Parkinson’s disease (PD) affects about one million people in the United States and ten million worldwide. While there is no cure, there are ways to help slow its progression, including choosing a lifestyle that addresses the challenges of this disease. If you, or a loved one, are affected by Parkinson’s disease, you should know about the numerous advantages that an assisted living setting can offer.

April Is Parkinson’s Awareness Month and the Theme Is #FutureOfPD

The goal is to raise awareness and inspire action to impact the future of Parkinson’s disease, whether that means learning how to navigate your own future with PD, or helping create a world without it.

Prevalence

The Centers for Disease Control and Prevention (CDC) rate complications from Parkinson’s disease as the 14th cause of death in the United States.

• PD is the second most common neurodegenerative disorder.
• Approximately 60,000 Americans are diagnosed each year.
• Incidence of Parkinson’s disease increases with age.
• Men are 1.5 times more likely to have Parkinson's disease than women.

What is Parkinson's?

According to the Parkinson’s Foundation, Parkinson's disease (PD) stems from gradual destruction of certain nerve cells—in a part of the brain called the substantia nigra—that make a key chemical known as dopamine. Dopamine helps relay messages within the brain centers that tell muscles to produce smooth, coordinated motions. Without that signal, muscles can’t respond properly, resulting in a wide range of motor skill deficiencies.

Symptoms generally develop slowly over years and can progress differently for each person. People with PD may experience:

• Tremor, mainly at rest and described as “pill rolling” tremor in hands (rubbing thumb against index finger). Other forms of tremor are possible.
• Slowness of movement (bradykinesia)
• Limb rigidity
• Gait and balance problems

Complications can be serious, but the disease is not fatal. The cause remains unknown, although genetic, environmental and lifestyle factors can be influencers. Treatment options include medications, surgery and changes in lifestyle, such as getting more rest and exercising. This is where the supportive lifestyle of assisted living can have major benefits.

In a Caring.com article entitled “Parkinson’s Disease and Assisted Living,” John L. Lehr, CEO of the Parkinson’s Foundation, says, “One of the things we encourage is that people living with Parkinson’s have the highest and best quality of life possible—and that they live in the least restrictive environment possible.” Lehr says that at some point, living at home with a spouse or caregiver is no longer safe. “At that point we would encourage, along with input from a physician and others, that they consider a different environment, including assisted living.”

Signs to Watch For

Diagnosing Parkinson’s is complicated, particularly in the early stages. One reason is that many of the symptoms could indicate other conditions, or even be harmless. And while the 10 signs listed below could signal the disease, the Parkinson’s Foundation strongly urges that you or a loved one first see a physician to avoid unnecessary worry.

• Slight shaking or tremor in finger, thumb, hand or chin.
• Smaller handwriting, words are crowded together.
• Trouble smelling certain foods, like bananas, dill pickles or licorice.
• Thrashing around in bed, acting out dreams, sudden movements during sleep.
• Stiffness in body; arms don't swing when you walk; stiff or shoulder hip or pain that lingers. Feet feel “stuck to the floor.”
• Daily severe constipation.
• Soft or hoarse voice.
• “Facial masking”: you look serious or mad even when you are in a good mood.
• Dizziness when you stand up.
• Stooping, slouching.

Actual Diagnosis

For an accurate diagnosis, a skilled practitioner must combine diagnostic tests with observation of symptoms. Two of the four main symptoms must be present over a period of time for a neurologist to consider a PD diagnosis:

• Shaking or tremor
• Slowness of movement
• Stiffness or rigidity of the arms, legs or trunk
• Trouble with balance and possible falls, also called postural instability

Stages of the Disease

Not everyone will experience all the symptoms. The order and intensity also can vary.

Stage one: Mild symptoms, such as tremor and movement symptoms on one side of the body only, that do not interfere with daily activities. Changes in posture, walking and facial expressions also are possible.

Stage two: Symptoms worsen. Tremor, rigidity and other movement symptoms affect both sides of body. A person can live alone, but daily tasks are becoming harder.

Stage three: Loss of balance and slowness of movement. Falls are common. Tasks take much longer, such as buttoning a shirt, cutting food or brushing teeth.

Stage four: Severe, limiting symptoms that require assistance with activities of daily living. A person cannot stand without assistance. Movement can require a walker. The individual can no longer live alone.

Stage five: Stiffness in the legs can make it impossible or stand or walk. 24/7 assistance is needed for all activities. Hallucinations can occur.

The Role of Assisted Living

Assisted living can offer a wide range of benefits for those dealing with Parkinson’s, as acknowledged by Parkinson’s Foundation CEO John L. Lehr. “Parkinson’s disease is a very socially isolating and stigmatizing disease. Despite all our efforts, it continues to be so,” says Lehr. “People can fall into deep depression or withdraw from their social lives altogether. Assisted living can bring them out for activities, social engagement, and opportunities to exercise and move around.”

