Each year, doctors diagnose 60,000 new cases of Parkinson’s disease (PD). With advances in pharmacology and surgery giving PD patients longer lives and increased motor function, interventions to prepare family caregivers, empower patients in their daily lives, and improve patient peace of mind become more involved. While many patients live more than 20 years after the diagnosis, the median survival has been measured at 12 years.1 The speed of progression underscores the value of that time and the importance of promoting quality of life during this important time of life. It’s obvious but noteworthy that Parkinson’s is more than a nigrostriatal disorder. While dopaminergic therapy improves rigidity, tremor, bradykinesia, other symptoms do not respond. These include hypersomnolence, imbalance, dysphagia, dysarthria, autonomic failure and cognitive motivation. Most notably, this includes, dementia, and drug-related hallucinations. These latter symptoms create the most concern for families. In Parkinson’s, these symptoms progress more rapidly with age.
Among the many recommendations doctors make for families with Parkinson’s, consider long-term home care, especially that from McKenney Home Care. Intermittent skilled care such as physical therapy can modulate the progression of Parkinson’s disease and comorbidities,2,3 but needs for more daily living assistance persist and advance insidiously. For instance, every year, approximately 71% of people living with PD experience a near fall, 59% have an accidental fall, and 20% have a fall injury.4 In spite of active interventions with physical therapy, walking aids, and home modifications, 35% of people living with Parkinson’s have experienced a fall-related fracture.1 Long-term home care can assist patients with transfers and mobility (especially in the bathroom where most fall injuries occur). At-home aides will also increase the likelihood of a rapid response to falls. Aide support not only works to reduce the risk of fall injury but also to increase patient confidence, so patients can participate more confidently in more activities. The same could be said for activities as basic as eating, as patients with dysphagia often worry and put off eating in the absence of a caregiver who can respond to choking.
With McKenney Home Care, the level of service can increase gradually as the need increases. For the first few years, tremors may only merit transportation assistance, so patients can get to their appointments. This can progress to personal care up to 24-hours per day according to patient needs and the family situation. Finally, with McKenney, long-term home care can progress to private-duty nursing to help with medication administration. In Parkinson’s, the insidious nature of dementia makes it easy for families to underestimate the need for assistance. Some evidence suggests that dementia is under-diagnosed in Parkinson’s. Researchers have commented that unless dementia is actively sought and excluded, it should not be assumed to be absent. Thorough neuropsychological assessments find dementia present in 39% of patients initially diagnosed with Parkinson’s at age 40 to 69. This prevalence progresses to 83% over the next 20 years.1 Especially when dementia is subtly present, it can interfere with driving, medication adherence, participation in medical treatment, visuospatial problems that contribute to fall risk, etc. By the 20th year of living with Parkinson’s, symptom burden progresses to excessive daytime sleepiness (70%), falls (87%), freezing (81%), fractures (35%), choking (48%), and hallucinations (74%). A well-trained, professionally managed home care aide can improve safety and quality of life in the face of each of these burdens.
McKenney Home Care, in Naples, FL hosts a Lewy Body Dementia Support Group the first Wednesday of every month. This is an ongoing support group approved by the Lewy Body Dementia Association in Atlanta and in affiliation with the Parkinson’s Association of SWFL and the Alzheimer’s Support Network.
McKenney Home Care provides exceptional in-home health services and client-centered care. With a passion for maximizing the quality of life of their clients and families, they are driven to ensure social engagement and specialty services during all stages of life.
For individuals with neurodegenerative disorders, McKenney Home Care delivers enriched specialized training for its caregivers working with Dementia Patients. In addition to specialized videos and manuals, McKenney educates the caregivers through the use of a Virtual Alzheimer’s App. This virtual reality experience helps caregivers understand the feelings and experiences of those suffering from Alzheimer’s and other forms of Dementia.
If you or someone you know would like more information about McKenney Home Care or the LBD Support Group, please call McKenney Home Care at 239-325-2273 or visit mckenneyhomecare.com
McKenney Home Care
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239-325-CARE (2273)
9655 Tamiami Trail North #201
Naples, FL 34108
References:
1. Hely M, Reid W, Adena M, et al. The Sydney Multicenter Study of Parkinson’s Disease: The inevitability of dementia at 20 years. Movement Disorders. 2008; 23 (6): 837-844. 2. Tomlinson C, Patel S, Meek C, et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease (Review). The Cochrane Library. 2013; 8 (8). 3. Petzinger G, Fisher B, McEwen S, et al. Exercise-
enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. The Lancet Neurology. 2013 Jul 31; 12 (7): 716-26. 4. Wang H, Lin C, Lau C, et al. Risk of accidental injuries amongst Parkinson disease patients. European Journal of Neurology. 2014; 21 (6): 907-13.