Parkinson's disease, often colloquially referred to as Parkinson's disease, is the most common disease of the human nervous system. The disease progresses slowly. Leads to the death of certain nerve cells in the brain. The consequences are mainly limitations in movements, such as tremors, muscle stiffness and generally slowed movements. Although the disease is still incurable, many affected individuals can be helped with proper care and special medication.
Parkinson's disease is named after the British physician James Parkinson. In 1817, he was the first physician to address the disease and its symptoms. Since then, symptoms, causes and treatment methods have been further researched.
Definition: What is Parkinson's disease?
Parkinson's is one of the most common neurodegenerative diseases diagnosed in humans. It leads to the death of nerve cells of the substantia nigra in the midbrain. The substantia nigra are melanin-containing. Dopamine-producing nerve cells.
If they die off, the nerve messenger dopamine cannot be produced and transmitted properly – in the worst case, the neurotransmitters stop working altogether. An imbalance develops that triggers the symptoms of Parkinson's disease.
What are the different forms of Parkinson's syndrome??
The term Parkinson's syndrome is used to describe various conditions that cause the typical syndromes of Parkinson's disease. Although the symptoms are similar, they have different underlying causes. These are divided into four syndromes.
Idiopathic Parkinson's syndrome (also called primary Parkinson's syndrome): With about 75% the most frequent Parkinson's syndrome. The cause is not yet known, but those affected usually respond well to dopamine replacement therapy Genetic form of Parkinson's syndrome: This syndrome often occurs in several family members Atypical Parkinson's syndromes: Symptoms occur due to other diseases of the nervous system, such as Lewy body dementia. Symptomatic Parkinson's syndrome (also known as secondary Parkinson's syndrome): In this syndrome, the triggers for the symptoms are known. These may include brain tumors or injuries, as well as medications and toxins.
What are symptoms of Parkinson's?
The symptoms of Parkinson's disease develop slowly and often over several years. The course of the disease varies greatly from person to person. Is therefore also difficult to predict.
The symptoms of Parkinson's disease patients are divided into main symptoms and accompanying symptoms. However, not everyone with Parkinson's disease necessarily suffers from all the symptoms of the disease. Some symptoms may not appear at all or only after a longer period of the disease.
The main symptoms of Parkinson's are also called motor cardinal symptoms. These terms are used to describe the typical movement disorders that are very common in people with Parkinson's disease. Each of these symptoms develops slowly. Can be pronounced to different degrees. Also, not all patients experience all symptoms. Often one complaint or disturbance of movement is most prominent. The disease is then classified into a type of Parkinson's disease. The slowing down of movements (akinesia) dominates. Muscle stiffness (rigor). Tremor dominance type: The rest tremor, i.e. trembling in resting situations, dominates. Equivalent type: There are three main symptoms of movement disorders equally pronounced. These are slowing of movement, muscle stiffness and tremors. Monosymptomatic rest tremor: The only complaint is tremor at rest.
The accompanying symptoms of Parkinson's are non-motor symptoms. They often occur in an early stage of the disease. Thus appearing before the movement restrictions. Associated symptoms include:
– Olfactory disturbances – Constipation – Sleep disturbances – Visual disturbances – Sensory disturbances – Depression – Anxiety – Erectile dysfunction – Circulatory problems – Excessive sweating
Often, these symptoms occur before Parkinson's disease is even diagnosed. They often serve as a clue for doctors to recognize the disease. Many of the symptoms can of course also have harmless causes. None of these symptoms can be taken as a definite indication of Parkinson's disease.
What are causes of Parkinson's?
To date, medicine has not yet succeeded in finding the cause of Parkinson's disease. It is only suspected that a defect in the metabolism is involved. This thesis states that harmful free radicals are formed when the metabolism cannot process dopamine properly. These then damage the substantia nigra. The symptoms develop.
Doctors suspect that the disease may also be hereditary. It is rare for several relatives to develop Parkinson's disease, but hereditary causes cannot be ruled out.