The Benefits Assisted Living Can Offer:

Activities geared to specific needs. Assisted living communities offer a full calendar of engaging and interesting activities. Many of these are geared toward those residents with mobility issues. This is especially beneficial, because many with Parkinson’s find it difficult to complete regular activities, or to even get up and move about which can result in depression and anxiety. Having scheduled events geared to their needs is both physically and mentally helpful.

Assistance with activities of daily living (ADL). Buttoning a shirt. Combing their hair. Helping choose an outfit and dressing. Bathing, walking to dinner, personal hygiene—it’s all part of the assistance provided in assisted living. Whether it’s you, or your loved one, there’s no “standing out” or feeling conspicuous. You are in a community designed to support you.

Medication management. This is crucial with Parkinson’s. Prescribed drugs must be taken exactly as directed, at the necessary time. Levodopa-carbidopa, in particular, must be taken in precise, consistent dosages throughout the day in order to control symptoms and prevent serious effects such as “freezing.” Assisted living offers families the peace of mind that medications are managed by a professionally trained staff, preventing potentially dangerous delays.

An environment designed for safety. Research estimates that people with PD are twice as likely to fall as other older adults and nine times more likely to have recurrent falls. This is due to problems with balance, stiffness, medications, and “freezing.” Just the fear of falling can further restrict movement. In assisted living, you benefit from an environment designed for health and safety, with even surfaces, handrails in hallways and bathrooms, smooth flooring (no throw rugs), and maybe most importantly, a dedicated staff always on hand when needed.

Nutrition. Eating regular, healthy meals can be difficult as PD progresses. Problems can include difficulty chewing and swallowing, excessive salivation, dehydration and more. The natural movement of food from the stomach to the intestines can also slow. Constipation can be severe. According to Johns Hopkins Medicine, eating whole foods, such as fruits and vegetables, lean protein, beans and legumes, and whole grains is key. In addition, to maximize the effects of medication, high-protein foods should not be eaten when medications are administered. In assisted living, meal planning is overseen by a culinary professional who is dedicated to providing residents proper nutrition and the dining experience they deserve.

Exercise. WebMD cites research by Northwestern University that suggests vigorous exercise may slow, stop or reverse the progression of Parkinson’s. Exercise should include aerobic activity; strength training; balance, agility and multitasking; and flexibility. Yoga, walking or swimming can help improve flexibility and mobility and reduce muscle and joint pain; improve posture; loosen tight, painful muscles; and build confidence. Tai chi and qi gong have been shown to improve both motor and non-motor symptoms of Parkinson’s. Assisted living offers countless classes and activities—seated and standing—to help achieve these goals.

Therapy. In assisted living, residents have the advantage of access to professional physical, occupational, and speech therapy that can help target the symptoms of PD.

For example:

• Rock Steady Boxing can increase independence and confidence in individuals with Parkinson’s, as well as improve motor skills and improve quality of life.
• Dance for PD has shown that dance improves gait and balance issues, plus can help patients in their thinking abilities and decrease feelings of isolation through social interaction. In a 2019 study comparing the effects of dance for early-stage PD patients, researchers found that memory skills, anxiety and depression, and quality of life were significantly improved for participants in the dance group.
• LSVT BIG® trains improved movements for any activity, whether “small motor” tasks like buttoning a shirt or “large motor” tasks like getting up from sofa or chair or maintaining balance while walking. The treatment improves walking, self-care and other tasks by helping people “recalibrate” how they perceive their movements with what others actually see.
• LSVT LOUD® trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people "recalibrate" their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.

At Clearwater Living we have on-site therapy services through ONR (Orthopaedic & Neurological Rehabilitation, Inc.), a national leader in rehabilitation services. This gives our residents access to physical therapy, occupational therapy, and speech-language pathology just steps from their front door, or even in the comfort of their apartment. Benefits include increased independence, enhanced quality of life, quick access to care, personalized programs, and consistency of care.

Parkinson’s and Assisted Living: Benefits For You or a Loved One

Though it can be a challenging disease, Parkinson’s does not have to define your life, or that of a loved one. Choosing a supportive and stimulating assisted living environment can be hugely beneficial in terms of staying active, engaging with others, getting the attention and nutrition you need, and maintaining a high quality of life.

Caring for an aging adult can be wonderfully fulfilling. It can also be a very challenging undertaking for the senior and their loved ones. Without the needed skills and resources, both parties may go without the essential care they need.

At Clearwater Living, our Empowered Living goes beyond basic care to create opportunities for residents of varying tastes and abilities to fulfill their physical, mental, and emotional needs through individual choice and community involvement. Contact us to learn more.