Acknowledgement
We would like to thank Jelka Jansa, Occupational Therapist, University Medical Centre Ljubljana, Slovenia, for her contributions to ths section.
We would like to acknowledge the use of information taken from the Parkinson’s Disease Society Singapore publication ‘Parkinson’s News' (Aug-Sept 2007) in compiling this information.
An occupational therapist will assess their client’s home, work and leisure activities, and will then identify solutions to overcome the obstacles that hinder them in certain tasks. Some of these obstacles include:
By addressing these obstacles (especially if the client is referred early), the therapist can ensure their client maintains as much independence as possible, and adapts more effectively as Parkinson’s progresses. Because Parkinson’s is a progressive condition, occupational therapists are likely to remain in contact with their patients and their families for many years.
Empowering the person with Parkinson’s by allowing them to participate in everyday tasks, reduces the pressure and stress often placed on their families and friends.
Intervention by an occupational therapist in the early stages of Parkinson’s concentrates on establishing rapport with their client, helping them maintain independence and assisting them in overcoming environmental obstacles. This may help prevent some functional problems before they arise, or improve areas of ability that are proving difficult.
As Parkinson’s progresses, changes may be required in the client’s overall lifestyle. Occupational therapists will help the person with Parkinson’s to organise their daily routine in a way that encourages independence, safety and confidence in as many areas of daily life for as long as possible.
Some of the areas that may be of most concern at this stage are:
In this situation the therapist will provide techniques – such as visual and auditory cues – which will enable their client to use their remaining abilities to make particular tasks easier. For example, a therapist can help dressing become less of an ordeal simply by planning the activity sequence in advance: gathering and organising the garments and then suggesting their client sit down to dress.
Special equipment and environmental adaptations may also be introduced at this stage. These may include hoists, grab bars, stair lifts and devices to make handwriting, cooking, washing etc easier.
A condition marked by extreme tiredness, inability to function due lack of energy and a general state of lethargy, usually accompanied by a feeling of weariness, sleepiness, or irritability. Fatigue may be acute or chronic and be both physical and mental.
See section on fatigue.
Term used to describe the gradual return of symptoms that occurs at the end of a dose of levodopa. This pattern appears when a person with Parkinson's disease has been using levodopa for many years.
Where symptoms can reappear unexpectedly and quickly, which some people describe as being like a light turning on and off.
The ‘on ’ period is when the drugs are working and there is good symptom control.
The ‘off ’ period is when the drugs are not working and the Parkinson's symptoms return.
This appears to be caused by an interaction between Parkinson's disease itself and the drug treatment.
Involuntary movements that tend to occur in people who have had Parkinson's disease for some years as a side effect of long-term use of Parkinson's medication.
A symptom of advanced Parkinson's disease where the person becomes ‘glued’ to the spot for a few seconds or minutes before being able to walk.
See section on Freezing.
A mental state of melancholia, unhappiness or sadness characterized by decreased energy, reduced interest in sex, suppressed appetite, too much sleep or sleep disturbance, a pessimistic sense of inadequacy, a despondent lack of activity, despair, and discouragement.
