A Brief Case Study of a 68-Year-Old Woman With Three Month History of Frequent Falls at Home
Initially published by Illumination on Medium!
Parkinson's Disease is a slow, debilitating ailment. It affects almost 10% of the population over 80 years of age. Although it is commonly the problem that parallels aging, it does not spare the younger population. 1% of people over 65 and 0.4% over 40 suffer from "Parkinson's."
Mary is a 68-year-old retired farmer who lives alone in a rural community. She has had an active, independent life without any significant medical problems. Her husband passed away a year ago, and she has lived alone ever since.
Mary has never taken any medication over a short period or had a major surgical procedure. She has no allergies to anything and denies suffering from injuries. Nevertheless, she admits that her father died from a heart attack at 80.
During the last three months, Mary has fallen five times. Fortunately, she did not suffer significant injuries due to those incidents. More often than before, she feels lightheaded while trying to stand up. However, it has been taking her more than usual to do so.
She recalls friends and family recently expressing concerns about her demeanor change. Because they noticed a more forward-bearing gait as she seemed to be shuffling while walking at a languid pace. Furthermore, Mary has been having difficulty with sudden turning and reflexive movements.
As her symptoms have been persistent and interfering with her daily life activities, Mary shows up at the clinic for further evaluation.
When she walks into the exam room, doctor Jones, who has known her for many years, cannot help noticing the changes in Mary's appearance.
Dr. Jones sees a woman looking older than her age walking into the room slowly and coarsely as she totters forward. When she sits down, Doctor notices fine tremors in Mary's hands, just as she counts money with empty hands.
After getting insight into Mary's history, Dr. Jones performed a complete physical examination.
The examination reveals significant muscle rigidity and spasticity, heightened muscle reflexes, and some weakness in the lower legs. These findings are consistent with the diagnosis of Parkinson's Disease. However, Dr. Jones orders a CT scan of the Head and general blood tests, including blood toxicology and blood Lead level, to ensure possible reversible causes of Parkinson's Disease.
Mary being a retired farmer puts her at risk for potential pesticide exposure and Lead poisoning. Fortunately, all other findings turned out to be negative.
Dr. Jones discusses the finding with Mary as being related to Parkinson's. Based on that diagnosis, he started Mary on Carbidopa/ Levodopa and scheduled a follow-up visit in 2 to 3 weeks.
On the follow-up visit, Mary's symptoms and signs improved significantly, with minor episodes of relapse here and there.
Parkinson's Disease is a slowly progressive degenerative disorder of the brain. It may or may not be associated with dementia, which can be even more debilitating to Mary if it happens.
Parkinson's disorder can progress as it often does and may need more aggressive treatments. That includes surgical procedures.
Irrespective of the severity, people living with Parkinson like Mary, are at high risk of secondary complications, like full-blown rigidity and transient paralysis, and falls. Moreover, such events can have devastating consequences for patients like Mary, who live unaided.
Parkinson's has added an extra burden to the already demanding lifestyle of rural living. That is no surprise to an independent and vulnerable person like Mary. That necessitates a lifestyle adjustment, education, external support, and continual planning and execution of that aid.
At this stage, in addition to remote and on-site clinical support, Mary would benefit from the network of professionals available whenever and wherever. That is a Hybrid work and patient care model that extends real-time engagement to Parkinson's patients through their direct participation or the sensors they bear.
Furthermore, continual on-demand, secure independent collaboration between humans and medical device sensors allows patients like Mary to thrive at home. It creates a safe environment for Mary by ensuring the quality care she deserves.