4.12 Summary

We have now looked in detail at the management of Parkinson’s focusing in the three key areas of the importance of the multidisciplinary team, medication management and surgery. Whether you are directly involved in administering medication or not, you have seen why it is important that you understand key issues such as timing of medication. Hopefully you have considered how this information can help you improve your practice.

The following exercise will help you see the real impact medication timing has on people with Parkinson’s. It will also help you to use what you have learned throughout this course.

Exercise 4.3

First watch the video below.

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Transcript

Jean Ballantine
Mel went into hospital. He had his surgery. It was fine. I got a phone call, and it was Mel. And he said, are you in that house? And I said, yes. Well, I’m in this ward. Then he hung up.
And I went in to visit him that night, and he was just totally out of character. Nothing like Mel at all. Everybody that walked past the bed, he was shouting at them and waving. Nothing, nothing like him, was it? But you don’t remember that bit.
And I went to the staff nurse in the evening, and I said, there’s something not quite right. There’s something different about Mel. Oh, Mel’s fine. He’s been getting his medication on time. There’s nothing wrong with him at all.
Well, the next day, I went in, and what a shock. Mel was asking me to bring him earmuffs in. They’re hiding you in these cupboards, and they’re controlling me and telling me not to look for you. They’re playing music. It’s putting me off, this music, and I’m getting out of bed to look for you, because I know you’re here.
So I phoned the next morning, 6:00 in the morning, spoke to the staff nurse. And asked how Mel was. And she said, Mel says he’s had a hell of a night, and he’s in tears, and he wants to know where you are. And we’re trying to tell him you’re not here, but he says you are. We are hiding you to prove to you that he’s too violent to live with. And he’s trying to climb out of bed, and we can’t keep him in, and he just had a hip replacement. Please come to the hospital to visit as soon as you like, and stay as long as you like.
So I did for five days. I left home at 10:00 in the morning, and I got home at 10:00 at night. And these five days, I kept saying to Mel, don’t worry. This is going to pass. This is going to pass. You’ll be fine. You’ll be fine. I don’t think I believed it myself, to be honest.
And for five – torturous days, I really thought I’d lost Mel, that he’d gone. And then he said to me one day, they’re going to shoot me tomorrow. They’re coming here – to shoot me – because I’m too violent to live with you. So I won’t be coming home again.
So I went to the staff nurse, and I took Mel’s medication list with me, and I said there’s something so wrong. I don’t know what it is, but this is Mel’s medication list. Are you sure it’s right?
Oh, says she. I think the timings not quite right. The dosage is right, but the timings not quite right.
The next day, the phone rang, and a voice said, I’m back in the land of the living. And you just could not believe, what that was like. So that was a big lesson for us, how much difference one wee tablet can make.
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Having watched Mel and Jean’s story, use your reflection log [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   to answer the following questions.

  1. What are the issues and challenges for the people involved?
  2. What services or professionals might have helped in this situation?
  3. What could you have done to help?

Discussion

  1. What issues and challenges are they living with?
    • Not getting medication on time.
    • Lack of understanding from ward staff about how important it is that people with Parkinson’s get their medication on time.
    • Ward staff not listening to the person or their carer when they tried to explain.
    • Ward staff not understanding that the behaviour of the person with Parkinson’s was because of not getting their medication on time.
    • Stress and anxiety for both the person with Parkinson’s and their partners.
    • Experiencing hallucination and paranoia.
  2. What services or professionals might have helped in this situation?
    • Staff training.
    • A willingness by staff to accept that the person and their carer might know best how to manage their Parkinson’s.
    • Earlier intervention from the Parkinson’s nurse and/or their specialist.
    • Agreement before the person went into hospital about self-medication or agreement regarding timings of medication.
    • Physiotherapy staff and occupational therapists having an understanding of Parkinson’s.
    • An advocate for the carer (that is, a Parkinson’s UK local adviser).
  3. What could you have done to help?
    • Reminded nursing staff about the importance of medication times.
    • Supported the person and carers to speak to ward staff.
    • Listened and reassured both the person with Parkinson’s and their carer.

Now try the Section 4 quiz.

Well done – this is the last of the section quizzes. You will need to try all the questions and complete the quiz if you wish to gain a digital badge. Working through the quiz is a valuable way of reinforcing what you have learned in this section. As you try the questions you will probably want to look back and review parts of the text and the activities that you’ve undertaken and recorded in your reflection log.

Personal reflection

At the end of each section you will be given time to reflect on the learning you have just completed and what that means for your practice. The following questions may help your reflection process.

Remember this is your view of your learning, not a test. No one else will look at what you have written. You can write as much or as little as you want.

Use your reflection log to answer the following questions.

  1. What did I find helpful about the section? Why?
  2. What did I find unhelpful or difficult? Why?
  3. What are the three main learning points for me from Section 4?
  4. How will these help me in my practice?
  5. What changes will I make to my practice from my learning in Section 4?
  6. What further reading or research do I want to do?

If you have the opportunity to be part of a study group you may want to share some of your reflections with your colleagues.

Now that you’ve completed this section of the course, please move on to Section 5.

4.11 What other methods do people use to manage their condition?

Glossary