Many nursing homes have one or more residents suffering from Parkinson's disease. This disease is unique and can affect the resident's quality of life to a great extent. There are many small tricks that can make everyday life easier for these individuals.

How Parkinson's disease manifests

The disease is often noticeable by slower movements and it can be difficult to start certain movements. Tremors, muscle stiffness, and poor balance are other symptoms. The symptoms are due to nerve cells in part of the brain breaking down. Many get relief from the symptoms with medication, but for some, the symptoms can greatly affect daily life despite medication. Getting the supervision and proximity that living in an apartment in a nursing home offers can be a prerequisite for managing life.

Stress can exacerbate symptoms, so it is good to create calm in various situations where the resident needs help. Please discuss with the resident how you can work to help in the best way. Fixed routines are usually good support. Getting medication at the right time is also important to limit symptoms. Often, the resident can have medication at far more occasions per day than other residents. If the times are shifted, it can be too close or too far apart, which affects the symptoms.

Regular exercise maintains mobility, but the exercise programs may need to be adapted. The physiotherapist on the unit can give advice, support, and tips on how the exercise can be designed to work for the resident. It is often good to train with all the senses. Steady music and exercise aids such as markings on the floor can facilitate, for example, walking training.

Staff who gain knowledge about the disease in general but above all about what is beneficial for the resident can make a big difference in quality of life. Food is important in Parkinson's and there may be reasons to contact a dietitian to get a nutrient intake that best harmonizes with drug treatment. Swallowing difficulties also occur, which may also mean that the consistency of the food needs to be adapted. Sometimes the speech therapist's expertise can be beneficial for the resident.

The disease and drug treatment also increase the risk of constipation. A sedentary life also contributes to the resident becoming constipated more easily. You can prevent becoming constipated by drinking enough fluids, preferably water. Regular exercise and a diet rich in fiber are also good. The difficulties in coordinating movements may mean that the resident needs help with oral hygiene. The drugs often contribute to dry mouth. The dental hygienist can give advice on how you best help the resident.

If the resident has a wheelchair, the sitting position is important. The occupational therapist can assist so that the resident gets the right wheelchair and a good sitting position. The sitting position may need to be adapted to different situations. It's not easy to eat if you're leaning back. The occupational therapist also needs to follow up ADL status over time to person-centered support.

When you provide support to a person with Parkinson's, you should consider the following

- Knowledge about the disease and especially how it affects the resident facilitates when giving support in everyday life.
- Parkinson's disease can sometimes cause speech difficulties. It is important to give the resident time to finish speaking in order to understand the resident's needs and provide person-centered support.
- Encourage physical activity, e.g. regular exercise and walks. Exercise can help improve mobility and well-being. It can, among other things, alleviate stiffness and tremors.
- Those who have Parkinson's disease usually medicate. In Parkinson's disease, it is especially important for well-being to get medication at the right times. Often, medication can be given even between regular medication times.
- Ensure that the environment is adapted to the resident's problems to reduce the risk of fall injuries and other accidents.
- Parkinson's disease can affect appetite and swallowing. It is important to ensure that the person gets a nutritious diet and to adapt the food to any swallowing problems.
- The disease can also affect the person's mood and mental health. It is important to encourage social interaction and to offer support by being attentive and understanding. It can also be helpful to talk to others with experiences of the disease.
- Some people who suffer from Parkinson's disease also have sleep problems. Consider helping the person get a comfortable sleep position. Comfortable bed equipment contributes to good sleep hygiene. Likewise, the disease can affect mental well-being with, for example, depression or anxiety. Taking the time to listen and show concern often means support.
- Freezing, episodes of frozen step, is a common difficulty for people with Parkinson's disease. It means sudden difficulty in initiating forward steps. Freezing can occur when the person tries to start an activity, such as walking or turning, or when they encounter obstacles along the way. This can lead to an increased risk of falls and reduced quality of life. Stress, narrow spaces, distraction, and fatigue can trigger or exacerbate freezing. It is important that people with Parkinson's disease who experience freezing work together with their healthcare professionals to find suitable treatment methods and strategies to manage this condition in the best way.

It is important to remember that Parkinson's disease affects each person individually, so adapting care to the resident's needs and wishes is crucial.

It is also important to have open communication with the patient and their family to understand their individual needs and wishes. Collaboration with a multidisciplinary care team, including doctors, nurses, occupational therapists, and physiotherapists, can also be crucial to providing a holistic view of end-of-life care to a person with Parkinson's disease.

Reflection Questions - Parkinson's Disease
Care Staff:
- Do you have team conferences or further education where you have discussed how you best provide person-centered support to residents with specific diseases?

Manager, Nurse, Occupational Therapist, and Physiotherapist:
- How do you ensure that the advice that comes from various specialists gets through in the care of the resident?

Resident and Relatives:
- Do the staff provide good support and does the resident receive help from people with specialist competence when needed?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day