What is Parkinson’s Disease (PD)?‍

If you asked most people this question 30 years ago, the majority would probably say they hadn’t even heard of it before. Nowadays however, people hear the words “Parkinson’s Disease” and immediately picture Michael J. Fox and the visible tremors he experiences when they see him on TV. But what is Parkinson’s really?
Unfortunately, the cause of PD is still unknown, and a cure is yet to be developed. Being told this information for the first time after hearing the words “you have Parkinson’s” can be incredibly overwhelming and often leads to an extended period of grief including shock, denial, anger, sadness, or all of the above. The next question people often have is then “well if it can’t be cured, how will it affect me?”‍

What is the impact of PD in daily life?‍

PD is what we refer to as a “progressive” condition – meaning the intensity of the symptoms will increase and become more difficult to manage over time.
When I talk to people about PD, I often refer to the analogy Parkinson’s NSW uses by describing the symptoms as somewhat of an ‘iceberg’. The tremors or difficulties with balance that can be physically seen are just the ‘tip of the iceberg’ in terms of symptoms that can be experienced by a person with Parkinson’s. This is because PD can also be associated with difficulty swallowing, toileting, sleeping or speaking, and can also be a contributing factor in the development of other conditions such as depression, anxiety, or even Dementia[2].‍

So how can OT support someone with PD?‍

I’m glad you asked – the answer is one of the main reasons why I’m an OT today. We are in such a privileged position as OTs to help people with PD – not just by improving their safety or independence – but to improve their quality of life. There is so much literature and research evidence available in the industry nowadays that stresses the importance of quality of life (specifically for people with lifelong medical conditions) that we hardly even need to go looking for it anymore.

As much as each individual we work with is so unique and has their own goals, needs or preferences – the ultimate goal for OTs which revolves around improving our clients’ quality of life is no different in the management of PD. We will always be able to provide support in the ways that we are well-known for, whether that’s the prescription of walkers, grab rails, wheelchairs or ramps. But other specific assistance we can provide could look like any of the following:
1. Prescribing adapted cutlery with built-in stabilising technology, so that tremors don’t impact on an individual’s ability to independently bring a spoonful of liquid or food to their mouth.
2. Developing strategies to complete tasks in a different or easier way – whether that’s with preparing meals, hanging out the washing, getting in and out of bed or even getting dressed.
3. Making changes to daily routine to ensure tasks which require the most precise movement are done while any tremor-suppressing medication is working at its magical best.
4. Prescribing simple assistive technology such as spike boards to stabilise vegetables while they are chopped up using an easy-grip knife.
5. Prescribing easy-turn taps to ensure less force and/or control is required to navigate water pressure and temperature.
6. Making slight changes to the setup of the environment where activities are completed to make the overall task easier.
7. However in my experience (as a grandchild of a person with PD), the best support that we can provide as OTs? We can just be there to listen. As OTs, we work at our best when we know our client’s story and really do our best to understand who they are, what is important to them, and what they care most about. We could prescribe the best-looking ramp ever, but if our client’s main goal is being able to make a coffee for their children when they visit, then a ramp really isn’t going to have the life-changing effect that we would’ve hoped for.

Now let me tell you – the list of things we as OTs can do in the management of Parkinson’s Disease by no means ends there. And that’s what makes our profession so rewarding, and why OT is so vital in not just the short-term treatment, but long-term management of PD.

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References:

[1] Kouli A, Torsney KM, Kuan WL. Parkinson’s Disease: Etiology, Neuropathology, and
Pathogenesis. In: Stoker TB, Greenland JC, editors. Parkinson’s Disease: Pathogenesis
and Clinical Aspects [Internet]. Brisbane (AU): Codon Publications; 2018 Dec 21. Chapter 1.

[2] Parkinson's NSW, 2021. Accessed from: https://www.parkinsonsnsw.org.au/parkinsons awareness/.