4 Managing Parkinson’s

4.1 Introduction

Having worked through Section 3 [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   you should now have a general understanding of the possible communication and cognitive problems in Parkinson’s, how they can be managed, and your role in this. In the previous sections, you learned about what Parkinson’s is and studied in-depth information about motor symptoms and non-motor symptoms. We have also considered how you can support people with Parkinson’s to manage their condition. In this section we will look in detail at the ways in which Parkinson’s is managed. This section is important to build on your understanding and help you to support and manage people’s Parkinson’s as best you can.

In this section we look at the following questions:

  • What are the three main ways to manage Parkinson’s?
  • Who is in the multidisciplinary team?
  • What is medication management?
  • What are the main drug treatments for Parkinson’s?
  • Why is it important that people with Parkinson’s get their medication on time, every time?
  • What surgical options are available?
  • What other methods do people use to manage their condition?

Learning outcomes

The purpose of this section is to give you an understanding of the processes, procedures, methods, techniques and services used to manage Parkinson’s.

By the end of this section you should be able to identify and describe the following:

  • the range of methods, practices and possible interventions used to support people to manage their symptoms
  • common issues that arise when medication is not taken or given on time and the consequences of this
  • common side effects of Parkinson’s medication and the consequences of these for people with the condition
  • what can be done to lessen these side effects
  • the types of local, community and statutory agencies, support services, and networks appropriate to the person with Parkinson’s, and how to access these.
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Transcript

Tracy Temple
The different ways that Parkinson’s was managed prior to me taking the course was a mystery. I knew very little actually. I knew that there was a Parkinson’s nurse about somewhere. I didn’t realise that she is one of very few.
I didn’t realise that there was a whole multidisciplinary team working together with Parkinson’s. It was a whole new world. I realised that there’s so many support agencies out there that can be tapped into. It was phenomenal actually. It was quite exciting to see that you’re part of a much bigger team.
I think the biggest impact that doing the course has had for me has been the critical element of the person managing the medication, taking it on time, all the time. The effects of not having the medication on time, maybe the effects of having too much medication. The routine that they have to keep in taking the medication is so key to them being much more able, not dipping, having a much more active life. Also, working with the families, because even some families weren’t aware of the impact of taking medication on time, all the time.
Before I did the course, some of the side effects of medication that I knew about were the control of the tremor. That’s a good side effect of the medication.
One of the negative side effects I did know was compulsive-obsessive behaviour, which can manifest itself in many different ways, so people have to do certain things to achieve certain ends, or they might have a fixation on something. So kind of diverting that fixation was something that I was aware of.
Since doing the course I have learnt of other side effects of the medication, such as dizziness, the drop in blood pressure, sleepiness, compulsive behaviour, involuntary movements, memory, some behavioural aspects. They were new. Some cognitive problems, memory problems.
What I would do now, in particular, knowing some of these side effects with, say, the drop in blood pressure, if a client has been sitting for a while in a morning session doing an activity that hasn’t been active, who’s maybe reading the papers or something, what I would do now is before rising from a seat, do some simple chair exercises so that the blood’s moving. And when they’re now going to rise from the seat, they’re not going to have a dizzy spell and maybe fall back in the chair or something like that. Just to get them moving.
Before I did the course, I wasn’t aware that there was a multidisciplinary team. So, once again, my eyes have been wide opened. There’s a huge multidisciplinary team. And we all work together. There’s the speech and language. There’s physiotherapy. There’s the doctors, Parkinson’s nurses, day-care. There’s the Parkinson’s UK drop-in centre. There’s so much out there.
Working with Parkinson’s UK, working with the Parkinson’s nurse, working with the CPN has enabled this man to stay at home. At the moment, he’s on respite. And what they’re talking about for him now is, OK, we need to keep you at home. We need to keep you coming to daycare.
Because the difference in his mental health, his physical health, is so much better, just for the fact that tweaks have been made to when he takes his medication, how he takes his medication. It has to be before food so that it’s the most effective. You know, if you give it to him with his lunch, you might as well not give him his medication.
Just these little things are having such a major impact. And this man has gone from being stooped, depressed, sad, hopeless to having a life, going out walking, bowling, seeing his friends, enjoying his music. His life has changed.
I suppose there’s a kind of an unwritten, unofficial peer support that goes on here between the clients who live with Parkinson’s. They all know each other. If they didn’t know each other before they came here, they get to know each other. And they recognise the Parkinson’s in them.
And you see them supporting each other, saying, oh, you’re wanting to get up? And they might not be able to help that person to get up, but they’ll, maybe at the lunch table, somebody’s needing something. They’re starting to drool, get a tissue. They look out for one another.
But also there is a Parkinson’s UK group which they go to. And they’re so much more, I think, probably relaxed with one another, because they don’t have to explain themselves.

[Music playing]

End transcript
 
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4.2 What are the three main ways to manage Parkinson’s?