Now this one is more personal, right?
Because patients may be hesitant
to talk to you about this.
But a patient with Parkinson's
is at an increased risk for constipation.
So, these are the things
that anyone can do
who's at risk for constipation,
but these are particularly important
for someone with Parkinson's.
So you want them to have
consistent fluids and intake
up to about 2,000 milliliters a day.
All right, so that's the equivalent
of what we'd call a two liter of Pop.
Now we're not recommending
that they drink Pop.
I just wanted you to have kind of a feel
for how much volume that is.
Now if the patient has renal disease
or congestive heart failure,
we want to make sure that you work
closely with the healthcare provider
to make sure that the amount of volume
is appropriate for that patient's body.
Now, if they'll increase their intake
of dietary fiber,
the best way to do this is to eat
fresh vegetables, right?
Look for the foods
that naturally have fiber.
fresh fruits, or vegetables.
Those within the limits that
they have any other special dietary needs.
It's one of the best ways
to increase fiber.
We also have some medications
that you get.
Psyllium capsule fiber,
that's one way to take it.
But it's always best if you can
to get dietary in its natural form.
Now there's also stool softeners
or mild laxatives.
Those work in different ways,
but predominantly, they'll draw
more water or fluid into the waste
and make it easier
for the patient to pass.
Now, if we have to,
we can use bowel training techniques
because you just have to set
and establish a regular time
for bowel movements.
Usually about 30 to 40 minutes
after a meal,
you have that gastrocolic reflex,
and it's an appropriate time
for the patient to teach themselves
to go to the bathroom
in that time frame.
But you have to individualize
each one of their training programs,
but you'll find the right method.
The most important thing
So you teach that gut to empty
the same time every day.
Remember, everything requires extra time
including if someone's working
on bowel and bladder,
so they need to go maybe
even before they feel that urgency,
so they have plenty of time
to make it to the restroom.
Now we look at nutrition.
Everyone needs a healthy diet, right?
but patients with Parkinson's
are going to need longer to eat.
So we want them
to take smaller bites
because they might be
at risk for choking.
So when you go out to dinner,
you may consider slowing down
your own eating speed
and taking smaller bites.
That's good advice for anybody.
That's gonna help
your "Hey, I'm full signals in your brain.
Register for you more effectively
if you slow down
and take slower bites."
Then the patient with Parkinson's
also doesn't feel so self-conscious
about being the absolute
last person at the table
to finish eating.
We talked about the adaptive silverware.
That's pretty cool to help them
with the tremors and the grip.
You want to make sure
that you're assessing the patient
for any difficulties or complaints
or problems with swallowing
when you are the nurse,
and educate the patient and family
that they really need to let us know
if they start experiencing that
after they go home.
Now if you've watched
our other videos,
you know I hate this next option,
but it really is helpful.
You can use thickeners
or Thick-It with liquids
if the patient needs that.
A problem for me is
I'm a real texture person
when it comes to food.
And so you can take something
like iced tea and put Thick-It in it.
And my brain just can't get over
the concept of drinking
iced tea that's thick.
It seems like it's just rotten or nasty.
But if it's the only way
I could ingest that,
I'd have to figure out how to adjust.
So be prepared.
If your patients are like me,
they might be a little hesitant
to try that.
But you'll find a balance
in what they're willing to tolerate
in order to eat or drink
the food and beverages
that they really enjoy.
Be sure to be gentle about this
with your patient
and remind them about the high protein
in levodopa medications.
Now, why I say be gentle with this is,
you don't want to overload your patient
with a lot of dos and don'ts,
but consistently remind them
that if they're taking levodopa,
a form of medication
that treats Parkinson's,
you don't want them to have
a high-protein meal with the levodopa.
You want to make sure
there's time in between that.
Because what ends up happening
is the medication is more--
is less effective.
So it's more ineffective
or less effective
because that protein in the food
if it's high protein
is going to compete with receptors,
and so really messes up
the effectiveness of the levodopa.
So just remind them of that
that we can work with the timing in them
of the medication and their meals.
Nurses always have a responsibility
in helping a patient
understand their medication plan.
But in Parkinson's,
it's particularly problematic,
because this can be
a complex plan or progress
because one drug will work
and then it stops,
might have to consider a drug holiday
under medical supervision,
It can really be complex.
The earlier problems are identified,
the more effective a plan
we can develop.
So, first of all, it's our job as nurses
to assess the patient and the caregiver
how much do they know
about their prescribed medications,
are there any gaps,
and where are those gaps,
because this is critically important.
The adjustments that need to be made
in a Parkinson's patient's medication plan
involve the patient and caregiver
giving us lots of feedback
about their symptoms
and how things are progressing.
So the patient and family
need to clearly understand
how the medication works,
and know what needs to be communicated
to the healthcare team.
So it's all about consistency.
You just don't go in
at the discharge of the patient
and throw up all
this information on them,
or worse, hand them a stack of papers
with medical knowledge on it.
That's not the way
to educate the patient.
You want to be consistent about it.
Give them information and small,
And we keep using that word.
Because that's the way
we all learn best.
Small pieces over a period of time
to address the gaps
and the patient's knowledge
that you find is appropriate.
That's what a nurse's job is.
You don't do it in one shift.
You do it every shift
with all of your patients.
It will be much more effective for them.