Parkinson's Disease and Multiples Sclerosis (MS) (Nursing)

00:01 So let's take a look at the signs and symptoms of Parkinson's disease.

00:05 Let's stay with Jai, but let's say maybe Jai arrives at our emergency room this time and this time Jai's concerned partner says to the nurse, I had to bring him in.

00:18 For about a month, I've noticed he has like these small tremors.

00:23 He has them in his hands.

00:25 Sometimes when he's sitting there, I see these tiny little tremors with his chin.

00:32 You know, we used to leave each other's messages in the morning.

00:38 And lately I haven't been able to read the handwriting.

00:41 The letters are so small and they're they're all bunched together.

00:46 He has so much trouble sleeping now.

00:49 He's actually moved out of our room and he's always complaining of feeling so stiff.

00:55 In fact, he started walking like an old man too, all hunched over and stiff-legged.

01:02 Last week, he got dizzy and he fainted.

01:05 And for the rest of the day, he looks so depressed like like he was wearing, like, some sad old man mask.

01:15 We are so worried.

01:18 Now, as you hear this story and as you look at Jai and you kind of see this sad mask, it doesn't look like a person who has an expression on his face.

01:32 What's going on? What are you thinking? Let's think Parkinson's disease.

01:39 Parkinson's disease is caused by the death of dopamine cells in the brain.

01:45 And the symptoms don't appear until 60 percent of those cells are already lost.

01:53 There are cognitive changes and there's that amnesia, perhaps some confusion.

02:00 There is dementia and difficulty understanding what's being said to them.

02:08 There may be dizziness and some vision problems.

02:13 Difficulty speaking also occurs, and that blank mask that Jai's partner was talking about, it takes away that expression.

02:25 The person might also be complaining of smells, or perhaps you give them something that they love to eat and they say, "Well, this doesn't smell like my lasagna" because that sense of smell is being affected, Remember, Parkinson's is a brain disease, and when we start thinking about the brain and we think about the idea that 60 percent of these cells are now being affected, it's going to show up in multiple different ways.

02:56 Fatigue, dizziness, suddenly having poor balance.

03:03 Also having that, emotional lability, feeling anxious, depressed, or perhaps feeling nothing at all, that sense of apathy that nothing matters.

03:17 The tremors are something that you see that differentiates it from, for example, Alzheimer's.

03:25 When you see the tremors in the hands or the limbs, you might see some involuntary movements, or they might have this slow shuffling gait, which is also one of the cardinal signs.

03:43 It also affects their GI tract so they may complain of constipation.

03:49 They also may have some urine leaking.

03:53 They may have some dribbling of urine during the day.

04:00 I'd like you to stop and think about the fact, how this will impact a person's life, how these different signs and symptoms.

04:12 Having more difficulty understanding what people are saying to you, having dizziness, that you haven't been able to explain, having these tremors or perhaps having it affect your handwriting in such a way that now where you used to be able to write notes to people, you suddenly can't write notes.

04:34 How do you think that affects a person's sense of self? It's so important for us to understand that when we're taking care of our clients, our patients, that we are looking at the individual, we are not looking at their disease process.

04:53 For Parkinson's disease, there is currently no test or even a progression marker for this disease.

05:02 And there's also no cure for Parkinson's disease.

05:08 Multiple sclerosis is yet another disease that is a neurocognitive disease.

05:15 The statistics from multiple sclerosis, which is an autoimmune disease with the cause not known, is that more than 400,000 cases of MS occur in the United States alone, with 200 cases being diagnosed every single week.

05:42 It's important for us to understand that multiple sclerosis affects more than 2.5 million people worldwide.

05:55 So as you're thinking about these different neurocognitive diseases, MS being one of them, it's important to consider the idea of an autoimmune disease.

06:09 What are we talking about, autoimmune? Where we are having a reaction to ourselves, we are against ourself.

06:21 The signs and symptoms of multiple sclerosis, again, we have these cognitive changes.

06:30 We also have changes in the ability to control bladder and bowel.

06:35 So what has been our routine is no longer our routine.

06:42 There is a fatigue and a weakness that starts occurring that's unexplained by other things.

06:50 There's this emotional instability and a feeling of tingling or numbness.

06:59 The person might be complaining that there's dizziness, perhaps when they're walking.

07:05 There's issues with controlling their legs and their gait, and also that they're having some vision problems.

07:16 Persons with multiple sclerosis may also be confiding that there are now are sexual problems that they had not had in the past.