caregivers and chronic illness, chronic illness, Parkinson's awereness, parkinson's disease, Parkinson's Health

El cambio de papeles- Dra. De Leon

Al continuar la campaña de #EndParkinsons ( #terminemos con él Parkinson) este mes de abril reconocido como el mes de hacer conciencia por la enfermedad que afecta casi 10 millones de habitantes al rededor del mundo no debemos olvidarnos de aquellos que dan de su servicio y amor incondicional para cuidarnos. No cabe duda que el cuidar de un paciente se toma toda una aldea…

El cuidador que podría ser un amigo, esposo, o familiar es parte vital e integral del equipo del cual todo paciente debe tener a su alcance. Pero a medida que transcurren los años después del diagnóstico estas personas también tienen sus propios obstáculos. Con frecuencia estas personas requieren de mucha flexibilidad para poder ajustarse al nuevo papel de ayudante y cuidador. Esta transición en el papel de responsabilidades puede dejar al individuo que enfrenta el nuevo papel un poco aprensivo e incierto de su futuro y pueden manifestarse en síntomas de depresión, ansiedad y conducir al aislamiento.

Aquí les presento unos breves consejos que he aprendido después de años de cuidar a pacientes con enfermedades neurológicas crónicas para que puedan sobre llevar la carga de mejor manera. Es importante de recordar que el cambio de responsabilidades puede presentarse de muchas maneras. Por ejemplo si el paciente es el encargado de trabajar y mantener la familia la esposa tal vez se vea obligada de regresar a la fuerza de empleo por lo cual se verá doblemente afectada por tratar de proveer apoyo emocional y financiero. En estos casos es importante de envolver a la familia especialmente los hijos si son adultos en el cuidado del padre o la madre. Ellos pueden ayudar con el quehacer de la casa o en preparar comidas. Amigos y otros seres queridos también pueden dar una mano cuando sea necesario.

Para poder sobre vivir esta nueva posición es no perder de vista sus propios sentimientos, pasiones, y sueños. Y no dejarse arrastrar por la corriente de la enfermedad.

1.    No espere perfección o saberlo todo. Dejen lugar para los errores que se puedan cometer. Es como ser una nueva madre se aprende en las trinchas de batalla. Solo tiene uno que estar dispuesto a tener nuevas experiencias aunque no tenga tendencia de cuidador. Recuerden que “todos los caminos conducen a Roma.” Quiero decir que hay muchas maneras de hacer la misma cosa. Encuentren lo que más les favorezca y háganlo suyo.

2.    Encuentren valor en su nuevo papel de cuidador. No vean la experiencia como obligación sino como una aventura u oportunidad para crecer y aprender. Ustedes tienen mucho talento póngale ganas y sonrían le a la situación y verán que una buena actitud cambia todo. 3.    No traten de hacerlo todo. No somos una isla. Por favor de poder ayuda a sus médicos, trabajadores sociales, líderes religiosos, y otros familiares y amigos. Asistan grupos de apoyo para evitar el aislamiento. Y visiten las redes de  http://www.pdf.org  o caregiveraction.com

4.    No se les olvide que todo tiene un límite y esto también pasara. Pero las lecciones que pudiera aprender le durarán toda la vida. No dejen de soñar y hacer planes. Como decía mi abuelo que en paz descansa, “siempre hay más tiempo que vida.”

battling stigma in PD, chronic illness, dopamine and parkinsons, medications in Parkinson's, Parkinson's Diagnosis, parkinson's disease, Parkinson's Health, Parkinson's treatment, parkinsons dementia, parkinsons disease treatments, parkinsons symptoms, parkinsons treatments, parkinsons y tratamientos

Tips to dealing with Apathy : by Dr. De Leon

Tips to dealing with Apathy : by Dr. De Leon.

caregivers and chronic illness, chronic illness, parkinson's awareness month, parkinson's disease

Instructions not Included When it Comes to Caregiving: By Dr. De Leon

Instructions not Included When it Comes to Caregiving: By Dr. De Leon.

caregivers and chronic illness, chronic illness, parkinson's awareness month, parkinson's disease, parkinsons dementia

