A Landscape for Persons with Parkinson’s Disease Anthony W. Eichenlaub 19 April 2006.

A Landscape for Persons with Parkinson’s Disease

Anthony W. Eichenlaub19 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_articles/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