Eating With Parkinsons Disease
Specially designed eating utensils for Parkinsons patients feature padded or built-up handles to help facilitate the eating process. Individuals who have difficulty controlling the fine motor skills necessary for eating and drinking may also benefit from weighted utensils and cups. Knives with a curved blade can allow PD patients to cut their own food with a rocking motion instead of the traditional sawing motion that may be more challenging. Serving meals in bowls or on plates with high lips or sides can make it much easier for patients to scoop food onto utensils and encourages self-feeding. Dishware with non-skid rubber bottoms can be helpful as well.
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Prescription medications may also cause side effects like dry mouth, so it is very important to always encourage your loved one to sip on liquids during meals and throughout the day. This will help facilitate eating and swallowing and ensure they stay hydrated.
What Are The Symptoms Of The Disease
The four primary symptoms of PD are:
- Tremor. Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. The tremor associated with PD has a characteristic rhythmic back-and-forth motion that may involve the thumb and forefinger and appear as a pill rolling. It is most obvious when the hand is at rest or when a person is under stress. This tremor usually disappears during sleep or improves with a purposeful, intended movement.
- Rigidity. Rigidity , or a resistance to movement, affects most people with PD. The muscles remain constantly tense and contracted so that the person aches or feels stiff. The rigidity becomes obvious when another person tries to move the individuals arm, which will move only in ratchet-like or short, jerky movements known as cogwheel rigidity.
- Bradykinesia. This slowing down of spontaneous and automatic movement is particularly frustrating because it may make simple tasks difficult. The person cannot rapidly perform routine movements. Activities once performed quickly and easilysuch as washing or dressingmay take much longer. There is often a decrease in facial expressions.
- Postural instability. Impaired balance and changes in posture can increase the risk of falls.
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.
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Trouble Moving Or Walking
People without PD do not think about their walking. Their arms naturally swing, and their feet naturally land on the heels with each step. They can walk and talk and carry bags, purses and plates of food without difficulty.
Individuals with PD tend to lose their automatic movements. Especially as Parkinsons advances, it may bring with it a variety of symptoms that are uncommon in early stages, such as problems with walking and poor balance . Feet begin to shuffle, and performing two tasks at once becomes more difficult. Turning becomes challenging, often leading to a freezing episode and sometimes a fall.
Parkinsons Disease Is a Movement and Sensory Disorder
People with PD have trouble regulating the speed and/or size of their movements. Movements are bradykinetic or hypokinetic .
Changes in the movement system lead to challenges controlling movements, including the following:
- Starting and stopping movements
- Linking different movements to accomplish one task
- Finishing one movement before beginning the next
Changes in the sensory system also lead to challenges, particularly noticing and correcting movement and voice issues, including the following:
- Slowness or smallness of movements
- Lack of movement
- Changes in posture
- Changes in voice volume
Walking Changes
There are many PD-related walking changes:
Managing Walking Changes
Walking Tips
Turning Tips
Freezing
Managing Freezing
Tips for Care Partners
Freezing is a significant cause of falls.
Getting Dressed With Parkinsons Disease
Dressing someone with Parkinsons disease may become a time- and labor-intensive task as their motor skills and strength wane. In addition, muscle stiffness and painful muscle cramps can make dressing difficult and unpleasant. Whenever possible, replace buttons or zippers with Velcro or magnetized fasteners. Opt for loose-fitting clothing, which is easier and more comfortable to get on and off. An extra-long shoehorn can help with putting on shoes while seated. One of the most important things for a caregiver to remember when providing assistance with dressing is to go slow and set aside plenty of time for this activity of daily living .
Read:Tips for Dressing Someone with Parkinsons
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Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- medication
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
What Are The Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.
Parkinson disease dementia can cause problems with:
- Speaking and communicating with others
- Problem solving
- Forgetfulness
- Paying attention
If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.
