Parkinson's Disease Caregiver Information You Should Know

The role of caregiver is often thrust upon a person without any warning, usually due to sudden illness of a loved one.

However, with Parkinson's disease, you have a chance to test the waters before the disease progresses. The thing to keep in mind though is that as a caregiver, you are on call 24/7 and must be ready for anything.

Patience is a virtue and being positive and caring is a must. Inner strength and a determination to make the disease as manageable as possible for both you and the Parkinson's patient is the goal.

Understanding Parkinson's

Unlike certain illnesses, Parkinson's disease varies wildly in its symptoms. No two patients are quite the same.

One person may only have tremors for years while another may progress quickly into dementia in addition to the physical symptoms.

Understanding the disease will affect your patient in different ways than from what your research and the doctor tells you are important. Also, it is important to think positively and not think always in worst case scenarios.

As a caregiver, you should know that some symptoms of Parkinson's disease are not as noticeable at first and you may not realize it is part of the disease for a while.

Tremors and balance problems are widely known symptoms but would you recognize poor penmanship or softer speaking voice as signs of the disease?

Take note of anything uncharacteristic of your patient and write it down. It may be a symptom of the disease that has not been pinpointed yet.

Do not assume that their gradual shying away from public events is them being standoffish but rather a likely symptom of the disease just as not being able to maintain eye contact or even drooling.

Of course, you may be lucky in the role of caregiver to a Parkinson's patient as they may never display any more serious symptoms like bowel and urinary problems or dementia.

For sure, most patients will display the motor coordination problems but those you can easily get around by working with them to rearrange the home and office into a more maneuverable area and employing assistive devices.

Important Duty

As the caregiver, you should be attending the doctor appointments with your loved one that has the disease.

You have a unique perspective of the disease as an observer and your loved one may not remember to relay all the necessary details or not realize that some things you have observed may be important for the doctor to know.

Plus, being present at the appointment means you hear everything first hand rather than relying on the information relayed via second hand sources.

In addition, you are in the unique position of evaluating the doctor as well. Perhaps your loved one is still in a bit of denial and won't go for the second opinion.

Therefore, your perception of the doctor appointment is less clouded and if you feel a second or even third opinion is necessary, you are in the position to convince your loved one of doing it.

In addition to taking care of your Parkinson's patient, you are also in the role of advocate. You have the ability and position to fight for your loved one's rights, especially, when it comes to treatment and disability benefits.

One thing you should not forget too is your own needs. Cultivate outside resources for support and recruit family or friends to relieve you occasionally so you can have a break as well as your loved one.

Pharmaceutical Drug Treatment Options for Parkinson's Disease

Considering all the technology and pharmaceutical tools at the world's disposal, there is still no cure or definitive treatment that will halt Parkinson's disease in its tracks.

The only thing that can be done is finding a treatment that addresses the most bothersome symptoms of the disease so sufferers can stay independent as long as possible and retain quality of life.

Treatment for Parkinson's disease starts with drug therapy, of which there are several different types. Other options include surgery and several different types of therapy that treat the effects of the disease.

For now, pharmaceutical drug treatment is the best option for most disease sufferers. The choice of drug treatment will vary from patient to patient, depending on the severity of their condition.

In addition, each person's body chemistry is different and can change over time so dosages will change as well as adding new drugs to enhance others.

Levodopa

Levodopa has been around in some form or fashion for over 30 years and is the leading prescribed drug for treating Parkinson's disease.

It works by manipulating those nerve cells in the brain to produce dopamine, the chemical neurotransmitter that communicates with the part of the brain responsible for motor coordination and function.

The lack of dopamine is what causes the symptoms of the disease to occur so Levodopa works to greatly slow down the disease's progress.

Typically, Levodopa is combined with an enzyme inhibitor as Levodopa itself might get broken down by enzymes in the blood before it could reach the brain to be of some good.

Levodopa is absorbed by the gastrointestinal tract and the blood carries the drug to the brain where it "wakes up" the nerve cells to produce dopamine so it can be released to other parts of the brain.

There are controlled-release as well as immediate-release formulas available of the drug.

Anticholinergic drugs

One of the oldest drugs used for Parkinson's disease, this medication works on some of the symptoms to reduce their severity.

Rigidity of the limbs and tremors are the two main symptoms that anticholinergic drugs work on. Some doctors prescribe this class of drugs in conjunction with Levodopa as a complement to one another.

However, it is not a good drug for the elderly with the disease as confusion or disorientation is a common side effect.

Amantadine

The drug amantadine's original use was as an anti-viral medication but it showed great promise in reducing the severity of symptoms in Parkinson's disease patients.

