Tips For Caring For Someone With Parkinsons Disease
Caring for a loved one with early onset Parkinsons can be difficult. If youre a caregiver for someone with this condition, its important that you remember your own emotional and physical health.
Not only are you dealing with a difficult diagnosis, youre also managing an increased number of responsibilities. Burnout is common in caregivers, so make sure youre checking in with your own needs.
The Michael J. Fox Foundation Center for Parkinsons Research recommends these tips for caregivers:
Defining Populations At Risk For Parkinsons Disease
One of the areas of research that aims to aid in the early detection and treatment of PD is seeking to identify biomarkersprotein or chemicals in the blood, urine, or cerebrospinal fluid that reliably help diagnose PD, particularly at the early stage. For example, a recent study detected aggregates of alpha-synuclein in the cerebrospinal fluid. These aggregates were found in PD patients but not patients with other neurologic disorders. Many research studies are attempting to identify new biomarkers, particularly those that may even predict whether someone will develop PD over time.5
Stage One Of Parkinsons Disease
In stage one, the earliest stage, the symptoms of PD are mild and only seen on one side of the body , and there is usually minimal or no functional impairment.
The symptoms of PD at stage one may be so mild that the person doesnt seek medical attention or the physician is unable to make a diagnosis. Symptoms at stage one may include tremor, such as intermittent tremor of one hand, rigidity, or one hand or leg may feel more clumsy than another, or one side of the face may be affected, impacting the expression.
This stage is very difficult to diagnose and a physician may wait to see if the symptoms get worse over time before making a formal diagnosis.
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Can Doctors Miss The Early Signs Of Parkinsons Disease
Yes, doctors are human.
There has been a tremendous increase in human knowledge over recent years. It is not possible for a single person to recognize all the symptoms of all the diseases.
Thus, when a patient only has the early symptoms of Parkinsons disease, the diagnosis of Parkinsons disease is often missed.
As noted above, the early symptoms of Parkinsons disease can be vague.
Even if you have some of these symptoms, your diagnosis needs to be confirmed by a physical examination. This examination detects the early signs of Parkinsons disease.
Sometimes when the doctor examines you, everything might be perfectly normal. This may be due to one of two things:
The last thing to make sure is that you dont have a disease that can mimic Parkinsons disease. This can lead to misdiagnosis.
If the doctor is not sure, a test called Trodat/F-Dopa scan may help with diagnosis
Stage Two Of Parkinsons Disease
Stage two is still considered early disease in PD, and it is characterized by symptoms on both sides of the body or at the midline without impairment to balance. Stage two may develop months or years after stage one.
Symptoms of PD in stage two may include the loss of facial expression on both sides of the face, decreased blinking, speech abnormalities, soft voice, monotone voice, fading volume after starting to speak loudly, slurring speech, stiffness or rigidity of the muscles in the trunk that may result in neck or back pain, stooped posture, and general slowness in all activities of daily living. However, at this stage the individual is still able to perform tasks of daily living.
Diagnosis may be easy at this stage if the patient has a tremor however, if stage one was missed and the only symptoms of stage two are slowness or lack of spontaneous movement, PD could be misinterpreted as only advancing age.
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What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy. This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinson’s will affect your life
For more information, visit our Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Managing Depression In Parkinsons Disease
People with Parkinsons, family members and caregivers may not always recognize the signs of depression and anxiety. If you are experiencing depression as a symptom of Parkinsons, it is important to know it can be treated.
Here are some suggestions:
- For information and support on living well with Parkinsons disease, contact our Information and Referral line.
- As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself.
- You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinsons, including nortriptyline and citalopram .
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How Long Can Mild Parkinson’s Last
Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinson’s Research, patients usually begin developing Parkinson’s symptoms around age 60 and many live between 10 and 20 years after being diagnosed.
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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Early Symptoms Of Parkinson’s Disease
Parkinson’s disease is a progressive disease of the nervous system that affects movement. Approximately 1 million people in the U.S. are living with the disease. This year, about 60,000 more will be diagnosed with Parkinson’s disease.
Many people associate Parkinson’s disease with tremors or shaking of their hands. While this is a common symptom, other important symptoms include stiffness of muscles and slowing of movement.
Symptoms of Parkinson’s disease usually start on one side of the body. They usually remain worse on that side even after symptoms begin to affect both sides.
The early signs and symptoms are different for each person. The symptoms may be mild enough to go unnoticed for months or years.
