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Parkinson disease - discharge

Your doctor has told you that you have Parkinson disease. This disease affects the brain and leads to tremors, problems with walking, movement, and coordination. Other symptoms or problems that may appear later on include difficulty swallowing, constipation, and drooling.

Over time, symptoms get worse and it becomes more difficult to take care of yourself.

Your doctor may have you take different medicines to treat your Parkinson disease and many of the problems that may come with the disease.

  • Parkinson medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and confusion.
  • Make sure you follow instructions. Do not stop taking medicines without first talking to your doctor.
  • Know what to do if you miss a dose.
  • Keep these and all other medicines stored in a cool, dry place, away from children.

Activity and safety

Exercise can help your muscles stay strong and help you keep your balance. It is good for your heart. Exercise may also help you sleep better and have regular bowel movements. Pace yourself when you do activates that may be tiring or need a lot of concentration.

To stay safe in your home, have someone help you:

  • Remove things that can cause you to trip. These include throw rugs, loose wires, or cords  
  • Fix uneven flooring.
  • Make sure your home has good lighting, especially in hallways.
  • Install handrails in the bathtub or shower and next to the toilet.
  • Place a slip-proof mat in the bathtub or shower.
  • Re-organize your home so things are easier to reach.  
  • Buy a cordless or cell phone so you have it when you need it make or receive calls.

Your doctor or nurse can refer you to a physical therapist to help with:

  • Exercises for strength and moving around
  • How to use your walker, cane, or scooter
  • How to set up your home to safely move around in and prevent falls
  • Replace shoe laces and buttons with Velcro
  • Get a phone with large buttons

Bowel care

Constipation is a common problem with you have Parkinson disease. So have a routine. Once you find a bowel routine that works, stick with it.

  • Pick a regular time, such as after a meal or a warm bath, to try to have a bowel movement.
  • Be patient. It may take 15 to 30 minutes to have bowel movements.
  • Try gently rubbing your belly to help stool move through your colon.

Also try drinking more fluids, staying active, and eating lots of fiber, including fruits, vegetables, prunes, and cereals.

Ask your doctor about medicines you are taking that may cause constipation. These include medicines for depression, pain, bladder control, and muscle spasms. Ask whether you should take a stool softener.

Diet and swallowing

These general tips may help with swallowing problems.

  • Keep mealtime relaxed. Eat small meals, and eat more often.
  • Sit up straight when you eat. Sit upright for 30 to 45 minutes after eating.
  • Take small bites. Chew well and swallow your food before taking another bite.
  • Drink milkshakes and other thick drinks. Eat soft foods that are easy to chew. Or use a blender to prepare your food so that it is easy to swallow.
  • Ask caregivers and family members not to talk to you when you are eating or drinking.

Eat healthy foods, and keep from becoming overweight.

Other care

Having Parkinson disease may make you feel sad or depressed at times. Talk to friends or family about this. Ask your doctor about seeing a professional to help you with these feelings.

Keep up to date with your vaccinations. Get a flu shot every year. Ask your doctor if you need a pneumonia shot.

Ask your doctor if it is safe to drive your car.

When to call the doctor

Call your doctor if you have:

  • Changes in your symptoms or problems with your medicines
  • Problems moving around or getting out of your bed or chair
  • Problems with thinking of becoming confused
  • Pain that is becoming worse
  • Recent falls
  • Choking or coughing when eating
  • Signs of a bladder infection (fever, burning when you urinate, or frequent urination)

Resources

The American Parkinson Disease Association -- www.apdaparkinson.org

The National Parkinson Foundation -- www.parkinson.org

References

American Parkinson Disease Association. Be independent: a guide for people with Parkinson disease. Staten Island, NY: American Parkinson Disease Association, Inc. 2009. Available at: http://action.apdaparkinson.org/images/Downloads/Be%20Independent.pdf?key=31532425. Accessed September 26, 2013.

Jankovic J. Movement disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 71.

Update Date: 9/25/2013

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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