When prescribed, it is often used in conjunction with levodopa or dopamine agonists. Amantadine works to reduce slowed movement, rigidity of limbs, tremors and fatigue and is best in patients in the early onset of the disease.

Enzyme inhibitors like Selegiline

There is a special enzyme called monoamine oxidase B or MAO-B which breaks down dopamine, the essential chemical neurotransmitter that communicates with the part of the brain that controls motor movement.

To combat this, drugs like Selegiline, an inhibitor of this enzyme, work to prolong the effects of the released dopamine before the enzyme can break it down.

Some believe these enzyme inhibitor drugs can slow the progression of the disease but there is no definitive evidence to the fact.

What doctors do know is that it also has an antidepressant effect, a positive side effect for someone dealing with a disease which has no cure.

Each person is different and suffers from a varying severity of symptoms. Therefore, the medications prescribed will reflect and treat the most common problems patients are dealing with.

Be prepared for some experimentation before the right combination of drugs is reached to produce maximum effect.

Possible Causes of Parkinson's Disease

Everyone always wants to know what caused something when they first receive a diagnosis.

What they really want to know is doing, I do anything that made this happen to me?

Then, once they know what caused a disease, if there is a particular cause, they have unleashed a thousand other questions about the disease. In the case of Parkinson's disease, there is no clear-cut cause for the disease.

There is no definitive cause for Parkinson's although scientist and researchers are still working on answering the "cause" questions with more certainty.

However, it is likely that the cause will turn out to be a combination of genetic and environmental factors. The cause, or various factors may be different for each person that has Parkinson's.

Scientists do know that the risk for the disease increases with age, so much so that by the time an individual reaches age 60 the risk for developing Parkinson's has now become 2 to 4% compared to a 1 to 2% risk in the general population.

The two factors that scientists through research, believe to have the most likely influence on whether or not a person develops Parkinson's is genetics and environmental factors.

Genetics - Did you know that of the individuals who have been diagnosed with Parkinson's disease 15 - to - 25% of them have a relative that also has the disease?

Scientists have found that if you have a first-degree relative such as a parent or a sibling with Parkinson's disease than your risk of developing Parkinson's is now 2 - to - three fold higher than the general population's risk.

So, if you have a mom or dad with Parkinson's you have a slightly higher risk to develop the disease than the rest of the general population.

Scientists believe that there is a common gene involved in those who have Parkinson's. The gene is one that involves proteins that play a role in dopamine cell functions.

There is currently intensive research being done on this gene connection to the disease.

Environmental Factors - Scientists have a theory that Parkinson's may develop as a result of exposure to environmental toxins or environmental injury.

There have been several factors identified that may link Parkinson's disease, to the environment such as these factors: rural living, well water, herbicide and pesticide exposure such as used in farming and the synthetic narcotic agent called MPTP if injected.

At this point there still is no conclusive evidence that environmental factors alone are the cause of Parkinson's disease.

It is more likely that after more study it will be discovered that it is a combination of factors. It is not clear what the combination might be. Further research may reveal the answers associated with the "cause" question.

PSP and Why It's Often Misdiagnosed as Parkinson's Disease

If you have the telltale tremors and shakes that signal Parkinson's disease, don't be resigned to that fate just yet.

There is another condition that is quite similar but granted, it is rather rare and not always known and tested for by doctors.

It is called progressive supranuclear palsy or PSP and often is misdiagnosed as Parkinson's disease. Like Parkinson's, PSP is a degenerative neurological disease for which there is no known cure.

PSP Probable Causes

There are several areas of the brain where the decline and destruction of brain cells occurs. These areas are quite small and include the substantia nigra, a crescent shaped place in the brain that produces dopamine, a chemical neurotransmitter.

Just like with Parkinson's disease, when this area is affected palsy symptoms become evident. There is not much known about why these brain cells start deteriorating.

Early Identifiers of PSP

The early stages of progressive supranuclear palsy or PSP include fainting spells, body stiffness in muscles and joints and even body freezing or the in ability to walk from point A to point B.

Those people with PSP often report feeling dizzy just before the act of falling. Some doctors may diagnose inner ear problems or even atherosclerosis, a hardening of the arteries which blocks blood flow to the brain.

There are other symptoms of PSP as well with some of them being close to Parkinson's disease. You may become forgetful or disoriented at times.

Your personality may change and this is attributable to those dying brain cells in key motor areas, which so happen to influence the "reward" areas of the brain. 

Loss of interest in friends and family is another common trait. At times, you may not be conscious of any problems, especially when around friends and family but they are the ones who point out to you that you may have the problem.

