Monday, October 3, 2022
Monday, October 3, 2022
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Parkinson’s Disease Self Care

Hcps Skills And Knowledge To Support Self

Parkinson’s Disease Care Partners: Self-Care at Home When Caring For A Loved One

HCP acknowledged several limitations in their capability to support self-management. Some of those interviewed did not see many Parkinsons patients in practice and, together with the complexity of the disease, this group found it challenging to support people with Parkinsons to self-manage especially at later stages:

People, you know, again people, there arent maybe vast numbers, people are at different stages, some people who are housebound, some people are mobile, some people are working. So I just find it hard to know how it would work in practice really. GP

If there were no specialists available for advice or if someone had not had much or recent training on Parkinsons, HCPs had to seek out their own information online:

So I havent had any Parkinsons training since Ive been here and Im not sure Ive had any ever. Its kind of just that you do your own, like thinking that, oh, I havent looked after someone with that condition for a while, so kind of going back and doing a bit of your own research and your own reading. Palliative care nurse

Occasionally HCPs displayed a lack of understanding on how to motivate people to change and overcome barriers in capability:

But the patients also expect a lot, by the way. They become really lazy. So a lot of patients say, oh, were only given a leaflet.I say to them youre full-time at home, so make use of your time. Neurologist consultant

Theory Of Pd Progression: Braaks Hypothesis

Researchers believe a combination of genetic and environmental factors cause Parkinsons. In 2003, Heiko Braak, MD, hypothesized that an unknown pathogen in the gut could be the cause of PD.

This was followed by a more extensive hypothesis, stating that PD starts in two places: the neurons of the nasal cavity and the neurons in the gut. This is now known as Braaks hypothesis. In this theory, the pathogen enters the body via the nose and/or gets swallowed and reaches the gut. The pathogenic products thus come into contact with the olfactory and/or enteric neurons, triggering the aggregation of an abnormal protein called -Synuclein. The aggregated -Synuclein then spreads toward the central nervous system , and eventually arriving in and causing the degeneration of the dopaminergic neurons in the area of the brain called the substantia nigra.

This theory is supported by evidence that non-movement symptoms, such as a loss of sense of smell, sleep disorders and constipation, may appear several years ahead of movement symptoms. For this reason, researchers focus on these non-motor symptoms to detect PD as early as possible and to look for ways to stop its progression.

Page reviewed by Dr. Jun Yu, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.

Actionable Ways To Practice Self

As a caregiver for a loved one with Parkinsons disease , your days may include medication alarms, driving to and from appointments and helping your loved one with activities of daily living. Simultaneously, you may be managing finances, cooking, working and trying to keep up with family and friends. It can be easy to forget that your needs require attention too. Self-care is defined as any practice that relieves stress and encourages a healthy mind and body.

We know you are busy, so weve compiled 15 realistic ways you can implement self-carestarting now:

  • Eat healthy with less hassle. The better you eat, the better you feel.
  • Manage stress. Determine what helps you relax most: a hot bath, a meditating app, reading a new book or going on a walk. Then devote time to it every day.
  • Exercise regularly. We know that exercise plays a role for your loved ones PD, and consistent exercise can also help you. Just 30 minutes of daily exercise can help you sustain your energy and lead to better sleep.
  • Set limits and stick to them. This means asking for help when you need it. Try new resources. Bring in outside help so you can take a break. Call the Parkinsons Foundation Helpline at 1-800-4PD-INFO . No one can do everything for everyone all the time!
  • Reflect on the rewards of caregiving. Alongside trials and challenges, caregiving offers triumphs and joys. Take pride in how much you have learned and in discovering your own strengths.
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    Complications Of Parkinsons Disease

  • Speech problems. Speech is often affected in PD patients. Issues relaying messages is a common problem and often a cause for disappointment in individuals suffering from the disease.
  • Difficulty chewing and swallowing. Changes in movements related to PD typically affects the ability to chew and swallow as well. This often leads to malnutrition therefore, options for nutritional support will need to be discussed with the patients too.
  • Depression and Anxiety. Due to the complexity and progressiveness of the disease, people with PD often suffer from depression and anxiety.
  • Sexual dysfunction. Reduced sex drive is typical in PD. It may be due to other symptoms like fatigue, pain, and depression.
  • Sleep disorders. Sleep problems may arise even before the diagnosis of PD. Common complaints related to sleep are Apnea, restless leg syndrome, and difficulty falling asleep.
  • Urinary problems. Controlling the bladder may be challenging for people with PD.
  • Constipation. Constipation is another symptom associated with PD that may become apparent even before the diagnosis.
  • Dementia. Parkinsons disease is closely related to dementia. The changes in the nervous system often lead to Parkinsons dementia.
  • Pain. This is a common symptom of PD. About 60% of PD patients experience pain.
  • Seek Support From Others

    Self

    Friends and family can be a great source of help when youâre dealing with Parkinsonâs. But sometimes, itâs a relief to be able to relate to someone who knows what itâs like to deal with the disease. In-person or online support groups can offer comfort and practical advice. They can also help you feel less alone. Ask your doctor, nurse, or social worker to suggest local or online groups you can join.

