Brought to you by...

Prepare and Empower People with Parkinson’s to Get the Best Possible Care When Hospitalized

By Kate Kelsall, MSW, blogger at Shake, Rattle and Roll: An Insider’s View of Parkinson’s disease and DBS

Medication-ManagementThe challenges involved in hospitalization of the person with Parkinson’s Disease (PD) can be overwhelming for the patient and family. These problems may include medication mismanagement and the lack of training of the hospital staff about how to care for persons with PD. Typically, a person with Parkinson’s sees a neurologist for diagnosis and treatment and many people go for years without a proper diagnosis. The neurologist deals with the neurolgocial condition, while the primary care provider deals with everything else. A patient, or those who act as patient advocates, attempt to keep the neurologist and the primary care provider (PCP) informed about the medical condition of the patient and also try to keep the doctor communicating.

Many of the difficulties that you will encounter as a person with Parkinson’s while in the hospital relate to medications. Some patients take PD meds around the clock from every two hours to every five hours. The PD meds help the patient manage the symptoms of tremor, bradykinesia, stiffness, and rigidity.

The problems include the following:

  • Wrong medications being dispensed
  • Correct medications not being dispensed on a timely basis or not at all
  • Patient’s medication is not stocked by the hospital.


Provide a typed list of patient’s medications and make sure it is written into the doctor’s orders. List should include:

–Name of medication including whether it is standard or long-acting form (CR)

–Strength of dosage

–Specific times that medication should be administered (specify exact times such as 7 AM, 11 AM, 3 PM, 7 PM instead of four times a day)

–Whether medication should be administered with or without food, before, during or after meals

–Whether the medication can be crushed

In case the patient’s medication is not stocked in the hospital, patient may want to bring his/her own medication from home in its original prescription bottles and give to nursing staff to administer.

Problem: Some PD patients find their PD symptoms worsen while in the hospital.

One possible cause is the introduction of new medications in the hospital and how they interact with PD medications and anesthesia.

Solutions: Become an informed patient. Develop a list of medications that should not be administered with patient’s current PD medications. For example, certain drugs block dopamine receptors and worsen PD symptoms.

Find out if patient’s PD meds need to be temporarily stopped before surgery.

It is often difficult for the patient to act in the capacity as his own advocate. Get a Patient Advocate involved. Arrange for someone (or several people doing shifts) to be with the patient round the clock or at least 16 hours/day, as an advocate. The advocate’s role is to monitor the patient’s care, including the medication, to ask questions and act as spokesperson and educate the staff about PD.

Problem: Often the medical staff doesn’t have the experience and training to care for PD patients. There are many family members of PD patients who attend support groups and conferences on PD resulting in some of the family members being better informed about PD than some who work in a hospital setting. In addition, the family members live with the patient and attend the patient’s doctor appointments so they have become educated on the health care of their own family member, but not educated on the needs of all patients.

Solution: Educate the hospital staff. Order the free Aware and Care Kit from the National Parkinson’s Foundation. The free Aware in Care Kit can be requested at or by calling 1-800-4PD-INFO (473-4636). The kit is large enough to fit the Parkinson’s medication and provides tools and information to share with hospital staff during a planned or emergency hospital stay. The kit includes the following:

Hospital Action Plan
Read about how to prepare for your next hospital visit—whether it is planned or an emergency.

Parkinson’s Disease ID Bracelet
Wear your bracelet at all times in case you are in an emergency situation and cannot communicate.

Medical Alert Card
Fill in your card with emergency contact information and place in your wallet.

Medication Form
Complete this form and keep copies in your kit for use at the hospital.

Parkinson’s Disease Fact Sheet
Share the facts about Parkinson’s with hospital staff and ask that a copy be placed in your chart.

I Have Parkinson’s Reminder Slips
Share vital information about Parkinson’s disease with every member of your care team in the hospital.

Kate Kelsall blogs about Parkinson’s disease on Shake, Rattle and Roll: An Insider’s View of Parkinson’s and DBS. She was named a top health blogger by Wellsphere.


Good Nutrition is About More Than Food

eat well to live wellMarch is National Nutrition Month, so we invited Nutritional Therapy Practitioner Kellie Hill to discuss the importance of good nutrition.  In her business, Kellie sees an abundance of caregivers – people who have a tendency to place the health of others over their own.