Progressive Progress of the Disease

Just like with Parkinson's, PSP often displays motor coordination problems and they can become progressive. Of course each person is different, so the palsy-like symptoms may take longer or shorter to manifest than others.

It may take up to ten years before the symptoms become so unbearable that independent living is not possible. Balance problems are the focal point as is stiffness in the body.

Progressive supranuclear palsy can create even more symptoms of the disease. In the later stages of this condition, eye sight could fail.

Tunnel vision may form where you cannot see anything out of the corner of your eyes, only what is in front.

Maintain eye contact with someone else may be difficult and a bit disconcerting as well.  These eye problems do not bode well for driving.

Some degree of mental problems does occur when it comes to PSP, similar to that of Parkinson's.

Dementia is the extreme but there is also mental confusion as well as the inability to quickly assess a situation or pick apart a problem. The slow thought processes are frustrating.

No cure exists for PSP but there are medications that can help keep some of the symptoms under control from Parkinson's medications like levodopa to antidepressants and sleeping pills. The sole focus of this disease is ensuring quality of life is as good as possible.

Several Conditions that Could Be Mistaken for Parkinson's Disease

The tell-tale characteristics of tremors, slow movements and balance problems are all attributed to Parkinson's disease and collectively these symptoms as well as several others are classified as Parkinsonism.

However, did you know there are other conditions that display Parkinsonism but are not the actual disease?

Only through thorough testing by a neurologist can Parkinson's disease and other these other conditions be properly diagnosed.

When a patient's disease is in its early stages and displays all the characteristics of Parkinsonism, often times both they and the doctors believe it is Parkinson's disease.

Indeed, it is a typical response but as the disease progresses and more symptoms are experienced, they give doctors more of a clue of what to test for to actually rule out Parkinson's disease and focus in on something else.

In fact, it should be noted that the vast majority of people who display Parkinsonism do not actually have Parkinson's disease.

Drug Interference

There are several different types of medications that are known to cause Parkinsonism that when discontinued, resolved itself with little issue.

A number of anti-psychotic drugs cause those hallmark tremors and mobility instability as do some types of calcium channel blockers, medications for heart problems.

CBD or Corticobasal Degeneration

While the least likely cause of Parkinsonism symptoms, this condition usually crops up in late middle age, around 60 years.

While the shaking and rigidity of limbs is common, so is the interruption of normal speech and comprehension. In addition, a limb of the body can be affected by CBD but show no loss of sensory issues.

PSP or Progressive Supranuclear Palsy

The collective symptoms of Parkinsonism are present with PSP but there is an addition of abnormal eye movement, particularly a paralysis with vertical eye movements.

This greatly hinders vision which can cause balance problems and falling. Eventually, dementia develops with PSP but no particular treatment exists for it.

Strokes

Vascular issues like strokes contribute to the collection of symptoms known as Parkinsonism. The blood vessels narrow due to high blood pressure or a clot forms which limits the blood flow into certain areas of the brain.

When a stroke occurs, it causes damage thus problems with balance, tremors and more.

MSA or Multiple System Atrophy

This condition is a degenerative neurological disease of which there is no known cause. For the most part, it is quite hard to distinguish this disease from Parkinson's disease as the symptoms are nearly identical. 

However with MSA, there are three subtypes that each affect different parts of the body and is the only way this disease is differentiated from Parkinson's.

In one subtype, there is not much tremors or shaking and it does not respond well to dopamine medications.

The other two subtypes also do not respond well, if at all, to dopamine medications which are an indicator that Parkinson's disease is not the culprit.

Lewy Body Dementia

Lewy body dementia is basically damage to the brain caused by these round deposits in which there are damaged neurons.

This damage initially causes Parkinsonism but with a neurological and psychological profile completed, other problems are found like the ability to recognize numbers or match items together or even planning or problem solving. Attention span is easily diverted as well. Hallucinations can occur as well.

All of the conditions that can mimic Parkinson's disease are not simple in the least to diagnose.

This is the likely reason why it takes a lot of testing to pinpoint the problem so as to avoid pinning a generic Parkinson's diagnosis on someone.

While none of the conditions are curable, at least the medication induced Parkinsonism can be cleared up.

The Stages of Coping and Living with Parkinson's

Coping with Parkinson's disease takes on many forms from feelings of helplessness to denial and anger.

You may feel isolated and withdraw from family and friends. Canceling doctor appointments and ignoring prescribed medications are quite common as well.

All this deniability is in the faint hope that the Parkinson's diagnosis is wrong and is something that can be cured with a simple pill.

Unfortunately, simple is not in Parkinson's disease vocabulary. Eventually, you have to confront the fact you have the disease and start becoming proactive in treatment so you can delay its progression for as long as possible and enjoy life.