Here are early symptoms that can raise concern for Parkinson’s disease:
- Smaller handwriting
- Family members may observe that one arm swings less on one side when walking.
- Soft or low voice Again, it is family members or friends who may ask one to speak louder. The speech may be more of a monotone without the usual inflections.
It is the combination of several symptoms that would raise suspicion for Parkinson’s disease. A single symptom is not enough to make a diagnosis of Parkinson’s disease.
It is important to talk with your health care provider if you have any of the symptoms associated with Parkinson’s disease. This is to properly diagnose the condition and rule out other conditions with similar symptoms.
Leonardo Fugoso, M.D., is a neurologist in Eau Claire, Wisconsin.
Improving Your Motor Skills
- Work on your tremor. This may include things like putting a little weight on your hand to help reduce tremor and restore control.
- Improve speech quality by working with a speech therapist .
- Reduce problems with eating and drooling by changing how and what you eat.
- Practice overcoming freezing with various techniques, such as stepping toward a specific target on the ground.
- Be open about sexual function problems. Talk to your doctor about your specific issues. He or she may be able to suggest a change in your treatment, such as a change in your medicine or exercise.
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Symptoms Of Parkinson’s Disease
You can attribute the symptoms of Parkinson’s to a deficiency of a chemical in your brain called dopamine. The four classic motor symptoms of Parkinson’s include:
Shaking and tremors while you are resting is typically the first sign of Parkinson’s disease, but about one-third of patients won’t experience those symptoms. These symptoms tend to be worsened by emotional and physical stress. Sleep or moving can help reduce these issues.
Parkinson’s disease is both chronic and progressive with symptoms generally getting worse as time goes on. As it progresses, other disabilities can develop, including:
- Difficulty talking and swallowing
- A sudden inability to move,
Some sufferers also have symptoms that don’t affect their motor skills, including:
- Mental health issues such as anxiety, depression and memory loss
- Loss of smell
- Trouble sleeping, including thrashing and other sudden movements
- Change in blood pressure
A Note For Caregivers
Caregivers can be challenged by the increasing needs of a declining Parkinson’s patient. It is important that caregivers have a good concept of this progressive disease. Support groups are available to help caregivers understand the disease process and how to cope with the various problems they face in caring for a Parkinson’s disease patient.
Additional Information on Parkinson’s Disease
For more information about Parkinson’s Disease, please consider the following:
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Can Parkinson’s Symptoms Come And Go
Why Symptoms Come and Go It helps replace dopamine, which can ease motor problems. However, as the disease progresses, the beneficial effects of the medication often wear off before it is time to take another dose. This creates what is sometimes referred to as the on-off phenomenon of Parkinson’s.
Some Parkinson’s Treatment Options
Parkinson’s disease has no cure, but there are treatment options to control your symptoms and improve your quality of life which include:
- Medication. Levodopa and other medications, which are trying to boost dopamine . There are number of those medications which can be used alone or in combination. Although many of those medications can help you significantly control your motor symptoms , you might also experience side effects and diminished efficacy over time.
- Physical, occupational, and speech therapy are usually part of your treatment plan and can improve your balance, mobility, ability to do daily tasks, and speech.
- Deep brain stimulation is a surgery performed by a neurosurgeon, and in indicated patients can help with motor symptoms, though non-motor symptoms, such as falls, constipation, low blood pressure and incontinence do not improve.
- Tai Chi is a Chinese martial art that may help sufferers regain some of their balance and strength, as well as decrease the risk of falling. Dance, such as a Zumba, may also help, as can using a stationary bicycle and rock steady boxing.
Many treatment options for Parkinson’s are most effective when used in conjunction with others such as taking medication and doing physical therapy.
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Causes Of Early Onset Parkinsons Disease
Its unclear exactly what causes Parkinsons at any age. Genetic factors, environmental factors, or some combination of the two may play a role. This condition occurs when cells are lost in the part of the brain that produces dopamine. Dopamine is responsible for sending brain signals that control movement.
Certain genes are associated with early onset Parkinsons.
According to the National Parkinson Foundation, studies show that 65 percent of people with Parkinsons who experience onset before age 20 may do so because of a genetic mutation. This organization also suggests this mutation affects 32 percent of people who experience onset between age 20 and 30.
Environmental causes of the condition may include exposure to chemical toxins such as certain insecticides, fungicides, and herbicides.