Instructions not Included When it Comes to Caregiving: By Dr. De Leon

Don’t dwell on the disease. Value the moments, the pearls of wisdom, their smile, their humor.” St. Elizabeth

seekcodes_659_26138     Caregiving is not for the faint of heart. I have had to be the caregiver for two of the people I love, my grandmother and father. Although the experience was extremely rewarding, I was left completely emotionally and physically spent when it was all said and done. Being a caregiver requires inner fortitude, perseverance and above all a great deal of love. Love for that person you are providing care for is the only thing at times that drives you and keeps you from losing your wits.  In dealing with my loved ones as a caregiver, I had my moments of frustration as many of you have in taking care of your own loved ones who suffer from chronic illnesses like PD. The problems usually arise from thinking we know what is best for them which may be in opposition of what they think is best for them.   Just because they are physically handicapped this does not mean they are mentally handicapped hence conflict ensues. This is entirely different when taking care of someone whose faculties have diminished as in those with dementia, we must then be the voice of reason. But when someone is still able to make decisions although in our opinion are not the wisest we have to find compromise to respect their wishes, keep their dignity, and maintain their safety.

So how do you decide when to step in and when to watch from the side lines (cautiously holding your breath)?

This question is extremely complicated of when to override their needs and desires for safety sake?

For example, my dad was very frail and getting extremely weak in addition he had fallen twice; yet, he insisted in continuing to use a walker instead of wheel chair. This entire scenario only made me cringe expecting to hear the sound of broken bones at a moment’s notice. Despite my better judgment as a doctor, I had to respect his wishes.

It is important not to fall into a trap as a caregiver of assuming what the person with PD needs. It is best to ask your loved ones their wishes. An honest and frequent dialogue can go a long way in maintaining the personal dignity of the care recipient or patient as well as that of the care partner who will not come across as a tyrant but rather as a truly caring individual.

So here are some tips I learned in providing care:

Learn to compromise– avoid disputes and old issues from getting in the way! During chronic illness especially as a loved one reaches end of life; this is the time to stick together! So as to make him or her feel like he/she still has some independence … instead of forcing the wheelchair in the case of my dad, I explained my concern for him of falling again and breaking a hip and ending in the hospital. Then let them decide based on the information.

Learn to reiterate your concerns in a compassionate manner – I explained to him that we had been lucky until now not to have broken any bones. But, as his bones were extremely frail and he was very weak any small insignificant injury even a simple bump from sliding off the bed could result in a hip or wrist fracture. However, if he did not wish to use the wheelchair, then we had to device another plan to maintain his safety. He agreed with this, he was then instructed to call someone first prior to getting up either from bed or sitting to alert them of his intentions of wanting to be mobile. He then was to sit at side of bed if reclining for few minutes rather than jumping up from laying (although  this was emphasized more for theoretically purposes just so that he  would remember to take it easy because in all honesty he could not jump anywhere when movements  were extremely slow, deliberate and  laborious). These recommendations can be used for anyone with mobility issues especially if getting orthostatic, dizzy and at risk of falling.  I instructed him on appropriate safe use of walker and asked for him to carry safety belt around so if he did slip it would be easier for me or my mom to catch or lift him up.

Learn to coordinate: some of us are better at this than others. If you are good at delegating and seeing the big picture- this is your calling. Nothing is more important than having a game plan! For instance, I am good at this … While my mom tends to the daily needs of my dad, I can step back and see what needs to be done so I can guide my mother and assist her in getting things done. For instance dealing with matters of insurance, are documents in place?  Are Wills done?  Over see funeral arrangements if dealing with end stage disease? Are other legal documents in order? Because, as we know when we are dealing with the task of caring for someone 24/7, we can become so overwhelmed we sometimes can’t see the trees for the forest. This is especially the case when death is imminent, or contemplating placing loved one in a nursing home. Sometimes our judgment can become clouded and we may become paralyzed with grief! Be the one that initiates conversation and steers it in a positive direction to get things done.

Learn to facilitate: emotions tend to run ramped when dealing with a chronically ill loved one.  At times, it is hard to step outside your situation and see things objectively. This is when a friend, pastor, social worker, healthcare professional or in my case a relative that does not live there all the time comes in handy. They can help provide valuable insight into the situation, give impartial advice to diffuse a stressful situation by offering prayer and even referring to other counseling services, support groups and other resources on line and to other community organizations that may be able to assist with specific needs. (I.e. help find a sitter/respite care). When I was caring for my grandmother who had end stage Parkinson’s she would at times get very belligerent and accuse me of holding her hostage since she was bed bound. Being a neurologist, I knew this was part of her illness I knew how to treat and did not bother me. However, when I was at the office and at the hospital having to deal with PD patients all day who were hallucinating and belligerent then come home to same scenario sometimes was a bit overwhelming. It was nice to have friends to talk to and even place her in respite care for a week so that I could decompress. Learn to listen: this is the most difficult task of all! Some of us hear but don’t really LISTEN. Listening takes special skills, understanding, and putting oneself in the shoes of the person living with PD. When we are in a stressful situation we all desperately need to be heard so everyone talks but No one LISTENS! Often times no words need to be uttered to have truly listened and made the person you are caring for feel special, unburdened, understood and loved. A simple kiss, hug, brush of the hair or hand, and even smile can go a long way!

