Long-Term Care

PARKINSON’S DISEASE: NURSING CARE

LTC Nursing Assistant Trainer, December 7, 2005

CNAs play a very important role in the life of Parkinson's residents. They can assist in the following areas to help residents remain functional for many years:

Tremors-Many people with Parkinson's disease feel embarrassed by their tremors. Suggest that they hold a book or put their hands in their pockets to try to reduce the tremor.

Walking-Encourage people with Parkinson's to concentrate on their walking. Don't talk or ask questions while they are walking because the distraction may bring them to a sudden stop. When Parkinson's residents become frozen in place, sugget that they rock slightly from side to side and count out loud to get themselves moving again. Stand nearby and offer support to help them balance.

Exercise-Keep the person as mobile as possible with active or passive range-of-motion exercises. In the later stages of the disease, regular exercise helps prevent contractures.

Elimination-Fill out intake and output sheets on Parkinson's residents to watch for constipation, which can cause fecal impaction and urinary tract infections. Both are common in residents with this disease.

Nutrition-Chewing and swallowing becomes a problem as the disease progresses. Substitute three large meals a day for six small meals a day for residents. Keep the person upright for at least 30 minutes after eating to avoid aspiration of food into the lungs.

Communication-Don't rush the resident to speak. The stress of trying to hurry will make his or her speech harder to understand. When communication between residents and CNAs is critical, staff should ask questions that can be answered with a yes or no.

Skin care-Skin breakdown is a common problem caused by drooling, incontinence, excessive perspiration, and scaliness. Watch for redness or breaks in the skin and report them immediately. Take all of the usual preventive measures to reduce skin breakdown, such as keeping the skin clean and dry, and keeping bed linens and clothes free of wrinkles.

Emotional stress-Parkkinson's residents often become depressed. Allow them to talk about their feelings. Emotional support is important because anxiety and fearfulness increase the severity of their symptoms.

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