The U.S. Department of Veterans Affairs recognizes Parkinsons as a disease caused by exposure to Agent Orange. Agent Orange is a synthetic chemical herbicide that was used to spray vegetation and trees during the Vietnam War.
You may have a higher risk of developing Parkinsons if you:
- are a man
Environmental Factors And Exposures
Exposure to pesticides and a history of head injury have each been linked with PD, but the risks are modest. Never drinking caffeinated beverages is also associated with small increases in risk of developing PD.
Low concentrations of urate in the blood is associated with an increased risk of PD.
Drug-induced parkinsonism
Different medical drugs have been implicated in cases of parkinsonism. Drug-induced parkinsonism is normally reversible by stopping the offending agent. Drugs include:
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Braaks Hypothesis On How Parkinsons Disease Begins
Braaks hypothesis, named for professor Heiko Braak, MD, who outlined the theory in 2003, suggests that rather than beginning in the brain, Parkinsons disease begins in the periphery of the body. Braaks hypothesis proposes that the earliest signs of PD are found in the gut and the olfactory bulb, an area of the brain involved in the sense of smell.2-4
The accumulation of the protein alpha-synuclein is believed to begin in the gastrointestinal tract or the olfactory bulb before progressing to other areas of the brain. After the aggregates of alpha-synuclein have formed, they appear to be capable of growing and spreading from nerve cell to nerve cell across the brain.2-4
The appearance of alpha-synuclein aggregates coincides with the appearance of symptoms: alpha-synuclein aggregates in the brainstem correlates with the onset of motor symptoms. Appearance of alpha-synuclein aggregates in the cortex correlates with dementia and cognitive dysfunction.2-4
In The Loop: Staying Ahead Of Parkinsons Disease One Ping Pong Game At A Time
Since being diagnosed with Parkinsons disease, Steve Grinnell has worked hard to stay active, stepping up his table tennis game and, thanks to co-workers, testing his skills outside his home.
Four years ago, Steve Grinnells life was forever changed when doctors at Mayo Clinic in Rochester diagnosed him with early-onset Parkinsons disease. Since that time, the progressive nervous system disorder has begun to take a toll on Steve and his family, just as it does on the millions of other Americans living with the disease. It has greatly diminished his quality of life, leaving him with tremors, physical exhaustion, impaired balance, troubled grasping things with his right hand, slow right-arm movement and problems sleeping, the Rochester Post-Bulletin recently reported. Thats to name just a few of his symptoms.
Reading that, one might assume the disorder is winning. And to Steve, sometimes it feels like it is. But much of the time, he tells us he also feels like hes staying one step ahead of the disease by staying as physically active as possible. Parkinsons presents such a conundrum because it wears you down physically, and yet exercise is so valuable, Steve says. My legs, feet and right arm are always cramping, so it takes mental effort to get moving.
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Reduced Sense Of Smell
Most Parkinsons patients in their early stage are reported to have a reduced sense of smell. This problem occurs several years prior to the appearance of motor symptoms, and therefore researchers think that this could be among the early warning signs of the disease.
The link between loss of smell and Parkinsons disease has been increasingly realized in recent years. In fact, newresearch suggests that it could be one of the screening tools for diagnosing Parkinsons disease.
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Who Is Affected By Tremor
About 70% of people with Parkinsons experience a tremor at some point in the disease. Tremor appears to be slightly less common in younger people with PD, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.
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Tremor In Other Conditions
While tremor is a common symptom of Parkinsons, it can also be a symptom of other conditions, most notably essential tremor. The main difference between Parkinsons tremor and most other types of tremor is that in Parkinsons resting tremor is most common. Other conditions are usually characterized by action tremor, which tends to lessen at rest and increase when youre doing something, like trying to make a phone call or take a drink.
Tremors of the head and voice are also common in essential tremor but rare in Parkinsons.
Who Gets Parkinson’s Disease
As stated previously, men are about 1.5 times more likely to develop Parkinson’s disease than women however, although the majority of all patients that get the disease are over 60, the total chance of getting the disease is about 2% to 4% in this age group. Consequently, the disease is not rare but the chances of someone age 60 or over developing the disease is not high.
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Acting Out What Youre Dreaming
- People with REM sleep behavior disorder might talk in their sleep and flail their arms and legs during dreams, accidentally hitting or kicking a person in the same bed.
When people learn about the sleep disorder, they often say, Ive been doing that for years. Theyre sometimes astonished to learn its an early symptom of Parkinsons, Dr. Joseph says.
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
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