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A Landscape for Persons with Parkinson’s Disease Anthony W. Eichenlaub 19 April 2006 Introduction Parkinson’s Disease Therapies The Client A Therapeutic Landscape Persons with Parkinson’s Non-discrimination Social Racial Gender Older Population Most aged 65 or older 15% 55 years or younger Parkinson’s Disease Degenerative disorder of the brain Brain stops producing dopamine Symptoms Slowness Rigidity Tremors Treatment Options Medication/Surgery Physical therapy Psychological treatment Treatment Options Common Drug Types Levodopa preparations COMT Inhibitors Dopamine agnosts Amantadine Anticholinergic Selegiline preperations Treat the disease Alleviate symptoms Common Treatments - Drugs Common Drug Side Effects 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 Brain lesioning Damages parts of the brain that are overactive Deep brain stimulation Electrodes stimulate parts of the brain to give the patient better control Common Treatments Physical Therapy Education Lifestyle changes Arranging furniture Using tools to offset physical disability Actual Physical Work Walking Weight Training Body Weight Supported Treadmill Training Common Treatments Psychological Treatment Mental health Depression Stress Spiritual health The Client Rochester Parkinson Center Focus on persons with Parkinson’s Residents with advanced cases Outpatient care for newly diagnosed cases Full range of physical therapy and treatment options The Client 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 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 Adapt the landscape for safety and convenience 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 Integrate Physical Therapy into the Landscape 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 Handrails snap easily into various points in the landscape When removed these areas are useful in other ways 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 Provide areas for education and training Small 3-4 seat secluded areas One area to seat 8-10 people Movable benches for added flexibility Landscape as a Treatment Provide a serene, peaceful environment 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 Entertainment options Table with games Scrabble Large playing cards Crossword puzzels Sound system Provide music programming throughout the landscape Provide books on tape or other audio entertainment Large buttons for easy use A variety of programming is available Measuring 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 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