After a Parkinson’s diagnosis
Tim* was 70 when he was diagnosed with Parkinson’s disease, on top of osteoarthritis of both knees and spine pain.
He handed in his driver’s licence and within four months his health went further downhill. With no licence, he did not get out and about much and mostly just sat in his chair. But as he moved less, his pain actually increased and his Parkinson’s symptoms worsened.
When Wenika visited him at home, he told her: “The more I move, the less pain I feel. I know I have to keep moving and I try to remind myself to stay upright, but once I feel the pain it’s hard to convince myself to do anything.”
Wenika saw Tim was trapped in a vicious cycle. “We have to break it – and we have to use interventions Tim will actually enjoy,” she said.
What is the vicious cycle of immobilisation?
* While every person with Parkinson’s disease is different, early intervention can help improve quality of life.
What to do
With wife Denise still working full time, Tim was at home by himself five days a week. He attended exercise classes but only for one hour, twice a week.
He spent the majority of his time sitting in the couch, with just a little walking about.
“I think you have lost some purpose in life, and you don’t need to do much problem solving since your retirement,” Wenika told the couple.
Denise agreed: “Yes – he has lost his mojo.”
Wenika discussed with the couple how important it was for Tim to do something he enjoyed, to boost his sense of living a “normal” life again.
“We will incorporate the therapy into his lifestyle, rather than changing his whole life to revolve around therapy sessions, so it’s not boring and depressing,” the physio said.
Tim’s tasks: From shopping to dot to dot
- Sense of purpose: Wenika suggested giving Tim a new responsibility each week. She asked Denise to write a shopping list. Then Tim and a home support worker travelled to Marion shopping centre, where they walked around, buying everything on the list. Back home again, Tim put the groceries away, with some assistance. This task gave Tim a reason to get moving, and to use problem-solving skills to plan the outing and compare food pricing.Wenika said: “Doing the shopping ticks all of the boxes. It stimulates Tim physically and cognitively. He gains a sense of purpose in life, as he is helping Denise with household duties and not feeling he is a burden. The home support worker will remind Tim to walk straighter and rest a bit in between shops, but overall it’s important for Tim to enjoy these outings and gets his mojo back.”
- Help the helpers: Wenika taught the carer strategies he could use if he noticed Tim was tired, shuffling more or stooped over.
- Exercise: Tim still had to attend exercises classes twice weekly and see Wenika for physio help with pain management.
- Dot to dot: Wenika put colourful dots on the floor of Tim’s hallway to remind him how far apart an average step should be. She encouraged him to practise stepping on the dots throughout the day, to help get him out of “shuffle mode”.
What happened next
- Tim really enjoyed his shopping outings. Denise said that Tim usually could walk for about 10 minutes before tiring. However, on his first trip to the shops the carer reported that Tim walked and shopped for 30 minutes non-stop.
- Tim said his pain reduced significantly and he could walk much more upright.