    Sometimes people have problems that are better addressed in a one-on-one atmosphere. By taking part in individual counseling, you may be more able to express sensitive or private feelings you have about your condition and its impact on your lifestyle and relationships.

    Itâs common to feel depressed and anxious, too. Check in with a mental health professional if you’re having a hard time enjoying life the way you used to, or if you are often angry, sad, or unlike your usual self.

    Show Sources

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    Nursing Care Plan For Parkinsons Disease 6

    Deficient Knowledge

    Nursing Diagnosis: Deficient Knowledge related to lack of knowledge about Parkinsons disease, difficulty understanding the disease process, lack of coping skills, and cognitive impairment secondary to Parkinsons disease as evidenced by verbalization of questions and incorrect information from the patient and family, presence of preventable complications, and inappropriate behavior.

    Desired Outcomes:

    • The patient and the patients family will be able to express an accurate understanding of the disease process, medication regimen, and treatment plan of care for Parkinsons disease.
    • The patient will be able to fulfill the medication regimen and will notify the physician if the patient experiences unusual side effects.
    • The patient will be able to prevent injury by demonstrating safety precautions.
    • The patient and the family members will identify the need for long-term goals and the potential for end-of-life decisions to be done.

    Get The Support You Need

    One member mentioned the importance of support groups with other caretakers. I see a therapist, which helps, but its not the same as talking to another caregiver, they said.

    You might want to join a caregivers support group during the early stages of Parkinsons. It can be helpful to anticipate the challenges of caregiving as the disease progresses. If you need individual counseling, ask your doctor for a referral for a mental health professional or psychotherapist.

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    How Is Parkinson’s Treated

    Although there’s currently no cure for Parkinson’s, treatments are available to help reduce symptoms and maintain quality of life for as long as possible. These include:

    • supportive therapies, such as physiotherapy and occupational therapy
    • medication
    • deep brain stimulation .

    If you have mild symptoms of Parkinsons, your doctor might not recommend medication and instead focus on supportive therapy and lifestyle improvements such as exercise and relaxation. As your symptoms progress, you will be prescribed medication.

    Nursing Care Plan For Parkinsons Disease 4

    Self Care Panel for People Living with Parkinson’s Disease

    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.

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    Outcomes Among Care Partners

    There were no statistically significant differences between the intervention and control groups of care partners . Scores in the care partners intervention group tended to show slight improvements or remained stable following participation in the NPS but did not reach levels of statistical significance. In the control group, most scores stable or slightly worse following seven weeks of standard care of these, only satisfaction with life as a whole was significantly lower after seven weeks of standard care .

    How Common Is Parkinson’s

    About 1 in 500 people have Parkinsons. Most people develop it between 55 to 65 years of age.

    • Parkinsons is most common in older people. About 1 in 100 people over the age of 60 are diagnosed with Parkinsons.
    • Parkinsons in people younger than 60 years of age is known as early-onset Parkinsons. Of people diagnosed with Parkinsons, about 1 in 20 are younger than 40 years.
    • In rare cases, Parkinsons-like symptoms can occur in children and teenagers. This is known as juvenile parkinsonism and is considered to be a separate condition to Parkinsons.

    There is a very small increase in Parkinsons risk in people with family/whnau who have Parkinsons.

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    Peter Was Introduced To Bowen Massage And If It Wasnt So Expensive He Would Have Liked To Have

    So what are the differences that you see?

    What in what way?

    Is that something youve found out by trying it out or was it?

    Some people said that therapies like yoga, Tai Chi and massage helped them to relax and to feel as if they were doing something positive to help themselves. Relaxation meant relief from pain, spasm and feelings of stress. Many people, several of whom had noticed that their emotional state greatly affected their symptoms, noted that relaxation helped calm their tremor, helped them to sleep and made them feel generally better. Joe had tried various things and felt they did more for his mood than for his physical symptoms’ I think it helped me feel I was doing something to be better, made me feel lifted a bit and of course attention to ones body, physical attention, massage, acupuncture. Anything like that makes one feel better, makes one feel loved really.

    Last reviewed May 2017.

    Nursing Care Plan For Parkinsons Disease 1

    Promote Self

    Ineffective Airway Clearance related to Parkinsons disease as evidenced by shortness of breath, SpO2 level of 89%, cough, use of accessory muscles, increased mucus production, difficulty to expectorate phlegm

    Desired Outcome: The patient will be able to maintain airway patency and improved airway clearance as evidenced by being able to expectorate phlegm effectively, respiratory rates between 12 to 20 breaths per minutes, oxygen saturation within target range , and verbalize ease of breathing.

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    Considerations For Choosing Strategies

    A review of this page along with the other pages related to Parkinson’s Lifestyle Medicine makes it clear that there are many options and strategies to consider as interventions for a person with Parkinson’s. How does one decide which options to use? The clinical judgment and evaluation skills of the provider are important, and the clinician will need to base decisions on subjective and physical assessments to help prioritise the intervention. Once an area of need is identified, whether it is sleep, stress management, nutrition, exercise, substance abuse, or socialisation, the provider should discuss the options for specific areas to address and techniques to be used. This patient-centred focus will be helpful in building the therapeutic alliance.

