Jessica from www.vivehealth.com has written this great article about helping our patients who suffer from Parkinson's Disease. Learn about the cause, symptoms, and more.
Managing Patients with Parkinson’s Disease
In the U.S., doctor’s diagnose up to 60,000 new cases of Parkinson’s every year. Worldwide, as many as 10 million people live with Parkinson’s disease, average onset age being 60. A 2016 systematic review in the Neuroepidemiology Journal looking at incidence rates of Parkinson’s found that chances of developing the disease do increase with age, though somewhat leveling off after age 80.
What is Parkinson’s?
A neurodegenerative brain disorder, Parkinson’s disease is named after the 19th-century doctor, James Parkinson, who first wrote about the disease in his 1817 work, An Essay on the Shaking Palsy. Much of Parkinson’s results from a lack of dopamine production in a patient’s brain.
Dopamine plays a critical role as a neurotransmitter, helping neurons send biochemical messages back and forth to one another. This message relay triggers crucial bodily functions including those associated with movement. Pathological characteristics of Parkinson’s include widespread cell death of dopaminergic neurons in the substantia nigra region of the brain and therefore the basal ganglia, which is responsible for controlling voluntary motor movements among other things.
Researchers are not crystal clear on what causes dopamine-producing brain cells to become damaged and start dying off, but they believe some risk factors like gene mutations, environmental exposure to toxins like pesticides, and previous head trauma can contribute to development of Parkinson’s. Lewy bodies, or clumps wrapped around alpha-synuclein proteins, are also found in the brain cells of people with Parkinson’s according to the MayoClinic. Their presence there as well as in the brains of patients with Lewy bodies dementia is a leading focus of Parkinson’s research into the cause of cell death in the brain.
What are Symptoms of Parkinson’s Disease?
Contributing to the care of a patient with Parkinson’s requires a thorough understanding of presenting symptoms, including:
Tremors - unlike MS where tremors may present when a patient is standing or reaching for something, Parkinson’s tremors can happen while a patient is moving or at rest. A pill-rolling tremor is often characteristic of Parkinson’s, where a patient’s thumb and forefinger rub together in an appearance of rolling something like a pill.
Bradykinesia - as less and less dopamine gets produced, the neural signals that cue the body to act taken longer and longer to transmit. This results in slowed movements called bradykinesia; examples include dragging the feet when walking, very slowly lifting the arms, holding on to words a long time before speaking.
Difficulty speaking - in addition to slowed or slurred speech, a major reduction in speaking volume can be symptomatic of Parkinson’s. The normal tone and inflection of a patient’s speech may change over time as well and they can become hard to understand.
Muscle stiffening - a rigidity of the muscles sets in with Parkinson’s, limiting a patient’s flexibility and coordination, as well as impairing their range of motion and potentially their mobility.
Trouble balancing - the culmination of slowed movement and response times, muscle rigidity, and tremors can put Parkinson’s patients at a higher risk of losing their balance and falling.
Changes in writing - patients with Parkinson’s commonly experience changes in their writing as it becomes smaller, wigglier, and harder to read.
Disruption of autonomic functions - patient’s with Parkinson’s are commonly diagnosed in part due to presenting loss of functions which the body does automatically without thinking. These might look like lack of arm swinging when walking, not blinking for extended periods of time, not smiling, drooling instead of swallowing saliva, etc.
Additional symptoms may include non-motor related conditions like losing the sense of smell, trouble sleeping, excessive sweating, personality and mood changes, impulsive control disorders, neck pain, and slowed bladder and bowel function.
How Can Nurses Help Manage Parkinson’s Patients?
Whether you are a home health nurse or a hospital nurse, you can help manage a Parkinson’s patient’s care in a handful of critical ways:
Vitals monitoring can play a significant role in care as some Parkinson’s medications that help to convert to or mimic dopamine in the brain can cause sudden changes in blood pressure. Acknowledging baseline pressures and monitoring patients closely for any significant increases or decreases can help you and the rest of the care team address potential issues before complications arise.
Fall prevention is also key to keeping Parkinson’s patients safe as their bradykinesia, tremors, and balance issues make them more prone to experiencing a potentially debilitating fall. In the home, alarm mats for elderly patients can help cushion a fall and lessen its impact as well as alert caregivers. Additional upgrades like grab bars, railings, and non slip tape on bathroom floors can help prevent falls.
Educating family members is always a must when caring for a patient with chronic illness. The more you can relay to caregivers about Parkinson’s symptoms to look out for, fall prevention, nutrition, exercise, and tips for getting through freezing episodes, the better off your patient will be when you are not there.
Jessica Hegg is the content manager at ViveHealth.com. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle. Through her writing she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.