Coming to Terms

Coming to terms with the disease is not something that happens overnight. One day you are independent, healthy and strong and the next you are coming to grips with the fact that one day you will be totally dependent on someone else for your health care.

It is no wonder that deniability is the first step in coping with the disease. You might feel you have lost control of your life but that is simply not true.

By confronting the disease head-on, you can make great strides in control symptoms and delaying the disease's progression.

It is common for you to want to hide your symptoms when you first get your diagnosis of the disease.

You won't want to tell your friends and family about it because you don't want to be treated any differently.

You want to appear strong and in control for your children, no matter what their age and be strong support for your partner in life as well.

Everyone will act differently to your diagnosis but it is important to know one thing – it is not your fault and it is not a sign of weakness.

You will need your family and friends in the years ahead for support – both emotionally and physically.

Getting Help

Your doctor will take care of your physical treatment in regards to the disease, but you will need treatment for the things you cannot see such as your mental health.

There are many support groups both on and off-line that can help you cope with the diagnosis and get you to a stage where you feel positive about life and treatment.

A few sessions with a psychologist might help as well to learn some coping mechanisms.

Physical therapy has shown to be a big boost to dealing with Parkinson's. It can help with strengthening your body to handle the symptoms as well as make adjustments to your work and living spaces to better maneuver and handle the disease.

Most of all, the exercise and therapy you get can help reduce stress and anxiety, two things that can exaggerate your symptoms.

The best thing you can do is be open and honest with your family, friends and co-workers.

Tell them what you expect will happen to you physically and the plans you have to adapt your lifestyle so that you can stay independent for as long as possible.

You will be pleasantly surprised at the outpouring of support you will get and the declarations of help you will get from your loved ones and co-workers.

By acknowledging what you cannot change, you can move forth and make the best out of this disease called Parkinson's.

Types of Pain Associated with Parkinson's You Should Expect

When you think of Parkinson's disease, the most prominent images in your mind are that of hands shaking, engaged in tremors, slowness of movement and balance issues.

If you are more educated, you might know that problems with fine motor coordination like handwriting and involuntary muscle movement like swallowing are also impacted.

What you don't really hear much of is how much Parkinson's disease can hurt. Yet, ask anyone with the disease and you will ferret out the fact that they have painful symptoms that impact daily life.

Some of the pain that Parkinson's patients suffer through includes numbness and tingling in body extremities, aching joints, stiffness in muscles and joints and much more.

In fact, for some people, the pain of Parkinson's surpasses other symptoms the disease causes.

Doctors well versed in Parkinson's disease and its treatments often classify the pain in five different ways. Here are those ways:

• Nerve pain – typically this is associated with arthritis pain in the back and neck areas.

• Dystonia – Pain can arise from repetitive movement such as favoring certain body parts due to Parkinson's disease. Twisting or holding the body in a certain posture is the primary cause of dystonia.

• Musculoskeletal – When poor posture occurs or the body is used in a way it is not accustomed or made to do, problems in the musculoskeletal system occurs causing pain.

• Restless leg syndrome and other restless conditions – A feeling of restlessness like restless legs syndrome can occur which can be annoying at first but eventually builds up into relentless dull throbbing pain.

• Pain from the brain – Often called primary pain, this irregular condition stems from the fact that the pain is coming straight from the brain.

Doctors view a patient's history to help them determine the type of pain they have so treatment and therapy options can be chosen wisely.

There are a few questions that doctors will have about the pain such as:

• Where is the pain located?

• Does it extend out beyond the initial pain site?

• How does the pain feel? (i.e. sharp, dull intense, etc.)

• Does the pain coincide with taking medications or partaking of a particular activity?

• Is the pain continuous or does it come and go?

• What do you do to help alleviate the pain and what makes it worse?

The pain needs to be identified as well as possible in order to get the right prescribed treatment.

This is particularly true if it is a Parkinson's medication that is causing the problems.  In addition, chronic pain has been known to create depression, a by-product of Parkinson's disease.

This can be easily remedied – at least the depression part – with therapy, medication or switching current disease medications.

Of the all the types of pain, it is the one that stems straight from the brain that is the most compelling and troublesome.

This "brain pain" causes off sensations and pain through the body from a scalding feeling across the skin to stabbing pains in parts of the body, particularly weird areas like the armpits, chest, mouth or genital area.

Because pain is not often linked to Parkinson's disease, it is not noticed or recognized legitimately, by some doctors right away.

If this occurs, it is time to find a new doctor that recognizes that Parkinson's can indeed hurt.

Edit By E-Dove Services Team

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