Parkinson’s Disease & Psychosis in the Post-Acute and Long-Term Care Setting
Key Points
Key Points
- Parkinson’s disease (PD) is a progressive, neurodegenerative movement disorder. Currently there are an estimated 9.4 million people living with PD around the world, which is significantly higher than the previously reported 6 million cases in 2016. As the population ages, so does the increase in prevalence of PD. As a result, a growing number of residents living in long-term care settings are also living with PD. Both motor and neuropsychiatric symptoms contribute to institutionalization, but the presence of dementia is its strongest predictor. Ultimately, 20% to 40% of people with PD are admitted to a nursing home or assisted living facility. Of nursing home residents with PD, only one-third are followed by a neurologist, leaving the majority of care for these residents to long-term care providers. This pocket guide is intended to provide guidance on the management and treatment of Parkinson’s disease for clinicians in the post-acute and long-term care settings.
- PD typically presents in people who are in their 50s and 60s. Clinically, the four well known cardinal motor features are rigidity, bradykinesia, asymmetric rest tremor, and gait instability. These motor symptoms are due to the loss of dopaminergic neurons deep in the midbrain, which cause the majority of dysfunction in the motor circuitry of the basal ganglia. Additionally, there are many non-motor features of PD (discussed later in the pocket guide).
- There is no known treatment to slow or halt the progression of PD. However, good symptomatic control is possible with dopaminergic and non-dopaminergic medications; exercise; physical, occupational, speech, and music therapy; and in select cases, brain surgery.
- Research into disease modifying treatment, new medications, and better medical devices is advancing at a rapid pace. In this pocket guide, you will learn the basics of diagnosis and management of PD.
Glossary/Key Terms/Abbreviations Defined
...y Terms/Abbreviations DefinedHaving troub...
Recognition
...ognition...
...lude both motor and non-motor symptoms, which...
...nd Non-Motor Features of Parkinson’s...
...ure 1. Differential Diagnosis – Parkinsonis...
...Feature - Possible Alternate DiagnosisHaving troub...
...er Symptoms Not Consistent with th...
...is Requires the presence of parkins...
Assessment
...ssessmen...
.... Symptoms and SignsHaving trouble viewing tab...
...ties Motor and non-motor symptoms...
...nePresentations Sudden decreased functions an...
Treatment
...eatment...
...eatment of Non-Motor Symptoms (in alphabe...
.... Physical, Occupational, and Speech Ther...
...ble 6. Some Factors that Increase Risk o...
...Considerations Refer resident to a...
...onsiderationsDental health PD...
...apiesMarijuana Marijuana contains hundreds of can...
...Pharmacotherapy The goal of pharmacotherapy...
...UT DYSKINESIAS:Dyskinesias are slower, writ...
...mal Levodopa Dosing and Blood Levels...
Misconceptions and Common Questions from People...
...ble 7. Motor Pharmacotherapy Options...
...Pharmacotherapy Options Carbidopa-levodopa IR...
...sia Treatment Amantadine (Symmetrel)...
...fects Carbidopa-levodopa: Nausea, up...
...rgical Options There are three major surg...
Monitoring
Monitoring
...ality Measures with Proposed FrequencyNote: See â...
...s/Palliative Care/End-Of-Life IssuesPrognosis...
...le 8. Medicare Hospice Eligibility CriteriaHavi...
Parkinson's Disease Dementia and Psychosis
Parkinson's Disease Dementia...
...is a common feature of PD. The mean pre...
...ementia with Lewy Bodies vs. Parkinson...
...3. Differential Diagnosis of Parkinson...
...n assessing for PD psychosis, most esse...
...n People with Parkinson’s Disease Parkinso...
...epwise Process for Treating Parkinso...
...t Dementia in PD - Most but not all studi...
Appendices
...pendices...
...ong-Term Care Interval History: Parkinson'...
...LTC Interval History: Parkinson’s Diseas...