How To Deal With Parkinson’s Disease

Support For People Living With Parkinsons Disease

While the progression of Parkinsons is usually slow, eventually a persons daily routines may be affected. Activities such as working, taking care of a home, and participating in social activities with friends may become challenging. Experiencing these changes can be difficult, but support groups can help people cope. These groups can provide information, advice, and connections to resources for those living with Parkinsons disease, their families, and caregivers. The organizations listed below can help people find local support groups and other resources in their communities.

What Are The Early Warning Signs Of Parkinson’s Disease

Parkinsons warning signs can be motor symptoms like slow movements, tremors or stiffness. However, they can also be non-motor symptoms. Many of the possible non-motor symptoms can appear years or even decades ahead of motor symptoms. However, non-motor symptoms can also be vague, making it difficult to connect them to Parkinson’s disease.

Non-motor symptoms that might be early warning signs include:

• Sleep problems such as periodic limb movement disorder , rapid eye movement behavior disorder and restless legs syndrome.

Managing Anger And Irritability In Parkinsons As A Caregiver

Informal caregivers particularly family members often play a significant role in helping and caring for loved ones with Parkinsons. Research has shown that caregivers are especially affected by caring for someone dealing with cognitive and mental dysfunctions from Parkinsons. These caregivers report higher caregiver burden and lower overall well-being and quality of life than caregivers of people with PD without significant cognitive impairment. Many caretakers of people with Parkinsons experience anxiety and depression.

The stress of caregiving is a common topic of conversation on MyParkinsonsTeam. One member wrote, My wife has Parkinsons. It is hard to deal with all her ups and downs. We are both exhausted.

Another member wrote about her husband with Parkinsons: His dementia is hard. He is emotional at times, angry at times, and is not aware where he is at times. One member said, My husband has Parkinsons, dementia, diabetes, and a bad heart. It is getting more and more difficult to give him his medications, as he gets very angry and does not take them.

Its important to remember that anger and irritability in people with Parkinsons is often a part of the disease. It is not your fault.

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What Causes Parkinson’s Disease

No one knows for sure what makes these nerve cells break down. But scientists are doing a lot of research to look for the answer. They are studying many possible causes, including aging and poisons in the environment.

Abnormal genes seem to lead to Parkinson’s disease in some people. But so far, there is not enough proof to show that it is always inherited.

Traditional Chinese Medicine And Acupuncture

Traditional Chinese Medicine views disease as caused by internal imbalances. It has historically been used to treat Parkinson disease with acupuncture and individually prepared herbal remedies. One study showed that acupuncture improved symptoms in a small group of people with Parkinson disease. People with Parkinson disease may also find that acupuncture helps them sleep better. If you consult a TCM practitioner, make sure your doctor is aware of any suggested treatment.

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Learn Everything You Can About The Disease

Parkinsons disease is a movement disorder. If youre a caregiver for someone living with Parkinsons, youre likely familiar with some of the symptoms of the disease.

But do you know what causes its symptoms, how the condition progresses, or what treatments can help manage it? Also, Parkinsons doesnt manifest the same way in everyone.

To be the best ally for your loved one, learn as much as you can about Parkinsons disease. Do research on reputable websites like the Parkinsons Foundation, or read books about the condition.

Tag along for medical appointments and ask the doctor questions. If youre well informed, youll have a better idea of what to expect and how to be the most help.

Causes Of Parkinsons Disease

At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:

• environmental triggers, pesticides, toxins, chemicals
• genetic factors
• combinations of environment and genetic factors

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Dealing With Parkinson’s Disease: A Guide For Patients And Families

Parkinson’s disease is an ongoing, progressive disease of the nervous system that affects a patient’s movement. Millions of individuals worldwide are diagnosed with Parkinson’s disease. The cause of Parkinson’s disease is presently not known. However, research attributes the disease to a combination of genetic and environmental factors. Age also plays a role. Most cases of Parkinson’s disease beginning after an individual is sixty years old.

Unfortunately, there is currently no Parkinson’s disease cure. There are, however, treatments for Parkinson’s disease. Many patients take Parkinson’s disease medications to control their symptoms. Occupational therapy is also a huge part of treating Parkinson’s disease. Overall, this condition requires intense treatment and symptom management for patients to live a full life.

As Part Of Our Livetalk Series Being Patient Spoke With John Gastil And Movement Disorder Specialist Dr Zoltan Mari About The Symptoms Diagnosis And Treatment Of Parkinsons And Lewy Body Dementia

Parkinsons is the second most common neurodegenerative disease after Alzheimers roughly 60,000 people in the United States are diagnosed with the former annually. As a child, John Gastil watched his grandmother navigate Alzheimers. Decades later, his father was diagnosed with Parkinsons and eventually Lewy body dementia.

Being Patient spoke with Gastil about his fathers journey with the disorders and with Dr. Zoltan Mari, director of the Parkinsons and Movement Disorders Program at Cleveland Clinic Lou Ruvo Center for Brain Health, who shared insights in the diagnosis, clinical care and science of the neurodegenerative diseases.

