Parkinson’s disease is something that develops slowly over time. In the beginning, symptoms may be mild, but will eventually become more severe. This is due to the gradual decrease of the neurotransmitter dopamine. Nerve cells that use dopamine to send messages to control muscles can no longer do so if the brain cannot supply them with sufficient amounts of the chemical messenger.
Recognizing Parkinson’s
The common conception of a person with Parkinson’s is that they suffer from uncontrollable tremors and muscle movements, but this doesn’t occur in the early onset of the disease, nor is it universal in all sufferers. Researchers have isolated four pre-motor symptoms:
- Body movements occurring during REM sleep when only the eyes should be moving
- History of constipation
- History of depression and anxiety
- Diminished sense of smell
Since early treatment can keep the disease under control, it is vital that you be aware of the above warning signs in loved ones as well as:
- Changes in speech patterns such as slurring, hesitation, low volume, a monotonous voice, and difficulty in choosing words
- Increased sweating or urination
- Changes in personality
- Low blood pressure when standing
- Foot cramps
- Drooling
As the disease continues to progress, the following areas may be affected:
- The face: this manifests itself as “Parkinson’s Mask,” or the loss of ability to smile, blink, or alter facial expressions
- Fine motor skills: handwriting may be unusually small
- Muscle coordination: there may be difficulty with walking, rising from a seated position, and swallowing
- Cognition: watch for memory problems, the degeneration of problem-solving skills, attention deficit, confusion, and the inability to make decisions,
- Mental health: the person may experience depression, hallucinations, or signs of dementia
Diagnosis
The importance of early diagnosis and treatment cannot be overstated since Parkinson’s often makes an insidious entry into a victim’s life, establishing itself before he or she realizes something is wrong. So if you notice even one of the above symptoms in a loved one, pursue immediate medical evaluation.
There is no definitive diagnostic tool for Parkinson’s. Blood testing rarely uncovers abnormalities, nor do MRIs, EEGs, and CAT Scans spot any brain change. Therefore a doctor must make a clinical diagnosis (one based on his or her own judgment). It is crucial you seek a neurologist with a thorough knowledge of Parkinson’s disease to evaluate your loved one.
Evaluation
After taking a family history and performing a physical examination, the doctor will ask you and the patient about observed symptoms, then watch him or her stand up, turn around, walk around the room, etc… all in an effort to judge movement, balance, and coordination.
Treatment
The Doctor will prescribe drugs to alleviate symptoms, the most common of which is Sinemet (Levodopa/Carbodopa).
- Levodopa, also known as L-Dopa, travels to the nerve cells of the brain that should be producing dopamine, where it is converted to dopamine for use as a neurotransmitter.
- Carbidopa increases Levodopa’s effectiveness and decreases possible side effects like nausea, vomiting, and occasional heartbeat disturbances.
If medications have minimal effects, or cease to be effective, depending on age and overall physical condition you may want to pursue alternate treatments as Deep Brain Stimulation or Stem Cell Treatment.
Care
A Parkinson’s patient needs individual care and constant observation. In a perfect world he or she could remain in their own home, but this is often not possible. An excellent alternative is a board and care home, like Raya’s Paradise, where staff keep a watchful eye and make sure medication is taken.
There is no cure for Parkinson’s, but we can buy time and make that time as pleasant as possible.
Physical therapy can do seniors with Parkinson’s disease a world of good, slowing the decline that these patients experience. The physical challenges that those with the disease face–slow movement, hesitation, balance issues, rigidity, and resting tremors–can severely impact their ability to complete everyday functions. A physical therapist should be able to design an exercise plan that can enable Parkinson’s patients to overcome these problems and achieve maximum mobility.
In addition to improving physical abilities, a physical therapist can also take a look at the senior’s home environment for potential safety problems and usability issues. Maybe there are throw rugs that should be removed, or grab bars in strategic places in the bathroom would be helpful. They can also give advice on what exercise is best given a senior’s particular medication, so that they can get the most benefit from their treatment. They will also send the senior home with a plan to continue treatment outside of the therapy setting.
One of the greatest benefits of physical therapy is that it can provide help with walking, which is a particular challenge for Parkinson’s patients. A good therapist will know how to overcome the “freezing” reaction that many patients experience. They may use an auditory cue, such as a ticking metronome, to prompt the patient to take steps, or visual reminders on the floor may help them remember how to walk in such a way that the chance for a fall is reduced.
Some physical therapists may incorporate tai chi, yoga, or pilates and can address rigidity and balance problems, as well as build strength. They can also help Parkinson’s patients determine whether a cane, a Rollator (a walker with wheels), or a similar device would be a good thing to obtain.
Consider physical therapists with BIG certification. These therapists have been trained to work specifically with Parkinson’s patients.
The recommendation used to be that Parkinson’s patients wait until the later stages of the disease to start physical therapy, but this is no longer the case. Instead, it is advised that patients start treatment as soon as possible, as this can have benefit before a major event like an injury or another type of decline. By building up these habits of physical activity now, they may be much better off as the disease progresses. If a loved one has Parkinson’s disease and there isn’t currently a physical therapist on their treatment team, take some steps to bring one aboard.