WELCOMEParkinson’s 101 for the Newly Diagnosed

Today’s Topic:Parkinson’s Basics presented by Cari Friedman, LCSW

Parkinson’s Disease 101

4/18/2019 Parkinson Association of the Rockies

Presenter for Today• Cari Friedman, LCSW

• Patient and Family Service Director, Parkinson Association of the Rockies 1999-Present

• 1325 S. Colo Blvd. Suite 204• Denver, CO 80222• (303) 830-1839, Office• (303) 861-1810, Referral Line

4/18/2019 Parkinson Association of the Rockies

Parkinson’s Disease Definition• Is thought to be the result of neuron degeneration in the section of the brain controlling spontaneous movement and balance.

• It is in a group of conditions called movement disorders.

• The result from a loss of the brain’s control of voluntary movement.

4/18/2019 Parkinson Association of the Rockies

Dopamine• Neuro transmitter in the brain.• Relays signals from the Substantia Nigra to the area of the brain collectively Basal Ganglia.

• This area of the brain controls movement, balance and coordination.

4/18/2019 Parkinson Association of the Rockies

Facts about P.D.• Men are 1.5 times more likely to get Parkinson’s Disease

then women.There is no socio economic status that is more likely to get Parkinson’s then others.

• Highest incidence of Parkinson’s is in Western Nebraska.

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Example of what this all means• Compare the motor of a car to the “motor” of a person.

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Signs and symptoms: • Bradykinesia - profound slowness of movement

• Resting tremor - shaking, worse on the affected side

• Rigidity - marked stiffness, worse on the affected side

• Decreased arm swing on the affected side (asymmetrical)

4/18/2019 Parkinson Association of the Rockies

Signs and symptoms• ● Problems with walking and balance - may experience a

shuffling gait or episodes of • "freezing", being unable to initiate a step forward • ● Micrographia - small, cramped handwriting • ● Masked face - reduced facial expression • ● Dysarthria - lower volume or husky quality to the voice • ● Impaired manual dexterity • ● Depression, anxiety or other mood disorder • ● Some people fatigue easily and have increased PD

symptoms in response to external stress.

4/18/2019 Parkinson Association of the Rockies

Secondary signs and symptoms• Facial mask• Slowed or slurred speech• Small cramped hand writing• Constipation• Urinary incontinence

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Non motor signs• Anxiety/depression• Dizziness/light headedness• Sleep disturbance• Executive dysfunction

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Distinguishing between P.D. and related conditions:• Essential tremor• Drug or toxin induced parkinsonism• Pseudo parkinsonism• Parkinson-plus Syndrome

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Stages of P.D.• Early Stage - Symptoms are mild and often easily explained.

• Moderate - Symptoms on both sides of the body.• Late stage - Generally, need assistance with mobility

• Remember, the length of each stage is unique to each person. You can maintain the early stage status for several years!!

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If you have P.D.:• You have a challenge before you.• Many face it every day.• You can get through this!!

4/18/2019 Parkinson Association of the Rockies

Young Onset• Under the age of 50. Hits people in their prime.• Less likely to experience dementia or balance problems.

• Appear to respond well to antiparkinsonian medications. Wear off meds quicker.

• Dyskinesia-uncontrollable movements may affect them more quickly then elderly.

• Less likely to have tremors.• Experience dystonia - cramping in a particular area of the body.

4/18/2019 Parkinson Association of the Rockies

Employment Young Onset• Prognosis is good. Proper management of symptoms

through diet, medication and exercise• Think about demands of job. Might need some

compromise, flexibility.

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What causes Parkinson’s Disease?• Combination of ENVIRONMENT:• Pesticides• Paint• Chemicals in developing own film

• GENETIC MARKERS:• Mutated genes• 1997, researchers at National Institutes of Health

discovered that mutations in a gene called SNCA (alpha synuclein) common in several families with a high prevelance of Parkinson.

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P.D. is NOT:• Contagious• Curable• Normal for older people or impossible for younger.• Bound to get you if you live long enough• A reason to make immediate life changing decisions.

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P.D. is:• Chronic• Slowly progressive over time• Manageable with proper treatment• Life changing for you and your family

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Health Care Team• Primary Care Physician• Neurologist• PT, OT, Speech• Pharmacist• Social Worker• Spiritual Advisor• Legal and Financial Advisor• Support Groups• Counselor/Therapist• Family/Friends

4/18/2019 Parkinson Association of the Rockies

Helping treat symptoms• Freezing - Sing song (Happy B. Day), Beam on floor,

Favorite food visualization• Sticky feet - Marching• Voice - Projection• Memory - note taking• Constipation - diet, fluid intake

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Visualize the stop sign

• “What if?”

• Why me?• What am I going to be like?

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Carpe diem• “Seize the Day”

• Now is your chance to do what you have put on hold…

• Live in the here and now

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Care Partner Tips to help PWP• Find out everything you can about P.D....... When you are

ready.• Ask Questions• Take an active role with medical team• Remind each other about other adversities that you

conquered.

• POSITIVE STEPS YOU CAN TAKE:• Keep priorities straight .• Give yourself permission to take a break.• Identify and nurture your personal space.

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Dr. Michelle Tagliati’s 10 ways to care for partner (Parkinson’s for Dummies)

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• Respect the partnership• Accentuate the positive• Acknowledge life beyond P.D.• Ask, don’t demand• Have a balance in caregiving• Use please and thank yous• Find joy in life• Get over yourself• Accept services as a gift for your care partner• Encourage laughter and dreams

RESOURCES:

• Parkinson’s Association of the Rockies 303-830-1839• www.parkinsonrockies.org

• Davis Phinney Foundation 303-733-3340• www.davisphinneyfoundation.org

• National Parkinson’s Foundation 1-800-473-4636• www.parkinson.org

Michael J. Fox Foundation 1-800-708-7644www.michaeljfox.org

4/18/2019 Parkinson Association of the Rockies