Comprehensive Care

Parkinson's Treatment at the Eastside Neuroscience Institute

Every person with Parkinson's disease (PD) is different—not only in how they are affected by the disease, but also in how they react to the life changes associated with living with PD.

Through the Eastside Neuroscience Institute, we provide a comprehensive care approach that goes beyond treating the symptoms of PD and also works to reduce any disability, maintain your independence and enhance your safety. We focus on your needs and preferences.

Treating the many symptoms may prove overwhelming for a single physician. That's why our team approach draws on the strength and specialties of your individual team members. They concentrate on all aspects of your care, including:

• Movement
• Ability to perform daily activities
• Communication and social needs
• Success in relationships
• Self awareness
• Emotional health
• Wellness
• Hobbies

Counseling, education and support are important functions of the team, and your comprehensive care is enhanced when you take an active role in your care. This combination of individual initiative and group concern can strengthen hope, successfully address issues related to loss and life changes and aid adjustment to daily frustrations and new challenges.

Components of Comprehensive Care

• Your care team
• Self-management of PD
• Patient-centered care
• Quality of life

The Value of Comprehensive Care

It is commonly believed that people with advanced PD are the only ones who will benefit from a comprehensive evaluation. This is not necessarily true. With the appropriate goals, motivation and expectations for treatment, individuals in all stages of Parkinson's disease will benefit.

The Early Years with Parkinson's

In early-stage disease, the focus is not as much on movement problems and disability as it is on maintaining health and wellness. Because PD is a progressive disease, patient-centered self management should be introduced at this early stage. The emphasis is not typically on "fixing" a problem but on preventing future problems. It's about maintaining hope, setting goals and establishing control. Awareness and education are critical to self management, but education alone is not enough. Education includes active participation by teaching action-oriented problem-solving techniques.

At this point, you'll want to address current and possible future problems. As you gather information about PD symptoms, treatments and side effects, get started with an exercise program. Think about lifestyle management, including stress reduction and coping skills, and be sure to practice general health maintenance by getting adequate sleep, exercising and keeping a healthy diet. You may also want to obtain an occupational assessment and a social evaluation including home care needs and social support networks.

When and If Disability Increases with PD

After several years of living with Parkinson's, challenges to your quality of life may increase in such areas as movement, mood, communication and socialization. At this stage, your team may need to include a specialist in gait and balance therapy, and fall prevention techniques. Therapists in speech and communication may need to be consulted, perhaps along with experts in swallowing, diet and cognition.

If driving becomes a problem, it is wise to undergo a professional assessment. And if getting around the house becomes more difficult, have your home evaluated for safety while figuring out how much help you may need with home and work activities. A "complete-care" approach can include a reassessment of hobbies and recreational activities and adaptation to changing roles in one's life and family.

Living with Advanced Parkinson's

In the later stages of Parkinson's, the focus turns to managing the condition and finding ways to optimize your quality of life. Among the issues that you and your family may face at this stage are bed and seating comfort, transfers to and from furniture and home health needs. Your care team will want to explore and implement palliative and comfort care measures. This is also the time to gather information about home living arrangements such as assisted care, hospice, respite adult day care and nursing home care.

Emotional and social support issues will become especially important at this stage of the disease, for both you and your caregiver(s). Your caregiver(s) should get proper training and be sure to take care of themselves to avoid burnout.