Our body, when entering old age, it is common for the disease to occur. One of the many diseases that can occur in Parkinson’s disease is caused by disorders of the central nervous system that can cause tremors, spasms, and slow movement.
The leading cause of Parkinson’s disease in the elderly.
- Brain aging.
The effect on the brain cells that make dopamine (Caused by a group of black neurons in the brainstem by performing an important function in directing the body to move) has decreased. It is mostly found in people aged 65 years and over, both male and female, and classified as a group with no specific cause It is also the most found in the deceased group.
- The main antidepressant or sleeping pills that suppress or resist the production of dopamine compounds.
It is most commonly found in patients with psychiatric disorders who are prescribed this drug to prevent mania. Including other neurological symptoms. But nowadays, this drug has reduced its popularity. But it is safer and does not affect Parkinson’s disease.
- Antihypertensive drugs.
In the past, antihypertensive drugs had active properties on the central nervous system. This causes the brain to reduce the production of dopamine. But in later stages, most blood pressure-controlled drugs affect the central nervous system. However, it has the effect of dilating the peripheral blood vessels, so it does not pass on the brain to cause Parkinson’s disease.
- Cerebral arteries are clogged. As a result, the brain cells that make up the number of dopamine cells are small or depleted.
- Brain-damaging toxins, including manganese in the battery factory. Carbon monoxide poisoning.
- Brain deprived of oxygen, In case of drowning, strangling. Obstruction of the respiratory tract from phlegm or food, etc.
- Head was concussed in an accident or a severe blow to the head in a boxer.
- Brain inflammation
- Hereditary diseases such as Wilson’s disease, which are caused by symptoms of impaired liver disease coming with brain disease. This is caused by a very dangerous build-up of copper to the liver and brain.
- Anti-calcium drugs used in heart disease, brain disease, dizziness, and some antihistamines.
Parkinson’s disease in the elderly There are 4 specific symptoms which are:
- Tremor is characterized by being Having tremors while resting It is an early symptom that is detected in 70 percent of Parkinson’s patients. The tremors are often pulsating, unable to control the hand while shaking. Tremors may be seen on the feet, head, chin, lips, or tongue. But it is most common on the hands and arms. The tremors disappear while asleep or while resting in calm and will have new symptoms sporadically. Shaking will be more intense if you are stressed. But will decrease when trying to move. Patients often feel a trembling before the symptoms become more pronounced.
- Spasticity is a stiffness in the muscles in order to resist seizure or movement. Patients will have symptoms of stiffness. Muscle spasms even at rest. Causing a jerky gait posture and can make you feel ache, numbness, and body pain. When there is a contraction of the back and neck muscles, the patient will experience a headache or if the contraction in the chest and shoulders can cause chest pain.
- Slow-motion Patients tend to stay still, rarely changing their posture and response to stimuli. Will lose movement implicitly such as swinging your arms while walking, blinking your eyes, or swallowing including sitting or walking in the correct posture and the expression of hand and face movements (like wearing a mask). Slow-motion affects the patient, for example getting out of a chair. Or walking or writing over and over.
The speech changes to speak in one tone. Often have unexpected symptoms. The resulting symptoms may be triggered by stress and may disappear in a short time, sometimes unable to move at all. The patient will have a stiff body.
- Loss of balance, From problems in motion control and poor balance causing problems in standing. The risk of falls may cause disability. However, it is not clear whether this is a posture disorder or a symptom of the slow movement.
Other symptoms of Parkinson’s disease in the elderly that may be seen which is a symptom that caregivers should know In order to understand the patient and provide correct care as follows:
- Irregular walking.
Walking is an unusual condition that is characteristic of the patient. Doctors often test by allowing the patient to walk first to give the diagnosis. Symptoms of the disease in the early stages The patient may be walking with one arm. With more symptoms, the patient will not swing the arm while walking. The body becomes stiff when turning the whole body. When walking, tend to lean forward. Take a short walk and walk very quickly.