• While Alzheimers is characterized by beta-amyloid plaques and tau tangles, the hallmark of Parkinsons and Lewy body dementia is a protein called alpha-synuclein.
• The sequence of symptoms between Parkinsons disease dementia and Lewy body dementia differ early on, but as the disorders progress, their symptoms and brain changes are similar clinicians often think of the two as being on the same spectrum as opposed to distinct diseases.
• Early on, Parkinsons damages the nigrostriatal pathway, a brain region with dopamine-producing neurons that regulate movement.
• Dr. Mari urged people to consult with a movement disorder specialist for accurate diagnoses of Parkinsons and Lewy body dementia.

Being Patient: We often hear Parkinsons and dementia mentioned together, can you help us understand the two conditions?

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Whats Really Going On In The Brain That Develops Parkinsons Disease

Your brain has full control over everything you do. Apart from other key functions, your brain controls the different movements of your body. The region responsible for this job is known as the Substantia nigra, a Latin word meaning black substances.

The Substantia nigra is abundant with special brain cells called Dopaminergic neurons. These are named dopaminergic because they produce Dopamine, a chemical messenger released by the brain for controlling body movements .

In Parkinsons disease, these Dopaminergic neurons start to die and the brain becomes unable to produce dopamine in sufficient quantity to governs body movements .

As a result, the body becomes stiff and slow in movements . In addition, some parts of the body, like hands, develop an uncontrolled shaking normally known as tremor .

What To Avoid As A Caregiver For Parkinsons Disease

These are some things to avoid while caring for someone with Parkinsons disease:

• Avoid changing their day-to-day schedule: Stick to a daily routine as far as possible, so the person knows what to expect at each time of day. They may struggle to cope with changes to their routine.
• Avoid distracting stimuli: Try to keep the persons environment free of distractions, such as loud noises or brightly-patterned decor, as it can be confusing and disorienting.
• Avoid changing their environment: Try not to make any changes to the persons surroundings, such as changes to the layout of the house. Keeping it the same can help prevent falls caused by disorientation.
• Avoid confusing them: When you communicate with the person, use simple sentences and ask only yes or no questions. Avoid interrupting them or finishing their sentences. Though it may take them time to complete a sentence, interjecting in between can confuse and frustrate them.
• Avoid losing your patience with them: Parkinsons disease can cause the person to speak and move slowly. Be patient with them and try to match their pace to make them more comfortable.
• Avoid shouting at them: There may be times when you get angry or frustrated with your loved one. However, try to refrain from shouting at them or speaking to them sharply. The dementia that may accompany Parkinsons disease can cause them to respond aggressively. Stay calm and be still while you talk to them.

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Caring For A Loved One With Parkinson’s Disease

The caregiver of an individual affected by Parkinson’s disease is often their spouse, child, sibling, or another loved one. Caregiving is the actions performed to help a relative or friend with a disability or illness. An individual who is a caregiver for their loved one with Parkinson’s disease will experience changes in their role as the disease progresses. A caregiver will most likely manage their medications, schedule their appointments, help with daily care and hygiene, and act as a healthcare advocate. They will also provide emotional support as their loved one learns to cope with their condition.

As a loved one’s symptoms worsen, the demands of their caregiver will increase. Some challenges noted by caregivers for a loved one who has Parkinson’s disease include frustration around the ability to communicate, chronic fatigue, and the pressing responsibility for injury prevention.

What Are The Risk Factors For Parkinsons Disease

Risk factors for Parkinsons disease include:

Genetics

People with a first-degree relative with Parkinsons are at an increased risk for the disease possibly as much as 9 percent greater.

Fifteen percent of people with Parkinsons have a known relative with the disease, but a condition called familial Parkinsons, which has a known genetic link, is relatively rare.

The average age of onset is 60 years, and the incidence rises with advancing age. About 4 percent of people have early-onset or young-onset disease, which begins before age 50.

Gender

Parkinsons affects about 50 percent more men than women, for unknown reasons.

Pesticide Exposure

Exposure to some pesticides has been shown to raise the risk of developing Parkinsons.

Problematic chemicals include organochlorine pesticides like DDT, dieldrin, and chlordane. Rotenone and permethrin have also been implicated.

Fungicide and Herbicide Exposure

Exposure to the fungicide maneb or the herbicides 2,4-dichlorophenoxyacetic acid , paraquat, or Agent Orange may raise the risk of Parkinsons.

The U.S. Veterans Health Administration considers Parkinsons to be a possible service-related illness if the person was exposed to significant amounts of Agent Orange.

Head Injuries

Head injuries may contribute to the development of Parkinsons in some people.

Coffee and Smoking

People who drink coffee or smoke tobacco have been found to have a lower risk of Parkinsons disease, for reasons that remain unclear.

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Lewy Body Dementia Vs Parkinsons Disease Dementia

Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.

Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.

The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.

This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.

The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.

Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.

Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.

Parkinsons disease itself isnt fatal, but complications can be.

Research has shown a median survival rate of about

What Are The Symptoms

The best-known symptoms of Parkinson’s disease involve loss of muscle control. However, experts now know that muscle control-related issues aren’t the only possible symptoms of Parkinson’s disease.

Motor-related symptoms

Motor symptoms which means movement-related symptoms of Parkinsons disease include the following:

Additional motor symptoms can include:

• Blinking less often than usual. This is also a symptom of reduced control of facial muscles.
• Cramped or small handwriting. Known as micrographia, this happens because of muscle control problems.
• Drooling. Another symptom that happens because of loss of facial muscle control.
• Mask-like facial expression. Known as hypomimia, this means facial expressions change very little or not at all.
• Trouble swallowing . This happens with reduced throat muscle control. It increases the risk of problems like pneumonia or choking.
• Unusually soft speaking voice . This happens because of reduced muscle control in the throat and chest.

Non-motor symptoms

Several symptoms are possible that aren’t connected to movement and muscle control. In years past, experts believed non-motor symptoms were risk factors for this disease when seen before motor symptoms. However, theres a growing amount of evidence that these symptoms can appear in the earliest stages of the disease. That means these symptoms might be warning signs that start years or even decades before motor symptoms.

Non-motor symptoms include:

Stages of Parkinsons disease

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Support For People With Parkinsons Disease

Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.

Medications Used For Treating Psychosis

Antipsychotic agents are designed to balance abnormal chemical levels in the brain. Up until the 1990s, the use of antipsychotics in PD was controversial because the drugs used until that time work by reducing excess dopamine. This alleviated psychosis but caused dramatic worsening of PD motor symptoms.Fortunately, medications that are better tolerated by people with PD are now available. Today, there are three antipsychotic medications considered relatively safe for people with PD. They cause limited worsening of PD while treating hallucinations and delusions.

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Can Parkinson’s Disease Be Cured

No, Parkinson’s disease is not curable. However, it is treatable, and many treatments are highly effective. It might also be possible to delay the progress and more severe symptoms of the disease.

A note from Cleveland Clinic

Parkinson’s disease is a very common condition, and it is more likely to happen to people as they get older. While Parkinson’s isn’t curable, there are many different ways to treat this condition. They include several different classes of medications, surgery to implant brain-stimulation devices and more. Thanks to advances in treatment and care, many can live for years or even decades with this condition and can adapt to or receive treatment for the effects and symptoms.

Deep Brain Stimulation Surgery

DBS surgery has been available for over 20 years and is used to treat troublesome tremor, to prevent off times and to moderate excessive dyskinesia. Recently there is a shift to perform DBS in the early stages of PD in an effort to delay the onset of disabilities and to maintain good quality of life for longer.

DBS surgery involves inserting electrodes into targeted areas of the basal ganglia, usually the sub thalamic nucleus. The electrodes are connected to an impulse generator battery that is inserted under the collar bone. The generator provides impulses to the brain via the electrodes. Usually the PD medications can be reduced dramatically after surgery.

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Lifestyle And Home Treatments

Doctors will help patients find an appropriate treatment plan, often involving medication, that helps relieve symptoms with the fewest side effects. However, living with Parkinson’s disease can be made quite a bit easier with specific lifestyle changes. A healthy, balanced diet high in fiber and fluids can help relieve symptoms such as constipation. Omega-3 fatty acids may also beneficial for Parkinson’s disease patients. Exercising will help reduce emotional disturbances, such as depression and anxiety, and help improve balance.

Daily living activities can be difficult for individuals dealing with Parkinson’s disease. Thus, they should see an occupational therapist who can teach them techniques to help make life easier. Lifestyle changes, furthermore, are also something family members can also join in on with no worries as to side effects. However, they must follow the recommended guidelines from doctors as well. This kind of participation can provide invaluable support to the Parkinson’s disease patient.

Accurate Parkinson’s Disease Diagnosis

Parkinson’s is challenging to diagnose because symptoms, such as difficulty walking, can be a sign of other movement disorders. Some people have parkinsonism. This group of diseases causes Parkinson’s-like symptoms that do not respond to Parkinson’s treatments.

At Cedars-Sinai, we consider your health history and perform a nervous system exam before confirming a Parkinson’s diagnosis. Our years of experience enable us to detect subtle symptoms that do not show up on other tests.

Tests may include:

Levodopa Testing

Testing your response to a Parkinson’s drug, levodopa, allows us to rule out some other movement disorders. Levodopa boosts dopamine levels and is not an effective treatment for other movement disorders. If your symptoms improve with levodopa, you likely have Parkinson’s.

DaTscan Test

We may use this noninvasive imaging test to help rule out Parkinsonian syndrome. This group of disorders causes movement problems similar to Parkinson’s but might not stem from the disease. Learn more about DaTscan.

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