Elderly Health Service

How to enlarge font size

How to tell a friend

Carers' Corner

Caring Patients with Parkinsonism

How does Parkinsonism affect daily lives

Patients with Parkinsonism may suffer from hand tremor, rigidity of joints, slow movement, and walking instability which affect their daily lives. Family members and carers should help patients to maximize their independence and abilities, rather than do everything for them, otherwise ,their self-care abilities would deteriorate. In general, carers should assist patients according to their needs and abilities. Applying the appropriate techniques including using suitable aids when necessary, as well as providing encouragement to patients would help them in optimizing their self-care ability.

The caring tips below apply to clients with different stages of impairment of activity of daily living. Carers can apply these caring skills according to individual's need.

Tips for Daily Living

1.Feeding

Aim	Points to note
For easier feeding	Use non-slip mat to fix utensils. Scoop from a bowl with a raised curved lip. Weighted cup with enlarged handles reduces tremor.
To avoid choking	Sit up with the head tilted forwards during meal time. Do not lie down or tilt the head backwards while eating. Cut food into smaller pieces or prepare pureed meals. Food which is too dry (e.g. crackers, toasts), too hard (e.g. nuts), chewy or hard to control (e.g. marsh mallow, caramel, etc.), or sticky (e.g. melted cheese, peanut butter, etc.) may cause choking. Encourage patients to chew and swallow slowly and do not hurry them.
To prevent constipation	Encourage high fibre diet (like vegetables, fruits, oatmeal) and adequate fluid intake.

2.Dressing

Aim	Points to note
For easier dressing	Choose clothes which are easier to wear such as clothes with front opening and large buttons or Velcro. Replace zip with elastic band for trousers. Shoes fastened by elastic band or Velcro are more convenient.
To prevent falls	Sit down when putting on trousers. Avoid trousers which are too long or too loose. Shoes should be well-fitted, and preferably with non-slip soles. Replace shoes when they look worn.

3.Getting up and transferring

Aim	Points to note
For easier transfer	Chairs and beds should be of suitable heights such that both feet are on the ground while the patient is sitting on the bedside. Chairs with armrests can help with rising from the chair.
To prevent falls	Always stand with feet apart for easy balancing.

4. Toileting and bathing

Aim	Points to note
For easiertoileting and bathing	If the toilet is too low, a raised toilet seat can allow the patient to stand up more easily after toileting. Install handrails at suitable places.
To prevent falls	Use non-slip mats in tubs and shower stalls to prevent slipping. Climbing in and out of the bath tub could be dangerous. Shower stalls are safer. Shower curtain is better than sliding glass door. Alternatively, a stable shower chair or a bathboard can be used. By using a hand-held shower hose rather than a fixed hose, the patient can wash his/her back without turning. (For further information, please consult medical professionals.)

5.Home environment

Aim	Points to note
To prevent falls	Keep the passageway clear of unnecessary items to allow enough space for turning and use of walking aid. Loose wires should be fixed against the wall. Ensure the floor is flat and dry to prevent falls. Ensure adequate lighting. Corridor and bedside lights facilitate going to the toilet at night time. Place non-slip mats at toilet & kitchen entrances. Label door thresholds with sharp-coloured strips.
To prevent accident	Install an alarm call system if patient is living alone.

6.Communication skills

Aim	Points to note
To communicate effectively	Reduce background noise. Sit face-to-face with patient. Keep good eye contact and listen attentively. Ask simple questions Encourage patients to speak slowly and to use simple words or phrases and body gestures to facilitate communication e.g. nodding to represent "yes". If patients experience much difficulty with speaking, writing or drawing pictures on cards can help.

7.Mental health

Aim	Points to note
To maintain mental well- being	Patients are more prone to depression. Therefore reassurance and support from family members and caregivers are very important. Watch for any change in emotion or behavior for early detection of depression.

8.Prevention of complications (For bed-ridden patients)

Aim	Points to note
To prevent bedsores	Keep the skin clean and dry. Observe the skin condition of pressure areas for any signs of bedsores such as redness and ulcers. Change patient's position at least every 2 hours to avoid prolonged pressure on bony prominences. Avoid placing heavy objects on the limbs. Encourage the patient to perform appropriate exercises.
To prevent chest infection	Encourage adequate water intake and daily activities, sit up during meal time, build up the body resistance and perform breathing and coughing exercises. These can help to reduce the chance of chest infection since patients may have difficulty in coughing and spitting.