COVID 19 PRESENTS DISTINCT CHALLENGES FOR CLIENTS WITH PARKINSONS

Due to the COVID-19 pandemic, people with Parkinson’s disease are experiencing increased stress and limitations on physical activity which may worsen their symptoms. Fortunately, there are ways to mitigate the mental and physical stress of social distancing and other changes in your loved one’s daily routine.

People with PD do not have a higher risk of contracting the virus. However, people with PD may have a more severe reaction to the virus. Parkinson’s researchers are concerned about the vulnerability of patients with a neurological condition like PD to the Coronavirus for many reasons. PD is common in the elderly, and PD can compromise the respiratory system. There is already an increased risk of pneumonia in patients with advanced PD. The pandemic poses a unique problem for people with Parkinson’s disease, as they are more likely to have severe complications if infected. Add advanced age to the equation and the risk is even higher. 

Be on the lookout for symptoms such as fever, cough, and/or shortness of breath. You may want to isolate yourself or your loved one immediately, if you live with other people. You can call your doctor so they can determine if you need to be tested for the virus or not. Do not just show up in your doctor’s office without notification. Your advance warning will help protect the members of the health team and other patients from the virus, and prepare in advance an isolation room for you. If your symptoms become more severe, such as increased shortness of breath, call the nearest emergency department. Discuss what medications will work well with your Parkinson’s prescriptions for the symptoms and fever.

Social distancing and self quarantine are necessary changes for protection and that require adapting to new circumstances, which is a cognitive function depending on dopamine. Many PD patients experience cognitive and motor inflexibility, as a result of dopamine depletion. When dopamine is deficient, it leads to a sense of loss of control and increased psychological stress which is why anxiety and depression are so common in PD. Thus the impact of the pandemic puts those with PD at increased risk of chronic stress. Increased levels of stress can temporarily worsen various motor symptoms, such as tremor, rigidity, freezing of gait or dyskinesia.  It also has been suggested that it makes Levodopa, a mainstay of PD treatment, less effective.  

Cabin fever is another consequence of the pandemic and social distancing due to a reduction in physical activities. Many people are now completely stuck at home, being unable to go out for a regular walk, let alone to see their physiotherapist or attend a fitness class at the gym. A loss of aerobic exercise during the pandemic may lead to a worsening of motor symptoms in PD. Non-motor issues such as insomnia or constipation may also worsen due to lack of physical activity. Furthermore, reduced physical exercise may also contribute to increased psychological stress, thereby further aggravating the symptoms of PD, as discussed above. Promoting frequent home-based exercises, like cycling on a stationary bicycle, is more important than ever before. Look for web-based exercise and yoga programs, and singing or dancing classes for PD patients. Here are some web-based or virtual classes you can consider participating in.

• Dance For Parkinson’s
• Power for Parkinson’s (voice and body exercises)
• Re+Active Classes
• Yoga for Parkinson’s

Several recent studies have shown that mindfulness can reduce depression and anxiety, and even improve motor symptoms. First, it is okay to feel anxious or depressed. While there are so many things we cannot control, we do have things that we can. We can acknowledge our feelings and overcome them by writing in a journal, practicing meditation, or calling family or friends. You can join online groups that you have similar interests with and share ideas. You can join online support groups. You can write emails or actual written letters to friends and loved ones or you can utilize FaceTime, Skype or any virtual apps to stay connected. You can check out things you are curious about and learn to do them. You can take online courses.

Below, are a few Parkinson’s websites that provide free online webinars and information:

• American Parkinson Disease Association
• Parkinson Foundation
• PMD Alliance
• The Michael J. Fox Foundation

Contact Us: Your loved one might benefit from home care or companion care during the pandemic. Our caregivers are skilled in the care of those with Parkinson’s and well trained in the proper protocols to prevent transmission of the Coronavirus. Their care and compassion can help ease the stress and loneliness that comes from social distancing. We will shop, cook, manage medication protocols and do the necessary disinfecting of high touch surfaces needed in the home. In addition, our caregivers can encourage exercise and help prevent falls to keep your loved one out of the hospital, which is a high risk environment at this time. Help is just a phone call away at 561-328-7611.

Till Next Time!

Irv Seldin, JD, President and Owner, Visiting Angels of the Palm Beaches

This article is not intended as medical advice.