The same rules apply for the caregiver; find someone who is willing to listen to your story. This simple act can allow you as a caregiver an outlet to relieve your own stress and open the door of communication and a way for you to ask for assistance in the area of specific need.

Lastly, learn to socialize: again if you are a leader or a take charge kind of person or event planner, this would be right up your ally. After all, we are all social beings most of us even the shyest of us thrive when we are bonding with others either individually or as a group. Therefore, it is important to plan social outlets to get yourself the caregiver out of a routine. Planning social gatherings with and without the person you are proving care for will help to diminish the risk of  depression, loneliness, feelings of helplessness, spiritual exhaustion which might lead to suicidal ideation in both patients and caregivers alike. The outings or get together will also help to remind those involved of their unique talents and gifts and bring closer together as a couple or family. One activity my grandmother always enjoyed was painting. So we would paint as a family. This was always fun and made us forget for a bit about the struggles we each faced on a daily basis. This is fairly cheap to buy paints, brushes and canvas at a place like Hobby Lobby. Now they even have coloring books for adults but even children’s coloring books are fun to do as a group. Help organize activities for family, individual etc. Put your imagination to work. Even if it means taking them out for an unexpected “ice cream” run, my dad loved this or whatever their favorite activity may be; in my dad’s case fishing (even if it’s just in bucket or fish tank because he got too sick to go outdoors fishing as he would have liked).

caregivers and chronic illness, chronic illness, parkinson's disease, parkinsons dementia

Keeping Track of Doctors Bills : By Dr. De Leon

” I am not telling you is going to be easy, I am telling you is going to be worth it!”

As many of you may already know, November is caregivers’ month; thus, I will talk about an issue that affects caregivers and patients alike.

The care giver has many responsibilities and roles in making sure that their loved ones needs are met. Among one of the biggest responsibilities a care partner or giver may have is being responsible for the financial stability of the Patient fully or in part. But, even when the patient is able to care for him or herself financially he or she may still need an advocate to help decipher the ever complex and confusing world of doctor and hospital bills.

This becomes more pressing as the disease advances and dementia begins to set in. Those of you who have a chronic illness or care for someone with a progressive debilitating  illness like Parkinson’s know that as the disease advances the need for services ( PT, OT, Pain doctors etc.) increases exponentially. Subsequently, the amount of bills you receive also increases at an alarming rate. The rate can suddenly shift to ‘a warp speed’ if your loved one ends up having procedures or being hospitalized; especially if the hospitals stay is lengthy.

In which case, you can find yourself being inundated in bills and paper work. This can drive a person mad trying to make heads and tails especially when the person you are caring for needs 24 hour care or pretty constant supervision in all other aspects of care from grooming to ensuring they take their medications properly.

Here are a few tips that I have learned to help simplify life. These can be used whether you are a patient or a caregiver.

First, set a side a special box or place where you will place all the mail relating to this subject/away from all other mail so it can be easily accessed.

Second, make sure that you know what your insurance covers in and out of the hospital before you have tests, procedures; become hospitalized; so there are no surprises. If you have Medicare go to Medicare.gov. Otherwise get a copy of benefits/coverage from your insurers.

Third, designate an area and a time when you will dedicate exclusively to this. once a month is good if not so many bills but if having ongoing procedures, hospitalizations, and doctors evaluations, you will most likely start receiving bills weekly if not daily therefore be best to tackle once a week to avoid getting yourself overwhelmed.

Next…

1) Make a proper binder to place all the (EOB’s- extended office bills) and label yearly. Also if hospitalization extends several months put color dividers to delineate various months. The same can be done if patient had doctor’s appointment or procedures extending various months.

2) Do not pay a single bill until you receive an explanation of benefits from your insurance/ compare it with doctor’s bill and pay only after they have paid their part. If you have secondary insurance have to wait till both insurances have paid. Which usually means you should not have to pay anything unless at beginning of insurance cycle when you have to meet your deductibles. (the beginning for your calendar  year may vary slightly but usually around the last quarter of the year or first quarter of the new year). For Medicare the deductibles are due at the beginning of every year.

