Parkinson's symptom management
Key points
- Parkinson's is more than tremor: non-motor symptoms like depression, constipation, voice changes, and fatigue are common and treatable.
- Medication timing is critical; use a log and alarms to stay on schedule, and never stop medications abruptly.
- Exercise is medicine: daily physical activity improves mobility, balance, and mood.
- Prevent falls by modifying the home environment and using assistive devices as recommended by a therapist.
- Hallucinations and delusions are common but manageable; do not argue, report to the doctor, and avoid typical antipsychotics.
- Caregiver health matters: build a support network, use respite, and prioritize your own well-being.
General caregiving information, not medical advice. Check medications and major care changes with your clinician.
Step-by-step
Schedule a comprehensive evaluation with a movement disorder specialist or neurologist. Bring a list of all motor and non-motor symptoms with timing details. Ask about medication options, timing, and side effects.
Create a daily medication schedule using a pill organizer or smartphone alarm. Many Parkinson's medications must be taken at exact times to maintain steady dopamine levels; missed doses can cause sudden worsening of symptoms. Record symptom changes after each dose for the doctor.
Establish a consistent daily exercise routine to maintain mobility, balance, and mood.
Practical tools
Pill organizer
Helps ensure medications are taken at correct times and doses.
Smartphone alarm
Set reminders for exact medication times to prevent missed or delayed doses.
Discuss with your clinician
Ask your doctor about the risks and benefits of starting or adjusting levodopa-carbidopa, especially if confusion, hallucinations, or dizziness upon standing occur.
If hallucinations or delusions develop, ask about pimavanserin (Nuplazid) or other atypical antipsychotics that are safer for Parkinson's, and discuss the potential for worsening motor symptoms.
Discuss whether any current medications (including over-the-counter drugs) might have anticholinergic effects that could worsen cognition or cause confusion.
Ask about a referral to a movement disorder specialist, a physical therapist, an occupational therapist, a speech therapist, and a mental health professional for a comprehensive care plan.
If the person has difficulty swallowing, ask about a swallowing study (videofluoroscopy) and whether texture-modified foods or thickened liquids are needed. Also ask: 'Is it safe for my loved one to drink thin liquids, or should we use thickened liquids?'
Discuss when it might be appropriate to consider hospice care, and what services are available through Medicare or Medicaid for end-of-life support.
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