One new twist in medicine is specialized care for chronic illness. A Parkinson's program is discussed here, but many others are out there, among them programs for diabetics or for those with congestive heart failure.
Patients live at home but visit a clinic as out-patients for checkups, medical treatment and medications. Research has shown that chronic care can keep patients out of nursing homes and add a new measure of quality and pleasure to life. How do you get started? Speak to your family doctor for a referral.
Parkinson's disease causes tremor, loss of balance and decreased ability to move about. The symptoms always get worse, but no two patients experience health decline in the same way or at the same rate.
Independence and self-sufficiency are of utmost importance to patients with this disease as well as to their spouses or caregivers. Special programs of support can lessen anxiety and help families cope.
Q. What are the goals of this specialized Parkinson's program?
A. To help the person coping with Parkinson's manage the ordinary activities of life more effectively. For instance, a physical therapist might teach the patient how to move from the bed to a wheelchair without help from a family member. An occupational therapist might teach techniques and demonstrate the use of devices to make the business of bathing and getting dressed less problematic.
Q. What services are provided?
A. Usually physical therapy, occupational therapy and speech therapy, three days a week, several hours a day, with lunch provided. Each patient's program of rehabilitation is individualized. Some patients remain in the program two weeks, some 12 weeks.
Q. Does insurance cover the program?
A. Medicare Part A and B will cover 80 percent of the cost of the program. Secondary insurance, or the patient, will be responsible for 20 percent. All patients are subject to their annual deductible.
Q. My husband has Parkinson's, but is not experiencing troublesome symptoms right now. Are there any services for patients like him?
A. The Parkinson's Outreach Program can provide education and resource materials about Parkinson's disease to patients and families. Even a patient free from any physical problems can receive assistance in designing an individualized home exercise program and/or information about exercise programs in the community. Program staff will work with the patient to monitor goal achievement and to adjust the exercise program over time, if need be.
Q. What are the criteria for enrollment in this program?
A. A diagnosis of Parkinson's disease, approval to participate from a doctor and Medicare Part A&B and secondary insurance (or 20 percent co-pay).
Q. Are there any kinds of ongoing assistance available for patients and caregivers after the patient's "graduation" from the program?
A. Staff will continue to work closely with patient and caregiver, to let them know about local support groups and other after-care programs. This kind of ongoing support is what is often needed to keep patients managing on their own, outside of nursing homes.
Q. Is there any research going on in the area for Parkinson's disease?
A. Yes, at the Parkinson's Disease and Movement Disorders Center of the University of South Florida. It has an international reputation for excellence in patient care and research. Patients are evaluated by leading physicians to establish a diagnosis and delineate appropriate treatment. Call 253-4455 for information or an appointment.
Q. How can exercise be beneficial for people with Parkinson's disease?
A. By attaining or maintaining cardiovascular health, muscle flexibility and muscle strength. The more patients can stretch and strengthen their muscles, the better they feel.
Q. Where are Parkinson's clinics located?
A. The Parkinson Outreach Program takes place within clinics known as "Certified Outpatient Rehabilitation Facilities." Call (800) 243-3333 to speak with a service coordinator who will identify programs nearest you and assist with transportation needs.
_ Helen Susik is a gerontologist with Suncoast Gerontology Center at the University of South Florida in Tampa. You can write her c/o Seniority, the Times, P.O. Box 1121, St. Petersburg, 33731.