Introduction

Parkinson's disease (PD) is one of the brain degeneration ailments that majorly affects the motor system and is identified by a gradual damage of dopamine secreting cells in the brain's substantia nigra area. (Kalia & Lang, 2015). Mrs. Sun's Parkinson's illness has worsened in the last six months, causing postural instability, tremors in her left hand, and weight loss. Her latest fall also resulted in a broken wrist, adding to her physical health problems. Mrs. Sun Lan is suffering from depression and withdrawal. These are the two main issues that have been identified in the case of Mrs. Sun. The purpose of this study is to focus on the functional problem Mrs. Sun faced that resulted in her acquiring rehabilitation.

Results

The study done by Dorsey et al. (2018) goal is to draw attention to the growing impact of PD on society and the need for more resources and attention to address this problem. To obtain and combine pertinent data from diverse sources, the authors conducted a literature study. The authors discovered that PD is becoming more common everywhere and that this neurodegenerative condition has a big impact on people, families, and society as a whole. Overall, the article offers significant new outlook on the rising incidence of PD and the pressing need for action to address this public health issue. Another study by Fleisher et al. (2020) examined disease severity and Quality of life (QoL) in homebound advanced PD patients. Cross-sectional data were collected from a group of homebound advanced PD patients. Disease severity, cognitive function, depression, and QoL were assessed using conventional techniques. 20 US homebound advanced PD patients receiving home healthcare were studied. All participants had PD and had lived at home for at least three months before enrolling. Cognitive impairment and depression also decreased QoL.

Depression symptoms are associated with lethargic movement and reaction times, poor balance, diminished muscular strength, and mental retardation (Demanze Laurence & Michel, 2017). Moreover, the study by Choi et al. (2019) discovered factors that may cause freezing of gait (FOG) in PD patients. Cross-sectional data from PD patients were obtained in the study. Motor symptoms, cognitive function, sadness, anxiety, and medication use were assessed using conventional assessments for FOG. 116 South Korean neurology clinic patients with PD were studied. The study identified PD patients' palliative care needs. The mixed-methods study collected quantitative and qualitative data. PD patients and carers were surveyed about palliative care and their requirements. In other complex older groups, modern home visits have improved care quality and reduced neurodegeneration (Jung et al., 2020). Although there haven't been many PD implementations, interdisciplinary approaches have shown to be the most successful.

Choi et al. (2019) and Fleisher et al. (2020) examined the FOG and standard of life in homebound advanced PD patients. Choi et al. (2019) used a quantitative research design and surveys to identify factors related with the freezing of gait in PD patients, while Fleisher et al. (2020) used a mixed-methods approach and surveys and interviews to examine severity of the disease and status of life in homebound advanced PD patients. Dorsey et al. (2018) synthesized the evidence on the "Parkinson's pandemic" and its effects on healthcare systems worldwide using a narrative review approach.

Discussion

As Mrs. Sun Lan's primary nurse in the inpatient rehabilitation unit, the result section is crucial. Choi et al. (2019) investigated Parkinson's disease gait freezing variables. Parkinson's disease's freezing of gait can cause falls and mobility issues, which may have contributed to Mrs. Lan's fall. Age, disease severity, medication use, and cognitive impairment were linked with freezing of gait. Mrs. Lan, 80, may have fallen due to freezing gait due to her Parkinson's symptoms developing. To identify contributory factors, her medication and cognitive function should be assessed. Dorsey et al. (2018) studied Parkinson's epidemic evidence. The study emphasized the global rise of Parkinson's disease and the need for increased research, funding, and resources. As the world population ages, more people will have Parkinson's disease, and healthcare personnel will need to be prepared to address their complicated demands. This research emphasizes the necessity of recognizing and addressing the requirements of patients like Mrs. Lan, who need specialized care and support to manage her symptoms and improve QoL.

Fleisher et al. (2020) examined disease seriousness and standard of life in homebound advanced Parkinson patients. The study indicated that homebound advanced in PD patients have a significant disease burden. The study also stressed carers' importance in meeting patients' daily requirements. George, Mrs. Lan's principal carer, is probably stressed and burdened. To continue caring for his wife, he may need to assess his own needs and receive appropriate help and resources. According to the findings of Vriend et al. (2016), a smaller amygdala is connected with anxiety. This discovery may shed light on the underlying neurological pathways that contribute to Mrs. Lan's anxiety symptoms. If her amygdala is smaller, it could be due to structural abnormalities in this brain region, which could affect her emotional processing and contribute to her anxiety.

Gilat et al. (2018) research the neurological mechanisms that are fundamental in the freezing of gait (FOG) in PD. FOG is a prevalent and weakening motor indication of Parkinson's disease that is characterized by brief episodes of difficulty to commence or sustain walking, which can lead to falls and a lower quality of life. Mrs. Lan, as described in the case study, has frozen episodes, especially when commencing stride or turning, which severely hinders her mobility and increases her risk of falling. The study by Ko and Noh (2020) emphasizes the significance of defining and assessing homebound status in the elderly. The findings of this article could help healthcare providers better understand the idea of homebound status and its impact on Mrs. Lan's everyday life. Mrs. Lan's limited movement due to her condition of Parkinson's disease which has rendered her housebound, which can have serious consequences for her mental and physical health, social participation, and general quality of life.

