Hospital Preparedness for People with Parkinson’s Disease
Kristina Hart, DO
The Parkinson’s Foundation works with it’s Centers’ of Excellence, including UC Davis Department of Neurology, to improve quality of care for people with Parkinson’s Disease (PD) who need to be hospitalized. Consider downloading or ordering the Parkinson’s Foundation Hospital Safety Guide and discussing a hospital preparedness plan with your neurologist. In the meantime, there are steps that people with PD and caregivers can take to prepare and advocate for the best possible care during a planned or unplanned hospital stay.
One of the biggest issues people with Parkinson’s Disease face while in the hospital is proper timing and administration of their Parkinson’s medications. This is especially important because missing doses of medication or incorrect timing can make symptoms worse and put people with PD at higher risk of complications, such as falling, or result in longer hospital stays. Ideally, PD medications should be given within 15 minutes of their scheduled time for every dose.
To help minimize this issue, it is recommended to keep a detailed and updated medication list that includes the exact dose, number of pills taken with each dose, and times of day that each is taken. It can be helpful to keep a small emergency supply of Parkinson’s medications ready in a go bag that can be grabbed easily for an unplanned hospital visit. Some newer medications may not be available in the hospital resulting in the need to use medications brought from home. There may also be instances where a person with PD cannot swallow their pills, if this occurs then a temporary feeding tube may need to be placed so that medications can be given.
Ensuring proper medication dosing and timing is essential, but it’s also important to know that certain medications should not be given to people with Parkinson’s disease as they can worsen symptoms. These medications include dopamine-blocking drugs. There are two main classes of these drugs: antipsychotics and anti-nausea medications. There are only a few safe options for people with Parkinson’s disease including two antipsychotics called Quetiapine and Clozapine; Ondansetron is the safest anti-nausea medication that is available at most hospitals.
In addition to proper medication management, there are some additional steps that are recommended. Early and frequent mobilization is key. People with PD should get out of bed as often and as soon as possible, at least 3 times a day. Ideally a physical therapist should be consulted on the first day of hospital admission.
Trouble swallowing is also a common symptom in people with Parkinson’s disease and may worsen during times of illness. Trouble swallowing can increase the risk of inhaling something into the lungs which may result in complications such as aspiration pneumonia. For this reason, it is recommended to have an early screening with a speech therapist.
If there are any concerns or questions that arise about appropriate management of a persons’ Parkinson’s symptoms while in the hospital a neurologist should be consulted for guidance.
