Care Tips for Parkinson’s Disease Patients

Parkinson’s disease is a neurodegenerative disorder caused by the deficiency of dopamine-producing neurons. Parkinson’s disease generally affects elderly people in 6os and 70s however young onset Parkinson’s disease affects people younger than 50 years in about 5-10% of cases. 

Clinical symptoms 

The clinical symptoms can be divided into two categories 

1. Motor symptom 
2. Non-motor symptoms

Motor symptom

1. Shake or tremors 
2.  Slow movements
3. Stiffness in body parts or rigidity in medical terms
4. Loss of balance or difficulty walking

Non-motor symptoms of Parkinson's disease

There are many troublesome non-motor symptoms that adversely affect the quality of life of Parkinson’s patients

1. Fatigue
2. Low blood pressure or fluctuation in blood pressure with posture
3. Bladder and bowel problems
4. Restless legs- discomfort in legs
5. Skin and sweating problems
6. Sleep problems
7. Eating, swallowing, and saliva control
8. Speech and communication problems
9. visual problems 
10. Pain
11. Mild memory and thinking problems
12. Anxiety
13. Dementia
14. Depression
15. Hallucinations and delusions

Symptoms preceding the onset of Parkinson’s Disease

Some symptoms may precede the onset of Parkinson’s disease by many years

1. Constipation
2. Rapid eye movement sleep behavior disorder or RBD is a sleep disorder in which you physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during sleep
3. Loss of smell or reduced smell sensation.

What causes Parkinson’s Disease

Parkinson’s disease is caused by the interplay of genetic and environmental factors. Environmental factors which are associated with Parkinson’s disease are rural living, well water drinking, farming, and pesticide exposure repeated head trauma like in boxing. Tobacco Smoking and association with pets seem to protect against Parkinson’s disease.

Treatment 

Symptoms are controlled with medicine to a large extent for 8-10 years after the onset of the disease. As the disease advances effect of the medicine wears off soon and patients may freeze completely for some duration which is known as “freezing episodes”. There may be excessive extra involuntary movements known as dyskinesia. Some patients swing between freezing and dyskinesia and hardly spend any time in a normal state. Apomorphine injections help in overcoming freezing quickly. At this advanced stage, patients benefit from Deep Brain Stimulation or DBS surgery. 

Care tips for Parkinson’s disease patients

1. Eat healthy food and maintain good hydration, including plenty of vegetables, fruits, and fibers in your diet, which can help with constipation which is quite common with this disease. Flax seeds and Isbgol husk are good sources of fiber

    

2. Levodopa medicine should be taken empty stomach, one hour before or two hours after the meal. A high protein diet or vitamin B6 or pyridoxin interferes with the absorption of levodopa

    

3. Stay active, exercise daily, and practice yoga and meditation. Cycling skill is exceptionally preserved in patients which can be opted as exercise. As falls are quite common, go for static cycles and exercises which are safe.

    

4.  There are also exercise programs that are designed specifically for people with Parkinson’s disease

    

5. Make your home safer – get rid of loose rugs and clutter, make sure all electrical cords are neatly tucked away and anti- slip flooring /tiles and side rails in the washroom

    

6. Join support groups as it gives you strength that you are not the only one and you get many innovative care tips from other people

    

7. Take all necessary adult vaccination shots like pneumococcal, influenzas, and COVID- 19. Infection worsens symptoms of Parkinsonism followed by a prolonged recovery period

    

8. Any surgery or intercurrent illness is poorly tolerated by these patients and symptoms worsen after surgery. Go for a specific rehabilitation exercise program to attain pre-surgery status

    

9. Vision should be clear, get cataract operated, appropriate corrective of presbyopia (nearsightedness) refractive errors but avoid progressive lens as it may increase risk of fall. Artificial tear drops should be used for the lubrication of the eyes

    

10. Get hearing checked and get hearing aids if needed

     

11. Be aware of driving safety – there may be a misjudgment of distance, avoid driving. If you still drive get your vision checked thoroughly

     

12. Patients should carry an identity card or GPS tracker, as there may be trouble with memory with disease progression

     

13. Learn more about Parkinson’s disease and its treatment – This way you can be actively involved in your care, and maintain symptoms diary as this guide doctor to titrate medicines

These small care tips bring can bring significant changes in the quality of life of Parkinson's disease patients.