Nursing Care of Individuals with Parkinson's Disease

Nurses care for patients with Parkinson’s disease in many ways and in several different settings.  If a patient is hospitalized, care is round-the-clock. Nurses must monitor and administer medications, assist with mobilization and stabilization so that the patient can return home as soon as possible. Because most patients with PD are not in the hospital and they are living with their symptoms at home, this is what we’ll focus on.

A person who has PD has a lot of different symptoms that must be managed in their home environment to maintain a good quality of life and keep them out of the hospital. The nurse can help with the symptom management and care coordination between many other care professions- physical therapists, speech therapists, mental health counselors, etc. He or she may coordinate care from a doctor’s office or from a hospital, make house calls or oversee nursing assistant care on a daily basis. Nursing care of people with PD involves a great deal of patient/family education. It also requires astute assessment of the patient: complex medical and social history, progression of the disease, current state including gait assessment, cranial nerve assessment, motor function and more!

Assessment is a huge part of nursing but beyond that skill, there are many ways that nurses can help with the daily lives of those with PD. Check out this table for a summary of some of the most common nursing actions (aside from assessment) for people living with PD.

Symptom/Aspect of Care	Nursing Responsibilities
Bradykinesia/Rigidity	Physical exercises Medication education Teach how to get in and out of chair/bed Speech exercises
Diet	Guidelines of what to eat and when to eat Texture of diet (soft foods to prevent choking) Swallow evaluation Educate about high calorie, high fiber to help with constipation and weight loss Educate about avoiding caffeine and alcohol
Medication	Plan schedule and reminders Ensure patient understands purpose and routine for each medication Teach timing for each medication and whether or not to take it with food Use pill box if needed Monitor for side effects and balance therapeutic value with side effects Screen for drug interactions and contraindications
Sleep	Teach about proper sleep hygiene Ensure quiet environment Manage medication
ADLs (activities of daily living)	Teach patient how to use assistive devices, encourage independence Assist patient with ADLs if needed- feeding, dressing, teeth brushing
Fall prevention	Teach patient how to get in and out of a chair/bed Encourage mobilization Teach how to use walk-assist devices if needed
Mental Health	Assess mental health- depression and anxiety is common Provide emotional support Provide resources to mental health professionals

Some links for more information of nursing care of people with Parkinson’s Disease:

1. http://ncpnanda.blogspot.com/2012/08/parkinsons-disease-nanda-nursing-care.html

2. http://www.americannursetoday.com/caring-for-patients-with-parkinsons-disease/

3. http://ac.els-cdn.com.offcampus.lib.washington.edu/S0149763488800630/1-s2.0-S0149763488800630-main.pdf?_tid=43388e40-b23b-11e4-b069-00000aacb35f&acdnat=1423693012_fad282fe119c970b57ca07b72543d848

References:

Grosiran, B. (2012). Parkinson's Disease Nanda Nursing Care Plan. NCP Nanda

Accessed 2/12/15

Retrieved from http://ncpnanda.blogspot.com/2012/08/parkinsons-disease-nanda-nursing-care.html

Lynn, S. (2012). Caring for patients with Parkinson's disease. American Nurse Today. 7 (12). Retrieved from http://www.americannursetoday.com/caring-for-patients-with-parkinsons-disease/

Szigetti, E (1988). Nursing care of patients with Parkinson's disease. Neuroscience & Biobehavioral Reviews. 12: 307-309

Retrieved from

http://ac.els-cdn.com.offcampus.lib.washington.edu/S0149763488800630/1-s2.0-S0149763488800630-main.pdf?_tid=43388e40-b23b-11e4-b069-00000aacb35f&acdnat=1423693012_fad282fe119c970b57ca07b72543d848