- Dizziness when changing postures.
This is often caused by the use of anti-Parkinson’s drugs. Patients may complain of mild headaches. If a patient falls or complains of a lack of energy while walking, special attention should be paid.
In some patients may be numbness in the muscles located deep in the limbs. This may be a symptom of anti-Parkinson’s drugs, some may complain like being scalded or numbness along the nerve endings.
It’s symptoms affecting intelligence and emotional intelligence. Most importantly, there are problems in taking care of, including:
4.1 Anxiety It’s very common Some people may have symptoms at all times, or some may have symptoms while the drug is nearing its end, causing some patients to take the drug to cause inanimate movement.
4.2 Depression Will find about 30 percent.
4.3 Dementia It is found that approximately 30% of patients show symptoms similar to those of Alzheimer’s patients, so be aware that dementia can be seen in Parkinson’s patients.
4.4 Confusion, hallucinations Caused by anti-Parkinson’s drugs.
4.5 change signature handwriting will be smaller and the curves of the text will decrease in size, This Is caused by a movement defect which will have slow motion.
Parkinson’s disease is one of the most common neurological health problems in the elderly. The incidence of disease will be higher as we get older. Causing the elderly to have lower levels of self-help as the disease progresses, resulting in the elderly becoming more dependent. As more symptoms of the disease affect the quality of life of the elderly and caregivers. Therefore, in the next part, we will discuss the problem and care for the patient.
Elderly people with Parkinson’s disease There are often problems as follows
- Decreased level of self-help, Due to impaired movement
- Communication impairment, Due to tremor or contraction of the lips
- Not getting enough nutrients, Due to weak chewing and swallowing muscles Shaking or contracting
- Have a high risk of urinary incontinence.
- Have a high risk of developing constipation. Due to impaired movement
- have a decrease in self-esteem. Have decreased self-help levels
- Patients and carers lack knowledge of disease and treatment.
- The caretaker is likely to experience stress. Due to the burden of care
Taking care of patients according to the problems found as follows:
- Decreased level of self-help due to impaired mobility.
Characteristics found that the patient has a stiff body. Move slowly, walk slowly, stand with your legs bent forward, Short footsteps, fast feet, lose balance
Care objectives to promote greater self-help reduce disability and promote quality of life.
- Caring for the sick should promote and encourage more self-help by:
Patients should have stretching activities each day. With an exercise program, This exercise is very important in Parkinson’s disease because it can make the patient feel relaxed and moved the body in life better every day From exercise can be done in several ways.
This typically includes jogging, brisk walking, cycling, or swimming, etc. Specific exercises are programmed to address each problem. How much exercise a patient can exercise should consult a healthcare professional, and each individual program may be different. Here are just a few programs that patients can do at home. Which will ask for details in the next part:
Exercises for the elderly with Parkinson’s disease
- Neck exercises.
- Bow down to the chin.
- look back
- Facing the far-right
- face to the left end
- The head is upright and then tilted down to the right side to the right ear. Touch the right shoulder
- Tilt the head down so that the left ear touches the left shoulder. Try to do each move slowly and tilt as much as you can. Perform the exercises above about 10 times.
2 Shoulder exercises.
- Lift up both shoulders, count 1-5 in the mind, and loosen it down to normal. Do this at least 10 times.
- Raise both arms straight above the head. Attach to two ears, count 1-5, and put your hands down, do this at least 20 times.
- Sit against the chair on the back upright.
Put 2 hands back, hold each other and pull the mind count 1-5 and loosen. Repeat several times to work out the back muscles. Helps straighten your back.
- Exercise in a sitting position.
To lift one foot across the table in front, Then use your hands gradually, Keep your knees straight, hold a count of 1-5 and repeat this exercise 10-15 times. This will stretch the muscles.
