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Allied Health support for people with Parkinson’s Disease

Did you know, each day in Australia, 37 people will hear, ‘you have Parkinson’s.’ for the very first time. That’s more than one person every hour, of every day! There is no simple way to deal with the life-changing event of a Parkinson’s diagnosis. But the good news is most people find acceptance and quality of life after the initial adjustment period.

We believe it is important to continue education and research to seek better outcomes for people who live with Parkinson’s disease. There is a range of Allied Health service available to help, from Dietitians, Speech Pathologists, Physiotherapists and Occupational Therapists.


What is Parkinson’s Disease?

Parkinson’s disease is a chronic, progressive brain disorder that causes problems controlling muscles of the body. This leads to unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance/coordination. Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioural changes, sleep problems, depression, memory difficulties, and fatigue.


Causes of Parkinson’s Disease

Parkinson’s disease occurs when brain cells that make dopamine (a chemical that coordinates movement) stop working or die. Hence, people with Parkinson’s have lower levels of dopamine. Over time, people with Parkinson’s have less dopamine, making movement more and more difficult. It may take many years before symptoms begin to cause major problems with daily life. When they do, many of these symptoms can be managed with treatment and support.’


Symptoms of Parkinson's Disease

The signs and symptoms of Parkinson’s may look different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of the body and progress to affect both sides of the limbs.


Some symptoms include:

  • Tremors

  • Slowed movement (bradykinesia)

  • Rigid muscles

  • Impaired posture and balance

  • Loss of automatic movements

  • Speech changes

  • Writing changes

There’s a range of Health professionals that can help with Parkinson’s Disease

General Practitioner

Your GP or primary care doctor is important in the care of Parkinson’s. A GP manages your overall health, helps to assist with medication, and may recommend lifestyle changes.


Speech Pathologist

A speech and language pathologist can assist people with both verbal and nonverbal communication (facial expressions, sign language, visuals, and communication devices).

For a patient with Parkinson’s disease, they may see a Speech Pathologist to assist with both communication and swallowing. The Speech Pathologist can complete either or both of a communication and swallowing assessment, and provide appropriate recommendations to support your individual goals and needs.


Physiotherapy

Parkinson Disease can be a limiting disease in terms of mobility & function, where progression would lead to other co-morbidities such as falls. However, this can be improved with Physiotherapy, where this disease’s progression can be delayed or managed.


Physiotherapy can assist in strategies & evidence-based rehabilitation program, to improve your mobility to move around as freely as independently, your function to maximise your daily quality of life to maintain as much regular activities as possible, strategies to live at home safely & to prevent falls, as well as strategies to manage freezing episodes that could be frustrating. So don’t stop moving!



Dietitian

Adequate nutrition is vital to maintain health. This is particularly important when living with a chronic condition such as Parkinson’s. It is common for people with Parkinson’s to experience weight changes for various reasons, such as decreased appetite, increased movement due to tremors and nausea. This is where an Accredited Practising Dietitians can help.


Social worker

Social workers help you get access to the resources you need for treatment and support. They work in the community setting, hospitals and private treatment facilities. They assist with navigating your health insurance coverage and disability payments, home care, nursing facility placement, hospice, or other resources.


Your social worker is also a good person to talk with about how Parkinson’s has affected your life and the lives of your loved ones. They can recommend healthy ways to cope with the many emotions that come with living with Parkinson’s and needing care.


Occupational Therapist

Occupational therapists focus on helping you to complete everyday tasks at home (like dressing and bathing) and in the workplace. They can recommend ways to modify tasks to work with your level of ability and suggest devices designed to make life easier for you and help you stay independent for as long as possible. Eg. Anti-slipping mats, weighted cutlery.


Tips from a Dietitian to help Parkinson’s Disease

People living with Parkinson’s are particularly susceptible to weight loss and malnutrition. Dietitians play a key role in helping people with Parkinson’s to maximise their nutritional status and manage various nutrition-related symptoms and medication side effects in a sustainable way.


