Nursing Care In Parkinson’s Disease
What Is Parkison’s Disease
Parkinson’s Disease (PD) is a progressive, degenerative
neurological disorder that manifests severe physical symptoms and also brings
emotional issues to the surface.
PD is not a new illness; as far back as 1817
an article was written by James Parkinson in which he described a “shaking
palsy” The cause, which was a mystery then, remains one today.
The symptoms of
PD result from a significant degeneration of the neurotransmitter dopamine
located in the substantianigra of the brain.
Dopamine is responsible for
maintaining the normal function of the extra pyramidal motor system, including
control of posture, support, and voluntary motion.The symptoms of PD may vary
greatly from individual to individual.
Classic Triad of the Symptoms
The “classic” triad of symptoms
includes: tremor, rigidity, and bradykinesia. Patients may complain of hand
tremors as their first symptom. As the disease progresses, patients become
rigid as their muscles lose the ability to relax.
The third symptom many people
complain about is related to the slowing of movement. Patients can describe
feeling “frozen” and they become stuck in one place. It may take them up to
several minutes to begin moving again.
Due to the degenerative nature of the
disease, many patients begin with mild symptoms and over time become
significantly debilitated. Pharmacological therapy is the mainstay in treatment
for PD. There are several well known medications in use, the most common being
Carbidopa/Levodopa (Sinemet).
Sinemet is effective in treating PD by allowing
more dopamine to be available for use in the brain. Unfortunately, over time,
this and many of the other drugs become less effective, causing a return of
symptoms.
Nursing Roles and Responsibilities
Nurses can be pivotal forces in helping patients live with PD. C
Hayes (2002) identified important issues for people living with PD. Her
research focused on seven key areas: Anatomy and Physiology/Medical Aspects,
Activities of Daily Living, Lifestyle, Mobility, Psychological Issues,
Medication, and Advice.
The three most important issues identified in the study
were available treatments, maintaining independence, and the effects of PD on
the brain (Hayes).
Care Aspects and Role of Spouse
Due to the debilitating nature of PD, many spouses often find
themselves assuming the caregiver role. Many times relationships change
drastically as people assume new roles. Caregiving can be a 24-hour
responsibility, and the needs of caregivers as well as the needs of patients
must be addressed.
Edwards and Scheetz (2002) explored the factors that
contribute to the perceived burden of caregivers of PD patients. This study
supported the hypothesis that caregivers are affected when their
spouse/significant other is diagnosed with PD, and their needs must also be
ad-dressed when formulating a plan of care.
It was suggested that the nurse
prepare and support the family for the progression of the disease. The nurse
should assume the role of counselor, educator, and supporter.
Nurses should
recognize that caregivers have varying abilities, and support groups can be on
an indispensable avenue for venting feelings and emotions (Edwards &
Ruettiger, 2002).
Future Concerns of Parkinson’s Disease
Future research in PD will continue to explore the causes and
treatments of this disease. Nursing research will continue to investigate ways
in which patients with this disease and their caregivers can obtain the most
appropriate treatment, while maintaining the highest possible level of function
and quality of life.
Lifestyle alterations as well as medications are necessary
when treating Parkinson’s disease, and the physical as well as emotional needs
of patients must remain a top priority in research surrounding this disease.