Nursing Care Plan For Parkinsons Disease 4
Nursing Diagnosis: Disturbed Thought Process related to psychological causes, parkinsonian medications, chronic illness, and depression, secondary to Parkinsons disease as evidenced by memory impairment, distractibility, inability to perform activities, abnormal lab studies, and insomnia.
Desired Outcomes:
- The patient will be able to express understanding of the factors that may produce depressive reactions.
- The patient will use different techniques that will effectively decrease the amount and frequency of depressive reactions.
- The patient will show compliance to the different therapeutic regimens.
Focus On Life Outside Parkinsons
Its easy to let Parkinsons overtake your life together, especially as the disease progresses. Try to focus on the good moments and remember that you both have a life after Parkinsons. Discuss other topics with your family and friends and try to participate in fun experiences as much as you can. Take trips while you are still able to do so together and check items off their bucket list when possible. You wont regret having these happy memories to treasure later on.
Symptoms Of Parkinsons Disease
As a neurodegenerative brain disorder, Parkinsons Disease affects the way the brain and nervous system control movements of the body. Second to Alzheimers Disease in terms of the most common neurological disorders, Parkinsons affects about 1% of the worlds population over the age of 60.
What can begin as a slight tremor or a slowing of movement and generalized stiffness, as the disease progresses it will continue to diminish muscle movement and control over time. Symptoms may also begin and worsen on only one side of the body, or it may progress over time to both sides.
Initial signs and symptoms of Parkinsons Disease can be hard to detect and typically include:
- Trouble communicating
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Selecting Healthcare Professionals For Parkinsons Disease
Because of the complexity of Parkinsons disease and the wide range of effects that the disease has on a persons physical, emotional, and cognitive functioning, a number of healthcare professionals are usually required to help manage the disease effectively. Healthcare professionals who may be able to help an individual adapt and cope with Parkinsons disease include:
- Primary care physician or nurse practitioner
- Physical therapist
A Supportive Community Is Vital
At the end of the day, Evans says the assisted living experience should not be seen as a limiting one, but rather as an opportunity for nuanced care combined with an increased quality of life for someone living with Parkinsons.
A great attribute of an assisted living community for someone with Parkinsons is supporta community that is friendly and loving where other people are suffering with the same diagnosis, says Evans. It can be a beautiful experience.
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Registered Nurse Case Managed Psw Care Makes The Difference
At Eldercare Home Health weve been providing care for clients with Parkinsons since 1995.
A real, Ontario Registered, Registered Nurse will assess your parent at no charge.
We will assign a Registered Nurse Case Manager to the care of your parent .
We understand Parkinsons medications and the side effects. We will liaise with your parents doctor, pharmacist and other members of the healthcare team on a professional level. Well also advocate for your parent.
Eldercare Home Health is plugged in to the various resources for clients with Parkinsons in Toronto, and we are well acquainted with many of the top Parkinsons specialists in Toronto.
We understand the issues that your parent with Parkinsons deals with every day. And we know that you may be worried about falls and safety. Our goal is to provide the care your parent needs and the peace of mind that you need.
Contact us today to learn more about how we can help.
Eldercare Home Health was the Official Sponsor of the Parkinson Society Central & Northern Ontario branch Spring/Summer 2012 Speaker events. See: Love, Intimacy & Parkinsons and Drug Therapy for Parkinsons Disease.
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Helping Parkinson’s Patients To Think Big
Parkinson’s Disease is a progressive neurological condition that affects more than one million people in the United States, with over 60,000 newly diagnosed cases each year. People with Parkinson’s Disease experience slowness of movement, rigidity and tremors which affect voice, facial expression, fine and gross motor movements. Medication to manage the effects of the disease, as well as the recommendation to engage in regular exercise to maintain mobility have been the most often recommended methods to manage the condition.
The Rehabilitation Team, under the direction of Dr. Sean Horrigan – Neurologist, at The Pavilion Rehabilitation and Nursing Center in Hyannis is looking to make a BIG difference in the quality of life of Cape Cod residents with Parkinson’s and similar neurological disorders with the announcement that we are now offering LSVT Big and LSVT Loud treatment.
“The American Parkinson Disease Association reports that 89 percent of patients suffering from Parkinson’s disease have speech problems that make it difficult or impossible to speak for themselves. There was no effective medical or therapeutic treatment for these problems until 1993, when LSVT Global developed a speech therapy called LOUD. Three years ago, the organization applied the LOUD concepts to limb movements to create the BIG program”.
What is LSVT?
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Signs And Symptoms Of Parkinsons Disease
- Tremor. The presence of tremors is one of the triad symptoms of Parkinsons disease. Tremors usually start in the limbs, most commonly in the hands and fingers. They are likely to occur when the body is at rest and relaxed. Pill-rolling tremors are common in Parkinsons disease patients. It is characterized by the rubbing of thumb and forefinger back and forth.
