2/7/18. Caring for the Person with Parkinson s: Key Considerations. Content. Listen to the Person with Parkinson's
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1 Caring for the Person with Parkinson s: Key Considerations Kay Baggley Parkinson s Nurse Specialist South, Inner City & East Bristol Content Nine important areas to consider when caring for a person with Parkinson s Listen Medications on time Medications to avoid Review and support Monitoring and Reporting Communication Swallowing difficulties Exercise Education Listen to the Person with Parkinson's Listen to the person with Parkinson's and their family about how the condition affects them as they are experts. Parkinson's affects everyone in different ways. How the condition affects the person may vary from hour to hour and day to day so the amount of help and support you give will need to vary too. 1
2 Medication on Time Make sure you give the Parkinson s medication on time, every time, record the exact time the medications are given. Taking medication at exactly the right time is crucial, so that the person with Parkinson's stays as independent as possible. How do the tablets work?. Medication side effects. Medications to Avoid Medications to avoid in Parkinson s include but are not limited to: Metoclopramide, Prochlorperazine, Haloperidol. Levomepromazine and Cyclizine can be considered but may worsen Parkinson s so should be used with caution. As professional advocates for your Parkinson s residents, please work to encourage your organisations to tweak mandatory medication policies to include the wording that Medications for Parkinson s must be given on time and Medications to avoid are listed also and added to their Medication records. Review and Support People with Parkinson's should have regular medical reviews by a specialist and access to any therapy support they need, such as physiotherapy, occupational therapy, speech and language therapy etc. Make sure you request this help or these referrals for the person you are caring for. 2
3 Monitoring and Reporting A variety of things may cause or contribute to a deterioration in Parkinson s symptoms including low blood pressure, falls, constipation, dehydration, infection [for example chest, urinary, skin], also some other conditions/other non-compatible medications or delay/missing a Parkinson s medication or side effects. Monitor the person s fluid intake and bowel actions daily, or if any falls occur and report. It may be necessary to record lying and standing blood pressure. Contact the GP if there are concerns. Anticipatory Care Management Guidance Link: Communication Communication can be difficult, it may take time for a person to respond but, this doesn t mean they are not listening or don t understand. Talk to the person at regular intervals and give them time to answer. 3
4 Swallowing Difficulties People with Parkinson s may encounter swallowing difficulties; this may include coughing/choking on fluids, food or tablets. Weight loss may occur. Managing saliva may be problematic. Refer to the Speech and Language Therapist for assessment; make sure that the person has access to a varied and balanced diet, monitor their weight weekly/monthly as appropriate. Exercise Exercise has been shown to be extremely beneficial in Parkinson s. Exercise can reduce pain and stiffness, and has been shown to have a positive effect on all aspects of mobility and can improve mood. Music can help people with Parkinson s to initiate movement. Ensure exercise is offered. Parkinson's Education Barriers NMC Revalidation mandatory requirement to demonstrate learning -self directed and participatory Parkinson s UK Excellence Network ensures Parkinson s education is accessible for all. On-line learning and group meetings Accreditation Care Home Education- Pilot Project Volunteer Educator / Champions / Links 4
5 Learning Opportunities Key Considerations Place in the residents record. Framework in which to work from. Basis for good practice. Demonstrating an understanding of the condition. Reassures. COMING SOON Management of community based Parkinson's patients unable to swallow medications Guidelines aimed at staff, primarily non-specialist doctors caring for patients in the community with Parkinson's to enable optimal management when patients are acutely unable to swallow medications where it is a chronic problem seek specialist advice from physicians and speech and language specialists 5
6 Questions? 6
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