3) If you detect a problem- call your insurance company customer- service first and make sure you get names and dates of whom you speak to and if checks issued get amounts, to whom, dates issued and check numbers.

4) Once a certain bill is paid – make sure you check off ( and remove from your pile /box and file into binder in section labeled paid) so you don’t pay again or have to deal with it again because sometimes may get duplicate! Look at it carefully for services and dates!!! Use a red pen or marker to check off

5) If the problem is at doctor’s office or hospital, make sure you speak with billing person directly.

6) Always take good notes.

 7) Usually insurances give discounts so pay close attention and if doctors office or hospital tries to bill you for difference when you have received a discount, send them copy of EOB. If no discount listed in your invoice call your insurance to make sure whether one should be applied.

8) Always make sure that bills are sent to correct insurance with right policy number and that everyone has correct spelling of patients name to avoid claim errors.

 9) At times claims are kicked back due to coding errors, so always inquire if there were any problems with codes causing it to be denied which you could address with your doctors or hospital billing office.

If you remember these simple tips: you can avoid going mad when bills come in daily. Happy trailing’s!!

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Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; http://www.aan.org, http://www.defeatparkinsons.blogspot.com All materials here forth are property of Defeatparkinsons. without express written consent, these materials only may be used for viewers personal & non-commercial uses which do not harm the reputation of Defeatparkinsons organization or Dr. M. De Leon provided you do not remove any copyrights. To request permission to reproduce release of any part or whole of content, please contact me at defeatparkinsons101@yahoo.com contributor http://www.assisted-living-directory.com Contributor http://www.lavozbrazoriacounty.com

 

 

caregivers and chronic illness, chronic illness, depression and suicide, fall prevention in parkinsons, falls in parkinsons, parkinson's disease, parkinsons health and beauty tips

Tips for Making Life Easier for Both Caregivers & Chronically Ill Alike : By Dr. De Leon

Last month I have been dealing with my dad’s terminal illness. I have had my moments of frustration as many of you have in taking care of loved ones with chronic illnesses like PD because sometimes what we think is best for them is not what they think is best for them. So how do you decide when to step in and when to watch from the side lines (cautiously holding your breath). This question is extremely complicated of when to override their needs and desires for safety sake?

For example my dad is very frail getting extremely weak and has fallen twice but still insists in using a walker instead of wheel chair which makes me cringe. It is important not to fall into a trap as a caregiver of assuming what the person with chronic illness or PD needs or wants. It would be best to ask that person what their wishes are. An honest and frequent dialogue can go a long way in maintaining the personal dignity of the care recipient or patient as well as that of the care partner who will not come across as a tyrant but rather truly caring individual.

Learn to compromise– avoid disputes and old issues from getting in the way! During chronic illness especially as a loved one reaches end of life; this is the time to stick together! So as to make him or her feel like he/she still has some independence …so instead of forcing wheelchair in the case of my dad, I explain my concern for him of falling again.

You must Reiterate your concerns in a compassionate manner – I explained to him that we had been lucky until now not to have broken any bones thus far. But, as his bones are frail and weak any small apparently insignificant injury even a simple bump from sliding off the bed can lead to a hip fracture or wrist fracture. However, if we are to not use wheelchair, then we must have a safe plan in place. So, he was instructed to call someone first prior to getting up either from bed or sitting to alert them of his intentions of wanting to be mobile. He then was to Sit at side of bed if reclining for few minutes rather than  jumping up from laying ( although  this is more theoretically purposes just so that he remembers to take it easy because in all honesty he is not jumping anywhere when movements are extremely slow, deliberate and  laborious); these recommendations are meant to safeguard him from getting orthostatic, dizzy and avoid subsequent falls. Furthermore, I again instructed him on appropriate safe use of walker and asked for him to carry safety belt around so if he does slip it would be easier for me or my mom to catch or lift him up.

Learn to coordinate: some of us are better at this than others. If you are good at delegating and seeing the big picture- this is your calling. Nothing is more important than having a game plan! For instance, I am good at this … While my mom tends to daily needs of my dad I can step back and see what needs to be done so I can guide my mother and assist her in getting things done. For instance dealing with matters of insurance, are documents in place?  Are Wills done?  Over see funeral arrangements if dealing with end stage disease and terminal as is my dad’s condition? Are other legal documents in order?

