Parkinson disease - discharge

Over time, symptoms get worse and it becomes more difficult to take care of yourself.

Your provider may suggest you take different medicines to treat your Parkinson disease and many of the problems that may come with the disease.

• These medicines can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and confusion.
• Some medicines can lead to risky behaviors such as gambling.
• Make sure you follow instructions. Do not stop taking medicines without first talking to your provider.
• Know what to do if you miss a dose.
• Keep these and all other medicines stored in a cool, dry place, away from children.

Exercise can help your muscles stay strong and help you keep your balance. It is good for your heart. Exercise may also help you sleep better and have regular bowel movements. Pace yourself when you do activities that may be tiring or need a lot of concentration.

To stay safe in your home, have someone help you:

• Remove things that can cause you to trip. These include throw rugs, loose wires, or cords.
• Fix uneven flooring.
• Make sure your home has good lighting, especially in hallways.
• Install handrails in the bathtub or shower and next to the toilet.
• Place a slip-proof mat in the bathtub or shower.
• Re-organize your home so things are easier to reach.
• Buy a cordless or cell phone so you have it with you when you need to make or receive calls.

Your provider can refer you to a physical therapist to help with:

• Exercises for strength and moving around
• How to use your walker, cane, or scooter
• How to set up your home to safely move around in and prevent falls
• Replacing shoe laces and buttons with Velcro
• Getting a phone with large buttons

Constipation is a common problem if you have Parkinson disease. So have a routine. Once you find a bowel routine that works, stick with it.

• Pick a regular time, such as after a meal or a warm bath, to try to have a bowel movement.
• Be patient. It may take 15 to 30 minutes to have bowel movements.
• Try gently rubbing your belly to help stool move through your colon.

Also try drinking more fluids, staying active, and eating lots of fiber, including fruits, vegetables, prunes, and cereals.

Ask your provider about medicines you are taking that may cause constipation. These include medicines for depression, pain, bladder control, and muscle spasms. Ask whether you should take a stool softener.

These general tips may help with swallowing problems.

• Keep mealtime relaxed. Eat small meals, and eat more often.
• Sit up straight when you eat. Sit upright for 30 to 45 minutes after eating.
• Take small bites. Chew well and swallow your food before taking another bite.
• Drink milkshakes and other thick drinks. Eat soft foods that are easy to chew. Or use a blender to prepare your food so that it is easy to swallow.
• Ask caregivers and family members not to talk to you when you are eating or drinking.

Eat healthy foods, and keep from becoming overweight.

Having Parkinson disease may make you feel sad or depressed at times. Talk to friends or family about this. Ask your provider about seeing a professional to help you with these feelings.

Keep up to date with your vaccinations. Get a flu vaccine every year. Ask your provider if you need a pneumonia shot. It is recommended that people with Parkinson disease get a COVID vaccine.

Ask your provider if it is safe for you to drive.

These resources can provide more information on Parkinson disease:

The American Parkinson Disease Association -- www.apdaparkinson.org/resources-support/

The National Parkinson Foundation -- www.parkinson.org

Contact your provider if you have:

• Changes in your symptoms or problems with your medicines
• Problems moving around or getting out of your bed or chair
• Problems with thinking of becoming confused
• Pain that is becoming worse
• Recent falls
• Choking or coughing when eating
• Signs of a bladder infection (fever, burning when you urinate, or frequent urination)

Paralysis agitans - discharge; Shaking palsy - discharge; PD - discharge

American Parkinson Disease Association website. Living with Parkinson disease. www.apdaparkinson.org/resources-support/living-with-parkinsons-disease/. Accessed September 14, 2023.

Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and movement disorder society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-1266. PMID: 29570866 pubmed.ncbi.nlm.nih.gov/29570866/.

Jankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.

Parkinson's foundation website. Parkinson's & the COVID-19 vaccine. www.parkinson.org/blog/tips/covid-vaccine. Updated January 14, 2021. Accessed September 14, 2023.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.