Parkinson's Disease and Chronic Care Management
Parkinson's disease is the second most common chronic progressive neurodegenerative disorder. Like Alzheimer disease, the most common neurodegenerative condition in America, symptoms of Parkinson's patient's progress and worsen over time. Parkinson's disease is a disorder of the brain caused by a lack of dopamine that may result in shaking and difficulty with walking, movement, speaking, swallowing and coordination. Older adults with chronic conditions and complex illness may have an increased vulnerability to the disease. Parkinson's disease is one of the most common nervous system disorders for seniors over the age 50.
Individuals diagnosed with Parkinson's disease may develop dementia, experience increased episodes of tremors, problems with dexterity, and slow movement. Posture begins to stoop, there may be feelings of a “stiff” foot, and the body may feel imbalanced. Other symptoms include a slowing or stopping of automatic movements like blinking, muscle aches, muffled speech patterns or monotone voice, difficulty swallowing, and drooling. Symptoms are typically mild at first and progressively worsen The progression of Parkinson's disease can have an impact on some of the most routine daily activities like getting dressed, rising from a chair, and grooming.
Parkinson's disease is unique in the way it affects individuals. For example, like many other cognitive health conditions, patients with Parkinson’s disease require specialized and coordinated care. Chronic Care Management (CCM) and Transitional Care Management (TCM) Care Teams can design a care plan that incorporates therapies as well as assistance with homemaking tasks and medication management. CCM and TCM Care Managers can bring together a diverse set of resources focused on good overall nutrition and health, as well as safety and coordinating the aspects of garnering assistance for those individuals who may ne in need of assistance with their activities of daily living. For instance, many patients may find it helpful to have special utensils to better facilitate cooking and eating, or the installation of railings and banisters in the home to prevent falls, and aid in mobility.
Physical therapy, speech therapy, and occupational therapy are important treatments for people with Parkinson's disease. Equally significant is access to outpatient neurology, subspecialty movement disorders clinics, and coordination of post-discharge service needs. Care Managers can coordinate communications and planning between healthcare professionals in both the acute and post-acute care settings. As Parkinson's disease in seniors is not easily diagnosed, as neither x-rays nor blood tests reveal the condition, Care Managers can screen for associated symptoms. On a monthly basis, they can routinely monitor for a variety of secondary symptoms or complications requiring medical interventions.
In general, older adults benefit from good overall nutrition and health that boost quality of life. Currently, there is no cure for Parkinson's disease.Thus, the main objective of treatment is to manage symptoms and coordinate services to ensure appropriate medical care. Care Managers can help extend the network of health care services and guide patients through the types of questions they need to ask about their prognosis and care. As with any long-term disease and chronic condition putting together the right information and bringing together the best resources are important steps for better health.
About the Author
Joseph F. West, ScD, is a population health and data analytics leader with over 10 years of research and enterprise consulting experience. He is a recognized leader in the development of outcomes-based healthcare. Joseph has served as Chief Population Health Officer, Senior Epidemiologist, Program Director, and Adjunct Assistant Professor. As a consultant and content creator, his current work focuses on population health management (PHM), health information technology (HIT), care coordination innovation, and healthcare risk management.