Parkinson's Disease
Case Study:
Paul's Life with Parkinson's
Patient Name: Paul P.
Age: 72
Symptoms: Bradykinesia, resting tremor, rigid muscle tone, impaired balance and coordination, diminished facial expressions, soft and slurred speech, impaired swallowing.
Diagnosis: Parkinson's Disease
Therapy Setting: Paul is seen by a home health Physical Therapist and Speech Therapist along with weekly nursing services.
Primary Caregiver: Paul's wife and daughter are actively involved in his care.
Communication: Paul's had been coping well with his health at home until he took a fall down the stairs about 6 months ago. At that time, Paul refused home health services. He was recently seen at home after a 5-day hospitalization due to pneumonuia, which was likely caused from aspiration. Paul's function had significantly deteriorated until his recent hospitalization. Paul is now home and is being seen by a Speech Therapist, Physical Therapist, and nursing services. Paul's communication has been affected due to his condition. His speech is simplified, but still functional for his daily communication needs. His volume is an issue and his voice is not always loud enough to be heard. His articulatory precision is diminished, but adequate enough when he can be heard by the listener. Paul's swallowing evaluation revealed extensive lingual pumping, poor tongue base retraction, mildly delayed trigger of the swallowing reflex, and frequent gurgling after the consumption of fluids due to diminshed pharyngeal sensations.
Concerns: Paul's healthcare team is concerned with poor intelligibility due to limited volume, inefficient oral propulsion, mildly delayed swallowing reflex, and pharyngeal residue secondary to diminished sensation.