Your Home And Lifestyle
- Modify your activities and your home. For example, simplify your daily activities, and change the location of furniture so that you can hold on to something as you move around the house.
- Eat healthy foods, including plenty of fruits, vegetables, grains, cereals, legumes, poultry, fish, lean meats, and low-fat dairy products.
- Exercise and do physiotherapy. They have benefits in both early and advanced stages of the disease.
My Parkinson’s Story: Driving
This 9-minute video alternates between an interview with a man and his wife and several specialists. The man and his wife share how he gave up his driver’s license due to Parkinson’s symptoms and how he is adjusting. The specialists share how Parkinson’s symptoms affect a person’s ability to drive, and how driving and cognitive assessments can determine a person’s fitness to drive.
Driving With Parkinsons Disease
Parkinsons disease is a progressive condition that may affect someones ability to drive safely. Dr Wyn Parry, DVLAs Senior Medical Adviser, tells us more about driving with this condition.
I joined DVLA as Senior Medical Adviser after thirty years in the NHS. Its my job to advise on how certain medical conditions can affect someones ability to drive. After blogging last year about driving with diabetes, this time Id like to focus on driving with Parkinsons disease.
Parkinsons disease affects the nervous system and may affect the muscles, causing movement problems. In some circumstances, it can even affect the functions of the brain.
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If You Develop A Tremor
Urgent medical care isn’t needed if you have had a tremorâshaking or tremblingâfor some time. But you should discuss the tremor at your next doctor’s appointment.
If a tremor is affecting your daily activities or if it is a new symptom, see your doctor sooner.
A written description will help your doctor make a correct diagnosis. In writing your description, consider the following questions:
- Did the tremor start suddenly or gradually?
- What makes it worse or better?
- What parts of your body are affected?
- Have there been any recent changes in the medicines you are taking or how much you are taking?
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
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Legal Obligations Insurance And Tax
Your legal obligations will depend on the laws of the country in which you live. In many countries, your doctor will be obliged to carry out a regular ‘fit to drive’ check.
The most common heath-related driving laws in European countries are outlined below but you should always check on current legislation with your doctor or a suitably qualified member of your healthcare team.
Parkinson’s Drugs And Excessive Sleepiness
Some Parkinsons drugs can make you very sleepy. Sometimes this happens suddenly and without warning. This may be more likely in people with advanced Parkinsons who are taking multiple medications or are increasing their medication, particularly dopamine agonists.
Although this is concerning, the DVLA has stated that the risk of falling asleep suddenly is low and that taking Parkinsons drugs should not automatically mean you have to stop driving. However, if you experience any sudden or excessive daytime sleepiness, you should not drive and tell your GP, specialist, or Parkinsons nurse.
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How Is Parkinson’s Disease Diagnosed
Your doctor will ask questions about your symptoms and your past health and will do a neurological examination. This examination includes questions and tests that show how well your nerves are working. For example, your doctor will watch how you move, check your muscle strength and reflexes, and check your vision.
Your doctor will also ask questions about your mood.
In some cases, your doctor may have you try a medicine. How this medicine works may help your doctor know if you have Parkinson’s disease.
There are no lab or blood tests that can help your doctor know whether you have Parkinson’s. But you may have tests to help your doctor rule out other diseases that could be causing your symptoms. For example, you might have an MRI to look for signs of a stroke or brain tumour.
How Will My Daily Life Be Affected
Parkinsons is such an individual and personal condition, it affects everyone differently so it is difficult to say to how it will impact on your everyday life. Many people find they can carry on as usual with hardly any problems for some time, but as the illness progresses you will probably find that you need to adapt your routine to make life easier.
The type of symptoms you experience and how well your medication controls them will be a big factor, so keeping a close eye on how effective your medication is and communicating well with your doctor is crucial in managing your Parkinsons and enabling you to continue your usual activities. Keeping in contact with friends and doing the things you enjoy are also important in maintaining a positive attitude and ensuring that you continue to enjoy a good quality of life.
If over time you find some activities start to get difficult, talk to your doctor and other healthcare professionals, they may be able to suggest adaptations or specialist equipment that can help you continue to do these things for longer.
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What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
What Are The Symptoms
The four main symptoms of Parkinson’s are:
- Tremor, which means shaking or trembling. Tremor may affect your hands, arms, or legs.
