Download A Landscape for Persons with Parkinson`s Disease

A Landscape for Persons with
Parkinson’s Disease
Anthony W. Eichenlaub
19 April 2006
Introduction
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Parkinson’s Disease
Therapies
The Client
A Therapeutic Landscape
Persons with Parkinson’s
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Non-discrimination
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Social
Racial
Gender
Older Population
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Most aged 65 or older
15% 55 years or younger
Parkinson’s Disease
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Degenerative disorder of the brain
Brain stops producing dopamine
Symptoms
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Slowness
Rigidity
Tremors
Treatment Options
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Medication/Surgery
Physical therapy
Psychological treatment
Treatment Options
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Common Drug Types
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Levodopa preparations
COMT Inhibitors
Dopamine agnosts
Amantadine
Anticholinergic
Selegiline preperations
Treat the disease
Alleviate symptoms
Common Treatments - Drugs
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Common Drug Side Effects
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Nausea, Vomiting, Dry mouth,
Dizziness, Confusion, Hallucinations,
Psychosis, Diarrhea, Dyskinesias,
Drowsiness, Feeling Faint, Sedation,
Difficulty concentrating, Insomnia,
Nightmares, Agitation, Leg swelling,
Mottled skin, Blurred vision,
Constipation, Urinary retention,
Heartburn
Common Treatments - Surgery
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Brain lesioning
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Damages parts of the brain that are
overactive
Deep brain stimulation
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Electrodes stimulate parts of the brain
to give the patient better control
Common Treatments
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Physical Therapy
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Education
Lifestyle changes
 Arranging furniture
 Using tools to offset physical disability
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Actual Physical Work
Walking
 Weight Training
 Body Weight Supported Treadmill Training
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Common Treatments
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Psychological Treatment
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Mental health
Depression
 Stress
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Spiritual health
The Client
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Rochester Parkinson Center
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Focus on persons with Parkinson’s
Residents with advanced cases
 Outpatient care for newly diagnosed cases
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Full range of physical therapy and
treatment options
The Client
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Underused courtyard area can be
completely re-landscaped
Desire an area for both recreation
and therapy
Spiritual and mental health must be
addressed
Landscape as a Treatment
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Increase Physical Therapy Options
for Persons with Parkinson’s
Address the Mental and Spiritual
Needs of Persons with Parkinson’s
Measurable design elements
Landscape as a Treatment
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Adapt the landscape for safety and
convenience
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Crumb rubber pavers that will be hard
enough for a wheelchair, but soft
enough to cushion falls.
Seating throughout the landscape for
frequent stops
No blind intersections
Landscape as a Treatment
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Integrate Physical Therapy into the
Landscape
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Figure eight patterned path for walking
Movable handrails so that self
supported walking treatment can be
performed anywhere in the landscape.
Secluded area where a body weight
supported treadmill can be installed
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Handrails
snap easily
into various
points in the
landscape
When
removed
these areas
are useful in
other ways
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Training area is
near the Activity
room for easier
access
Body weight
supported
treadmill can be
moved to this
area during
favorable
weather
conditions
Landscape as a Treatment
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Provide areas for education and
training
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Small 3-4 seat secluded areas
One area to seat 8-10 people
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Movable
benches
for added
flexibility
Landscape as a Treatment
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Provide a serene, peaceful
environment
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Soft plant material chosen to attract
birds and butterflies
Landscape divided into smaller sections
for a private, secluded feeling
Pondless waterfall installed as a
meditative focal point
Landscape as a Treatment
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Entertainment options
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Table with games
Scrabble
 Large playing cards
 Crossword puzzels
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Sound system
Provide music programming throughout
the landscape
 Provide books on tape or other audio
entertainment
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Large buttons
for easy use
A variety of
programming
is available
Measuring
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Interview therapy staff and clients
Monitor rates of depression and
stress levels of patients before and
after installation
Monitor the use of entertainment
features
Bibliography
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National Institute of Neurological Disorders and
Stroke, Living With Parkinson’s: A Jekyll and Hyde
Existence April 2, 2006
http://www.ninds.nih.gov/news_and_events/news_ar
ticles/news_article_living_with_pd.htm
Fisher, B., Yip, J., Physical Therapy For Individuals
With Parkinson Disease: A Paradigm Shift March 24,
2006
http://www.parkinson.org/site/pp.asp?c=9dJFJLPwB&
b=71125
Schwarz, S. (2002). Parkinson Disease: 300 Tips for
Making Life Easier. New York, Demos Medical
Publishing
Lieberman, A, Williams, F. (1993). Parkinson Disease:
The Complete Guide for Patients and Caregivers.
New York, The Philip Lief Group