senior man in wheelchair enjoying listening to music as he looks at his smartphone
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of Tucson

Managing Parkinson’s Disease by Managing Medications

We have a client in Tucson with Parkinson’s Disease.  His family moved him into an assisted living facility because they were facing challenges associated with falls and mood changes.   His situation only got worse because he did not receive the attention he needed.  He desperately wanted to return home so his family contacted us and asked us to provide 24-hour care.

Our caregivers began to assist him with daily activities, and a family member proactively managed his medications with the help of his doctor.  The caregivers help him take his medications multiple times a day as prescribed because timing is incredibly important when it comes to managing Parkinson’s symptoms.  Now, nine months later, this client is doing extraordinarily better.  His is not a fall risk and mood changes are no longer an issue.  He has gone from 24-hour care to only needing care during the daytime.

Levodopa is the most effective drug for treating Parkinson’s Disease.  Used alone, it can cause nausea but combined with carbidopa, it becomes more tolerable and more effective.  Carbidopa prevents levodopa from being converted into dopamine prematurely, allowing more of the drug to get to the brain.  Levodopa is the gold standard for Parkinson’s treatment because it replaces the dopamine that your body no longer produces.  Parkinson’s patients typically require more Levodopa as the disease progresses, not because the body develops a tolerance to the medication, but because the therapeutic window narrows over time.

Caregivers are often the first to notice when medications begin to wear off.  Motor functions that are symptoms of a decline in Levodopa’s effects include rigidity or muscle cramps, slowness of movement, tremors, poor balance, difficulty swallowing, soft speech, and difficulty with fine motor tasks.  Non-motor signals include fatigue, anxiety, change in mood, slowness in thinking, restlessness, and pain.  These non-motor signals that Levodopa has worn off often precede motor signals.

Situations that are typical of Levodopa “off” episodes are 1) end of dose before the start of the next dose, 2) delayed on where it takes longer to absorb the medication, 3) morning when the last dose at night has begun to wear off, and 4) unpredictable off due to daily variation in stress levels, physical fatigue, etc.

Parkinson’s patients should talk to their doctor if they need help managing their medications or their Parkinson’s Disease symptoms.  Various forms of Levodopa may be more beneficial in certain situations.  Rytary is an extended-release capsule with one-third immediate release and two-thirds extended release.  Duopa is a gel form that is fed through a pump on a continuous basis over sixteen hours, bypassing the stomach.   Inbrija is an inhaled powder form of Levodopa used as a rescue medication for off episodes to quickly treat Parkinson’s symptoms.   The Parkinson’s Foundation is a good resource for information on PD medications as well as other Parkinson’s issues for patients and their families.

SYNERGY HomeCare caregivers can improve daily function and overall quality of life for people with Parkinson’s Disease.  Caregivers help with medication reminders, safety supervision, personal care, meal preparation, and companionship.