Understanding The Progression Of Parkinson’s Disease Is Essential When Providing Home Health Care
Pegasus skilled in-home caregivers in Antelope Valley and elsewhere assist individuals of all ages in remaining independent. Some of their clients have movement disorders, one of which is Parkinson’s. Our career home health care nurses help others understand the progression of Parkinson’s disease.
Movement disorders are neurological conditions that affect how an individual moves. They may impact an individual’s intended movements or cause unintentional motions. The disorders range from almost unnoticeable to annoying to debilitating.
Symptoms vary among individuals and may be attributed to other causes in the early stages. Persistent symptoms that require a medical evaluation include:
- Muscle spasms
- Tremors
- Twitching
These can progress to:
- Akinesia
- Bradykinesia
- Cognitive impairment
- Dysarthria
- Dysphagia
- Dystonia
- Essential tremor
- Psychiatric issues
- Restless legs syndrome
- Spasticity
Millions of individuals in the United States have a movement disorder.
Parkinson’s Disease Is A Movement Disorder
Parkinson’s disease is a common movement disorder. Other conditions include, but are not limited to:
Patient handouts on these and other movement disorders are available in numerous languages.
Thousands of Americans have been diagnosed with Parkinson’s disease. Experts estimate that thousands more are undiagnosed or misdiagnosed. The condition is chronic and progressive.
A Lack Of Dopamine Underlies Parkinson’s
Parkinson’s disease occurs when specific brain cells stop producing adequate amounts of dopamine. Dopamine is a chemical that affects body movements. The exact cause of why the cells make less dopamine is unknown.
Researchers are studying factors that may affect dopamine production. These include:
- Exposure to environmental toxins
- Genes
- Lewy bodies
Risk factors include aging and gender. More men than women develop Parkinson’s as they age.
Progressive Stages Of Parkinson’s
Although the symptoms and progression of Parkinson’s differ among individuals, medical science has identified stages of increasing severity. The generally accepted stages are as follows:
- Stage One: The primary symptoms are tremors accompanied by slow or stiff movements. These usually affect only one side of the body and do not hamper daily activities. You may start noticing gait changes in your patient and postural changes that increase their risk of falls. They may not exhibit their usual facial expressions.
- Stage Two: The tremors and other symptoms worsen and begin hindering your patient’s ability to function unaided. Both sides of the body exhibit symptoms, although not to the same degree. You may observe initial difficulties with speech.
- Stage Three: Your patient has reached the mid-stage. Movement and their reflexes have significantly slowed. They may have trouble getting out of a chair, and they lose their balance more easily. The risk of falling increases. They begin to experience difficulty with daily activities such as getting dressed. Meal preparation and eating may necessitate using adaptive utensils and additional safety precautions.
- Stage Four: Your patient begins losing their independence. They often need a walker, and it’s unsafe for them to live alone. They need help with the activities of daily living.
- Stage Five: Parkinson’s advanced symptoms in stage five mean that your patient often needs 24/7 care. Their limbs become stiff and rigid, and they are unable to stand or walk. They experience non-motor symptoms that include, among others:
- Anxiety and depression
- Constipation
- Fatigue
- Hallucinations and delusions
- Loss of sense of taste or smell
- Sleep disorders
- Urinary incontinence
Your patient may develop Parkinson’s disease dementia or Lewy body dementia.
Healthcare providers use rating scales to determine the stage of Parkinson’s in an individual. The Hoehn and Yahr scale was the first method and formed the basis of the stages of progression.
The Unified Parkinson’s Disease Rating Scale (UPDRS) uses a point system to measure severity. It has been updated due to feedback from patients and caregivers and is now known as the UPDRS-MDS scale. It assigns points based on:
- Intellectual function, which includes anxiety, depression, and physical conditions such as pain and fatigue.
- Ability to perform activities of daily living.
- Motor examination, which includes agility, speech, facial expression, tremors, and gait.
- Motor complications, which include dyskinesia, dystonia, and fluctuations of motor movements.
The scale consists of 50 questions. Each answer is rated as indicating normal function, minimal problems, mild or moderate problems, or severe problems. The total of the points assigned to each answer measures the degree of severity.
Treatment Of Parkinson’s
There is currently no cure for Parkinson’s disease. Physicians have an arsenal of treatments for the symptoms, especially in the early stages. They often recommend lifestyle changes that include getting aerobic exercise.
Physical, occupational, and speech therapy helps many individuals. Several medications stimulate the brain to produce more dopamine or replace dopamine. Other drugs slow the breakdown of dopamine.
Some drugs are used to control tremors. All the medications have side effects and require medical supervision. Surgery may reduce symptoms in some instances, but it does not slow the progression of Parkinson’s.
Pegasus is a licensed Home Care Organization and a Joint Commission Accredited Home Health Care organization. Our in-home caregivers in Antelope Valley and our other locations provide comprehensive services to individuals. Expert career home health care nurses understand the assistance needed by patients with Parkinson’s disease.
