Whenever a patient with Parkinson's disease (PD) is admitted to an acute care setting, there is more to evaluate than the reason for the admission. First, no one is ever admitted due to acute PD. The cause of the admission may be the result of the many issues that the person must face daily.
For example, falls occur as a major dillema for movement disorder patients. A fractured hip could result. But that doesn't mean the patient ONLY has a fracture and Parkinson's disease. Other issues that could result due to PD include:
- Pain management may not be easy to assess.
A PD patient usually has a facial mask. Nurses cannot depend on typical signs of facial expressions that indicate the level of their patients pain.
- Constipation is a daily challenge.
PD adds to slowed bowel patterns. Medications to treat PD frequently cause constipation. Since pain medications can also be constipating, an injured patient receiving those additional medications has a third contributing factor increasing the agony of constipation.
- Rehabilitation for a PD patient must be scheduled around their "on time."
Respect to the timing of PD meds must correlate with when therapy is planned. If a patient is "frozen" due to PD, any therapy will be less effective. This could result in a longer hospitalization and complicate their rehabilitation.
- The reason for the fall still exists.
Balance is a primary problem for anyone with PD. This translates into a high likelihood for a readmission. Evaluating how to prevent further falls is more complicated when the underlying reason for fall cannot be changed by the hospitalization. Education for falls prevention is an ongoing struggle.
To summarize, the implications for nurses must include all the issues that the individual with PD handle daily. The only way this can be successful is by seeing that patient as a unique individual.