Approach to managing Parkinson's disease
“An effective team delivers
care that is greater than the sum of its parts”
European Parkinson’s Disease Association and the World Health
Organisation have published a charter of rights for people with
Parkinson’s disease (PD). This states that people with PD have the
- -be referred to a doctor with a special interest in PD
- -receive an accurate diagnosis
- -have access to support services
- -receive continuous care
- -take part in managing their illness
this standard of care is to be achieved routinely, then management of
the multiple physical, psychological and social effects of PD demands a
coordinated team approach. No one professional - even a PD specialist -
can have all the knowledge and expertise that is required.
to the team is the person with PD and their family. They live with the
condition 24 hours a day and soon become experts. If health and social
care professionals acknowledge patient and carer
expertise and work together with them, then outcomes are likely
to be most satisfactory for all.
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has shown that people with PD and their carers often feel that they
are not adequately informed about all the professionals and
interventions that might help them. In particular, they feel uncertain
about the role of non-drug treatments. Some carers feel uncertain
about how or when to start providing care and express need for
management is therefore best conducted within protocols designed to
make best use of individuals’ team roles and functions. Personal
treatment plans help patients to navigate the complexities of
multi-professional care and should ensure that their own views and
preferences are integral to management.
the lack of hard evidence of efficacy, most therapists claim that
their intervention should begin early in the course of the illness, in
order to establish a useful rehabilitation program and to prevent
avoidable disability and handicap. Therefore a close working
relationship between patient, carer and medical, nursing and therapy
staff is essential.
dialogue is the key to a successful team approach. Both sufferers
and professionals have much to learn from each other. Improved
interaction will reduce the problems associated with the limited
number of specialized PD centres, complements rather then challenges
communication skills and lack of expertise, and fosters a
partnership that is essential for better outcomes.
MacMahon DG, Thomas S. Practical approach to
quality of life in Parkinson’s disease. J Neurol 1998; 245 (suppl 1):
Bhatia K, Brooks D, Burn D et al. Updated
guidelines for the management of Parkinson’s disease.
Hosp Med 2001; 62: 456-70.