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How Is The Disease Diagnosed
There are no tests that can provide a hundred percent diagnosis of the disease. The neurologist will mainly diagnose the disease by looking at the medical history and the symptoms. The tests that help a neurologist diagnose Parkinsons disease include:
- Single-Photon Emission Computerized Tomography: The test helps to have scans of dopamine levels in the brain.
- Imaging Test: MRI and CT scan help determine if other illnesses correlate to the symptoms.
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
Simplifying Activities Of Daily Living For Parkinsons Patients
Many aspects of daily life that we take for granted become increasingly difficult for someone who is living with Parkinsons. Movement symptoms like weakness, tremor, rigidity, balance problems and bradykinesia become especially pronounced in the middle and later stages of the disease. Medications used to treat PD, such as carbidopa-levodopa, dopamine agonists, MAO B inhibitors and anticholinergics, can also have bothersome side effects like dyskinesia , lightheadedness, drowsiness, hallucinations and confusion that interfere with daily routines. Fortunately, there are assistive devices and adaptations that can help patients maintain their quality of life and make caring for someone with Parkinsons easier for family caregivers.
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Related Diagnosis: Lewy Body Dementia
Current research is helping to differentiate dementia related conditions in relationship to Parkinsonâs disease. Doctorâs use a 12-month arbitrary rule to aid in diagnosis. When dementia is present before or within 1 year of Parkinsonâs motor symptoms developing, an individual is diagnosed with DLB. Those who have an existing diagnosis of Parkinsonâs for more than a year, and later develop dementia, are diagnosed with PDD.
In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. Cholinesterase inhibitors, medications originally developed for Alzheimerâs disease, are the standard treatment today for cognitive DLB and PDD symptoms. Early diagnosis is important, as DLB patients may respond differently than Alzheimerâs disease patients to certain drug, behavioral, and dementia care treatments.
This challenging, multi-system disorder involving movement, cognition, behavior, sleep, and autonomic function requires a comprehensive treatment approach to maximize the quality of life for both the care recipient and their caregiver. It is very important to pay attention to symptoms of dementia and to search for an expert clinician who can diagnose the condition accurately.
How Can People Cope With Parkinson’s Disease
While PD usually progresses slowly, eventually daily routines may be affectedfrom socializing with friends to earning a living and taking care of a home. These changes can be difficult to accept. Support groups can help people cope with the diseases emotional impact. These groups also can provide valuable information, advice, and experience to help people with PD, their families, and their caregivers deal with a wide range of issues, including locating doctors familiar with the disease and coping with physical limitations. A list of national organizations that can help people locate support groups in their communities appears at the end of this information. Individual or family counseling may also help people find ways to cope with PD.
People with PD may also benefit from being proactive and finding out as much as possible about the disease in order to alleviate fear of the unknown and to take a positive role in maintaining their health. Many people with PD continue to work either full- or part-time, although they may need to adjust their schedule and working environment to accommodate their symptoms.
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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.
Key Programs And Resources
The Parkinsons Disease Biomarkers Programs , a major NINDS initiative, is aimed at discovering ways to identify individuals at risk for developing PD and Lewy Body Dementia and to track the progression of the disease. It funds research and collects human biological samples and clinical data to identify biomarkers that will speed the development of novel therapeutics for PD. Goals are improving clinical trials and earlier diagnosis and treatment. Projects are actively recruiting volunteers at sites across the U.S. NINDS also collaborates with the Michael J. Fox Foundation for Parkinsons Research on BioFIND, a project collecting biological samples and clinical data from healthy volunteers and those with PD. For more information about the PDBP and how you can get involved, please visit the PDBP website.
The NINDS Morris K. Udall Centers of Excellence for Parkinsons Disease Research program supports research centers across the country that work collaboratively to study PD disease mechanisms, the genetic contributions to PD, and potential therapeutic targets and treatment strategies.
The NINDS Intramural Research Program conducts clinical studies to better understand PD mechanisms and develop novel and improve treatments.
