Nursing and Inter-Professional Care and Management

Impaired swallowing increases with age among people with chronic diseases, for example, Parkinson’s syndrome. Thus, it is important to assess a patient’s energy levels, endurance, and their impact on a patient’s respiratory status (Nazarko, 2016). Additionally, assessing a patient’s respiratory stats for depth, rate, ease and use of accessory muscles provides baseline data useful for evaluating a patient’s status. Therefore, it is recommended having the patient engage in deep breathing and coughing exercises every two hours to boost lung contraction and to dislodge secretions, making expectoration easier (Nazarko, 2016). Providing soft food that does not require chewing and maintaining the patient’s position during eating will help reduce the likelihood of choking (Nazarko, 2016).

Risk of Falls

During ambulation, it is important that patients lift their heels and swing arms. In addition to that, encourage the patient to maintain an upright posture and always look ahead when walking as a stooped posture can make the patient collide with objects. Teach the patient a variety of motion exercises and stretching that should be performed daily to increase flexibility and improve the patient’s balance and strength. These activities are effective ways of helping a patient maintain proper gait and prevent falls (Hiorth et al., 2017).

Impaired Physical Mobility

Parkinson’s disease leads to rigidity, tremors, and bradykinesia, which makes it difficult for the patient to get out of a sitting position. For instance, to train a patient how to get out of a chair, instruct them to slide to the edge of the chair, place their hands on the chair for support, bend forwards, then rock back and forth to assume a standing position (Tosin et al., 2016). Instruct the patient to sit in chairs that have backs and armrests, use toilets with elevated seats and bathrooms with sidebars. Doing so makes it easier for a patient to assume a standing position as well as preventing falls. Instruct the patient to elevate the head of his bed and change his position in the bed slowly (Crawford & Harris, 2016). The patient should also dangle his legs for a few minutes before rising from the bed. Teach the patient how to focus on walking erect using a wide gait.

Learning a particular technique helps in offsetting a shuffling gait and the tendency to lean forward (Tosin et al., 2016). The method requires that the patient makes a conscious effort of swinging their arms and walking appropriately. Instruct the patient to perform daily exercises to gain muscle strength. These activities include riding a stationary bike, walking, swimming and gardening (Crawford & Harris, 2016). These exercises prevent contractures, which usually occur when patients with Parkinson’s disease do not use their muscles. These activities would reduce the risk of low blood pressure that accompanies long periods of lying or sitting down. Furthermore, physical exercises help in improving muscular coordination and agility. Performing these exercises daily also delays the progress of Parkinson’s disease (Crawford & Harris, 2016).

Impaired Verbal Communication

Most patients with Parkinson’s disease have speech disorders. Therefore, physicians should perform the following assessments:

• Evaluate the patient’s ability to speak
• Cognitive or sensory impairment
• Identify the presence of psychosis, dyslalia, aphonia,
• Or any other neurological disorder that affects speech (Shin & Habermann, 2017).

These assessments will help determine areas that a patient has problems and speech impairment as well as facilitate the development of a care plan. Monitor the use of non-verbal communication, such as pointing and smiling, and encourage the patient to use speech whenever possible. Doing so will help establish how well a patient can cope with a speech impediment when expressing their thoughts and feelings.
It is important that caregivers anticipate a patient’s needs during therapy to avoid frustrating or causing anxiety (Shin & Habermann, 2017). Talk to the patient using simple, direct questions that require them to provide one-word answers. Reword or repeat questions if there are misunderstandings which help promote self-confidence in patients who have a certain level of communication or speech ability. Desist from rushing the patient when he is struggling to express his thoughts and feelings. Therefore, compassion strengthens the therapeutic relationship and the development of a sense of trust, which is vital for continued communication (Shin & Habermann, 2017).