Introduction:

Parkinson's disease is the second most common neurodegenerative disease in Singapore. It is a disease which affects the dopamine-producing nerve cells in the brain. There is currently no cure for Parkinson but there are treatments which can slow down the progression of Parkinson as well as to maintain the quality of life of a Parkinson patient.

What are some lifestyle changes?

Lifestyle changes help patients to maintain their quality of life and hence, they are important in one's journey.

Firstly, dietary changes can help to alleviate one's symptoms.

• A common symptom is constipation and hence, increasing fibre and fluid intake will help
• A balanced diet filled with nutrients and healthy substances such as omega-3 fatty acids will also be beneficial

Secondly, exercise is extremely crucial to maintain and increase one's muscle strength, flexibility and balance. Along with that, one's mental well-being is also taken care of.

• Parkinson's disease affects one's motor abilities and hence, exercise helps to improve one's condition
• Simple exercises such as yoga, walking or Taichi can be a great starting point

Caregiver education:

Being a caregiver is not an easy task and it definitely will get tougher as your loved one's condition progresses. Hence, it is important to learn how to adapt as well as to take care of your own well-being while caring for others.

Caring for someone who is diagnosed with Parkinson's disease comes with its own set of challenges. Some of the major responsibilities include assisting your loved one with daily activities, managing medications and taking care of their mental and physical well-being.

How to adapt?

It may come across as a shocking piece of news when you find out your loved one has been diagnosed with Parkinson's disease. However, you will be able to learn and adapt better throughout the journey. One thing to think about would be how you would balance your commitments. This way, you would not be piled with work but will have some time for yourself too!

Learn more about Parkinson's Disease

Learning about the disease would help you understand your loved one better. It would also enable you to make more informed choices and decisions. You could join support groups, ask for advice from healthcare professionals or surf the internet but do ensure that you visit credible sites to avoid myths.

Ask for help when you need it

When you are unable to handle it by yourself, it is alright to seek help from external parties such as family, nursing facilities or an experienced caregiver. It is important that you do not burn out taking care of the patient. By seeking external help, you are not neglecting your loved one but rather, you are benefiting both your loved one and yourself.

What should you expect?

There will be changes in your life and your loved one's life. You should be prepared for these changes:

• Mood changes: It is essential to understand what your loved one is feeling, thinking and understand that it can be very frustrating for the patient.
• You will also have to consider new safety considerations. Due to the symptoms of Parkinson's Disease which affects one's motor abilities, it is essential to decide which tasks a patient is able to carry out and which tasks they will need help with

Take care of yourself

Caregivers have a crucial job which is often draining and tiring. However, taking care of yourself is important in ensuring that your relationship with your loved one remains healthy. So, forgive yourself when you make a mistake, ensure that you stay within your limits and take regular breaks!

What types of rehabilitation should a patient go for?

Therapy and rehabilitation will assist patients in alleviating their symptoms to lead a better lifestyle.

Physiotherapy

Physiotherapy would help to relieve muscle stiffness and joint pain through movements and exercises. A physiotherapist would help with this and also aim to make mobility easier.

Occupational therapy

An occupational therapist helps to identify areas of difficulty in your everyday life and would help you work out practical solutions. This would enable one to maintain their independence.

Speech and language therapy

Slurring of speech is a common symptom and hence, a speech and language therapist can help to improve speech problems.

Medications:

Although there has yet to be a cure for Parkinson's disease, medications are being used to improve the main symptoms.

The main types of medication which are commonly used are:

• Levodopa
• Dopamine agonists
• Monoamine oxidase-B inhibitors

Levodopa

This is often prescribed to Parkinson patients. It is absorbed by the nerve cells in one's brain and turned into the chemical dopamine. Parkinson's disease affects the dopamine-producing nerve cells in the brain and hence, this medication helps to increase dopamine levels. However, the effect of levodopa may decrease over the years.

Side effects of levodopa include:

• dizziness
• loss of appetite
• diarrhea.
• dry mouth
• sore mouth and throat
• constipation
• change in sense of taste
• forgetfulness or confusion

Dopamine agonists

These act as a substitute for dopamine and have a similar but milder effect compared to levodopa. They are often prescribed together with levodopa as this enables lower doses of levodopa to be given. Dopamine agonists can be taken as a tablet or as a skin patch

Side effects of dopamine agonists include:

• excessive daytime sleepiness or sudden sleep attacks
• visual hallucinations
• confusion
• leg swelling and discoloration
• dyskinesia (involuntary movements of the face, arms, legs)
• compulsive behaviors

Since dopamine agonists can also cause hallucinations and increased confusion, they need to be used carefully with elderly patients.

Monoamine oxidase-B inhibitors

Monoamine oxidase-B (MAO-B) inhibitors block the effects of a substance which breaks down dopamine, hence, increasing dopamine levels. They can be prescribed together with levodopa or dopamine agonists.

Side effects of monoamine oxidase-B inhibitors:

• dry mouth
• nausea
• diarrhea or constipation
• headache
• drowsiness
• insomnia
• lightheadedness

What is Deep Brain Stimulation (DBS)?

Parkinson's disease is often treated with medication but there is a type of surgery (deep brain stimulation) which is used in some cases.

Deep brain stimulation involves surgically implanting electrodes into a specific part of your brain. These electrodes are connected to a pulse generator which is implanted in your chest wall. This generator sends electrical pulses to your brain and stimulates the part of your brain affected by the disease and hence, helps in reducing symptoms. DBS can treat major movement symptoms of Parkinson's disease such as tremor, slowness of movement and stiffness. However, It does not improve non-movement symptoms of Parkinson's disease.

DBS is most offered to patients with advanced Parkinson's disease who do not respond well to medications. DBS also does not keep Parkinson's disease from progressing.

Side effects/risks:

• Hardware complications
• Infection
• Seizure
• Headache
• Stroke
• Confusion
• Difficulty concentrating
• Pain and swelling at the implantation site (temporary)

Alternative activities

There are other alternatives which would also help to alleviate symptoms. Some of which include:

• Massage therapy. It can soothe muscle tension and promote relaxation.
• Tai chi. This is a form of exercise which would greatly help with the balance of Parkinson patients.
• Yoga. This also helps one increase their flexibility and balance.
• Meditation. Being diagnosed with Parkinson's disease may result in one feeling depressed or down and hence, meditation helps with improving one's well-being.

Fun fact!

Having pets is a form of therapy! It may increase one's flexibility and movement as well as improve one's mental health.

For more information or if you require a medical consultation, please contact My Healthcare Collective here.