The NINDS Biospecimens Repositories store and distribute DNA, cells, blood samples, cerebrospinal fluid, and autopsy tissue to PD researchers around the world.
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How To Help Someone With Parkinsons Stay Mobile
A very common symptom of Parkinsons is freezing. This happens when a person is walking or moving and suddenly experiences extreme rigidity and an almost complete loss of movement as if their feet are glued to the floor. When this happens, prompting can help your loved one become unstuck. Ask them to pretend that they are stepping over an imaginary line or object on the floor, or even encourage them to rock very slowly and gently from side to side to help them get moving again. If freezing is a common occurrence for your loved one, consider purchasing a specialty mobility device like a walker or rollator that is equipped with a laser pointer. When freezing occurs, they can simply press a button to project a laser line on the floor and use it as a visual cue to help them continue moving.
Massage therapy for Parkinsons patients can alleviate stress and relieve spasms, tremors, rigidity and muscle cramps. Heating pads also soothe aching muscles, and menthol pain relieving gel does wonders for stiff joints, but never use both together.
Exercising can be difficult at first but very beneficial for those living with PD. Encourage your loved one to do hand exercises like squeezing a rubber ball for short periods of time throughout the day to help reduce tremors and to keep hands and fingers strong and flexible. Even short daily walks and a mild fitness routine can keep muscles, tendons and joints strong for as long as possible.
Gastrointestinal Issues In Advanced Parkinsons Disease
Problems with motility of the gut can be a major source of difficulty throughout the disease course and can be particularly problematic in advanced PD as well. . Constipation, which can be one of the earliest symptoms of PD is a very common problem throughout the disease course. Two gut issues that tend to be particularly problematic in people with advanced PD are abdominal pain and fecal incontinence.
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What Treatments Are Available
Many Parkinson’s patients enjoy an active lifestyle and a normal life expectancy. Maintaining a healthy lifestyle by eating a balanced diet and staying physically active contributes to overall health and well-being. Parkinson’s disease can be managed with self-care, medication, and surgery.
Self careExercise is as important as medication in the treatment of PD. It helps maintain flexibility and improves balance and range of motion. Patients may want to join a support group and continue enjoyable activities to improve their quality of life. Equally important is the health and well being of the family and caregivers who are also coping with PD. For additional pointers, see Coping With Parkinsons Disease.
These are some practical tips patients can use:
Medications There are several types of medications used to manage Parkinson’s. These medications may be used alone or in combination with each other, depending if your symptoms are mild or advanced.
After a time on medication, patients may notice that each dose wears off before the next dose can be taken or erratic fluctuations in dose effect . Anti-Parkinsons drugs can cause dyskinesia, which are involuntary jerking or swaying movements that typically occur at peak dosage and are caused by an overload of dopamine medication. Sometimes dyskinesia can be more troublesome than the Parkinsons symptoms.
How Is A Diagnosis Made
Because other conditions and medications mimic the symptoms of PD, getting an accurate diagnosis from a physician is important. No single test can confirm a diagnosis of PD, because the symptoms vary from person to person. A thorough history and physical exam should be enough for a diagnosis to be made. Other conditions that have Parkinsons-like symptoms include Parkinsons plus, essential tremor, progressive supranuclear palsy, multi-system atrophy, dystonia, and normal pressure hydrocephalus.
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How Does Parkinson’s Affect The Body
The telltale symptoms all have to do with the way you move. You usually notice problems like:
Rigid muscles. It can happen on just about any part of your body. Doctors sometimes mistake early Parkinson’s for arthritis.
Slow movements. You may find that even simple acts, like buttoning a shirt, take much longer than usual.
Tremors. Your hands, arms, legs, lips, jaw, or tongue are shaky when you’re not using them.
Walking and balance problems. You may notice your arms aren’t swinging as freely when you walk. Or you can’t take long steps, so you have to shuffle instead.
Parkinson’s can also cause a range of other issues, from depression to bladder problems to acting out dreams. It may be a while before abnormal movements start.