Dr. Lisa Shulman discusses secondary risks and considerations for patients with Parkinson’s during the pandemic
For those with Parkinson’s disease, secondary risk factors and stressors may affect their disability during the time of the pandemic. Lisa Shulman, MD, member of the American Brain Foundation’s Board of Directors and Director of the University of Maryland Movement Disorders Center, hosted a Facebook Live with the American Brain Foundation where she spoke about Parkinson’s disease and COVID-19. Watch the video for her advice on handling adjustments to routines, using personal protective equipment and practicing self-care for those with Parkinson’s disease.
Secondary Health Considerations
One major factor that puts those with Parkinson’s at risk during the COVID-19 pandemic is their vulnerability to infection. “People with Parkinson’s disease may be more vulnerable to infection in general,” says Dr. Shulman. Some of this vulnerability is related to age itself, as anyone over the age of 60 is at risk for COVID-19 complications. Additionally, people with advanced Parkinson’s disease may become more frail over time and as a result, be more vulnerable to illness. For those with Parkinson’s disease, infections of any kind typically cause Parkinson’s symptoms to worsen. Dr. Shulman points out that patients with other illnesses, such as a urinary tract infection, flu or a cough, find that these illnesses tend to worsen the symptoms of the disease and also reduce the effect of their medication. The same would be true of COVID-19 infection.
Additionally, those with Parkinson’s disease may find their basic healthcare routines affected by the pandemic. From visiting a neurologist to attending physical therapy sessions to refilling prescriptions, routines that are part of patients’ daily lives now require a change in their habits as they accommodate social distancing, whether through telehealth visits or rescheduled appointments.
For those who use physical rehabilitation services, Dr. Shulman explains, “It’s not safe to go to a rehab facility or have a physical therapist come into your home during social distancing. These things need to be delayed.” Other common practices like using health aides and housekeeping services now require carefully weighing the risks and benefits.
While personal protective equipment is recommended to limit spread and contraction of the virus, Dr. Shulman explains that for those with Parkinson’s, PPE may be difficult to use and may impede mobility and communication. Masks might make those with low speech volume or slurred speech harder to understand, create a problem for those with drooling or runny noses and obscure vision—contributing to issues with walking and balance, and increasing the risk of falling. Gloves may affect dexterity of the hands and interfere with using an assistive device such as a cane or walker.
Parkinson’s and Self-Care During the Pandemic
Dr. Shulman also discusses how beginning self-care routines during this time may benefit patients. “The pandemic is fostering social isolation and considerable stress,” she says. “There are mental health consequences that are bound to increase some of the mental health issues that are preexisting in Parkinson’s disease, like anxiety.” Behaviors like social distancing and staying in can work to lessen the spread of infection, but they can also result in further isolation for patients with Parkinson’s. Cognitive and social activity impact overall health and may also delay Parkinson’s-related disability. So she encourages viewers to become familiar with online communication to limit those feelings of isolation. They can use telemedicine, or just socialize with friends and family. Dr. Shulman also recommends that those with Parkinson’s find new ways to challenge themselves cognitively with games such as word puzzles.
Physical activity is especially important for those with Parkinson’s, but Dr. Shulman acknowledges that exercising may be difficult in the absence of gyms and personal trainers. “Right now we are all in the position that tends to promote sedentary habits. This is concerning because there’s evidence that exercise and movement is integral to delaying the onset of Parkinson’s disease disability,” she says. Virtual rehabilitation strategies and streaming exercise and yoga may be a worthwhile option for those at home.
Dr. Shulman ends her talk on a hopeful note, calling on viewers to share their own tips and ideas. Practicing self-care during this time “requires a lot of creativity, being proactive, and learning from one another,” she says.
For more COVID-19 resources for patients and caregivers, please visit the Brain and Life Resource Center.
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