* encourage independence - give a resident with Parkinson’s
          time to do things without being rushed ... allow frequent
          rest periods … an occupational therapist can provide
          practical tips to make tasks easier, e.g. eating and
          mobility aids ... medication given early enough before a
          task may make it easier to bathe, shave and dress a resident
          with Parkinson’s - this increases a resident’s independence
          and reduces your workload
        * look for signs of mental changes - this could include memory
          loss, slowed thought processes or mild dementia (not the
          significant dementia you might see in other residents)
        * provide a sympathetic ear - Parkinson’s can mean the loss of
          control in a person’s body and life … how a person living
          with Parkinson’s feels emotionally is directly linked to the
          disease and how it is affecting him/her at the moment …
          listening and caring can make an amazing difference
        * work with the resident on ways to cope with emotional
          hurdles, relieve stress, provide physical assistance and
          meet special needs
        * learn more about Parkinson’s

                        "Often I feel trapped in my
                        own body. It’s hard to have a
                        regular conversation because
                        the volume of my voice has
                        been affected. I can’t do
                        things because my tremor makes
                        my hands clumsy. I want to
                        socialize more and feel like a
                        normal human being."

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     -----------------------------------------------------------------
     Information is power!
     -----------------------------------------------------------------

     The more information you have, the better equipped you will be to
     cope with day-to-day obstacles of caring for people with
     Parkinson’s. They will have ‘good’ and ‘bad’ days. That’s normal.
     Listen, be patient and understanding.

     Some important things to remember:

        * Medication management is the most important part of
          controlling Parkinson’s symptoms. To achieve the best
          results, it needs to be given according to the schedule set
          by the treating physician. This is based on what has worked
          well for the person with Parkinson’s over a period of years.
        * Parkinson’s is a progressive disease, so a resident’s needs
          will change over time.
        * Coping with Parkinson’s involves a variety of unique
          challenges. You can obtain help and advice for your
          Parkinson’s residents by referring them to other members of
          your health care team, e.g. social worker, pastoral care,
          physiotherapist, speech language pathologist, occupational
          therapist, dietician.

       "My symptoms make my life very
       frustrating. There are many
       things I can and want to do.
       But, at any given moment, my
       medication stops working and I
       can’t do anything. Sometimes I
       become extremely tired. Please
       be patient and give me a
       little more time. When you
       tell me to hurry, the stress
       makes my symptoms even worse.
       I am not trying to be
       uncooperative."

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     -----------------------------------------------------------------
     Contact information and assistance
     -----------------------------------------------------------------

     Parkinson Society Canada is the national voice of Canadians
     living with Parkinson’s. Our purpose is to ease the burden and
     find a cure through research, education, advocacy and support
     services.

     Parkinson Society Canada’s National Information & Referral Centre
     at 1-800-565-3000 can respond to any enquiries you or other staff
     members have about problems experienced by your residents living
     with Parkinson’s.

     Ask for printed information on topics such as medication and
     potential side effects, constipation, sleep problems, speech and
     communication difficulties and mobility issues. You can also
     visit the Society’s website at www.parkinson.ca to download the
     information you require.

     Parkinson Society Canada
     National Office
     4211 Yonge Street, Suite 316
     Toronto, ON M2P 2A9
     WebSite: www.parkinson.ca
     Toll Free: (800) 565-3000
     Tel: (416) 227-9700
     Fax: (416) 227-9600

     For additional community resources or an experienced speaker to
     talk to you and the staff of your long-term care facility about
     the unique challenges of caring for residents living with
     Parkinson’s, contact one of Parkinson Society Canada’s Regional
     Partners:

       Parkinson Society British            Victoria Epilepsy and
       Columbia                             Parkinson’s Centre Society
       890 West Pender Street, Suite 600    813 Darwin Avenue
       Vancouver, BC V6C 1J9                Victoria, BC V8X 2X7
       WebSite: www.parkinson.bc.ca         WebSite: www.vepc.bc.ca
       Toll Free (BC only): (800)           Tel: (250) 475-6677
       668-3330                             Fax: (250) 475-6619
       Tel: (604) 662-3240
       Fax: (604) 687-1327

       The Parkinson’s Society of           The Parkinson’s Society of
       Alberta                              Southern Alberta
       11111 Jasper Avenue, Room 3Y18       480D 36th Avenue SE
       Edmonton, AB T5K 0L4                 Calgary, AB T2G 1W4
       Toll Free: (888) 873-9801            WebSite:
       Tel: (780) 482-8993                  www.parkinsons-society.org
       Fax: (780) 482-8969                  Toll Free (Alberta): (800)
                                            561-1911
                                            Tel: (403) 243-9901
                                            Fax: (403) 243-8283

       Saskatchewan Parkinson’s Disease     Parkinson Society Manitoba
       Foundation                           825 Sherbrooke Street,
       Box 102, 103 Hospital Drive          Suite 204
       Saskatoon, SK S7N 0W8                Winnipeg, MB R3A 1M5
       Tel: (306) 966-8160                  Toll Free: (866) 999-5558
       Fax: (306) 966-8030                  Tel: (204) 786-2637
                                            Fax: (204) 786-0860

       PSC Central & Northern Ontario       PSC Southwestern Ontario
       Region                               Region
       4211 Yonge Street, Suite 316         4500 Blakie Road, Unit #117
       Toronto, ON M2P 2A9                  London, ON N6L 1G5
       Toll Free (National): (800)          WebSite:
       565-3000                             www3.sympatico.ca/pf.swo
       Tel: (416) 227-9700                  Toll Free (Ontario): (888)
       Fax: (416) 227-9600                  851-7376
                                            Tel: (519) 652-9437
                                            Fax: (519) 652-9267

