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Assisted living or memory care? Patient has little dementia, not Alzheimer's.

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My Dad lasted 5 weeks with stage 5 PD. Stage 5 needs constant care. My Dad slept a lot, but someone needs to be there all the time. Don't force activity or food. Consider hospice. Medicine really doesn't work at this stage, talk to his DR. about what can be eliminated. You the caregiver will know better than the DR what is needed. Dr's know this, and will respect your decisions. Enjoy the time you have left. Now is the time to tell him how much he means to you, and how you love him. Family members will not see the change, be firm, you know best. If he falls, someone strong will need to get him up, as he will not be able to assist. He will be much more comfortable at home if you can do it. I can't say enough for hospice. Dad died peacefully, in his bed. It was beautiful, and not frightening or pain filled. My prayers are with you.
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It is clear, glad you could understand it.
I was hoping to point out that the staging described in the article ncloud posted was created in 1987 and we have come a long way in understanding the global nature of Parkinson's since then. Also, I wanted to emphasize the importance of a skilled evaluation over what can be gained from putting a person into a category.
Thanks everyone for sharing on this web sight.
Things can be complicated even if you ask a simple question!
Hugs to all.
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I actually find nclouds' document to be very clear and very understandable. The fact that I am the full-time caregiver of my mother who, according to nclouds' document is between stages 4 and 5) may in fact impact my ability/time to decipher the information provided by RhondaAllison though.
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There are several different scales, but, I would urge that the client's individual assessment is what is most telling rather than any category. The article provided by ncloud refers to the Hoehn and Yahr Scale. The UPDRS is much more comprehensive and current.

From the following article you may find a full description and comparison:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897716/

Basically it explains "The most common rating scales are the Unified Parkinson Disease Rating Scale (UPDRS), Hoehn and Yahr staging, and the Schwab and England rating of activities of daily living. Each of these rating scales are described, including detailed instructions on how to implement these ratings."
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I was just looking for some guidance on where my husband is in this Parkinson's. I found this wonderful description.

http://parkinsonsresource.org/wp-content/uploads/2012/01/The-FIVE-Stages-of-Parkinsons-Disease.pdf
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PD seems to have been categorized into 5 stages.......
It might be helpful if you google " Parkinson's has how many stages" .
It will help prepare you as the caregiver to know what symptoms to look for, and you may be able to judge the stages better than the Doc, who only sees the patient for a few minutes during the OV [office visit] ... I do wish you well..
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Oooh.. I forgot to mention, that if the one nurse in the NSG home distributes medication by starting on the opposite end of the hallways, than the Nurse does 4 hours later ... the medication can be as much as 6 hrs late... and that just does not work with Sinemet patients...... I do hope you can find a good solution and wish you well......
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Our neurologist has never given us a stage number though I was given an "about half way" when I asked him how far along DH was i his PD. How many stages are there?
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I do feel with you..... Stage 5 is terrible + needs constant attention by the caregiver....... regarding especially the medication timing.
I assumed care of my mother in that stage, and took her to a Neurologist as soon as she arrived. Yet no one ever told me about 2 things....
1]... If a person is stage 5 + on Sinemet... that medication has to be given every 4 hrs as prescribed....
2]... ..... NOT every 4.5 or 5 hours.... as they distribute medications in a Nursing home...just because they legally can do so... as going from room to room gives them the privilege to be late....
I could not get the NSG home to understand that this delay causes pain and Malaise - so just make a special 4 hr delivery to my mother's room on time.
She ended up there, after broken hip surgery. They insisted that she needs to be put on a tranquilizer because she complained of pain and malaise .... when all she needed was to get her Sinemet q4h not q5hours.
Since she was also almost blind, and could not comply with physical therapy due to the delays in Sinemet timing... I told the administrator that I had asked several times for compliance in giving the Sinemet no later than q4h, since I could not be there all day - as I also took care of my Atherosclerosis dementia affected father - I finally told them I can kill my mother at home just as well as they can... and took her home after less than 2 weeks there, as even hiring 24 hr bedside NSg assistants for my mother did not change a thing there.... At home she recovered from open sores caused by bloodthinners and infrequent depend changes , inside less than 2 weeks. Although she could never walk again... her quality of life improved dramatically, simply by adhering to the proper medication schedule, and healing the hand-size sores with Zinc-salve and liquid lidocain, covered with saran wrap and an increase in Vitamin C + liquid intake, since Vitamn C should never be given without a cup of fluid or it damages kidney-function....
I am trying to say here that a late stage Parkinson patient is not going to do well in any facility, due to the above mentioned liberal medication distribution law, that allows NSG-Homes to give meds and hour late........
I hope you can arrange for "in-your-home" care with Nsg-assistant's help... just make sure all valuables are locked up tight. We were fortunate to get Elder-services to provide help according to income level... That worked best for both my mother and father for a total of 3 of their last years.. I wish you well !!!
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Be careful if the individual drives. My father-in-law had Parkinson's and almost killed a man and his son. Until the man came up to my FIL's car window when he stopped to get gas and said to him "Do you know that you almost killed my son and I back there? " My FIL was clueless!
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After 25 years, my husband is losing most of his mobility, has some dementia, and very poor speech. We go to PT 2x/wk and are starting BIG & LOUD next week...it's a 4 week deal 4x/wk but they are having good results.
Yes, he falls daily, luckily has learned to roll more or collapse rather than the severe falls he used to have...BUT he has bandages all over his legs.
The biggest problem we have is at night when he gets up every 1-2 hours...sometimes not even knowing what he's doing....When I am lucky enough to have someone come in more than 1x/wk (grocery time), I close the bedroom door and take a nap because I am always so tired..
We are Christians and I just read "Work as for the Lord"....I am trying to remember all the wonderful things he has done in his life to help others and all I have to do is help the man I married 55 years ago. It's not always easy but I know there are others out there that have it worse....just need to keep reminding myself. HANG IN.....BUT....GET HELP!
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In home care is always the best option if you can find a quality company. It will make the client happy staying in the environment they are used to & give you peace of mind.
My mother was recently diagnosed with Parkinson's. I feel your pain.
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Around the clock care......Care for your self too.
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I am a Physical Therapist who specializes in geriatrics and Parkinson's Disease. I have practiced in this area for 30 years and have a Doctorate in PT.
As Nonna said you want to help limit falls, but there may come a time with advanced PD clients when it is better to utilize a wheel chair rather than attempt to reduce falls with walking. Without individual assessment it is impossible to say what is best for the person you are referring to of course. Due to the common cognitive deficits and obvious motor disturbances a person CAN enjoy quality of life in a more independent manner by utilizing a wheel chair. Many of my clients with more advanced PD who are ambulatory have repeat falls with fractures of facial and upper extremity bones. Helping a client recover from a hip replacement due to falling from advanced PD is a real challenge.
If they are still capable of learning and adapting PD clients often make significant gains from programs like LSVT BIG and LOUD. These specific treatment regimens are fantastic for earlier diagnosed clients and still have much to offer for more advanced folks. lsvtglobal.com Many PTs and OTs are trained in the BIG and Speech Pathologists are the experts with the LOUD program. Clients are often very empowered with being able to be heard again after years of not being able to speak loud enough to be heard.
Either of the settings you mention will have PT, OT, and SLP. Ask them if they have training or certifications in PD treatment. IF they do run with it. IF they do not give them the web sight for starters and learn together.
My heart goes to you. PD can be wicked.
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Lots of tlc; gait and speech are limited. In home care with 24/7 with my mom as caretaker was challenging but dad was more comfortable at home. PT is important to help limit falls.
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