Because, as we know when we are dealing with the task of caring for someone 24/7, we can become so overwhelmed we sometimes can’t see the trees for the forest. This is especially the case when death is imminent, our judgment can become clouded and we may become paralyzed with grief! Be the one that initiates conversation and steers it in a positive direction to get things that need done taken care of.

Learn to facilitate: emotions tend to run ramped when dealing with a chronically ill loved one.  It is hard to step outside your situation and see things objectively. This is when a friend, pastor, social worker, healthcare professional or in my case a relative that does not live there all the time comes in handy. They will ( I-you can ) provide valuable insight into the situation, give impartial advice to diffuse a stressful situation by offering prayer and even referring to other counseling services, support groups and other resources on line and to other community organizations that may be able to assist with specific needs. (i.e. Help find a sitter)

Learn to listen: this is the most difficult task of all! Some of us hear but don’t really LISTEN. Listening takes special skills understanding and putting one in the other person’s shoes. When we are in a stressful situation we all desperately need to be heard so everyone talks but No one LISTENS! Often times no words need to be uttered to have truly listened and made the person you are caring for feel special, unburdened, understood and loved. The same rules apply for the caregiver … ask them to tell you their story. This simple act can allow them an outlet to relieve their stress and open the door of communication and a way for you to offer assistance in the area of their specific need. (E.g. My dad still wants to maintain some semblance of dignity and independence/ mom wants not to have  him break a bone and hurt herself in the process if he falls). So, we came up with specific compromises on how to do things like grooming in a manner that is safe and convenient for everyone.

Lastly but not least learn to socialize: again if you are a leader or a take charge kind of person or event planner, this would be right up your ally… After all we are social beings …most of us even the shyest of us (we) thrive when we are in bonding with others either individually or as a group. Therefore, it is important to plan social outlets to get the caregivers out of their stressful situation from time to time to avoid depression, loneliness, feelings of helplessness, spiritual exhaustion which might lead to suicidal ideation but also to remind them they are individuals that have unique talents and gifts. It is important to Do the same for the patient – (to avoid same type of feelings) the social activities can be done together or separately-best if done separately from time to time.  Help organize activities for family, individual etc. Put your imagination to work. Even if it means taking them out for an unexpected ” ice cream ” run or whatever their favorite activity may be like in my dad’s case fishing (even if it’s just in a pond, bucket, or fish tank because he is now too sick to go outdoors far away from home fishing as he would like) and my mom -shopping! (Of course don’t forget to get someone to watch patient while care giver goes out).

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Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; http://www.aan.org, http://www.defeatparkinsons.blogspot.com All materials here forth are property of Defeatparkinsons. without express written consent, these materials only may be used for viewers personal & non-commercial uses which do not harm the reputation of Defeatparkinsons organization or Dr. M. De Leon provided you do not remove any copyrights. To request permission to reproduce release of any part or whole of content, please contact me at defeatparkinsons101@yahoo.com contributor http://www.assisted-living-directory.com Contributor http://www.lavozbrazoriacounty.com

alzheimers, depression and suicide, depression/suicide in neurological diseases, parkinson's disease, suicide in parkinson's

Depression in Neurological Diseases like Parkinson’s: By Dr. De Leon

You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome.” Hunter – Patch Adams ( one of the best performances by R. Williams)

In the advent of Robin Williams untimely demise, a great deal of spark and conversation has ensued around the topics of mental illness including depression anxiety and bipolar diseases well as their connection to Neurodegenerative diseases like Parkinson’s.

Let me begin by saying first that although there is news of Robin Williams’s early diagnosis with PD -we do not have any details on his actual neurological condition or whether he was on treatment or not?

Furthermore, we must recall that it has been said that he battled with bipolar disease most of his adult life. Bipolar disease is more likely to result in a higher suicide risk and suicidal ideation and behavior compared to Parkinson’s. Nevertheless, we should not underestimate the severity of depression in any patient no matter the cause. And anyone suffering any type of mental illness like depression, anxiety, bipolar disease, etc. should seek immediate attention and get under the care of a specialist.

But we do need to be aware of some of the facts.

Depression is found to be more common in certain diseases like Parkinson’s, Alzheimer’s, multiple sclerosis, epilepsy, migraine, and stroke.

