My full name is________________________________Room_____ Bed_______
AS A PARKINSONIAN I HAVE PROBLEMS WITH ITEMS CHECKED BELOW:
Medication 1. Need Parkinson medication administered EXACTLY on schedule
2. Without medicine will become rigid and disoriented
3. Response to medication may affect physical therapy timing
Ambulation 4. Have difficulty with balance
5. Freeze and fall. Require help getting motion started and walking
Elimination (check and underline specifics)
6. Have urinary problems: either hesitancy, frequency, inability to wait, or
incontinence
7. Suffer from constipation, need special diet or other treatment. Impaction is a
significant danger
Coordination 8. Cannot open food or other containers easily
9. Cannot always repeat a former action
10. May not have strength to push call button
11. Have slow responses
12. Have trouble turning in bed
Communication
13. Have low voice volume
14. Have difficulty enunciating
15. Face shows little or no emotion ("mask of Parkinsons")
Eating & Swallowing
16. Choke on food and need special diet
17. Very slow eater
Sleeping 18. Trouble getting to sleep
19. Sleep fitfully
20. Have anxiety sweats
Perhaps it would also be best to list *all* of the Parkinsons meds being taken. Ya 'all would be surprised at how very little the nursing staff understands about Parkinsons meds - or for that matter, which meds are specifically for PD. Since Parkinson's patients are rarely hospitalized for their primary disease, it is understandable the staff and pharmacists are unfamiliar with the meds and med contraindications.
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Regards
Mary Ann