- Bradykinesia. One other main symptom of PD is slow movements or bradykinesia. Individuals with PD display a distinctive slow and shuffling gait. Slowness in movements often make it more difficult for people with PD to complete activities of daily living.
- Rigidity . Muscle stiffness is also a common sign of PD. It may occur in any part of the body and may lead to dystonia or uncontrolled painful muscle cramps.
- Impaired posture and balance. Most people with PD often have a stooped posture.
- Loss of automatic movements. Unconscious movements such as blinking, smiling, and swinging of hands when walking may be reduced in people with Parkinsons disease.
- Anosmia. Loss of the sense of smell may occur even years before the diagnosis of PD.
- Speech changes. Changes in speech may also be noted in people with PD. Their speech may become soft, fast, slur, and their tone may become monotonous.
Ensuring Your Loved Ones Parkinsons
Depending on where you live, assisted living options may be numerous and overwhelming or somewhat narrow and restrictive. And finding an assisted living community thats right for someone living with Parkinsons can make the search even more stressful than it already is. But Lehr says that if you know what youre looking for the process doesnt have to make you anxious, because there are several criteria that prospective residents and/or their families should consider when searching for the right assisted living community.
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Why Are Elders More Likely To Develop Parkinson’s Disease
This is a degenerative disease that most likely effects adults 41 and over. However, since it is a slowly progressing condition, it is often in the senior years that individuals with Parkinson’s show clear symptoms. As noted, it is difficult to diagnose this disease. Therefore, it is often in the late stage when symptoms are more pronounced that individuals are diagnosed. By this time, they are more likely to be in their senior years.
Assisted Living And Parkinsons Disease
Edited by Dr. Kimberly Langdon, M.D., Board Certified Physician
If your loved one recently received a diagnosis of Parkinson’s disease, you have many important decisions ahead of you as a caregiver. One of the most important is choosing the best living arrangement for their health, safety, and well-being. Since this is a degenerative disease with no cure yet, you’ll need a long-term perspective to ensure the level of care meets your loved one’s needs now and in the future. Assisted living is often an ideal setting to care for individuals with Parkinson’s disease, since its effect on motor skills can impair daily living.
Let’s talk about the symptoms of Parkinson’s, how to choose the right setting, when assisted living might be best, and tips for finding the right facility for your loved one.
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What Is Parkinsons Disease
Parkinsons is a degenerative neurological disorder that primarily targets the brain cells that produce dopamine. Symptoms change and worsen as the disease progresses, and it is perhaps best known for its hallmark tremors and movement problems.
Common motor symptoms of Parkinsons include:
- Small, slow movements
- Stiffness in the arms and legs
- Problems walking and balancing
Financial Considerations With Parkinsons Disease
There are a number of financial implications to consider when an individual is diagnosed with Parkinsons disease. Financial needs related to Parkinsons disease may include:
- Prescription medications
- Veteransâ benefits
- Other public programs
Medicare is the main source of health care coverage for most individuals 65 and older. Other common sources of payment include private pay, employer pension plans, and personal savings.
Regardless of the age of the individual with Parkinsons disease, all health care plans meeting these needs should be kept active. It is sometimes possible to supplement an individualâs Medicare coverage with Medigap insurance which covers certain gaps in Medicare coverage such as paying for co-insurance or other items.
A long-term care insurance policy usually needs to be in place before a Parkinsons disease diagnosis occurs in order for long-term care to be covered for the disease. After a Parkinsonâs disease diagnosis, the policy should be reviewed to determine:
- Eligibility of the person diagnosed
- When the covered individual is able to start collecting benefits
- Date the daily benefit begins
- Whether the benefit is adjusted annually for inflation
- Length of time the benefits will be paid
- Whether there is a maximum lifetime payout
- Type of care covered by the policy
- Whether there is an elimination period before the coverage begins
- Any tax implications of the policy
In addition, Medicaid will pay for hospice care in most states.
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Impulsive And Compulsive Behaviour
Some patients who take dopamine agonists can experience problems controlling impulsive or compulsive behaviour .
Impulsive behaviour refers to the inability of patients to resist carrying out certain activities, some of these activities could be harmful to themselves or others. In many cases, this behaviour is out of character.
Compulsive behaviour refers to an overwhelming urge to act in a certain way to reduce the worry or tension this urge produces. This behaviour can be expressed in a number of ways, including addictive gambling, impulsive shopping, binge eating and hypersexuality.
Nurses who suspect a patient might be experiencing compulsive or impulsive behaviour should discuss the issue with the patient and the patients neurologist or GP as soon as possible.