- Stiff muscles.
- Slow movement.
- Problems with balance or walking.
Tremor may be the first symptom you notice. It’s one of the most common signs of the disease, although not everyone has it.
More importantly, not everyone with a tremor has Parkinson’s disease.
Tremor often starts in just one arm or leg or on only one side of the body. It may be worse when you are awake but not moving the affected arm or leg. It may get better when you move the limb or you are asleep.
In time, Parkinson’s affects muscles all through your body, so it can lead to problems like trouble swallowing or constipation.
In the later stages of the disease, a person with Parkinson’s may have a fixed or blank expression, trouble speaking, and other problems. Some people also lose mental skills .
People usually start to have symptoms between the ages of 50 and 60. But sometimes symptoms start earlier.
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Who Determines Fitness To Drive In Parkinsons Disease Patients
Fitness to drive protocols vary greatly from country to country. While no uniform international standard exists, medical standards for driver licensing and physicians guidelines for assessment of fitness to drive have been established in some countries, including the United States , Canada , United Kingdom , and Australia . Roles and responsibilities of drivers, health professionals, and driver licensing authorities have been proposed. While drivers have a responsibility to self-assess driving abilities and report any permanent injury or illness that may affect their ability to drive safely, health professionals have an ethical and legal duty to maintain patient confidentiality and must have legal justification for breaching that trust in cases where an unfit driver may pose a threat to public safety. Physicians that evaluate for fitness to drive and that identify a condition that may impair driving performance are obligated to report that finding to drivers licensing authorities . The driver licensing authority is then tasked with the responsibility of deciding whether to license a driver or not, based upon the drivers health report, driving performance record, and violation history.
Enjoy A Healthy Sex Life:
We have no particular reason to say that sexual ability goes down with Parkinsons disease, says Rosenthal. There are certainly challenges, but rest assured that a satisfying sex life is not something you have to put behind you after a diagnosis. Treatments for erectile dysfunction can work for Parkinsons patients, just as they do for non-Parkinsons patients. Problems that crop up run the gamut: Men may experience sexual problems, like erectile dysfunction, and men and women may have problems with decreased libido. Physical symptoms of the disease, such as stiffness and tremor, may make moving around in bed more challenging. But you can help some of these problems enormously through good self-care. For example, getting enough sleep and exercise can boost sex drive.
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Mood And Mental Problems
- Deal with depression. If you are feeling sad or depressed, ask a friend or family member for help. If these feelings don’t go away, or if they get worse, talk to your doctor. He or she may be able to suggest someone for you to talk to. Or your doctor may give you medicine that will help.
- Deal with dementia. Dementia is common late in Parkinson’s disease. Symptoms may include confusion and memory loss. If you notice that you are confused a lot or have trouble thinking clearly, talk to your doctor. There are medicines that can help dementia in people with Parkinson’s disease.
Learn The Protocol For Your State
Colorado is not a medically mandated state. Its a self-reporting state, which means its up to you to assess whether or not you are fit to drive. With that said, Dittmar says that approximately 75% of the driving assessments she does are direct referrals from doctors.
Once Dittmar has completed a driving assessment, she sends the report to the drivers doctor and it gets linked back to the drivers DMV profile. The recommendations then become connected to a license.
These recommendations must be measurable. For example, some of the restrictions that could be placed on a driver include:
- Can only drive in daylight
- Can only drive within a certain radius of their home
- Can only drive below certain speeds
In some states, the report gets sent to the medical board. Contact the DMV in your state to learn more about how its done where you live.
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How Parkinsons Disease Symptoms Affect Driving Skills
Parkinsonâs disease symptoms vary from patient to patient. They can range from mild to severe. But even in mild cases, common symptoms such as shaking in the arms, hands, or legs, impaired balance, and slowed physical and mental responses can affect driving skills.
Episodes of tremor, for example, often begin in a hand or a foot and can affect the ability to operate a carâs controls. Rigidity can result in jerky motions while steering. Slow movement can interfere with braking in heavy traffic or ability to quickly react to road hazards. Postural instability often results in a stooped posture in which the head is bowed and shoulders are drooped, further reducing driversâ awareness of their surroundings.