When taking care of others, it is easy to neglect to care for ourselves.  Yet, when we don’t nourish and care for our own health eventually we can’t provide proper assistance to those that depend on us. Here are nutritional tips for taking care of you:

Take A Few Minutes to Eat:

It is easy to neglect fueling our bodies during the busy day, but it’s critical to health to take a few minutes every 3-4 hours to eat a quick, healthy snack.  This will help you make better food choices rather than becoming so ravenous you reach for a candy bar or donut.  Eating regularly also supports an active metabolism which will help protect you from an expanding waistline and bouts of fatigue.  Healthy snacks don’t need to be complicated; try an ounce of raw cheese with an ounce of your favorite nuts; 2 tablespoons of hummus with some raw vegetables; a hard-boiled egg; jerky; ½ an apple with nut butter; trail mix.  Keep a stash in your car for emergencies so you never find yourself overly hungry.  Get free weekly nutrition tips similar to these by signing up at

Stay Hydrated:

Just as important as fueling your body is hydrating the body.  Every part of the body works better when properly hydrated.  Water is the most important nutrient in the body, making up 55-60% of total body mass.  There have been direct links between conditions such as pain, heartburn, stress, chronic fatigue, weight gain, allergies, and diabetes with the continuous state of dehydration.   Try and sip water throughout the day – most people can only metabolize about ½ cup of water every half hour.  If drinking plain water seems too boring, try flavoring it with slices of lemon, lime, orange or cucumber.

Reduce Stress:

People don’t think about stress being related to nutrition, but they go hand in hand.  When we are experiencing stress, nutrients aren’t properly absorbed, which leads to overeating and weight gain.  But, as busy caregivers taking the time to meditate or go to the gym may not be realistic.  The solution is as simple as taking a few breaths.  The breath has an amazing ability to calm our systems.  Just taking some very deep breaths will reduce stress.  Feel the air enter your nose, travel down into your lungs, feel your stomach rise as the air enters, and then slowly descends as you exhale.  Count how long it takes to breathe in and how long it takes to breathe out.  Try to increase the number, taking longer for each inhale and exhale.  This simple stress management technique may be enough to lower your heart rate and blood pressure, calm your nerves, get your body out of the “fight or flight” state, and decrease stress.  Watch a simple breathing technique video here.

Learn more  at where you can receive free weekly nutrition tips or sign up to be a member and receive nutrition coaching through weekly videos, recipes, articles, forums, and Q & A support.

Author Bio:  Kellie Hill is a Nutritional Therapy Practitioner at The Right Plan.  She is also the radio host of Eat Well to Live Well with Kellie Hill on Voice America’s Health and Wellness Channel. Kellie is the author of The Right Plan 2 Week Fat Loss Program and Cleanse and Detoxify Your Body: 28 Days to Better Health Using Nutrient-Dense Whole Foods.


New Medical Image Viewing and Management Aids Patients and Caregivers

Despite advancements in technology, there are still many hurdles when it comes to accessing and viewing your medical images including CT, MRI, X-ray and ultrasound scans.

Nephosity is one company attempting to bring these walls down, by providing a mobile and web-based platform for patients and their caregivers to manage their medical images securely and efficiently. The platform, called Jack Imaging, is free for patients and caregivers to use and creates the ability to share medical images with doctors, including for second opinions and remote consults.

Take Control of Your Medical Images

To give you an idea of why medical imaging is so complicated (and why you, as the caregiver, often pick up those easy-to-lose CDs), we have created an original chart to illustrate the various stakeholders involved in our healthcare imaging, and how your loved one’s images flow through the system. 


For example, when your loved one receives a digital X-ray or MRI, those scans are stored within the picture archiving and communication system (PACS) of that same facility. With this system, your loved one is dependent upon the imaging center as well as his/her doctor (who typically receives a text-only report, stating the findings from the scan) to share the information gleaned in the images. In short, you and your loved one rarely receive the information directly.

In addition, when there is a need to transfer these images (e.g., when you go to a new doctor) or get access to them in the future, it can be a long, complicated process. When images are difficult to access, it impacts the patient—and possibly their caregiver or other advocate—and their ability to have the best possible outcome for their treatment and care.

Modern Medical Image Sharing

To remedy these issues, Jack Imaging has made images available online to you, anywhere, anytime. All you need to do is upload your images, or ask Jack Imaging to collect your records on your loved one’s behalf. Once your imaging records are loaded, you’re ready to share them with your doctor, ask for a second opinion or even receive a remote consult. You can also easily view our images on your iPad, alongside your doctor, for greatest engagement and understanding of your loved one’s condition. Nephosity received FDA clearance for the iPad last year.