This depression is not caused by the fact that patients are given chronic progressive mostly incurable diseases; although, certainly the notion of having these illnesses has sometimes a negative impact on an individual and can accelerate or worsen symptoms. Furthermore, some of the medications used in the treatment of these illnesses themselves can cause depression, anxiety and other mood disorders. (e.g. amantadine, L-dopa, baclofen, bromocriptine, etc. while some meds that are used to treat pain in PD like those in the seizure class-depakote, lamotrigine, carbamaepine, etc.; and of course SSRi’s-Cymbalta, Zoloft, Lexapro, Effexor, etc. can be beneficial)  in the majority of neurodegenerative diseases, the depression precedes the neurological deterioration as a harbinger of  things to common.

In the case of PD, and Alzheimer’s these can be the very first clues of something amiss especially when there has never been a prior history of mental illness, depression or family history of such problems. According to the National Institute of Mental health roughly 18 million Americans suffer from depression yearly with a 12 month period. Depression is characterized by loss of appetite, although sometimes can be the opposite, loss of interest In things that used to bring pleasure and happiness, poor sleep or too much sleep, lack of energy, suicidal thoughts, poor concentration, feelings of guilt, and low self esteem these symptoms last longer than 2 weeks and the key is that the interfere with activities of daily living.

Women are twice as likely to suffer from depression than men which already puts PD women at higher morbidity this compounding effect maybe one of the reasons are now finding out that women with PD have more negative effects (meaning non-motor symptoms) like depression as opposed to men with PD who have more tremors (positive symptoms)…roughly about 50 % to 60 % of all PD patients suffer depression at one point during their illness and about 1/3 of patients present with depression as an early symptom before diagnosis. Yet despite this knowledge, the overall risk of suicide in PD is somewhat controversial. One study, in 2001 in the U.S. including more than 144,000 people with PD found the rate of suicide in general population to be 10 times greater than in the Parkinson’s population while another study done in 2007 in Denmark found the rate of suicide among PD patients to be equal to those in the general population. Another in 2009 said PD patients although appearing to be at higher risk for depression, they truly were not at higher risk for suicide compared to general population of Denmark. Yet, one thing this study highlighted was the  increase in suicidal ideation (thoughts); this was found to be much greater among those with PD than in the general population. This last piece of information is vital to help us remember and keep in mind of the potential for a slip for those suffering from PD. The possibility of suicide is ALWAYS there and given the fact that some of the medications can trigger or worsen or even cause mood disorders, we have to be extra vigilant as patients, caregivers, and health care professionals to discuss this subject at every visit especially when there are concerns before symptoms get out of hand. There are many treatments for depression including medication. I have discovered that in PD patients, the first step is often a matter of adjusting medications if discussed early. In severe cases (ECT) electroconvulsive therapy has been instituted. Treatment of depression and other mood disorders often requires a team approach including a counselor, therapist (behavioral), psychiatrist, psychologist, and neurologist. (Don’t forget about caregivers too- they also have high rate of depression correlating with extent of care)

It is also extremely important to realize that the highest risk and higher than expected rate of suicide noted to date among PD patients has been among those that have undergone DBS particularly in those that had depression or were single. This is why is crucial if you are considering this treatment that you do not partake if you have no social support or have history of mood disorders like depression. (unless absolute last resort and are under strict supervision by a team of specialist as I described above throughout entire life-this is my opinion) Make sure that you seek opinion of an expert that has done thousands of DBS to get best outcome.

So, even though, we have lost a great entertainer and we mourn his loss, his passing although uncertain as to the cause which led him to his final acts of desperation has provided us with a stepping stone to a new beginning of discussions to remember to treat the person and NOT just the disease– no matter if its Parkinson’s, Alzheimer’s, Multiple sclerosis, Bipolar disease or another chronic illness.

Let us remember to keep in mind  all those that suffer mental illnesses like depression …..

If you have questions regarding your Parkinson’s or think that you might have Parkinson’s and depression

… I invite you to call the National HelpLine of the Parkinson’s Disease Foundation at (800) 457 6676 or email us at info@pdf.org.

Otherwise contact

www.Samaritans.org  or www.suicide.org/hotline/texas-suicide-hotlines.html or http://www.suicidepreventionlifeline.org/
http://www.Speakyourmindtexas.org

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Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; http://www.aan.org, http://www.defeatparkinsons.blogspot.com All materials here forth are property of Defeatparkinsons. without express written consent, these materials only may be used for viewers personal & non-commercial uses which do not harm the reputation of Defeatparkinsons organization or Dr. M. De Leon provided you do not remove any copyrights. To request permission to reproduce release of any part or whole of content, please contact me at defeatparkinsons101@yahoo.com contributor http://www.assisted-living-directory.com Contributor http://www.lavozbrazoriacounty.com