Tier 2: Safety Net
There is not half way point for Parkinson’s and I reckon the safety net would not be recognizing the symptoms of shuffling or mask-like features but the rest of the associated symptoms that is brought about by the disease. There is a whole myriad of issues like, psychosis, anxiety, depression, sleep issues, anhedonia, apathy and even impulsive-obsessive disorder.
Nowadays, the patients are more informed to look out for these symptoms. It is vital that they are informed and as we look at the disorders that may co-morbid with Parkinson’s, we can actually manage those disorders rather than Parkinson’s itself. Lifestyle changes may be in order. An increase of exercise or activities can help to alleviate depression and anxiety. Decreasing stressors in the daily life can also improve the symptoms of the associated disorders and improve sleep.
Support groups and family support and activities are vital to keep the patient engage with the community and not be alienated. Teaching the family members what to expect, how to engage the patient, how to approach certain symptoms creates a conducive environment for the patient to be. For example, before, when my mother had some rigidity, the doctor did not bother to tell us what we can help her with. It was only during psychology class when we learnt about the disorder did I learn we can help her imagine “stepping over” things. Currently, as her dyskinesias is rather pronounced and we know that it is distressing for her, I have learnt to act nonchalant so as not to add to her stress. It worsens when she feel anxious or excited and will leave her rocking to and fro at a spot. By not reacting to it, she then does not feel even more stressed my “dramatics”. These can be psychoeducation for the family members.