Jack Imaging is a platform for medical image viewing, sharing and collaboration that empowers patients – and you, their caregivers – to take control of their medical images, and save the time and emotional burden of dealing with lost CDs, records, the cost of replacing or retaking medical scans.

Nephosity (the company behind Jack Imaging) was founded with the objective to fix the U.S. healthcare system – beginning with medical imaging. By making images available to patients and their doctors, Nephosity saves time and money for patients, caretakers, doctors and our healthcare system at large. For more information, please visit or



Resolve to Brush and Floss

So many New Year’s resolutions are tall orders: start a business, lose weight, check an item off your bucket list. Why not give yourself an easy resolution this year? Simply commit to flossing your teeth daily. It sounds funny, but humor can make the lifelong process of oral health a rewarding daily practice. It is essential to establish good daily dental practices that can lead to years of healthy teeth and gums.

smileAs we age, it is more important to take good care of our teeth when there are specific concerns and issues that can arise. For example, many medications can lead to dry mouth which can in turn to lead to faster gum recession which make teeth more susceptible to cavities. Daily brushing and flossing are important and senior dental services can make it easier to keep dental disease at bay. For people who cannot get to the dentist because of decreased mobility and chronic conditions, there are in home options to consider that address the specific dental conditions that come with age.

In home dental providers are available to fill this gap and treat the dental issues specific to this population. Make sure that you or a loved one receive the best in senior home dental care by reviewing this expert checklist:

1. Getting into a dentist’s office can be difficult for an elder adult. A mobile dental provider will bring the office directly to the patient’s familiar environment, easing any worries about making it to an appointment and sitting in the dentist’s chair.

2. Ask the visiting dentist if there are any affordable dental plans or specialized discounts to help the senior patient save money on dental treatments, procedures and services. Keep in mind that in some instances there might be a slightly higher cost for the convenience and comfort of a home visit from the dentist.

3. Verify that the dentist coming to your home has the latest training in geriatric dentistry and the latest tools to make the dental process easier and less painful.

4. Be sure to ask the dental care provider about issues affecting seniors like dry mouth, gingivitis, and cavities and have them educate you about unique conditions for older adults.

5. Whether you or a loved one is uninsured or under-insured, the home dental provider should be able to meet your need with no pre-existing condition exclusions.

Gabrielle Mahler, DMD, was trained at the University of Medicine and Dentistry of New Jersey. She went on to do her residency in the Advanced Education of General Dentistry at Columbia University. She has been providing mobile geriatric dentistry to the senior community for 8 years. The warm and loving manner with which she treats patients makes her a favorite practitioner among the families that she works with.

There’s An App For That

Even if you don’t use a smartphone, you have likely heard of “apps” by now. App is short for application, which is a self-contained program or piece of software on a smartphone to fulfill a specific purpose. There seems to be an app for everything imaginable these days—including caregiving.

We have selected a short list of caregiving-related apps for you to check out:

  1. caregiving-appsCalm down and check your heart rate with your phone. The Azumio Heart Rate app is free and available on iOS and Android. All you need is one finger and a few seconds to detect your pulse. The app makers note that this data is for recreation and fitness uses only.
  2. The American Heart Association has created Pocket First Aid & CPR app, which is credited with saving at least one life so far. This app includes videos and colorful illustrations to guide a user through life-saving instructions. Available for both Google Android and Apple iPhone.
  3. Stop stress before it starts with an app. Certified by The American Institute of Stress, the Stress Stopper Pro app from Stress is Gone LLC aims to stop stress before it starts—precisely three minutes before it starts. At one touch, users are reminded to breathe or laugh. Currently only available for iPhone.
  4. CaringBridge, the non-profit that allows users to set up their own websites to share photos and personal information with a select audience, has a smartphone app for Google Android or Apple iPhone.
  5. You don’t need a lot of expensive recording equipment to document Grandpa’s life story—just download the Record Their Stories app and start asking questions as your loved one answers right into the phone. Read more about this app in our related article on making life stories into gifts.
  6. Koi Pond from The Blimp Pilots is a game as well as a relaxation app, complete with a timer for snoozing (see our current article on the benefits of good sleep) while you listen to the gentle sounds of rippling water. Users can “feed” the fish and let the fish “nibble” their fingers. Currently only available for iPhone.
  7. Walking is beneficial for everything from weight loss to dementia. Check out MapMyWalk, which allows users to yes, map a walking route, and also set fitness goals, share with family and friends, record duration, speed, calories burned and more.

We’d love to hear about apps that you find useful or just plain fun too.