The Parkinson’s Primer: 10 Tips for Parkinson’s Care

affordable home care services for seniors at home caregivers help for senior caregivers taking care of elderly parents with parkinson's disease home care companies elder care in MinnesotaWhen “Lars” was diagnosed with Parkinson’s disease, it was his goal to remain as active as he could for as long as possible.  He made sure to get out to visit people in hospitals and nursing homes, made home visits, crafted tables and pictures from wood, and remained very active in his church.

His wife “Marie” was known for the jam she made using the strawberries in their own yard, and when she was diagnosed with terminal cancer, she taught him how to make it so that he could continue to use the strawberries.  And after Marie’s passing, he did just that.  In addition to all his other pursuits, he made his wife’s homemade jam to share with family and friends.

As his Parkinson’s developed, Lars eventually had to move out of his home and into an apartment in his son’s house.  As it developed further and dementia set it, he needed to move into a nursing home where his advanced needs could be met by around-the-clock care.

At some point in the Parkinson’s journey, those with Parkinson’s will need the caregiving assistance of family or an elderly home care service.  In the eleven years that we’ve been providing elder care in Minnesota, we’ve helped many people with Parkinson’s.  Here are just a few tips to help you in caring for a loved one with Parkinson’s disease.

1.  Stress increases tremors.

Because of this, it’s important to keep the environment around the person with Parkinson’s as stress-free as possible.   Allow extra time for everything—dressing, eating, walking—so that the person doesn’t feel the stress of time.

If you are a high anxiety person, it’s important to be aware of your own level of stress to avoid transferring that to people with Parkinson’s since that will only worsen their symptoms.

2.  Keep floors clear and minimize background noise.

This is for two key reasons.  First of all, avoiding typical fall hazards—such as throw rugs, grandchildren’s toys, uneven flooring—becomes even more important because of the fall risks already inherent in Parkinson’s disease.  In later stages, it is difficult enough to walk, let alone navigate around tripping hazards on the floor.  Because people with Parkinson’s often revert to shuffling, these fall hazards pose an even more likely threat than with other seniors.

Secondly, those with Parkinson’s in later stages cannot process multiple things at once.  Patterns can distract them, overloading their brains with too much information and then stopping the flow of action.  As a result, floors with clutter or patterns in the flooring can trigger freezing.

This can happen with background noise as well.  In trying to pick up a sound or bits of conversation, the brain of a person with Parkinson’s can also get overloaded, in turn triggering a freeze.

3.  Encourage them to be loud.

It’s important to keep vocal chords stretched, so encourage people with Parkinson’s to speak loudly.  By encouraging them to speak loudly, they will go through the motions and maintain their vocal abilities for as long as possible.  Those with Parkinson’s develop an altered perception of their body and physical movement.  Although they will feel they are speaking at an inappropriate volume, they will not be able to speak too loud.

4.  Allow processing time.

Give them plenty of time to answer your questions since one effect of Parkinson’s is the slowing of thought processes.  Understand that there will be a significant delay in any responses to questions you ask or conversation you initiate.  Resist the urge to rephrase or repeat yourself since this will only work to overload their minds and create further delay in their response.

Also be sure to give simple instructions and don’t over-explain yourself.  Posing questions so that they can be answered with a simple yes or no is the best.

5.  Don’t overload them.

Having Parkinson’s disease slows down all physical and mental responses.  As a result, those with Parkinson’s cannot multi-task in the same way others can.  Overloading their brains will result in freezing or other motion difficulties.  For example, if someone with Parkinson’s is walking, you don’t want to offer a greeting to her.  In her effort to understand your greeting and offer one in return, she will likely stop moving and then be unable to resume.

Also avoid interrupting their activities to ask questions.  Allow them to finish the task at hand, and then ask your question.

When starting an activity, break down instructions into one step at a time.

6.  Minimize choking hazards.

Those with Parkinson’s are at a higher risk for choking because of their lack of muscle control.  To limit the threat of this happening, it’s important to keep mealtimes quiet to minimize distractions that can cause freezing.

Prepare textured foods—such as meals that are pureed, minced, or chopped—that are easier to swallow.  Research foods that pose a higher risk for choking and avoid using them in meals.  Also thicken liquids to make them easier to control.

Never allow someone with Parkinson’s to eat alone because of the threat of choking.  Be prepared to give swallowing reminders as well since, like walking, the physical motions of chewing can freeze.

7.  Encourage big actions.

In everything, encourage those with Parkinson’s to exaggerate their actions.  Again, people with Parkinson’s do not have an accurate perception of their body, so they will revert to small actions and movements.  It’s important to encourage them to do the big actions so that they maintain as much of their abilities as they can, stretching and using their muscles for as long as possible.

One common effect of Parkinson’s is for people to revert to shuffling when they walk.  When this happens, stop them and encourage them to use big steps, modeling if needed.  Shuffling is a serious fall hazard.

8.  It’s use it or lose it.

In caring for those with Parkinson’s, find a healthy balance between helping them and allowing them to do tasks on their own.  Whatever abilities they don’t use, they will lose, so it’s important for them to do as much as they can for as long as they can.

9.  Watch for changes in mobility.

If there are changes in mobility, it’s likely a sign that there needs to be an adjustment in medications to address changes in the brain.  If someone freezes while moving, it may also be a sign that their medication is wearing off.

Familiarize yourself with the specifics of each medication.  Taking Sinemet too closely to a meal with protein, for example, can inhibit the effectiveness of the drug.  Some medications need to be given exactly on time.

10.  Restarting action.

When people with Parkinson’s freeze, they need help restarting the action.  They’ll know that they should be moving, but knowing isn’t enough to get them going.  Try modeling the action by taking a big step with your foot next to theirs.  If that doesn’t work, tapping their foot may help to trigger a response.  The key is to jumpstart the brain into walking again, and it may take some trial and error to see what is effective for each person.

 

Remember that managing the care of someone with Parkinson’s disease is a constant process of trying different interventions until an effective intervention is found.  Assessment and re-assessment are par for the course.

For more information about Parkinson’s, check out our Parkinson’s Primer:  What is Parkinson’s Disease? and our Introduction to Parkinson’s Disease.

If you’ve been caring for a loved one with Parkinson’s, we’d love to hear your tips.  Please comment below.


 

Paul Blom, CEO

President, National Parkinson’s Foundation of Minnesota

May 11, 2012

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Comments (2)

 

  1. anna says:

    i am concerned for my friend who has Parkinson..they are foster parents and she is lieft alone to look after a boy who is severly handicapped..she always seems isolated ..she has swallowing problems,,sleep problems and anxiety…I cannot understand her allowing this to happen..she does not socialize well…and domated by her husband for many years she has lost the ability to express her own needs..or more then that afraid to seek professional help..it is time for them to give up the fostering sad to see her so alone

  2. Paul Blom says:

    Anna,

    I would encourage her to use the National Parkinson Foundation helpline to access resources. 1-800-4PD-INFO.

    Paul

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