Parkinson Disease Caregiver Training Program

1. Parkinson Disease Caregiver Training Program • Philosophy • Goals • Purpose of Training • Outcome – expectations • Certificate of Completion

2. Page 4 What is Parkinson Disease? A chronic (ongoing) and slowly progressive neurological (involving the nervous system) condition….medically classified as a “movement disorder” The cause is unknown and there is no cure – treatments are to minimize symptoms and maximize functional abilities *********************** 1.2 Million people in the US have PD 4.0 Million world-wide

3. Page 4 Early Detection of Parkinson Disease Initially, mild symptoms can come and go -- often mistaken for normal aging. The most commonly noticed first symptom -- one-sided shaking of the hand 25% do not have a tremor, but may feel -- Easily fatigued Slow moving Change in gait (walk) and balance

4. Page 5 Hallmark Signs of Parkinson Disease Hallmark Signs of PD include: Resting tremor – when limb not in motion Slowness – Bradykinesia Rigidity – stiffness in limbs Loss of balance, tendency to fall backwards

5. Page 5 What Caregivers Should Watch For Difficulty arising from chair Difficultly changing position in bed Hands and fingers less mobile Muffled speech or low voice volume Shuffling gait – tendency to drag foot Reduced eye blinking Less frequent swallowing Anxiety and depression, difficulty concentrating Constipation, low blood pressure, sleep disorder

6. Page 11 What is Wearing-Off? When symptoms begin to reappear or become noticeably worse before it is time to take the next scheduled dose of medication ****** Important to know this so you can adjust therapy to provide better control of the symptoms

7. Page 56 Performing Caregiving Duties Yourself You can receive training from: • Social service agencies • Hospitals • Community schools • The American Red Cross • Area Agency on Aging

8. Page 60 Safety, Safety, Safety “Among all age groups “falls” ranked as the second leading cause of unintentional injury deaths in the United States. Of those who survive a fall, 20-30 percent will suffer debilitating injuries that affect them the rest of their lives.” (National Safety Council, Report on Injuries in America, 2003) FIRST PRIORITY IS SAFETY • Many accidents can be prevented • Ask a relative or friend to survey the home • Your comfort, convenience, and safety are also important • Leave a blanket, pillow, and phone on the floor. In case of a fall, the person can stay warm and call for help.

9. Dressing Someone with PD Dressing is easier with a routine – don’t be rushed Dress the person while sitting - lay clothes out in the order they will be put on – choose loose-fitting garments and avoid busy patterns if the person has dementia Try adaptive equipment, such as a button hook, or Velcro fasteners If a person is bedridden, avoid wrinkles in clothes and bedding. Page 154

10. Page 81 Where to Borrow Equipment and Supplies • PD Support Groups, Salvation Army, Red Cross, Visiting Nurses Association • National Easter Seal Society, Muscular Dystrophy Association, American Cancer Society, • Charity organizations, churches, senior centers, leisure clubs Never buy equipment from a telephone solicitor, a door-to-door salesman, or a person who calls on you before the doctor or hospital discharge planner has told you what equipment will be needed.

11. Page 197 Special Diet for Parkinson Disease Protein management may be helpful for some patients with on/off motor fluctuations in response to levodopa. Levodopa and protein interaction Nutritional guidelines for those with PD PD slows gastric mobility Most benefit from taking levodopa on empty stomach

12. Page 209 Basics of Exercise Good fitness is made up of three types of exercise: • Stretching – always stretch before exercising. • Strengthening – in home or gym 3-lb easy grip weights are useful • Aerobics – works heart and lungs as well as large muscles

13. Page 228 Preventing Back and Neck Injuries To prevent injuries to yourself, get plenty of rest and maintain: • optimal nutrition • physical fitness / muscular strength • good body mechanics • a stress management program

14. Page 244 Emergencies • Many injuries can be avoided throughpreventive measures • Once a serious accident or sudden illness is obvious, do not delay calling for help. Make sure 911 is posted on your phone

15. Eating (3) Eating Problems and Solutions Drooling - remind the person to swallow Spitting out food – offer/suggest small bites Difficulty chewing & swallowing Eating with fingers Page 177

16. Dressing Someone with PD Dressing is easier with a routine – don’t be rushed Dress the person while sitting - lay clothes out in the order they will be put on – choose loose-fitting garments and avoid busy patterns if the person has dementia Try adaptive equipment, such as a button hook, or Velcro fasteners If a person is bedridden, avoid wrinkles in clothes and bedding. Page 154

17. Speech and Swallowing Speech Most people with PD have gradual decreases in voice volume or ability to speak clearly Targeted speech therapy programs (LSVT) Singing – great exercise for the voice! Swallowing Swallowing changes Swallowing evaluation Swallowing checklist How to improve swallowing Coping with drooling Page 178