Nursing Care In Parkinson's Disease
What Is Parkison's Disease
Parkinson's Disease (PD) is a progressive, degenerative neurological disorder that manifests severe physical symptoms and also brings emotional issues to the surface.
PD is not a new illness; as far back as 1817 an article was written by James Parkinson in which he described a “shaking palsy” The cause, which was a mystery then, remains one today.
The symptoms of PD result from a significant degeneration of the neurotransmitter dopamine located in the substantianigra of the brain.
Dopamine is responsible for maintaining the normal function of the extra pyramidal motor system, including control of posture, support, and voluntary motion.The symptoms of PD may vary greatly from individual to individual.
Classic Triad of the Symptoms
The “classic” triad of symptoms includes: tremor, rigidity, and bradykinesia. Patients may complain of hand tremors as their first symptom. As the disease progresses, patients become rigid as their muscles lose the ability to relax.
The third symptom many people complain about is related to the slowing of movement. Patients can describe feeling “frozen” and they become stuck in one place. It may take them up to several minutes to begin moving again.
Due to the degenerative nature of the disease, many patients begin with mild symptoms and over time become significantly debilitated. Pharmacological therapy is the mainstay in treatment for PD. There are several well known medications in use, the most common being Carbidopa/Levodopa (Sinemet).
Sinemet is effective in treating PD by allowing more dopamine to be available for use in the brain. Unfortunately, over time, this and many of the other drugs become less effective, causing a return of symptoms.
Nursing Roles and Responsibilities
Nurses can be pivotal forces in helping patients live with PD. C Hayes (2002) identified important issues for people living with PD. Her research focused on seven key areas: Anatomy and Physiology/Medical Aspects, Activities of Daily Living, Lifestyle, Mobility, Psychological Issues, Medication, and Advice.
The three most important issues identified in the study
were available treatments, maintaining independence, and the effects of PD on
the brain (Hayes).
Care Aspects and Role of Spouse
Due to the debilitating nature of PD, many spouses often find themselves assuming the caregiver role. Many times relationships change drastically as people assume new roles. Caregiving can be a 24-hour responsibility, and the needs of caregivers as well as the needs of patients must be addressed.
Edwards and Scheetz (2002) explored the factors that contribute to the perceived burden of caregivers of PD patients. This study supported the hypothesis that caregivers are affected when their spouse/significant other is diagnosed with PD, and their needs must also be ad-dressed when formulating a plan of care.
It was suggested that the nurse prepare and support the family for the progression of the disease. The nurse should assume the role of counselor, educator, and supporter.
Nurses should
recognize that caregivers have varying abilities, and support groups can be on
an indispensable avenue for venting feelings and emotions (Edwards &
Ruettiger, 2002).
Future Concerns of Parkinson's Disease
Future research in PD will continue to explore the causes and treatments of this disease. Nursing research will continue to investigate ways in which patients with this disease and their caregivers can obtain the most appropriate treatment, while maintaining the highest possible level of function and quality of life.
Lifestyle alterations as well as medications are necessary
when treating Parkinson's disease, and the physical as well as emotional needs
of patients must remain a top priority in research surrounding this disease.
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