Elder Care for Parkinson’s Disease

Michael J. Fox, a popular Hollywood actor who was diagnosed with young- onset Parkinson’s disease in 1991, stands as a hero with his organization Michael J. Fox Parkinson’s Research Foundation.  He states boldly on his website, “Our Challenges don’t define us.  Our Actions do!”

Increasingly, we are seeing caregivers dealing with patients and loved ones afflicted with Parkinson’s disease.  Parkinson’s disease is the second most common neuro-degenerative disorder after Alzheimer’s disease and affects over one million people in the US.  Parkinson’s is more common in the elderly and rises from 1% in those over 60 years of age to 4% of the population over 80 years of age.

As Parkinson’s is not a curable disease, all treatments are focused on slowing decline and improving quality of life and are therefore either rehabilitative and/or palliative in nature.

Rehabilitation can both ease symptoms and improve behavior.  Regular physical exercise is beneficial and necessary to maintain and improve mobility, flexibility, strength, gait, and quality of life.  However, when an exercise program is performed under the supervision of a physiotherapist or other clinical staff, there are generally more improvements in motor symptoms compared to a self-supervised exercise program at home.  I would recommend seeking help in this matter for best results.

Areas where the patient may see mobility improvement from a supervised program include improving gait speed, stride length, arm-swing movement and base of support. Having someone at the patient’s side for support helps the patient in regards to safety issues as well.

Weight training has also been shown to improve strength and motor function for patients suffering from Parkinson’s.  Reports show there is significant interaction between strength and the time their prescribed medication is taken.  Therefore, it is recommended that people with Parkinson’s disease should perform exercise 45 minute to an hour after meds, when they are at their best.  As a welcome side benefit, regular exercise will help relieve constipation.

Diet and proper nutrition have also been shown to be effective in alleviating symptoms of constipation which is the most widely recognized digestive symptom of Parkinson’s disease.  Constipation is often a side effect of drug therapies used for PD. (Levodopa, etc.)  A balanced diet and nutritional plan can be designed to avoid weight loss or gain, and minimize consequences of gastrointestinal dysfunction and constipation. Diets focused in increased fiber intake, water intake of 48-62 ounces of water a day if approved by the physician, and the addition of fruits and vegetables all help to alleviate constipation.

One of the most widely practiced treatments for speech disorders associated with Parkinson’s disease is the LSVT LOUD ® (Lee Silverman Voice Treatment).

This therapy which was developed in 1987 by Mrs. Lee Silverman improves vocal loudness by stimulating the muscles of the larynx through systematic exercises. Recent studies have also shown that LSVT may help improve issues of impaired swallowing.  Speech therapists can teach the patient other swallowing techniques if/when dsyphagia (difficulty in swallowing) appears in their disease course.  Thickening agents may be introduced for liquid intake and an upright posture is always best when eating to reduce the risk of choking.

The goal of palliative and rehabilitative care is to improve quality of life for both the person suffering from the disease and the family by providing some relief from the symptoms, pain and stress of this debilitating illness.  Palliative care support can also help with emotional factors such as loss of function and jobs, depression and fear.

Caregivers who provide and/or seek help for a well rounded regime of diet, exercise, rehab therapies, and other palliative care measures should improve the duration and quality of life for their patients suffering with this degenerative complex disease.

And as a Parkinson’s sufferer, Michael J. Fox states, its not these Parkinson’s challenges that define us, it’s the actions we take that defines us!

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