Tips and Tricks. For Living Well with Parkinson s Disease

Transcription

1 Tips and Tricks For Living Well with Parkinson s Disease Amanda Avila MD Medical Director Hope Parkinson s Program Staff Neurologist Florida Neurology Group

2 Motor Symptoms Bradykinesia Generalized slowness of movement Rigidity stiffness Tremor Postural instability Balance trouble Inability to right yourself

3 Non-Motor Symptoms Memory or cognitive problems Mood problems or stress Fatigue Back or shoulder pain Weight loss or gain Double vision Sweating Bladder dysfunction Drooling Constipation Erectile dysfunction

4 Helpful Hints Freezing of gait balance dysfunction Stooped posture Poor dexterity and clumsy fingers Bathroom/ Bedroom tips Dyskinesia Fatigue Memory Hospitaliztions

5 Freezing of Gait

6 FOG thaws Seeing cues Painters tape or floor strips U-step Stepping to the foot Hearing cues Rhythm Step to the beat Counting Metronome Marching in place

7 Tips to Avoid Falling Nightlights Grab bars Eliminate throw rugs Non-skid Mats De-Clutter Drink Water! Avoid multitasking Choose household chores wisely Take your meds! Sit down while dressing Bedside devices

8 Avoid Falling

9 Importance of Good Posture Difficulty speaking Changes your perception of your body s position in space Falling risk Stretching and strengthening exercises Chin tucks Scapular retraction Thoracic extention Weakens the postural muscles Decreased ROM

10 Fine Finger Movements In Hand Manipulation Rotate items Movements from palm to fingers Finger Isolation O Crumple a tissue or towel Musical instruments Dynamic Movements Sewing, knitting, pottery, chopsticks

11 Zippers and buttons Velcro Elastic waist bands Loop belts prior to putting on pants Sit down while dressing Occupational therapy

12 Tips for the Bathroom Modify the bathroom Shower seat, grab bars, non-skid strips Sit on the shower seat when washing hair or bending Avoid rushing Good lighting Dry your feet De -clutter

13 Tips for the Bedroom Adjust the bed height Satin sheet and PJs Getting into bed start by sitting on the edge When turning in bed, always bend the knees first and place the feet flat on the bed.

14 Wiggling Dyskinesia Usually due to a PD drug Comtan, MAOIs and DA make it worse Doses sometimes need to be held to keep under good control Use a CR or decrease the dose of Sinemet. Liquid Sinemet Crush tablet in OJ etc Drink over min Deep brain stimulation Amantadine

15 Stress Meditation Deep Breathing Diaphragmatic Breathing in through the nose moving the stomach outward Hold Release by relaxing the belly inward Box breathing 4 second intervals In, hold, out, hold Spa Environment Vanilla lavender Mood lighting Soft music

16 Constipation Activity or Diet Changes Increase exercise Fiber-rich food Medical Illness Medications Iron narcotics Lack of fluids Drink 8 glasses of water Natural Recipe Miller s wheat bran (1cup) Applesauce (1/2 cup) Prune Juice (1/2 cup) Stay away from metamucil and psylliym.

17 Fatigue Primary goal should be conservation of energy Create a Schedule Factor in breaks Sit Down when able Dressing, bathing, cooking Ask for help Take a nap Use tools Reachers Kitchen carts Dressing aids elastic shoe laces

18 Hallucinations Potential Causes Look out for infections Any new medications? Levodopa Another PD med Talk with your neurologist Possible treatments Rule out causes Adjusting current PD medications Simplifying the regimen Eliminate the DA, COMT or MAOI Neuroleptic medications

19 PD Dementia (MNCI) Boring is Good! Environmental control Slow and steady Use pictures Simplify Daily tasks

20 Hospitalizations Aware in Care Checklist, ID bracelet, forms to list medications, reminder slips

21 Staying Safe in the Hospital Bring an accurate and complete list of all medicines Ask your hospital doctor to write specific times for your medication. Be prepared for your PD to worsen temporarily Bring your programmer Common Medicines to avoid with PD Haldol (haloperidol) Abilify (aripiprazole) Zyprexa (olanzapine) Risperdal (risperidone) Geodon (ziprasidone) Phenergan (promethazine) Reglan (metoclopramide) Compazine (prochlorperazine)

22 Traveling with PD Bring plenty of medication Prescriptions from the doctors office Leave the Ego at home Keep transfers to a minimum Note the restrooms and drink lots of fluids Cruise Account for the time change Leave the more strenuous activities for the end of the trip Beware of the local climate

23 Thank You!