Living with any chronic health condition comes with many challenges and adjustments not only for the affected individual, but also the whole family.
Progressive chronic health conditions such as Alzheimer’s and Parkinson’s diseases can very taxing physically, mentally, and emotionally. Understanding the disease process for the most part helps in increasing coping skills. Informed anticipation of the progression of symptoms can help in the provision of corresponding care giving needs.
Parkinson’s disease is a progressive disease process of the nervous system affecting body movements. It develops gradually and may start with barely noticeable tremors in the fingers of just one hand. The signs and symptoms may vary from person to person, and so does the rate at which they progress. Some are more bothersome than others depending on what a person normally does during the day. While some people with Parkinson’s live with mild symptoms for many years, others develop movement difficulties more quickly.
The signs and symptoms may include:
• Tremor — or shaking usually begins in the hand or fingers. Rubbing the thumb and forefingers known as “pill-rolling” is a characteristic sign. The tremor of the hand occurs when it is relaxed or at rest.
• Slowed movement — Over time, the ability to move becomes impaired, making simple tasks difficult and time-consuming. Steps while walking become shorter and feet may drag.
• Rigid muscles — Muscle stiffness may occur in any part of the body. The stiff muscles can limits range of motions and cause pain.
• Impaired posture and balance — Posture may become stooped with progressive balance problems.
• Loss of automatic movements — Decreased ability to perform unconscious movements including blinking, smiling, or swinging the arms while walking.
• Speech changes — May speak softly, quickly, slur or hesitate before talking. Speech may be more of a monotone rather than with the usual inflections.
• Writing changes — Writing may appear small and become difficult.
There are certain tools that the doctor may use to determine the stage and severity of disease. The Parkinson’s disease Foundation offers the following descriptions of mild, moderate, and advanced Parkinson’s:
• Mild Parkinson’s — Movement symptoms may be inconvenient, but do not affect daily activities. Tremor may occur on one side of the body only. Friends may notice changes in a person’s posture, walking ability or facial expression. Parkinson’s medications suppress movement symptoms effectively. Regular exercise improves and maintains mobility, flexibility, range of motion and balance, and also reduces depression and constipation.
• Moderate Parkinson’s — Movement symptoms occur on both sides of the body and the body moves more slowly. Trouble with balance and coordination may develop and “freezing” episodes, with the feet feeling stuck to the ground, may occur. Parkinson’s medicines are not so effective and may “wear off” between doses. They may even cause side effects, including involuntary movements. Regular exercise, perhaps with physical therapy, continues to be important for good mobility and balance. Occupational therapy may provide strategies for maintaining independence.
• Advanced Parkinson’s — Great difficulty walking and may be in wheelchair or bed most of the day. Not able to live alone and assistance is needed with all daily activities. Non-motor problems including hallucinations and delusions may be more prominent. Balancing the benefits of medications with their side effects becomes more challenging.
The cause of Parkinson’s disease is unknown, but experts suggest that there are genetic and environmental factors. Your risk increases if your parents or siblings have the disease. Environmental exposure to certain toxins including pesticides and herbicides may also increase the risk, but is relatively small. More research is needed to identify specific factors causing Parkinson’s disease.
Onset of the disease is known to begin in middle or later age, and the risk increases with age. It is also known that men are more likely to develop Parkinson’s disease than are women. While there is no known cure for the disease, effective therapies are available to ease the symptoms at all stages of Parkinson’s.
Controlling the symptoms can make it possible for people with Parkinson’s disease to live well. Talk to your doctor.
A registered nurse, Dr. Elvie C. Ancheta is administrator of the California Department of Veterans Affairs’ William J. “Pete” Knight Veterans Home in Lancaster.