       Parkinson Society Ottawa             Parkinson Society Quebec
       1053 Carling Avenue                  1253 McGill College, Suite
       Ottawa, ON K1Y 4E9                   402
       WebSite: www.parkinsons.ca           Montreal, QC H3B 2Y5
       Tel: (613) 722-9238                  WebSite:
       Fax: (613) 722-3241                  www.infoparkinson.org
                                            Toll Free: (National
                                            Francophone Line): (800)
                                            720-1307
                                            Tel: (514) 861-4422
                                            Fax: (514) 861-4510

       PSC Maritime Region                  Parkinson Society
       5991 Spring Garden Road, Suite       Newfoundland & Labrador
       290                                  31 Peet Street, Suite 219
       Halifax, NS B3H 1Y6                  St. John’s, NL A1B 3W8
       WebSite:                             Toll Free (Nfld /
       www.parkinsonsocietymaritimes.ca     Labrador): (800) 567-7020
       Toll Free (NS, NB & PEI): (800)      Tel: (709) 754-4428
       663-2468                             Fax: (709) 754-5868
       Tel: (902) 422-3656
       Fax: (902) 422-3797

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     TIP SHEET
     -----------------------------------------------------------------

     Caring for Residents with Parkinson’s in Long-Term Care
     Facilities

     Please copy this Tip Sheet as needed and include it in the file
     of every resident with Parkinson's Disease

     NAME: ______________________________
     ROOM #: ____________________________

     Symptoms of advanced Parkinson’s include tremor, stiffness,
     slowness and difficulty with fine movements, impaired balance,
     soft speech, reduced facial expression, drooling, “freezing”
     while moving, fatigue, and sleep disturbances. Give a Parkinson's
     resident time to do things without feeling rushed. Stress can
     make their symptoms even worse. Remember, they are not trying to
     be uncooperative. Parkinson's changes over time. What worked in
     the past may need to be adjusted. Communicate with the resident
     and his/her family.

     MEDICATION

     is the most effective treatment for Parkinson’s. Its dosage and
     timing tend to be geared to each individual’s needs. It must be
     given on time which may not coincide with medication rounds, and
     should be accompanied by water. Controlled-released tablets
     should not be broken, crushed or chewed (unless instructed by
     treating physician).

     Tips:

        * find out from the resident or their family what the best
          timing is for them
        * medication timing is the most important way to minimize
          symptoms
        * find out if residents need medication with meals or on an
          empty stomach
        * for some, medication takes time to ‘kick in’ so dressing and
          eating could be scheduled around this timing

     BALANCE & POSTURE

     Exercise (especially stretching) is essential therapy, especially
     when residents are rested, but watch for “freezing”, a sudden
     inability to move, especially when walking or getting out of a
     chair.

     Tips:

        * if freezing occurs, do not push/move residents but do find
          out best visual/auditory cue to initiate movement such as
          placing foot or item on floor in front of residents, playing
          music or counting with steady beat
        * encourage residents to lift feet, heel first when walking,
          to avoid prolonged standing and to use appropriate walking
          aids (cane or walker)
        * encourage residents to keep hands free when walking, to
          pause before getting up, to place feet directly under knees
          and stand up firmly, to wear proper walking shoes without
          rubber or crepe soles and to avoid pivot turns

     EATING

     A failure to swallow properly can lead to choking which is a
     symptom of swallowing problems.

     Tips:

        * Encourage residents to sit in an upright position and remind
          them to swallow
        * consult a dietician for easy-to-swallow foods such as
          thickened drinks and a diet containing enough fluid and
          fibre (to relieve constipation)
        * ensure residents have iced drinks (with flexible straws) and
          suggest they take sips between bites of food - recommend
          spoons over forks
        * encourage residents to have a rest period before meals

     SOCIALIZATION & COMMUNICATION

     A resident with Parkinson’s often feels isolated so watch for
     signs. Depression (anxiety, anger, change in personal habits,
     withdrawal) and mental changes (memory loss, slowed thought
     processes, mild dementia) are also important to notice.

     Tips:

        * seek help from a recreation therapist, someone from pastoral
          care or a visiting volunteer if problems persist
        * find ways to include residents in leisure programs
        * to help residents communicate, provide cold water/ice to
          relax residents’ jaw and tongue muscles and ask questions
          which require a ‘yes’ or ‘no’ answer, be patient and answers
          will come
        * to help with drooling, remind residents to swallow
        * get practical communication tips from a speech therapist (if
          available)

     Other tips:

        * give residents time to do things without being rushed and
          allow frequent rest periods
        * an occupational therapist can provide practical tips to make
          tasks easier, e.g. eating and mobility aids
        * medication given early enough may allow residents to be more
          mobile and responsive during personal grooming
        * work with residents on ways to cope with emotional hurdles,
          relieve stress, provide physical assistance and meet special
          needs

     Parkinson Society Canada’s National Information & Referral Centre
     can help you with questions about Parkinson’s. Call
     1-800-565-3000 or visit our website at www.parkinson.ca


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janet paterson: an akinetic rigid subtype, albeit primarily perky, parky
pd: 56-41-37 cd: 56-44-43 tel: 613-256-8340 email: [log in to unmask]
my newsletter: http://groups.yahoo.com/group/newvoicenews/
my website: http://www.geocities.com/janet313/

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