Mrs. Lan's primary nurse must periodically check her physical and emotional wellness. Mrs. Lan's weight loss, postural instability, tremors, and depression should be watched and recorded. PD can cause tiredness, poor balance, and mental impairment. Thus, nurses should manage depressive symptoms with medication, therapy, and emotional support. Monitoring cognitive function and cognitive impairment can also detect depression and other mental health issues early on. As a primary nurse, Mrs. Lan's palliative care requirements should be taken care of and addressed with a multidisciplinary team of family, healthcare providers, and community resources. Emotional support and coordination with physiotherapists, social workers, and dieticians can improve Mrs. Lan's quality of life and function. Nurses should provide PD patients and their families with physical, emotional, and social care.

Conclusion

Physiotherapy, occupational therapy, and palliative care are needed to treat PD non-motor and motor symptoms, according to the literature study. The neurological processes includes anxiety and gait freezing have also been studied, providing insights into Mrs. Lan's rehabilitation plan. Studying the neurological processes of non-motor symptoms like anxiety and gait freezing has informed Mrs. Lan's rehabilitation plan. The literature advises Mrs. Lan's rehabilitation plan addresses motor and non-motor problems. Optimizing her Parkinson's medicines, monitoring side effects, and treating her postural instability, tremors, and gait freezing with physiotherapy and occupational therapy may help. House adaptations, assistive devices, and freezing of gait episodes can help Mrs. Lan and her carers prevent falls and increase her function.

References

Choi, S. M., Jung, H. J., Yoon, G. J., & Kim, B. C. (2019). Factors associated with freezing of gait in patients with Parkinson’s disease. Neurological Sciences , 40 , 293-298. https://doi.org/10.1007/s10072-018-3625-6

Demanze Laurence, B., & Michel, L. (2017). The fall in older adults: physical and cognitive problems. Current aging science , 10 (3), 185-200. https://doi.org/10.2174/1874609809666160630124552

Dorsey, E., Sherer, T., Okun, M. S., & Bloem, B. R. (2018). The emerging evidence of the Parkinson pandemic. Journal of Parkinson's disease , 8 (s1), S3-S8. 10.3233/JPD-181474

Fleisher, J. E., Sweeney, M. M., Oyler, S., Meisel, T., Friede, N., Di Rocco, A., & Chodosh, J. (2020). Disease severity and quality of life in homebound people with advanced Parkinson disease: A pilot study. Neurology. Clinical practice , 10 (4), 277–286. https://doi.org/10.1212/CPJ.0000000000000716

Gilat, M., Martens, K. A. E., Miranda-Domínguez, O., Arpan, I., Shine, J. M., Mancini, M., ... & Horak, F. B. (2018). Dysfunctional limbic circuitry underlying freezing of gait in Parkinson’s disease. Neuroscience , 374 , 119-132. https://www.sciencedirect.com/science/article/pii/S0306452218300745

Jung, Y. J., Kim, R., Yoo, D., Han, K., & Lee, J. Y. (2020). Late-life falling and depressive symptoms associated with the risk of Parkinson's disease: a nationwide cohort data analysis. BMC geriatrics , 20 (1), 284. https://doi.org/10.1186/s12877-020-01691-9

Kalia, L. V., & Lang, A. E. (2015). Parkinson's disease. The Lancet , 386 (9996), 896-912 https://doi.org/10.1016/S0140-6736(14)61393-3

Kluger, B. M., Shattuck, J., Berk, J., Sebring, K., Jones, W., Brunetti, F., ... & Bekelman, D. B. (2019). Defining palliative care needs in Parkinson's disease. Movement disorders clinical practice , 6 (2), 125-131. https://doi.org/10.1002/mdc3.

Ko, Y., & Noh, W. (2021). A scoping review of homebound older people: definition, measurement and determinants. International Journal of Environmental Research and Public Health , 18 (8), 3949. https://doi.org/10.3390/ijerph18083949

Vriend, C., Boedhoe, P. S., Rutten, S., Berendse, H. W., van der Werf, Y. D., & van den Heuvel, O. A. (2016). A smaller amygdala is associated with anxiety in Parkinson’s disease: a combined FreeSurfer—VBM study. Journal of Neurology, Neurosurgery & Psychiatry , 87 (5), 493-500. http://dx.doi.org/10.1136/jnnp-2015-310383

References

Australian Human Rights Commission. (n.d.). Who Experiences Racism? Retrieved July 10, 2023, from https://humanrights.gov.au/our-work/education/who-experiences-racism

Miller, S. (n.d.). Why children need protection in a digital world . Save the Children. https://www.savethechildren.org/us/charity-stories/why-children-need-protection-in-a-digital-world

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