In rare cases, Parkinson's-like symptoms may occur even though Parkinson's disease is not present. The symptoms can also be triggered by brain tumors, brain inflammation or carbon monoxide poisoning.
How is Parkinson's treated?
Since Parkinson's disease cannot be cured, treatment focuses primarily on the symptoms. With the help of therapy with drugs, these can be reduced or even completely suppressed. Since the disease is very individual, an individual approach is also always taken to treatment.
Before drug therapy is given, the symptoms and the stage of the disease are first analyzed. On this basis, a doctor prescribes suitable medication. Since new symptoms can occur during the course of the disease, the medication of Parkinson's patients is often adjusted.
To combat the symptoms, dopamine replacement is often prescribed as therapy. The active ingredients from the medication are converted to dopamine in the brain. Often another drug is prescribed to protect the active substance until it can be converted into dopamine in the brain.
Taking such dopamine supplements mainly combats slowing of movement and muscle stiffness. For some people, however, the effect of the medication wears off after they have been taking it for a long time. This causes fluctuations in the movements of the affected person.
The treatment of Parkinson's disease can also be done with the help of dopamine agonists. The active ingredients of such a drug mimic the effect of dopamine in the brain. This type of treatment is more likely to be used in an advanced stage of the disease, when dopamine substitutes no longer help reliably.
Note
Taking dopamine agonists triggers severe side effects such as paranoia, drowsiness or hallucinations in some patients. If medication is changed and dopamine agonists are started, patients should be monitored particularly closely and not left alone.
Who is particularly at risk of developing Parkinson's disease?
Parkinson's is considered to be a disease that usually only occurs at an advanced age. It often develops between the ages of 50. and 75. Year of life. In rare cases, however, younger people can also become ill.
An estimated 250.000 people suffer from Parkinson's disease in Germany. The number of unreported cases, however, is estimated to be much higher. Men and women are equally affected by the disease.
Experts ame that there will be more and more sufferers in the coming decades. They justify this with the fact that the society becomes ever older.
Parkinson's dementia
If Parkinson's disease is present for at least a year beforehand and the classic symptoms of dementia are not noticeable until later in the course of the disease, this is referred to as Parkinson's dementia
About one in three Parkinson's patients develops Parkinson's dementia in the course of the disease. It differs in some ways from Alzheimer's dementia, the most common form of dementia.
In Parkinson's dementia, attention is impaired and thinking is slowed down. It can also lead to depression. Lead hallucinations.
Changes occur in the brain similar to those seen in Lewy body disease. It is not uncommon for these two conditions to occur together.
The memory loss so typical of Alzheimer's dementia, on the other hand, only occurs in the advanced stages of the disease. Memories can often be recalled even after years of the disease, albeit with a delay.
In contrast to Alzheimer's dementia, in which memory disorders are in the foreground, in Parkinson's dementia other disorders dominate, especially in the area of movement. In addition to the usual symptoms, the following are typical of Parkinson's dementia:
– There is a chronic slowing of all movements. – Sufferers are unable to initiate new movements. – The fine motor skills are disturbed. – Although patients do not have actual paralysis, the movement disorder can be so severe that sufferers appear completely motionless and rigid (akinesia). The gait is bent. Small-step. The facial expression appears rigid. Expressionless. – In many patients, tremors characteristic of Parkinson's disease occur when the patient is at rest. Often a stiffness of the arms. legs (rigor) is observed. – you can determine an increased daytime sleepiness. – Frequent depressive symptoms. – There is limited attention. – Spatial vision may be impaired.
Treatment of Parkinson's dementia
First, pay attention to and urge that the Parkinson's medications be reviewed so that medications that may tend to exacerbate dementia are replaced with other. Parkinson's disease is treated symptomatically with drugs that specifically target the movement disorders and tremor. In some cases, electrical brain stimulation can also bring relief as a therapy. If dementia symptoms occur, recent studies have shown that they respond to treatment with an antidementive agent.