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Causes Of Parkinsons Disease
Parkinsons disease is an idiopathic illness, which means that its cause is unknown.
The signs and symptoms it present are caused by the loss of nerve cells in the part of the brain called substantia nigra.
This part of the brain is responsible for the production of dopamine, a neurotransmitter that links the brain and nervous system to coordinate body movements.
Loss of dopamine results in uncoordinated body movements, thereby producing the signs and symptoms of the disease.
Though the exact cause of Parkinsons disease is still unknown, there are possible explanations that may be responsible for the condition, such as:
- Genetics. Studies have shown that a minority of cases of PD have genetic involvement.
- Environmental factors. Exposure to pesticides, herbicides, and industrial pollution is now being looked at as a possible cause of PD. However, the results are still inconclusive.
- Presence of Lewy bodies. Lewy bodies are clumps of substances in the brain cells. These are often seen in people with Parkinsons disease. The studies about them are still inconclusive, but researchers believe that these substances hold useful information to what causes PD. Researchers are also focusing into alpha-synuclein found in the Lewy bodies.
The following are the associated risk factors in developing Parkinsons disease:
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How Do I Know If Home Care Is Possible
The following factors must be considered when determining whether home care will work for you and your loved one:
- The designated caregiver should have few other responsibilities not related to the care recipient .*
- The house must be large enough to comfortably accommodate the needs of the person with Parkinsons, including space for a lift chair, walker, wheelchair, bedside commode or other medical equipment required. Take a home safety tour to ensure your home is easily accessible.
- All rooms should be on one level. The home environment must be safe and supportive of maximum independence. Necessary structural changes, such as ramps, handrails, bathroom alterations, etc. have been made.
- Arrangements can be made to provide medications to the person with PD at required times, as well as meals, assistance with personal care, housekeeping, transportation and companionship.
*If the designated caregiver is someone you hire to provide around-the-clock care, consider the impact of someone else living in your home. Even though you are not responsible for daily cares, having another person in your house might cause stress and make it difficult to relax.
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Are There Any Risks Of Exercising With Parkinsons Disease
Some symptoms, like Parkinsons tremors, may seem worse during exercise. But exercise generally improves tremors and other symptoms in the long run.
Reduce challenges by stretching before and after exercise. Use good form to prevent injury. And avoid slippery floors, poor lighting and tripping hazards. If you have pain, stop and rest.
Pushing yourself too hard during exercise can lead to injury. Start slowly and increase intensity and duration over time. Keep a log to track your exercise choices and how you feel. Eventually, youll learn what works best for you.
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Renting Out Your Home
If only one parent is still living, or if both parents need assistance with daily living, the family home can be an important resource. Selling is an option, of course. But in many families, mom and dads house is cherished and family members arent ready to make this decision. In this case, consider renting out the house and using the rental income to pay for assisted living. The idea of being a landlord might seem scary, but for a percentage fee you can hire a service to manage the property for you.
How Do I Pay For Assisted Living For Elderly Parkinsons Patients
For starters, Medicare does not cover costs for assisted living for elderly Parkinsons patients. For low-income seniors, there is the option of Medicaid. However, the NCPC reports that only 11 percent of seniors in assisted living used Medicaid to pay for care in 2002. This may be due to the stringent rules for Medicaid recipients, such as they cannot have assets worth more than $2,000 in total.
The best solution for seniors is to purchase long-term care insurance to cover the costs of assisted living. Long-term care insurance typically covers this expense, but check the contract details to verify coverage. Ultimately, its the family that pays for care. The NCPC reports that 75 percent of patients depend on family members to pay out-of-pocket for assisted living.
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Find A Community With Experienced Staff
First and foremost, prospective residents or their caregivers should ask about the staffs experience and training with Parkinsons in particular.
An educated and trained staff is critical for Parkinsons, says Lehr. Loved ones should look for those who know about this disease and its various levels of progression. I would ask very specifically, What are the triggers you look for when you consider someone a viable candidate for this facility versus when you think this person should be in long term care? Thats going to tell you a lot about their depth of knowledge around Parkinsons.
Lehr also says the assisted living community should have a neurologist on staff and rehab specialists on site.
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Things To Know About Assisted Living For Someone With Parkinson’s
Assisted living facilities are not equipped to provide medical care, which your loved one with PD may need. You may be able to hire extra help, or the facility may charge additional for help with dressing or eating.
Doctors who see people at assisted living facilities are contracted, not employees. If you need to talk to them, make an appointment rather than hanging around the facility and asking them questions.
Medications for PD are complex, and as a person ages, they may receive additional prescriptions for other conditions. Its important for medication management to be overseen by a neurologist who is a movement disorders specialist, as they are trained in understanding the different medications for PD and potential interactions with other drugs.4
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