Parkinson’s Disease Often Affects Eating: How to Time Medication and Adapt Meals
Written by: 増田 翼 (Registered Nurse)
Parkinson’s disease is a progressive illness in which body movement gradually worsens as levels of dopamine, a neurotransmitter produced in a specific part of the brain, decline. The main symptoms include:
Stiff movements
A shuffling walk with small steps
Trembling hands
A tendency to fall
Apart from these changes in movement, disorders of the autonomic nervous system also appear, bringing various changes such as constipation, low blood pressure and depression.
Treating Parkinson’s disease
Treatment is based on medication that makes up for the missing dopamine (antiparkinsonian drugs). This makes the body easier to move and can relieve symptoms.
However, if these drugs act too strongly, symptoms such as involuntary movements (dyskinesia) can appear, so it is important to take the medication exactly as the doctor directs.
And because the disease progresses gradually, it cannot be completely cured. The aim is to slow the progression of symptoms with medication while keeping the limitations the disease places on daily life to a minimum.
Disease progression and eating
At first, symptoms such as trembling appear in one part of the body (a hand or a leg on one side). Symptoms then gradually spread: to the other limb on the same side, then to the hand on the other side, then to the leg on the other side.
Gradually, falls become more frequent, the person comes to rely on a wheelchair, and they may eventually become bedridden.
Many of the causes of death among people with Parkinson’s disease, such as pneumonia, choking and malnutrition, are related to eating. That is why enjoying meals safely is so important if people with Parkinson’s are to live well with the disabilities they have.
Visible disability doesn’t match eating ability
Eating problems caused by Parkinson’s disease can appear regardless of this progression. Even people who have no trouble walking and appear to live independently may have severely impaired eating function.
Conversely, some people who are bedridden can still eat by mouth without problems. Don’t be misled by how disabled someone appears; it is important to have a professional assess whether they can eat.
Eating problems in Parkinson’s disease
Trembling hands and stiff muscles can make it difficult to bring food to the mouth, so the person may need help. It also becomes hard to maintain posture; for example, the body may lean to one side during meals.
And because stiffness affects muscles throughout the body, when the muscles around the mouth and the tongue also stiffen, chewing solid food becomes difficult. As a result, crumbly foods that don’t hold together in the mouth feel hard to eat.
The throat muscles likewise move less well, so swallowing strength declines too. Then aspiration occurs: food enters the windpipe instead of the esophagus, its proper passage.
In a healthy person, food that enters the windpipe triggers coughing to expel it. The frightening thing about Parkinson’s disease, however, is that many people with it don’t readily cough. Even when they do cough, the cough may be too weak to clear the food from the windpipe, and aspiration pneumonia can result.
Measures for eating safely
Eat while the medication is working
The first measure is to treat the Parkinson’s disease properly. Besides tablets, antiparkinsonian drugs also come in other forms such as skin patches. The medication is adjusted to suit each person in consultation with the attending physician.
Parkinson’s disease also comes in waves, with times when the person can move and times when they can’t. Movement is especially poor when the medication has worn off and dopamine levels are low. So taking antiparkinsonian medication 30 minutes to 1 hour before a meal makes it easier to move during the meal.
Always consult the attending physician and other professionals such as nurses and pharmacists before changing when medication is taken. Lack of sleep and fatigue also make movement feel harder, so getting enough rest is important too.
Choose soft foods that hold together
It depends on how far the disease has progressed, but if food spills from the mouth or stays in it, soft foods that hold together well are a good choice. Be careful: finely chopping food so that it needs no chewing actually backfires. If you do chop food, pouring a thickened sauce over it helps it hold together and makes swallowing smoother.
Support posture, and loosen the neck and shoulders
If the person’s posture slumps during meals, support the body with cushions, bath towels and the like.
When the whole body stiffens, the neck stiffens too and can become fixed looking down or looking up. Stretching the neck and shoulders regularly helps prevent this, and also helps the person cough firmly and strongly when food goes down the wrong way.
Enjoy eating with the help of professionals
Parkinson’s disease gradually stiffens the body, but it can be controlled to some extent with medication.
One of the patients I regularly care for is a woman in her 90s. She developed Parkinson’s disease many years ago and is now bedridden, but she still eats the foods she loves and enjoys life.
I hope that, by adjusting medication in consultation with professionals, people with Parkinson’s will continue to enjoy eating by mouth.
About the author: 増田 翼 (Registered Nurse)
This article is a contribution from a medical or care professional, re-edited by our editorial team. It provides general information as of the time of writing, and symptoms and circumstances differ from person to person. For specific decisions, please consult your doctor, dentist, pharmacist or another professional.
This is an English translation of a column originally published in Japanese by Next Co., Ltd.
About Next Co., Ltd. We are a Tokyo-based company working in Japan’s senior care and end-of-life planning field. Alongside these expert columns, we publish professional training textbooks and support businesses entering Japan’s eldercare market. More expert columns | Our English textbook | Contact us
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