Things to look out for:

  • Unintentional weight loss

  • Decreased appetite/interest in food

  • Signs of difficulty swallowing

  • Nutritional deficiencies

  • Gastrointestinal discomfort eg. constipation, nausea, vomiting

Please reach out to one of our Accredited Practising Dietitians should you notice any of these symptoms.


Unintentional weight loss with Parkinson’s

Maintaining a healthy weight is key to living well with Parkinson’s. People with Parkinson’s may eat less and lose weight for a variety of reasons, including difficulty swallowing, nausea from medications, involuntary movement making it difficult to eat, or from feeling full after a small meal. Being underweight may lead to reduced muscle mass and strength, increasing the risk of osteoporosis and infection.


Tips to avoid weight loss with Parkinson’s Disease:

  • Eat small, frequent meals every 2-3 hours

  • Consume foods that are enjoyable

  • Add extras to foods where possible, for example

  • Generous knob of butter on toast

  • Drizzle olive oil to vegetables

  • Extra mayonnaise or avocado to salad

  • Cream in soups

  • Peanut butter/milk powder in smoothies

Nausea

Nausea is common as a side effect of many Parkinson’s medications, such as Levodopa. While Parkinson’s medications generally work best on an empty stomach, some may feel nauseous taking medication before food.


Nutrition Tips to deal with nausea:

  • Have a snack eg) plain cracker or biscuit, with your medication

  • Consult your doctor about anti-nausea tablets if you do feel sick after taking your medication

Constipation

Many people with Parkinson’s may experience constipation. The good news is that this can be resolved by drinking more fluids and eating more high fibre foods.


Fibre absorbs fluid as it moves through the bowel, forming a soft stool that can be passed more easily. If you increase the fibre in your diet, it is very important to increase your fluid intake. Too much fibre without enough fluid can increase constipation.


Nutrition Tips to help with Constipation:

  • Increase fibre intake gradually

  • Choose a high fibre breakfast cereal or add a couple of tablespoons of Bran flakes to your cereal.

  • Choose whole grains over refined grains - Wholemeal bread/pasta/rice varieties over white

  • Try using more peas and lentils in your diet like baked beans, chickpeas, etc.

  • Include more vegetables and fruits into your diet

Medication Interactions

Diet and Parkinson’s medications, such as Levodopa, can impact each other. When you take your Parkinson’s medication, it should always be discussed with your GP or specialist.

For some, taking Parkinson’s medications close to a protein-rich meal (such as meat, fish, eggs, dairy products, nuts and beans) may interfere with the absorption of the drug in the blood, causing it to work less effectively.


Nutrition Tips:

  • Take medications on an empty stomach or with a small snack, such as crackers or applesauce

  • Take medications at least 30 to 45 minutes before meals


How can a Speech Pathology help?

Speech Pathologists can provide a range of support for patient’s with Parkinson’s disease. This may look like assessment, recommendations and education in areas of both communication and swallowing. Additionally, support can be provided by the Speech Pathologist to not only the patient, but also their family and close others. Educating your loved ones on how Parkinson’s may impact you can further support the management of your condition. Some more specific examples of this Speech Pathology support can look like…


Voice training

patient’s with Parkinson’s disease may have changes to their voice, particularly noticing they speak more softly. A Speech Pathologist can help with voice training to maintain the patient’s current volume of voice and speak more loudly.


Unclear speech

sometimes, speech changes may occur with Parkinson’s disease and you notice you’re not speaking as clearly. A Speech Pathologist can provide clear speech strategies and advice to support with this.


Swallowing

As Parkinson’s disease progresses to later stage, some patient’s may experience swallowing difficulties. A speech Pathologist can provide a swallowing assessment and suitable recommendations to manage this as safely as possible.


Help and support for Parkinson’s

Being aware and recognising the less common or early signs of Parkinson’s means taking control and seeking advice sooner rather than later. Early diagnosis of Parkinson’s, followed by the start of a treatment plan results in controlling symptoms more effectively in the long run. If you think you, a family member or friend may have Parkinson’s, please reach out to your local doctor.


Experiencing these changes can be difficult, but support groups can help people cope. There are groups that provide information, advice, and connections to resources for those living with Parkinson’s disease, their families, and caregivers. The organizations listed below can help people find local support groups and other resources in their communities.

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