- Standing posture against the wall Or stand on the table
Lift your legs to stomp your feet alternately left and right. Like a stationary military parade, stomp your feet, raising each foot as much as possible. This position will help you walk better. Because when you can’t step on your feet Like feet glued to the ground Raising the foot like this will allow the foot to be able to step on it. Practice should be done several times, making a pathway like a railroad track, allowing the patient to cross the barrier one step at a time. To use when the patient cannot step on his feet.
Instruct patients to use comfortable, lightweight shoes with a heel cover. When walking When stepping on your feet, keep your feet high as if you were stepping on your feet, or lifting your feet as if you were crossing an obstacle forward. Try to step as long as you can. Should swing your arms while walking. If enough balance by yourself.
It can be seen that movement problems, especially walking, are a major problem for patients who are vulnerable to accidents. Therefore encouraging the patient to do the correct exercise and appropriate is essential. Because it allows the patient to have a more flexible movement and reduce the risk of falls.
Caring for people with Parkinson’s disease among other problems as follows:
- The patient has impaired communication due to tremors or spasms of the lip or tongue muscles. Causing the patient to speak blurry Difficult to pronounce Speak loudly in the throat A single tone throughout, speaking slowly and repeatedly, shaking and shaking the audience can not comprehend.
Care to allow patients to communicate more effectively It evaluates patients for their ability to communicate and understand spoken language. Assess your ability to write Understanding of written language or pictures and providing care to the sick To improve communication with patients as follows:
1.1 Make eye contact with the patient while communicating. Listen carefully and speak slowly and clearly. Avoid shouting loudly unless the patient is deaf and give time to the patient while talking should not be rushed.
1.2 Encourage the patient to move his face and tongue to reduce muscle contractions and encourage the patient to read aloud to aid in speaking.
1.3 Provide other devices that may assist in communicating with the patient.
1.4 Consultation with a therapist If there is a lot of communication problems or have trouble swallowing.
- Patients are at risk of getting insufficient nutrition and choking on food due to weak chewing and swallowing muscles shaking or contracting. Caregivers should assess the degree of difficulty in fluid, solid, and drug fluxing, nutritional assessment, weighing three times a week, and observing the amount of water in and out of the body.
Care to prevent insufficient nutrition and choking on food when the patient has eating problems. They should take care of the environment that will allow for convenient and efficient eating.
2.1 arrange to sit while eating As for the person who cannot sit Should have a high head position, half-sitting posture.
2.2 Give the patient time to eat without a hurry because of the slow movement of the arm. The cutlery does not feel right. May cause the cutting of food into the mouth to spill mess. And should be fed foods that are high in calories rather than large amounts during meals to get more calories.
2.3 Take care to eat thick food. Avoid eating large pieces of food. Because the patient has difficulty tearing food into small pieces and avoid liquid or liquid food since the patient has trouble swallowing, they may cough and choke easily.
Elderly people with Parkinson’s disease Have a high risk of developing constipation Most patients have difficulty in defecation. The stool looks like a hard lump.
Care to prevent constipation
- Drink orange juice and prune juice to aid bowel movements if needed.
- Avoid lumpy food. Because patients with gastric motility problems
- Encourage exercise both to increase the movement of the stomach and intestines.
- Encourage to drink 6-8 glasses of water per day.
- Give a laxative when needed.
Besides, most of the patients had decreased self-esteem. Due to decreased levels of self-help, changes in body image, dependence Noticeable by patients, often avoiding eye contact while talking. Show anger, shame, and refuse to meet people, even familiar, friends. Has a separate behavior.
Therefore, care should be taken to stimulate the patient’s self-esteem as follows.
- Allow the patient to express their feelings of fear or awareness. Inquire about the symptoms and their impact on the level of self-esteem.
- Giving a sense of the negative effects of having a bad attitude towards yourself.
- Helps to find patient strengths.
- Avoid overprotection of the sick, but should encourage social interaction where appropriate.
- Provide privacy and increase self-help.
How’s it going for patients with Parkinson’s disease? Hopefully, readers will have a better understanding of patients and gain knowledge to care for Parkinson’s disease patients.