For many people with early Parkinsonâs disease, medications can reduce symptoms. But medications may have side effects, such as drowsiness, that can affect driving as well. It can be difficult for doctors to devise a medication plan that reduces the primary symptoms of Parkinsonâs disease and allows some patients to drive without causing side effects that make driving a car even more dangerous.
Can You Drive A Car With Parkinsons Disease
Parkinsons disease involves a specific type of movement disorder, which significantly impairs an individuals driving skills and cause his/her safety concerns. Even the problem forces a large number of people suffering from parkinsons disease problem to stop driving their cars. Because of this, primary symptoms present in Parkinsons disease interfere seriously with one of the complicated tasks i.e. driving a car. These symptoms include the following-
- Tremor i.e. trembling in arms, hands, jaws, legs and head
- Rigidity i.e. stiffness in both trunk and limbs
- Slowness in body movements and
- Impaired balance or postural instability.
Along with this, a few people dealing with Parkinsons disease develops cognitive impairment, which includes defects in language, problem solving and language.
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Can I Still Drive With Pd
Most likely yes, in the early stages and if you take medicines that control your symptoms. Staying fit and active helps keep the muscle strength you need to drive. Here are some other options to help you maintain optimal driving safety:
- Eliminate driving distractions. Listening to the radio, talking on a cell phone, eating or drinking while driving all affect concentration and reduce safety.
- Avoid nighttime driving if you have vision changes in reduced light settings.
- Do not drive when you feel fatigued or your medication wearing off.
- Choose familiar, comfortable routes and non-peak driving hours. Consider a GPS system for directions.
- Maintain good posture. Reduce back strain with a lumbar support cushion.
- Do regular neck and trunk stretching exercises to increase mobility when backing up or watching for traffic and other obstacles.
- Consider taking a defensive driving course. AAA, AARP and other agencies offer these classes. It may also lower auto insurance premiums.
Knowing When To Give Up Your Car Keys: Transportation Issues In Parkinsons Disease
May 28, 2021 by Jared
In modern society, driving gives us the independence to go to the places we want to or need to, whenever we want. For most of us, transportation is a necessity in order to get to work, to do errands and for social events. Those of us who need to stop driving for medical reasons suffer a significant loss. Unless alternate transportation can be reliably arranged, peoples lives can be disrupted. I discuss here how to assess whether you are a safe driver and how to continue to travel if you are no longer able to drive.
Parkinsons disease may affect your ability to operate a motor vehicle due to both motor and cognitive deficits. Predictors of impaired driving in PD include older age, longer duration of disease, slowed movements and cognitive impairment . Some of the warning signs that you might recognize include that you get lost driving, that your friends and family are concerned, that you feel other drivers drive to fast or frequently honk at you, or that you are stressed when driving. You may also feel drowsy because many people with PD have sleep problems and several medications to treat PD can cause tiredness. Frequently the family of a person with Parkinsons disease recognizes that there is a problem. Care-partner perception is actually a good predictor of driving ability . However, they and the patient are often reluctant to bring this up at a physician visit.
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Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.
Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.
Advice On Driving With Parkinsons
Surrendering your drivers license is like surrendering your independence but unfortunately that time must come at some point in your Parkinsons journey.
It is important to remember that Parkinsons can affect your ability to self-evaluate. Therefore, it is a good starting point to discuss your driving with your caregivers and your doctor. They may have a different perception of your driving skills.
In the early stages of Parkinsons, you have the option to modify your driving habits to address the physical and cognitive changes you are experiencing. For example, you can adapt by driving shorter distances and avoiding peak hour traffic and night- time driving. Or if you drive a manual car, it may be sensible to convert to an automatic instead.
However, as your condition progresses, issues may develop which could result in impaired driving performance.
Insurance Regulations
It is recommended that you inform your insurance company of your Parkinsons diagnosis however it is not mandatory. In some cases, failure to disclose this information may result in your insurance being cancelled.
Driving, Parkinsons and Medications
Just as sight-impaired people must wear their glasses when driving, people living with Parkinsons must take their medication as prescribed when driving.
Therefore, when starting to take a new medication, check with your doctor and pharmacist that it is safe to drive.
Roads and Maritime Service Requirements
Will your doctor notify the RMS?
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