John Hopkins Medicine reports that more than a million Americans suffer from Parkinson's disease, a neurological disorder involving a decline in the number of functioning nerve cells in an area of the brain called the substantia nigra. Parkinson's affects body movement, causing difficulty with walking, swallowing and talking. Psychological impairments are often involved, with memory problems, emotional upsets and delusional thinking impacting quality of life. Parkinson's disease is diagnosed based on an examination and a description of the symptoms being experienced. The disease is often described as having five stages.
Stage 1
Also called the initial stage, the patient in stage 1 begins to notice a tremor in one hand. It appears as a fine tremor when the hand is resting, but full use of the hand and arm remains possible. One leg may seem weaker than the other, causing an occasional stumble. An observant friend or loved one may notice a change in gait or seated posture. The patient's face may no longer show a full range of emotion.
Stage 2
Many patients are diagnosed at stage 2. Both sides of the body become affected and walking becomes slow. The patient may seem to be shuffling his feet instead of picking them up properly. Both hands or arms may have a tremor. The face may show little emotion and body posture may appear stiff. Symptoms are considered to be mild at this stage.
Stage 3
The moderate stage of Parkinson's disease is characterized by greater difficulty with walking. A walking aid such as a cane may be needed, and the patient may need a good deal of extra time to ambulate from one location to another. The sense of balance may be affected, further impacting walking problems.
Stage 4
Symptoms are severe in stage 4. The patient remains able to walk, but with great difficulty. The ability to swallow normally is impaired, and speech is quiet and hard to understand. The muscles feel rigid and uncomfortable. Tremors may begin to decline. Activities such as eating, dressing and grooming require assistance.
Stage 5
"Medical-Surgical Nursing" explains that the patient is totally dependent in stage 5. Walking or standing alone is impossible. Swallowing is increasingly difficult and speech may be absent. Psychological effects may also be severe; depression and delusions are common manifestations during stage 5. The patient often requires nursing care to ensure adequate, safe nutritional intake.
References
- John Hopkins Medicine: Neurology and Neurosurgery: Parkinson's Disease
- CARE: Stages of Parkinson's Disease
- "Medical-Surgical Nursing;" Donna Ignatavicius, M.S., R.N. and Linda Workman, Ph.D., R.N.; 2002
