Role of the community nurse in Parkinson's disease and lower urinary disorders
Parkinson's disease (PD) is an incurable and progressive neurodegenerative disorder. People with PD also have increased muscle weakness and the typical symptoms of tremor, stiffness, slowness, balance problems and/or gait disorders. Other symptoms may include an overactive bladder, urgency and nocturia which can often lead to incontinence. Treatment options vary are dependent on the cause of the incontinence and should focus on improving Quality of life with a multi-pronged diagnosis-specific approach that takes into consideration a patient's ability to comply with treatment. The article looks at the role of the community nurse in caring for patients with PD and lower urinary disorders. They have a key role in assessment of patients and supporting families with tailor made bladder training such as establish a regular toilet routine, education about pelvic floor exercises or supply of incontinence products.
Parkinson's disease is the second most common neurodegenerative disorder in the UK (Worth, 2013). It is an incurable and progressive disease, although the rate of progression can vary from patient to patient (Worth, 2013). People with Parkinson's disease also have increased muscle weakness and the typical symptoms of tremor, stiffness, slowness, balance problems and/or gait disorders (National Institute for Health and Care Excellence (NICE), 2017). Other symptoms may include an overactive bladder, urgency and nocturia in Parkinsonism, due to the role of dopaminergic mechanisms and its function in maintaining normal bladder control (Sakakibara et al, 2012). Certainly, autonomic dysfunction, including orthostatic hypotension, sialorrhea, altered sexual function, urinary dysfunction and constipation, are common features of Parkinson's disease (Perez-Lloret et al, 2013). Some 80% of patients with Parkinson's disease also develop psychiatric problems, such as hallucinations and dementia, with a reduction in life expectancy (Hobson et al, 2010).
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