Parkinson's disease is primarily known as a disorder that affects movement. However, for some people with Parkinson's disease (PWP), there are other disabling symptoms of the disease. Coping with dementia, including difficulties with memory and slowness in thinking or communicating, is a challenge for both people with Parkinson's and their caregivers. Recognizing the signs and designing strategies to cope could increase the level of functionality of these people as well as their self-esteem.

So, although the topic of this article will certainly not concern all of our readers, we hope that it can be useful to those who are faced with these symptoms now or in the future, as well as to those who are dedicated to their care.

Initially, it is important to understand that memory lapses, confusion, and slow communication can be caused by a variety of problems such as stress, medications, or depression. Therefore, patients who experience such problems should try to discuss them with their doctors before jumping to conclusions about their thinking difficulties.

When talking about dementia, we usually think of Alzheimer's disease, in which people experience problems with memory, but may also have disorders such as speech difficulties or problems planning and carrying out daily tasks. In fact, dementia in people with Parkinson's may be due to coexisting Alzheimer's disease. However, dementia in Parkinson's can take a slightly different form and often presents as a completely different set of challenges.

In addition to becoming forgetful, people may find that their thought processes are slower and may take a long time to answer a question. There may be difficulty concentrating and a particular lack of drive or initiative, leading caregivers to complain of passivity in people with Parkinson's. Visuospatial processing may also be decreased, which could lead to difficulties with daily tasks from driving, dressing, or even inserting a hearing aid in the ear.

An important part of any conversation with your doctor is to first evaluate how medications may contribute to your symptoms and take steps to simplify your treatment regimen by eliminating medications that could worsen thinking difficulties, such as anticholinergics or sedatives. Furthermore, people with Parkinson's with dementia may be particularly prone to confusion and hallucinations as a side effect of medications used to treat the disease.

Second, it is important to distinguish dementia from depression. Depression can sometimes lead to slow responses and problems concentrating, or a tendency to be forgetful, but if recognized early, it responds to treatment.

Third, there are currently a variety of treatment options that can improve memory and overall cognitive skills, which can be discussed with your doctor.

It is important to mention that there are a number of changes that can be made to help people with Parkinson's cope with such difficulties. Maintaining a simple life is the best way to ensure that the person can continue to participate in normal activities as fully as feasible, and maintain some degree of independence for as long as possible.

For example, to help overcome slow thinking, instead of communicating at “normal” speed, try making eye contact and slowing down your speech to ensure that the person with Parkinson's is able to process everything you say. Allow plenty of time for the response and avoid interrupting or finishing the person's sentences. Try not to ask open-ended questions like “what would you like to have for breakfast?” Instead, offer examples and choices with closed-ended questions like “do you want coffee?” “Yes” or “no” answers are easy to communicate, either verbally or by nodding your head. A simplified home environment can reduce the risk of confusion. Removing accumulated clutter and unnecessary furniture or rarely used kitchen utensils and appliances is one way to do this. Another is by removing items that you do not want the person with Parkinson's to use.

This includes blenders, food processors and sharp knives in the kitchen, stairs and ladders, and tools in the garage or basement. Medications can be locked away if they are at risk of the person with Parkinson's getting confused about the doses.

We all know the importance of maintaining a regular exercise regimen. Likewise, mental exercises and activities are important to maintain mental agility. Exercises may include doing crosswords or puzzles, playing card games, reading or listening to music, keeping a diary (which can also help memory when reviewed), and continuing favorite hobbies.

Physical activity can also be incorporated, for example, exercises to the rhythm of music or dancing. Again, it is important to note that these tasks can take much longer to complete and patience is the key word here.

For patients who may have difficulty remembering the sequence of steps to follow to perform a particular task, it is helpful to list in large letters or demonstrate each step so that the person with Parkinson's can imitate and follow them. A “to do” list could be very helpful. For example, in the morning post a list in the bathroom, which, depending on the patient's abilities and limitations, may include:

MORNING ROUTINE

1.Brush your hair

2.Brush your teeth

3.Use the toilet

4.Wash your hands

5.Turn off the light when leaving

Each step on the list should be as simple and clear as necessary. Please remember that these lists may need to be more detailed over time. Performing activities of daily living in the same order each day provides structure and minimizes confusion.

Placing a large calendar in a common place (such as the kitchen or next to the bed), marking each day's appointments or events, is another way to help people with Parkinson's become more independent. This could be reviewed daily along with a list of tasks for the day.

Another important aspect to take into account is the act of dressing. The message here is to keep it as simple as possible. Have the person with Parkinson's wear clothes that are easy to put on and take off, with zippers or just a few buttons down the front or Velcro closures. Arrange or pile the clothes in the order they should be put on, with underwear and socks first. If the patient insists on wearing the same thing day after day, buy several identical clothes so that you can provide clean clothes without having to wash them every night.

Put door signs using images or keywords. For example, when you write the word “bathroom” put a photo of a toilet on the door, or a photo of a bed, along with the word “bedroom” on the bedroom door.

If you experience mental confusion and hallucinations, a dark room could trigger all kinds of frightening images. Consequently, you should consider installing night lights that turn on automatically when there is a certain degree of darkness. This way, the person with Parkinson's will never have to enter a completely dark room.

You can remove a lot of frustration from the daily life of the patient with thought processing difficulties by keeping tasks and questions simple, and preventing situations that a confused person might have trouble with. Equally important, this allows the person with Parkinson's to continue functioning and managing parts of their own life, which can alleviate caregiver responsibilities while giving the person with Parkinson's a sense of accomplishment and involvement in the home. and in everyday affairs.

It is important to reiterate that not all people with Parkinson's have memory problems, slow thinking and confusion since dementia does not automatically come with the disease. But these problems can coexist with Parkinson's and we believe that the best strategy is to be prepared.

10 tips to manage slow communication and thinking

(1)Consciously slow down your speech to make sure the person with Parkinson's is able to process everything you say and allow enough time for them to respond.

(2)Avoid overloading memory processing by asking closed questions, which invite a “yes” or “no” response.

(3)Organize daily activities to keep an active mind, such as listening to music or reading.

(4) Use a “to do” list for daily tasks so that the patient can perform each task in a specific order.

(5)Place a large calendar in a common location with appointments and events noted for each day.

(6) Provide clothing that is easy to put on and take off or has Velcro closures, arranging them in the order in which they should be put on.

(7)Make announcements using photos or objects rather than words, and post them on the doors of the corresponding rooms.

(8)Medical supplies may be locked up if there is a danger of confusion.

(9)Have a medical ID bracelet or chain that contains the patient's name, phone number, and diagnosis.

(10)Use night lights if the person with Parkinson's has confusion and hallucinations to make sure they do not have to go into a dark room.