We are very excited to be holding our first #MDTchat on Wednesday 9th April 8-9pm (BST), a collaboration between @wenurses, @otalk_occhat, @physiotalk and @sumesuk from @ParkinsonsUk for Parkinsons’s Awareness Week ‘In Control’ (7th – 13th April 2014).
Aims of this #MDTchat – how can healthcare professionals help people with Parkinson’s to stay in control?
Healthcare professionals have an important role in helping people with Parkinson’s to stay in control. This discussion aims to bring together nurses, occupational therapists, physiotherapists, other healthcare professionals, support workers, students; and people with Parkinson’s, their families and carers. We’ll be exploring how we can work together to improve care for people with Parkinson’s and how we can help people with Parkinson’s to stay in control.
This is our first joint #WeNurses #Otalk #physiotalk chat and to keep things simple we’ll be using the hashtag #MDTchat.
Helping people to stay in control: the role of the multidisciplinary team
Here are some perspectives from members of the chat team to get you started; we look forward to hearing from you all on the night!
Suma Surendranath @sumesuk
Having control is something people with Parkinson’s can never take for granted. The fluctuating nature of the condition means that someone who usually is working or taking care of their family can wake up one day and have difficulty leaving their front door. Medication can control symptoms but only if it is given at the right time, which may not fit with usual drug round times in hospital. This could mean the difference between someone engaging with and benefitting from their therapy sessions during an admission and someone having an extended stay because of additional unnecessary complications.
There’s much that professionals can do both in hospital and out in the community to help people with Parkinson’s take control. We recently set up a pledge for NHS Change Day asking professionals to ask their patients with Parkinson’s what one thing they could do today to help them take control – and then make it happen. What could you and your team do?
Teresa Chinn @AgencyNurse @WeNurses: Parkinson’s and the nurse’s role
People with Parkinson’s have very specific nursing needs, from ensuring that medication is given on time every time to ensuring that nurses understand the varying nature of the condition. The complex mix of motor and non-motor symptoms can make carrying out activities of living challenging (Cotton & Heisters 2013). Nursing someone with Parkinson’s involves really getting to know and listening to that person, as from day to day and even hour to hour a person with Parkinson’s can differ in condition.
In addition to this a multi-disciplinary approach is vital, Cotton & Heisters (2013) state:
“To help people living with Parkinson’s to lead a healthy lifestyle and have a good quality of life, health professionals need to collaborate and work as part of a multidisciplinary team.”
Therefore it is important that to effectively nurse and care for someone with Parkinson’s nurses need to understand the perspective of the rest of the multidisciplinary team.
Naomi McVey @Naomiphysio @physiotalk
As a physiotherapist and regular user of NHS services with my family, I think coordinated care and good communication are essential for helping people to stay in control. Here are some examples to think about ahead of the discussions:
- Shared decision making
- Comprehensive information for people who have Parkinson’s and also between teams and professionals – such as assessment findings, care plans, medication, how to find help and support, and when planning discharge from hospital.
- Integrated care – for example see a narrative for person on-centred coordinated care from National Voices.
- Our use of language! Such as avoiding jargon, abbreviations and medical terminology.
Kirsty Stanley @Kirstyes @Otalk_Occhat
When I was in clinical practice I attended a training session on Occupational Therapy and Parkinson’s (by Katrina Bannigan) and a couple of pieces of practical advice have always stayed with me and I think they are relevant to theme ‘In control’.
We often bombard clients with questions and comments without giving them time to process a response. Cognitive processing speed can be affected by Parkinson’s. So after you ask a question wait one minute before you say anything else. I challenge you to try it and reflect on how it affects your interactions.
Another tip for simplifying tasks are to enable people to tap into habitual processes. So rather than saying, go on, reach for the glass it’s right there, ask ‘Are you thirsty?’. Don’t underestimate simple practical solutions.
Of course there is rarely a one size fits all approach to working with clients and occupational therapists’ client and occupation centred approach is well suited to understanding complex conditions. I have one question for the Occupational Therapists – how can you best share your occupational therapy assessment with the client, their carer(s) and the wider MDT to help put the client back in control?
Janet Thomas @JanetThomas47 @physiotalk: Physiotherapy for people with Parkinson’s
Physiotherapy has an important role in helping people with Parkinson’s to take control of their symptoms and day-to-day activities. This can include giving people strategies for overcoming problems when walking, getting up from a chair or to turning over in bed. Keeping physically active is also really important for people with Parkinson’s and giving both general advice about activity levels and specific advice tailored to people with Parkinson’s is an important part of a physiotherapist’s role. Another way of handing back control to a person with Parkinson’s is by reducing their risk of (and fear of) falling. Having the confidence to move around in your chosen environment is empowering and is a key outcome from effective physiotherapy.
- Parkinson’s UK About Parkinson’s, Health and social care professionals, Parkinson’s Nurses, Parkinson’s UK support for professionals, the Get It On Time campaign and Phil’s story
- NICE clinical guideline on Parkinson’s disease: management in primary and secondary care (CG65)
- Diagnosis and pharmacological management of Parkinson’s Disease (SIGN guideline 113)
- Bleon and Munneke (2014) Revolutionising management of chronic disease: the ParkinsonNet approach
- Royal College of Nursing, Parkinson’s Disease Nurse Specialist Association and Parkinson’s disease society: A competency framework for nurses working in Parkinson’s disease management
- Jarman Et al (2002) Effects of community based nurses specialising in Parkinson’s disease on health outcome and costs: randomised controlled trial
- Kernohan (2011) Palliative care in Parkinson’s disease
- European Physiotherapy guideline for Parkinson’s Disease
- Physiotherapy Works: Parkinson’s
Cotton & Heisters (2013) How to care for people with Parkinson’s disease Nursing Times
All #MDTchat Participants