1. Nursing Assistant Monthly Copyright © 2010 Delmar, Cengage Learning. All rights reserved. Parkinson’s Disease: Meeting rapidly changing needs NOVEMBER 2010

2. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease What goes wrong in Parkinson’s disease? In Parkinson’s disease:  Dopamine-producing cells in the brain die  Dopamine is needed for normal brain and muscle function  Lack of dopamine causes two categories of symptoms –Motor (associated with movement) –Non-motor No one knows for sure what triggers Parkinson’s disease

3. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease Movement related problems  Muscle rigidity  Slowness of movement  Tremors  Poor balance  Poor swallow reflex  Facial expression is flat –Muscles of the face do not work properly  Voice may be very soft

4. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease Effects of movement problems  ADLs become difficult because muscles will not cooperate  Increased fall risk due to balance and poor muscle control  May have difficulty swallowing food –May need special diet, thickened food  Others may interpret the resident’s mood because lack of smile, soft voice  Can become frustrated, depressed

5. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease Non-movement related effects  Dementia occurs in some people with Parkinson’s disease  Depression is common  Urinary incontinence, constipation  Drop in blood pressure –Person may become lightheaded  Pain  Difficulty with sleep –Sleepy during the day; can’t sleep at night  Altered sense of smell

6. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease Hints for caregivers Symptoms of Parkinson’s disease can vary greatly through the day  Explain this to the resident and family so they know what to expect  Don’t be surprised if resident is able to function well sometimes and needs help at another time of the day Symptom severity largely depends on the timing and effectiveness of medication  Keep nurse informed of resident’s symptoms and how they vary

7. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease More care tips Fall prevention  Keep the area clear of clutter, spills  Place needed items within resident’s reach –For example: tissues, water, call light  Follow the individual care plan for fall prevention for that resident –Assist with ambulation, toileting, other ADLs as needed

8. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease More care tips Tell the nurse  Any changes in vitals signs – immediately –Such as lower than usual blood pressure  If you notice patterns in the resident’s functional ability –For example: resident is able to eat independently at breakfast but not at lunchtime

9. Copyright © 2010 Delmar, Cengage Learning. All rights reserved. November 2010 Parkinson’s disease Helping to preserve dignity  Expect the resident to be slow –Do not rush the resident  Offer choices –Daily activities, what to wear, when and how to bathe (bath or shower, whether or not to shampoo hair today)  Never allow impatience to show –The resident is doing their best