Choose One Neurological Disorder (1 Per Paper) Parkinson's

Choose one neurological disorder (1 per each paper) Parkinson Alzheimer Dysarthria 1)

Explain the disorder 2) Mention signs and symptoms in older people 3) Discuss its management of the disorder in older people 4) Discuss important nursing implications.

Paper For Above instruction

Parkinson's Disease: An In-Depth Overview

Parkinson's disease is a progressive neurodegenerative disorder characterized primarily by motor symptoms resulting from the loss of dopaminergic neurons in the substantia nigra pars compacta, a region of the brain integral to movement regulation (Kalia & Lang, 2015). The disease was first described by Dr. James Parkinson in 1817 and has since been recognized as the second most common neurodegenerative disorder after Alzheimer's disease. The pathophysiology involves the accumulation of Lewy bodies, abnormal aggregates of alpha-synuclein protein within neurons, contributing to neuronal death (Poewe et al., 2017). The progressive nature of Parkinson's leads to a decline in motor control, alongside non-motor symptoms, significantly affecting the quality of life in older adults.

Signs and symptoms of Parkinson's disease in older individuals include a classic four-motor feature triad: resting tremor, muscular rigidity, bradykinesia, and postural instability. Resting tremors, often beginning unilaterally, typically manifest as a "pill-rolling" movement of the thumb and forefinger. Rigidity presents as increased muscle tone causing resistance during passive movement, which can lead to masked facies and a shuffling gait. Bradykinesia results in slowed movement, difficulty initiating voluntary movements, and a reduction in spontaneous activity (Jankovic, 2008). Postural instability increases the risk of falls, a critical concern in the elderly with Parkinson's. Secondary symptoms such as speech difficulties (hypophonia, dysarthria), swallowing impairments, constipation, depression, and cognitive decline may also be observed, further complicating management (Schrag et al., 2019).

Effective management of Parkinson's disease in older adults involves a combination of pharmacological, surgical, and supportive therapies. Pharmacologically, levodopa remains the gold standard for symptom control, often combined with dopamine agonists, monoamine oxidase B inhibitors, and other agents to optimize motor function and reduce motor fluctuations (Olanow et al., 2009). Deep brain stimulation (DBS) can offer significant benefits for selected patients who are responsive to medication but experience debilitating motor fluctuations or dyskinesias. Supportive therapies such as physical therapy, occupational therapy, speech therapy, and exercise programs are essential to improve mobility, postural control, and speech functions (Hely et al., 2018). Non-motor symptoms can be managed with antidepressants, anticholinergics, and medications for autonomic dysfunction.

Psychosocial support and caregiver education are vital components of comprehensive care, ensuring patients maintain independence and optimize functional abilities. Tailoring management strategies to the individual's age, comorbidities, and disease severity enhances treatment efficacy and quality of life (Stern et al., 2019). Additionally, addressing fall prevention through home safety assessments, balance exercises, and assistive devices is crucial for reducing injury risk. Regular monitoring and adjustments in therapy are necessary to manage disease progression and side effects, emphasizing the need for a multidisciplinary approach involving neurologists, nurses, physiotherapists, and social workers (Van der Marck et al., 2019).

Nursing Implications in Parkinson’s Disease Management

Nurses play an essential role in the care of older patients with Parkinson's disease by providing comprehensive assessments, medication administration, and patient education. Educating patients and families about medication adherence, managing side effects, and recognizing symptom progression are fundamental nursing responsibilities (Arkadir et al., 2020). Nurses must also monitor for medication complications such as orthostatic hypotension, hallucinations, or dyskinesias, and coordinate with healthcare teams for timely interventions. Providing psychosocial support to address depression, anxiety, and social isolation is critical, as these are common comorbidities in Parkinson’s patients (Hirsch et al., 2018).

In addition, nurses are instrumental in implementing fall prevention strategies, assisting with mobility and exercise programs, and ensuring environmental safety. Observing and managing swallowing difficulties to prevent aspiration pneumonia, a significant cause of mortality in Parkinson’s patients, is another vital nursing duty. Lastly, nurses advocate for patient-centered care by respecting individual preferences, promoting autonomy, and fostering adaptive coping mechanisms, emphasizing holistic management tailored to older adults' needs.

References

  • Arkadir, L., et al. (2020). Pharmacotherapy of Parkinson’s disease: Current and upcoming options. Clinical Neurology and Neurosurgery, 193, 105890.
  • Hely, M. A., et al. (2018). The natural history of Parkinson’s disease in Victoria, Australia. Movement Disorders, 33(4), 627–632.
  • Jankovic, J. (2008). Parkinson’s disease: Clinical features and diagnosis. Journal of Neurology, Neurosurgery & Psychiatry, 79(4), 368–376.
  • Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. The Lancet, 386(9996), 896–912.
  • Hirsch, L., et al. (2018). Non-motor symptoms of Parkinson's disease: A review of current management strategies. CNS Neuroscience & Therapeutics, 24(4), 369–377.
  • Olanow, C. W., et al. (2009). Continuous dopaminergic stimulation in the management of Parkinson's disease. Annals of Neurology, 66(4), 504–512.
  • Poewe, W., et al. (2017). Parkinson disease. Nature Reviews Disease Primers, 3, 17013.
  • Schrag, A., et al. (2019). Non-motor symptoms and quality of life in Parkinson’s disease. Parkinson’s Disease, 2019, 1–10.
  • Stern, M. B., et al. (2019). Management of motor and non-motor symptoms of Parkinson’s disease. The Medical Clinics of North America, 103(6), 1073–1087.
  • Van der Marck, M. A., et al. (2019). Multidisciplinary care in Parkinson's disease. Journal of Parkinson’s Disease, 9(1), 45–54.

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