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Parkinson’s Disease and Assisted Living

Author: Helen Dennis, Specialist on Aging

Question: My mother suffers from Parkinson’s disease and lives with my sister, her husband and five young children in the Midwest in a small house. Mother sits in front of the television all day with no exercise and sees a local doctor who is not a neurologist. She is unhappy and would like to return to her home which is not possible since her condo has been sold. I am weighing the benefits of moving her to assisted living near me or having her remain with family. P.S., mother is paying my sister to live with her. Your thoughts?

Answer: Family relationships weigh heavily in such decisions. One approach to the issue is to evaluate the strengths and weaknesses of the current environment, with a focus on what is best for your mother.

Living in a home setting with all of the pleasures and comforts of family is enticing. I would guess there is lots of activity and interaction. The children are likely a bonus. Yet it is important to consider tradeoffs.

A little background — Parkinson’s disease (PD) is chronic and progressive. It persists over time a long period and symptoms get worse with time. PD results from the loss of nerve cells in the brain that produce dopamine, a neurotransmitter or “chemical messenger” that conveys signals to parts of the brain that control movement and coordination. When the brain cells begin to die, there is less dopamine produced, resulting in the impairment of movement with tremors, lack of balance and stiffness.

Many individuals function well at the early stages with mild symptoms that do not affect their daily activities. In other cases, symptoms can be aggressive leading to physical limitations and disability. The progression is unique for each person.

There is no way to predict the course of the disease for your mother. We do know that lifestyle has an effect.

Exercise: A recent study conducted by USC’s Keck School of Medicine revealed that treadmill exercise may benefit patients with Parkinson’s disease and other movement disorders. Note the research was conducted on animal models, not people.

The study revealed that exercise for subjects with brain cell loss affected dopamine levels. Michael Jakowec, assistant professor of neurology at USC is quoted in Science Daily as saying, “Exercise may help the injured brain to work more efficiently by allowing the remaining dopamine producing neurons to work harder and in doing so may promote stronger brain connections.”

The American Parkinson Disease Association (APDA) recommends exercise as a way to maximize health, vigor and independence. Walking is suggested for conditioning and endurance. Your mother’s lack of exercise counts as a negative in staying in her current environment.

Nutrition: The APDA tells us that with any chronic condition, good nutrition helps the body work better. Energy will be higher, medications will work better and motivation to exercise will be enhanced. Here are some questions you can use in evaluating your mother’s diet: Does she eat a variety of foods that include meat, fruits and vegetables, milk, and bread and cereals? Does her diet include less fat and more fish, poultry and other lean meats? And is she eating complex carbohydrates such as cereals and breads and especially those high in fiber. And finally, is she maintaining a reasonable weight and avoids eating too much salt?

If your mother is not adhering to a healthy diet, this would count as another negative.

Maintaining independence: The APDA suggests guidelines for making each room in the house safe and amenable to one’s independence.

With five young children in a small home, there may be crowded furniture and encumbered walkways which would compromise her safety risk. Clutter is a risk for falling and would count as another negative.

After assessing your mother’s current living conditions, evaluate new opportunities for exercise, good nutrition, physical safety and specialized medical care. Can any of the negatives or deficiencies be changed? If not, consider evaluating the benefits of assisted living.

For more information on Parkinson’s disease, visit the National Parkinson Foundation (NPF), online at In addition to its informative website, NPF has printed brochures and education manuals you can receive by mail with no charge.

A final thought – Discuss your concerns with your sister. Is she aware of your mother’s needs? Do have a chat.

© Helen Dennis 2010, all rights reserved.

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