1. Lisa Pezik, RN BScN Clinical Educator

2. Discuss the physiology and incidence. Review signs and symptoms at all stages. Discuss treatment options (pharm/non-pharm).

4. A genetic, progressive brain disorder Parent has 50% chance of passing on the HD gene Affects the basal ganglia Caudate Putamen Globus pallidus Voluntary movements Emotion Learning Reasoning

5. Appear between the ages of 30-50. Emotional Depression Irritability Anxiety Obsessiveness Cognitive Inability to focus and plan Trouble making decisions Physical Difficulty Walking Talking Swallowing

6. Death usually occurs 15-25 years after onset/diagnosis Diagnosis: Blood test for HD gene Neurological testing Psychological testing Review of family history

8. Cindy was admitted into LTC three years year: Having frequent falls Losing her mobility Unable to cook meals for herself. Became suspicious of family Suspicious of meals on wheels Refused visits from family MD What stage of Progression of HD was Cindy three years ago?

9. Cindy’s family is coming in for a care conference today. The goals is to discuss treatment options for Cindy’s frequent aspiration pneumonias. Cindy also frequently becomes anxious and refuses baths from unfamiliar staff. Cindy refuses all programming as she doesn’t want to spend time with “old people.” At times, Cindy’s spastic movements result in hitting staff. Her medications must be reviewed.

10. What stage in the progression is Cindy now?

12. No known cure at this time for HD In 2011, Canadian researchers were able to successfully reverse the physical symptoms of the disease in a mouse model. Goals is symptom reduction and comfort Involuntary movements Anxiety Depression Obsessiveness

13. Antipsychotics Treat the chorea and help with involuntary movements Worsen symptoms and rigidity Haldol Risperadol Seroquel Clonazepam Klonipin Antidepressants Stabilize mood and obsessiveness Nausea, weight gain, low BP, drowsiness Celexa Zoloft Depacon

14. Speech Therapy Recreation Therapy Physical Therapy/Occupational Therapy Volunteers

15. Huntington’s Society of Canada. www.huntingtonsociety.ca www.huntingtonsociety.ca