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Published By Brianna Barela LVN and Right at Home Boston and North on November 03, 2020

In-Home Care and Parkinson’s Disease

A diagnosis of Parkinson's Disease (PD) can be a life-changing event not just for the person diagnosed but for everyone involved, including caregivers. We understand your feelings of confusion and disbelief. It may be hard to fathom what the future holds. Right at Home Boston and North knows how important it is that you have the most up-to-date information and resources available so that your senior loved one gets the care that he or she needs.

What is Parkinson's Disease?

Parkinson's Disease is the 2nd most common neurodegenerative disease (right behind Alzheimer's) in older adults. Although the cause is unknown, hereditary and environmental factors may contribute to a diagnosis. PD affects many areas of the nervous system

The debilitating disease causes degeneration of the substantia nigra (meaning black substance) in the brain where dopamine is mainly produced. When degeneration occurs here, there is a decreased amount of dopamine in the brain. Low levels of dopamine cause a person to lose the ability to refine voluntary movement, affecting motor capacity. Four primary symptoms characterize Parkinson's Disease:

  • Tremor – Tremors are prevalent and start gradually, sometimes with just a barely noticeable tremor in one hand.
  • Muscle Rigidity - Muscle stiffness may occur in any part of the body. The stiff muscles can be painful and limit range of motion. MayoClinic
  • Bradykinesia – PD progressively slows movement, making simple tasks frustrating and time-consuming. For instance, buttoning a shirt or getting out of a chair.
  • Postural instability – Parkinson's Disease may cause balance problems, a stooped posture, and/or a flexed trunk.

Other symptoms include changes in facial expression caused by rigidity of the facial muscles, such as a masklike face with wide-open, fixed, staring eyes.

Treatment of PD

Although Parkinson's cannot be cured, medications and proper treatment may significantly reduce symptoms that occur due to the disease. In advance cases, surgery may be advised.

Therapy

Your doctor may recommend lifestyle changes such as regular aerobic exercise and a healthy diet. A team of health care professionals may collaborate with you and your loved one to develop a patient-centered plan of care, many times including:

  • A dietician
  • Physical/occupational therapy
  • Speech-language pathologist
  • Case manager

Other treatments may include psychosocial support and strategies for self-management promotion.

Medications

Drugs are prescribed to treat the symptoms of PD. The purpose is to increase functional abilities such as walking. These medications substitute for the hormone dopamine.

It is equally important to prescribe drugs with minimal long-term side effects. Dopamine agonists are typically most effective during the initial stages of PD but may be associated with adverse effects such as:

  • Hallucinations
  • Sleepiness/drowsiness
  • Orthostatic hypotension

There is also concern for a diminished effect of medications over time. Individuals with Parkinson's may develop a tolerance, making the drug's benefits less consistent. Thankfully, drug administration is closely monitored, and your doctor may alter dosages or therapies accordingly. It is important to remember that each person is affected differently by PD.

Surgical Management

Surgery is usually recommended when medications are no longer effective. Most commonly, deep brain stimulation (DBS). Electrodes are implanted into the brain and connected to a pulse generator that delivers an electrical current. The device is placed under the skin, similar to a pacemaker, and is programmed to provide electrical current therapy that decreases involuntary movements associated with PD.

Right at Home Boston and North Can Help

Right at Home Boston and North can ensure that your senior loved one gets quality care specific to Parkinson's Disease right in the comfort of his or her home. Our compassionate RN nurse supervisors and CareTeam members will provide non-medical assistance and support that includes:

  • Monitoring your loved one's ability to eat and swallow as well as adequate food & fluid intake.
  • Assessment for depression, anxiety, and other conditions that may arise due to PD.
  • Allowing ample time for your loved one to perform ADLs and to respond to questions.
  • Implementing interventions to prevent further complications of immobility such as constipation and contractures.
  • Help with routine ADLs such as mild house chores and shopping.
  • Transportation to doctor's appointments

Our RightMeds Medication Management program will provide:

  • Prompt medication reminders or administration to maintain continuous therapeutic drug levels.
  • Medication administration for pain and/or tingling.
  • Monitoring for drug side effects such as orthostatic hypotension and delirium.
  • Vital sign monitoring related to drug administration.

Right at Home Boston and North can provide quality care through each stage of Parkinson's Disease in collaboration with your senior loved one's health care provider.

What Are My Options?

Talk to your doctor if you may be experiencing symptoms of PD. Many questions remain about which drugs and treatments are most effective and when to start therapy. However, Right at Home Boston and North will be there every step of the way. We understand that families depend on our expertise, and we are here "to improve the quality of life for those we serve." RightMission

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