How to care for your ageing parents – Parkinson’s Disease

What is Parkinson's Disease

Parkinson’s disease is a common progressive disease of the brain cells (brain disorder) that affects the movement, loss of muscle control and balance. Usually the first symptoms include a tremor (hand, foot or leg), also termed as ‘shaking palsy’.

Progress

The majority of people develop Parkinson’s Disease after age 60 (there are cases where they have developed as early as 40 year of age or even earlier). Men are 1.5 times more likely to develop it than women. In general, the disease slowly progresses with more pronounced symptoms developing over many years. Although a few patients, especially those who develop in the younger years may have more rapid symptom development, symptoms slowly increase over many years.

Symptoms of Parkinson's Disease

Primary symptoms include

  • Tremor,
  • Stiffness,
  • Slowness,
  • Impaired balance,
  • and later on a shuffling gait.

Some secondary symptoms include

  • Anxiety
  • Depression
  • Dementia

Parkinson’s disease or Benign Essential Tremor?
Essential tremors may be confused with the tremors in Parkinson’s disease. However, essential tremors usually affect both extremities (hands) equally and get worse when the hands are used in contrast to Parkinson’s disease when tremors stops when the body part is in use.

Following are the symptoms that some persons with Parkinson’s disease may develop especially as the disease progresses; not every person will have some or all of these symptoms.

  • Bilateral tremors
  • Difficulty in sleeping and fatigue
  • Oily skin and dandruff
  • Speech changes (soft / slurred speech)
  • Constipation
  • Swallowing problems
  • Mental change (memory loss, easily confused, dementia)

Diagnosis of Parkinson’s disease is best accomplished by a specialist. Most diagnoses are presumptively made by doctors by confirming most of the early symptoms and by ruling out other conditions that may produce similar symptoms like such as tumor or stroke. The doctor would look for tremor at rest, rigidity, checking ability to recover the balance. There is no definitive test for the disease except for biopsy of specific brain tissue that is usually done at autopsy. Other tests (CT scan, MRI) maybe used to help physicians distinguish between Parkinson’s disease and other medical problems giving rise to similar symptoms.

Men are about 1.5 times more likely to develop Parkinson’s disease than women; although, majority of all the patients that develop the disease are over 60, the total chance of getting the disease is about 2-4% in this age group.

The cells of a part of the brain stem, Substantia Nigra, which controls movement, slow down and stop producing a chemical DOPAMINE, which helps nerve cells communicate about movement. Lack or deficiency of dopamine, results in Parkinson’s disease because the brain does not receive the necessary message about how and when to move. The ultimate cause of Parkinson’s disease, the reason that cells in brain stem alter and die, is still not known though researchers suggest that a combination of genetics (SNCA, PARK2 , PARK7, PINK1, LRRK2 genes) and environmental factors (pesticides, Herbicides) cause about 90% of Parkinson’s disease.

Parkinson’s disease is a usually slowly progressive over a period of years. Hoehn and Yahr scale and Unified Parkinson’s disease Rating Scale assess advancement by the symptoms and other measure like the mental and motor function, behavior, mood and the ability to complete daily activities, which gives the physician the best way to manage and treat these individuals.

Currently there is no treatment for the cure of Parkinson’s disease. LEVODOPA, which the brain converts to Dopamine, is the most effective medication to reduce and temporarily stop Parkinson’s disease symptoms. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown.

Surgery involving Deep Brain Stimulation is an option which might be attempted if the medication becomes ineffective. But this is not an option for every patient. It helps to overcome tremors, rigidity and slow movements, but does not stop other symptoms and neither does it end the progression of disease. In another type of surgery, specific areas in the brain that cause Parkinson’s symptoms are destroyed.

In addition to medication and surgery, general lifestyle changes (rest and exercise),a well balanced diet, physical therapy, occupational therapy, and speech therapy may be beneficial.

Presently there is nothing that can prevent symptoms of Parkinson’s disease, although treatment can reduce the symptoms. Researchers are trying to find medication which can protect the brain cells that produce dopamine.

Some studies suggest that exercise reduce and delay the symptoms of Parkinson’s disease. Reduction of tremors, balance improvement and muscle coordination can be some of the benefits of exercise.

How Does IRIS Healthcare Helps?

Although Parkinson’s disease progresses slowly, it will eventually affect every aspect of life – from social engagements, work, to basic routines. Caregivers can be challenged by the increasing needs of a declining Parkinson’s patient. Accepting the gradual loss of independence can be difficult.

Iris homecare provides caregivers who have a good concept of the progression of the disease. Being well informed about the disease, they can reduce anxiety about what lies ahead. They fully understand the disease process and have been trained to cope up with the various problems they face in caring for the Parkinson’s disease patient. Also in case of need, there is always a backend support from experienced nursing and doctor team who stay in close contact with the health care professional and the family to monitor the progression of the disease and to adjust therapies (if asked by the family) to maintain the highest quality of living.

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