Parkinson's include tremor, stiffness, slowness and difficulty with fine movements, impaired balance, soft speech, reduced facial expression, drooling, "freezing" while moving and sleep disturbances. It is important to stress that Parkinson's is not a mental disease, although roughly 1/3 will eventually develop dementia.

Medication is the most effective treatment for Parkinson's. Symptoms differ in each person so dosage and timing tend to be geared to the individual patient. Medication must be given on time according to the schedule that has worked well for the family and has been set by the treating physician.

    * Medication timing is the most important way to minimize symptoms.
    * Know which medication should be given with meals and which on an empty stomach
    * Dressing and eating could be scheduled around medication timing

Balance and Posture Exercise (especially stretching) is essential therapy and easiest to initiate when your loved one is rested, but watch for "freezing", a sudden inability to move, especially when walking or getting out of a chair.

    * If freezing occurs, do not push/move your family member, but use visual or auditory cues to initiate movement
    * Avoid prolonged standing and to use appropriate walking aids
    * Patient should be encouraged to keep hands free when walking, to pause before getting up, and to avoid pivot turns

Eating A failure to swallow properly can lead to choking which is a symptom of swallowing problems. To allow optimum nutritional intake, be sure the Parkinson's medication has been given time to take effect before a meal.

    * Patient should sit in an upright position when eating, and may need reminded to swallow
    * Consult a dietician for easy-to-swallow foods containing enough fluid and fiber
    * Encourage a rest period before meals

Other Tips

    * Allow time to do activities without being rushed and allow frequent rest periods
    * An occupational therapist can provide practical tips to make routine easier
    * Medication given on time and early enough may allow patients to be more mobile and responsive
    * Parkinson's is a progressive disease. It is a given that a care needs will need to be reevaluated over time

Holly Chaimov
Parkinson's Resources of Oregon
503-594-0901
www.parkinsonsresources.org

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