What financial& social legal aspects there are with Parkinson?
The diagnosis of Parkinson's disease comes as a shock to many people and often turns their lives and those of their relatives upside down. Dealing with the situation is an emotional challenge at first. In the further course, however, there are also financial. Social legal aspects on. Affected people wonder how they will make ends meet financially if they can no longer work. In addition, there are strenuous administrative procedures such as applying for a severely disabled person's card.
For affected persons and their relatives, it is often advisable to inform themselves as precisely as possible about assistance and possibilities. The first contact person is usually the family doctor. It can also refer to other help offers in the vicinity.
Often it can also be helpful to contact the health insurance company and ask for help here. Self-help groups for Parkinson's patients and/or their relatives often provide comfort and are a good way to exchange ideas with others affected by the disease.
Statutory health and long-term care insurance benefits for Parkinson's disease are
After the diagnosis of Parkinson's disease, affected persons should contact their long-term care insurance company. Those who need permanent help can apply for a care level and receive assistance benefits.
Many people who have Parkinson's disease can also apply for a severely disabled person's card. Advantages such as additional vacation, tax reductions or discounts on bus and train fares are available if the degree of severity is over 50%.
Who is ill with Parkinson, is considered by the health insurance as seriously chronically ill. Sufferers have thus the possibility of being exempted from additional payments. For this purpose, an informal letter to the health insurance company is often sufficient.
There are also medical rehabilitation measures for people with Parkinson's disease to ensure their ability to work. This includes, in particular, treatment in a Parkinson's specialist clinic. Treatment there can also be inpatient.
How to determine the degree of care in Parkinson& Apply?
After a long period of time, the symptoms of Parkinson's disease can lead to the need for nursing care for those affected. If this is the case, it is often relatives or even the spouse who initially take over the care. However, the immense psychological strain involved can at some point no longer be shouldered.
Those who are in need of care have the possibility to apply for a care degree. After such an application has been submitted to the health insurance company, a visit is made by the health insurance company's medical service.
This appointment often takes place at the patient's home. The goal is to find out to what extent the person needs help. On this basis, they are assigned to one of the nursing grades. These are divided into five degrees:
– Care level 1: Slight impairment of independence – Care level 2: Considerable impairment of independence – Care level 3: Severe impairment of independence – Care level 4: Most severe impairment of independence – Care level 5: Most severe impairment of independence with special requirements for nursing care
The aim of this system is to provide patients with exactly the care they need. Each of the degrees of care is accompanied by different benefits. This includes, among other things, respite services, a short-term care or subsidies.
People with Parkinson's disease often have a very good chance of being classified in one of the degrees of care.
How does care for Parkinson's work??
The care of patients suffering from Parkinson's disease often turns out to be intensive. Simply drinking a cup of coffee is often difficult for sufferers, as tremors or muscle stiffness make movement difficult and restrictive.
When caring for Parkinson's patients, as with other patients, patience and understanding are the most important factors. In some patients, communication is also affected by the illness.
When tremors also affect the lips, sufferers are often difficult to understand. Thus, it is important for the caregiver to patiently relate to the patient and show empathy.
What are the main priorities in the care of patients with Parkinson's disease??
When caring for patients with Parkinson's disease, the focus is primarily on everyday tasks. Due to trembling and limited freedom of movement, everyday life quickly becomes a challenge.
So care begins with washing, dressing and eating. If affected individuals can no longer maintain this familiar routine on their own, a caregiver should provide assistance.
Often, however, one of the goals is to promote the independence of those who are ill. Of course, they should get the help they need. Activities that they can still do themselves, however, they should continue to do on their own.
In daily care, it is especially important to show patience. Parkinson's is a serious disease. Patients need much longer than healthy people to do everyday things. Caregivers should keep this in mind at all times.
Parkinson's disease also often leads to a battered self-esteem in those with the disease. They feel helpless, desperate and not taken seriously by some people. Care should try to give patients new courage and encourage them to cope with life, even with PD.
