People Asset Management Occupational Health Services

People Asset Management Occupational Health Services

121 High StreetNewton le Willows WA12 9SL Tele 01925 227000

Parkinson’s Disease

Key Points (drop down)

Parkinson’s Disease (PARKINSONS DISEASE) is named after the doctor who first described it in 1817.

It usually develops after the age of 50.

Rarely it can develop in younger people.

Parkinsons Disease is not usually inherited and it can affect anyone.

About one in a hundred people over 65 will have Parkinsons Disease

Commonly asked questions (drop down)

What Causes Parkinson’s Disease?

A small part of the brain (called the substantia nigra) is mainly affected. This area of the brain sends messages down nerves to help control the muscles of the body. In people with Parkinsons Disease, the cells in this area of the brain become damaged (they degenerate). The cause of this is not known.

A small number of cells are damaged at first then in time, often over a number of years, more and more cells are affected. A chemical called dopamine, made by these cells is reduced as the damage increases.

Dopamine is one of the chemicals in the brain needed for the transmission of nerve impulses. A lack of dopamine causes an imbalance of brain chemicals in this part of the brain. A combination of damaged cells and the chemical imbalance in this part of the brain causes messages to the muscles to become slowed and abnormal.

What are the symptoms of Parkinson’s Disease?

The brain cells and nerves affected in Parkinsons Disease would normally help to produce smooth, well co-ordinated movements of muscles. The three most common symptoms are:

• Slowness of movement (bradykinesia) – for example, walking or getting up out of a chair may become more of an effort. In older people this at first may be put down to getting on in years if symptoms are mild. The diagnosis of Parkinsons Disease may not become apparent unless other symptoms occur. In time, a typical walking pattern may develop. This is commonly more ‘shuffling’ walk with some difficulty in starting, stopping and turning easily when walking.

• Shaking (tremor) – this is common but does not always occur. It typically affects the fingers, thumbs, hands and arms but can affect other parts of the body. It is most noticeable when resting and may become worse if anxious or emotional. When the hand is used to do something such as picking up an object it tends to become less.

• Stiffness of muscles (rigidity) – muscles may feel more tense. Trying to do everyday tasks such as tying laces may be difficult. The arms tend not to swing as much when walking

How does the disease progress?

The symptoms usually come on gradually. It may take months or years before they become bad enough to have much effect on your life.

It is usual for the symptoms to slowly become worse. It is common to have one side of the body more affected than the other. Muscles from various parts of the body may not work so well and other symptoms that may be noticed include the following:

a lack of facial expression such as smiling and frowning;

difficulties with writing (the handwriting tends to become smaller);

difficulties with balance and posture;

constipation may occur;

speech may become slow and monotonous;

in some people swallowing may become troublesome and saliva may pool in the mouth.

Tiredness and aches and pains are also common.

What can I do to help myself?

Staying as active as possible is the best approach.

Exercise regularly as much as you are able. Walking may be slower than before but a daily walk is good exercise and may help loosen up stiff muscles. Well meaning relatives may wish to let you rest and take things easy. However, as far as possible, resist the temptation for others to do things for you just because it may be quicker.

Constipation is common in people with Parkinsons Disease. Help to reduce the chance of this by having lots to drink and eating plenty vegetables, fruit and foods high in fibre. Some practical tips may help. For example, having a higher chair will make it easier to get up, Velcro fasteners instead of buttons, etc. Carrying a walking stick when out may increase your confidence if unsteadiness is a problem.

Depression is more common in people with Parkinsons Disease. It can cause symptoms, which may seem as if the condition is getting worse (such as a lack of energy and becoming slower). If a person with this condition eems to become worse quite quickly or over a few weeks or so, depression may be the cause. Tell your doctor if you suspect this. Depression can often be treated quite successfully with medication.

What are the Treatments for Parkinson’s Disease?

No treatment may be necessary at first if the symptoms are mild. Simply understanding the causes of the symptoms may help.

Treatment may be advised if symptoms progress. Medicines often help with symptoms but no treatment can reverse the damage to the brain cells. Common treatments increase the level of dopamine, which helps to correct the chemical imbalance.

Common medicines used for Parkinsons Disease contain a substance called levodopa. (Sinemet and Madopar are the two common brand names). The body converts levodopa to dopamine, which increases the low levels of this chemical to the brain.

Many people notice a marked improvement after starting levodopa. A low dose is usually needed at first. Over the years, the dose often needs to be increased to control the symptoms. Other types of medicines may also be advised in addition to or instead of levodopa. They have various effects, which try to correct the chemical imbalance in the brain. If the disease progresses the symptoms may not be completely controlled by treatment but they are usually helped.

Everyone is different and treatment schemes and doses vary. Surgical techniques are being developed which may help some people who have had the condition for several years

What about 'therapies'?

A physiotherapist may advise on posture, walking and exercises.

An occupational therapist may advise on home adaptations (such as hand rails) which may ease tasks.

If difficulties with speech arise, a speech or language therapist may be able to help.

Manager Section.

Everybody with Parkinsons Disease is different. Some people will only have mild symptoms. In others it may be more severe. Some people only develop one or two of the symptoms mentioned above, but others may be troubled by several. The common form of Parkinsons Disease does not affect the thinking parts of the brain and does not usually cause dementia. However, Parkinsons Disease usually affects older people who may also have other medical problems, which are common with advancing age.

Some medicines taken for other conditions can interfere with dopamine and make Parkinsons Disease worse. These may be prescribed for such things as mental illness, sickness, vertigo and dizziness. Check with your employee to see whether any new medications have been commenced and consult with OH Consultant if they have.

Short Term Sickness Absence.

When carrying out a sickness absence review with an employee known to have been previously diagnosed with Parkinsons Disease, a manager is recommended to ask the following questions:

Is there anything at work that you believe may be contributing to your problem

Do you think your poor attendance is related to your known medical problem

Are you taking your medication regularly as prescribed by your doctor

Are you paying enough attention to the lifestyle adjustments which you may have been advised to look at

When did you last have a check up with your specialist

Do you need to have a check up with your doctor

Long Term Sickness Absence

All cases of long term sickness must be referred to the OH Consultant for an on-site review.

Manager Options

Ask employee to see his GP

Use AskLine option to get further advice - click on icon

Refer to Occupational Health Consultant - Link to referral paperwork

Further Information Links

BBC Guide to Parkinsons Disease

Parkinsons Disease Society