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Parkinson's Disease with Dementia -
Special Challenges

Changes in Daily Living:

Finding out that your loved one had Parkinson’s was difficult enough. Adjusting to dementia can significantly add to stress. Remember not only to consider the person with Parkinson’s and how their life is affected, but it is especially important to reduce caregiver stress during this adjustment. In order to make a successful transition, you’ll need to make changes to daily routines. This requires not only cooperation from the patient, but the caregiver as well.

Avoid open-ended questions such as “What would you like to eat?” Since thought processing is affected, the patient may feel frustrated when they are unable to name something specific that they like to eat. Offer choices: “Would you like chicken or pork chops?” Give a limited number of choices so the person can name what they want without too many options.

Establish schedules and stick to them. Lists of activities may help. For example, next to the bed may be a list that reads:

Wake up
Put on slippers
Put on robe 

By breaking down the daily routine into small, manageable steps, you can avoid frustration from the patient and the caregiver perspective. Both people know what to expect and in what order you need to do the steps. 

Remember that as the dementia worsens over time, you may need to develop lists with more specific steps. For example, the first list may have said, “Brush your teeth.” 

The new list may read:
Open toothpaste
Get toothbrush
Put toothpaste on toothbrush
Brush teeth
Rinse

If you think your loved one may not be able to remember which medications they need to take, how much they need to take, etc., you may have to lock away medications and dispense doses as needed. This may be an adjustment to the person who was accustomed to independence in taking their medication. Explain the reasons why you need to control medications and that you want the person to be safe. Over time you can make this transition as well.

Keep living environments simple, free of clutter. Clutter in the home can resemble the clutter that the person feels in their thought processes. By keeping the environment free to extraneous objects, you can help decision-making processes go much smoother. Remember too that Parkinson’s will gradually worsen over time, making smooth movements almost impossible. Keeping the home area safe and fall-free will help with this as well.

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