What are the tasks of caregivers in Parkinson's disease?
Caregivers who treat Parkinson's patients should always respond to the individual situation. Each person's disease progresses differently – so caregivers' tasks can also vary widely.
Basically, however, three areas of care can be defined that are typical for work with Parkinson's patients.
Exercise
Stiff muscles and immobility are two of the main symptoms of Parkinson's disease. If these problems remain untreated, they often lead to gait instability and an associated risk of falling.
Risk of falling with Parkinson's
If patients lie and sit a lot, there is also a risk of prere sores forming or thrombosis occurring. Thus, in the care of patients with Parkinson's disease, movement exercises are very important.
Such exercises are for example:
– Exercises to improve facial expressions in front of a mirror – balance training – finger mobility training – sitting down and getting up from a chair
Caution
Many homes hide many tripping hazards that often lead to falls in people with Parkinson's disease. Cables lying around, carpet edges or disturbing objects should be removed if possible.
Body care
Sweating and increased secretion of talc are also common symptoms of Parkinson's disease. Increased personal hygiene is often necessary. If the patient can no longer manage these tasks independently, nurses can help by providing regular and careful skin care.
Nutritional support
Drinking plenty of fluids is important for everyone. For people with Parkinson's disease, even 2 liters per day are often not enough, as they lose a lot of fluid through increased sweating. They also tend to be constipated. Should consequently eat a high-fiber diet.
Many Parkinson's patients find it difficult to take in fluids as well as food. The tremor often makes it difficult for them to bring a cup or spoon to their mouth. In addition, cutting or crushing solid food is often impossible for them to manage.
Depending on the severity of the disease, drinking can be made easier with a straw. Feeding can also be made easier by pre-cutting solid foods. In the case of seriously ill patients, caregivers take over the care of the patient. Caregivers often also feeding or giving fluids.
Advanced nursing training: specialization in Parkinson's disease
Parkinson's disease severely affects many people's daily lives and quality of life as the disease progresses. For caregivers, this also results in special requirements.
It is also difficult that not everyone with the disease has the same symptoms and that the disease progresses in stages. Within a short period of time, the situation of people with Parkinson's disease can worsen.
Nurses who want to specialize in working with people with Parkinson's can take advanced nursing training. There they learn not only more about the disease and its causes, but also about dealing with sufferers. Many nursing facilities also place a lot of emphasis on additional qualifications. Treat appropriately qualified applicants preferentially. The diagnosis of Parkinson's disease means for those affected. Their relatives a big change in everyday life. Depending on the severity of the disease, they may no longer be able to work, or the patient may need around-the-clock care.
To cope with the initial shock, self-help groups or psychotherapies can be helpful. Talking about the diagnosis and symptoms can make it easier for sufferers and family members to deal with the situation.
Despite the diagnosis, everyday life must go on. It is important to give the patient as much independence as possible. A trip-free apartment is a first step in this direction. It may also help to install grab bars in all rooms for the person with the disease to hold on to in case of balance or circulation problems. Furthermore, shower stools can even enable independent showering.
Parkinson's disease often causes not only physical discomfort, but also psychological problems. Decreased self-esteem or depression may result. Here it can help to show understanding and to deal empathetically with the situation.
In addition, people with Parkinson's should avoid extreme temperatures and the sun. The disease can cause increased sweating in some sufferers. High temperatures can only make this worse. Caregivers and relatives should also make sure that the patient always drinks enough fluids.
Caring for patients with Parkinson's disease
Conclusion
Even though Parkinson's is a severe, incurable disease, sufferers can often live happily with it. The medical progress as well as various offers of help from different places can help to master the everyday life with the illness.
Patience, empathy and special training are the best way for caregivers to provide ideal care for Parkinson's patients. A nursing training for the work with Parkinson's patients is a worthwhile investment – not only for the patients, but also for yourself.