Caring for Client’s with Parkinson’s Disease ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Objectives List the causes and symptoms of Parkinson’s disease (PD). Describe the care and treatment of clients with Parkinson’s disease. Give appropriate care to clients with Parkinson’s disease. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Understanding Parkinson’s Disease In Parkinson’s Disease, brain cells that produce the chemical dopamine are destroyed or impaired. Dopamine helps direct muscle activity. When the cells that make it aren’t working, the brain can’t coordinate the body’s muscle movements. The result is disorganized movement, or a complete inability to move at all. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Understanding Parkinson’s Disease (cont.) Parkinson’s disease is one form of a group of movement disorders called Parkinsonism. All share the same main symptoms Result of the loss of dopamine-producing brain cells May have different causes and treatments Affect the motor, or movement of the body, which are controlled by the central nervous system ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Understanding Parkinson’s Disease (cont.) Affects over a million people in the U.S. 75% of cases are in people over age 50 Men and women afflicted equally Begins gradually, getting worse with time Named after a British doctor Most forms occur without known cause May be caused by drugs, head injury, genetic mutations, or other medical disorders ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Understanding Parkinson’s Disease (cont.) Not a fatal disease by itself. With the right treatment, most people can live productively for many years. May cause complications that can lead to death Choking Pneumonia No cure Falls ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Symptoms and Characteristics of Parkinson’s Disease Tremor or trembling in hands, arms, legs, jaw, and face Rigidity or stiffness of limbs and trunk Slowness of movement Impaired balance and coordination ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Symptoms and Characteristics of Parkinson’s Disease (cont.) Chronic, persisting over a long time Progressive, growing worse over time Not contagious or directly inherited Does not affect the thinking or feeling parts of the brain Client is aware of his or her disabilities and is often depressed by them. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Problems of Parkinson’s Disease Impaired mobility Halting or shuffling gait Freezing or slowing when trying to move Slowing of the stomach and intestinal muscles Constipation Loss of appetite Weight loss ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Problems of Parkinson’s Disease (cont.) Inability to control the muscles in the mouth, face, jaw, and throat Drooling and swallowing difficulties Dehydration and weight loss Creates speech difficulties A factor in respiratory infections and pneumonia Falls Due to poor balance and impaired muscle control ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Think about it Imagine that the following things start to happen: Your hands shake uncontrollably. You drool constantly. You can’t blink your eyes. Your limbs and body are stiff and rigid. You are unbalanced, leaning to one side. Your face becomes a blank mask. You shuffle as you walk. You can’t speak well enough to make anyone understand you. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Treating Parkinson’s Disease Medications None exist to cure the disease Many become less effective over time Most common side effects: Nausea Low blood pressure Dosages often have to be adjusted as they become less effective ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Treating Parkinson’s Disease (cont.) 2. Surgery Sometimes indicated to destroy parts of the brain that produce some of the symptoms Tremors Rigidity Most surgeries are experimental ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Treating Parkinson’s Disease (cont.) 3. Exercise Physical therapy or muscle-strengthening exercises can tone muscles and put rigid muscles through a full range of motion. Can improve balance, gait, strength, and speaking and swallowing ability May help with depression. Can postpone the worsening of the disability and enable the client to continue more activities of daily living for a longer time. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Treating Parkinson’s Disease (cont.) 4. Diet Research has not found any nutrients or special diets that have any therapeutic value. Adequate fluid and calorie intake are important to prevent dehydration and weight loss. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help a Client Improve His Mobility Client should learn to use ambulatory aids and should know and use fall prevention techniques. Maintaining a rhythmic stride is the key to smooth mobility and gait. Look ahead to anticipate changes in the flooring. Count while walking, saying “1, 2, 3, 4” over and over again. Listen to strongly rhythmical music. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help a Client Improve His Mobility (cont.) If the client freezes in place: Never pull him or her forward by the arms. Have the client take a step backwards or sideways. Have the client give orders to his or her body. Parkinson’s disease makes clients unstable in their movements. Use fall precautions and safety measures at all times. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help with Swallowing Difficulties Use thick liquids, not thin Give soft and semi-soft foods. Teach the client to think of swallowing as a sequence of small events: Put food on the tongue Close the lips Chew the food Teach the client to alternate chewing on one side of the mouth, then the other. Lift the tongue up and back Swallow ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help with Stomach Problems Constipation can be a very serious problem. Helpful hints: Provide a diet high in fiber Vegetables Fruits Whole-grain breads Encourage fluid intake Encourage exercise ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help with Stomach Problems (cont.) Weight loss caused by a loss of appetite and by swallowing difficulties leads to poor health. Do these things: Weigh the client weekly. Offer smaller, more frequent meals, which can be easier to swallow and digest. Offer high-calorie liquids like instant breakfast drinks. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help with Speech Difficulties Teach deep breathing exercises to strengthen the respiratory muscles: Take five deep breaths, expanding the stomach muscles on inhalation. Exhale while speaking the sounds “ah” and “oh” aloud. Deeply inhale, and then exhale while saying the days of the week with pronounced facial motions. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Ways to Help with Speech Difficulties (cont.) Don’t rush the client who is trying to talk. Be sure your body language is relaxed and that you are patient and encouraging. If the client becomes frustrated when trying to speak, phrase questions that require only a “yes” or “no” answer. Offer to provide a word or phrase, or offer to return later. Encourage the client to sing, and to read or speak aloud. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

Please Complete Test and Evaluation. Thank You. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease

©CareTrack Resources, Inc, 2008. All Rights Reserved ©CareTrack Resources, Inc, 2008. All Rights Reserved. May Not Be Used or Reproduced Without Permission. Contact 1-888-424-7003 for Assistance. ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease ©2008 CareTrack Resources: Caring for Client's with Parkinson's Disease