    It can also be crucial to consider some of the potential barriers the patient may face.

  • Is the patient even interested in exploring adjunct strategies and treatments? This can be determined early in the therapist/patient interaction with good communication.
  • Is the recommended programme financially feasible for the patient?
  • Will there be any concern about transportation related to the suggested treatment or strategy? It may not make sense to recommend a dance class or an outdoor nature hike if the patient has no way to access these.
  • Are the services being recommended available in the patient’s community?
  • Why Dance for PD®? Mark Morris Dance Group. Available from
  • Changes In Cognition And Parkinsons Disease

    Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.

    Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.

    Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.

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    Treatment Of Parkinsons Disease

    Currently, Parkinsons disease has no cure. However, treatments are extremely helpful in managing its signs and symptoms.

  • Supportive therapies, such as physiotherapy.
  • Physiotherapy can be helpful in relieving muscle stiffness and joint pain. It may improve gait and movement.
  • Occupational therapy. This therapy may help with the performance of activities of daily living. It helps promote independence and helps people make sure that their environment is conducive for their condition.
  • Speech and Language therapy. Speech is often affected in PD. Speech and language therapy helps individuals to cope with this issue.
  • Medication. Medications are commonly used to manage symptoms of PD. However, close, and regular monitoring is needed to watch out for side effects.
  • Central nervous system agents such as levodopa commonly prescribed for PD patients. Levodopa works by being converted into dopamine in the brain
  • Dopamine agonists work by mimicking the action of dopamine in the brain
  • Mao-B inhibitors act by blocking the chemicals in the brain that promote the breakdown of dopamine
  • Anticholinergics work by restoring the balance between dopamine and acetylcholine they help reduce tremors and muscular rigidity
  • Surgery in some cases. A surgical procedure called Deep Brain Stimulation can be performed. This procedure involves risks for complications hence it will need to be discussed thoroughly.
  • Maximising Capability And Opportunity

    Mindfulness Mondays – Grounded Optimism for Care Partners of Parkinson’s Disease

    It was noted that to achieve any task, people with Parkinsons need to be knowledgeable about what to do, how to do and why its important:

    Therefore that is the importance of self-managing your condition and taking some ownership over it in terms of them making sure if you want to get up at 7.30 in the morning, well maybe you can self-administer and give it to yourself at 7.30 in the morning. But to do that, to enable you to do that, you need to know about your medicines and they might not know about it. Pharmacist

    However, others felt that providing too much information at once that often happened in practice could be overwhelming and was therefore an ineffective way to support self-management:

    I think we do bombard people with a lot of information. And, you know, thats when you come back a couple of weeks later and it almost looks like, they just dont remember very muchtheyve just had a lot of information from the consultant, a lot of information about their medication, a lot of information about the diagnosis. And then we just come with more and more and it must be really overwhelming. Focus group: hospital-based outpatient MDT

    Capability to self-manage in late-stage Parkinsons was highlighted as a particular challenge although not discussed in depth.

    I think its very difficult. I have to say. I dont, I dont know whether, um, they do effectively self-manage in the end. I dont know. Community MDT

    Carers role in self-management

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    Get Support For Your Mental Health

    You can call our free and confidential helpline on 0808 800 0303.

    It’s open Monday-Friday 9am-7pm and Saturday 10am-2pm. Our trained advisers can provide support to anyone affected by Parkinson’s.

    You can also contact the Mind Infoline on 0300 123 3393, which is open 9am-6pm, from Monday to Friday.

    If you need to talk to someone outside of these hours, Samaritans are free to call 24/7 on 116 213.

    There are lots of places where you can connect with people who may be experiencing similar issues to you.

    Parkinson’s Disease And Movement Disorders Center

    Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.

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    Caregivers And Parkinsons Hallucinations

    Hallucinations are imagined sights, sounds, smells, or sensations that occur when someone is awake. Sometimes that person may be aware of the hallucination and have whats called insight, but it is also common for them not to know what theyre experiencing. Visual hallucinations, the most common type among people with Parkinsons, occur in as many as 75 percent of people with the condition.

    Its important for caregivers to know what they can do to manage their own stress related to a loved one whos having hallucinations. People with Parkinsons may have hallucinations caused by infection, simultaneous use of multiple drugs, or brain changes from Parkinsons or another type of dementia, such as Lewy body dementia.

    The first step in coping with hallucinations is to talk with your loved ones neurologist and health care team. Conducting a medical workup can determine if the hallucination was triggered by side effects from a medication, such as levodopa, or by an infection, such as a urinary tract infection. Treating the underlying infection may improve the hallucinations.

    Hallucinations are more common in dim or dark lighting, so caregivers can help minimize them and the associated stress they cause by maintaining bright lighting when someone with Parkinsons is awake. Reassuring someone whos having hallucinations can be more calming than telling them theyre wrong about what seems real to them.

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