PARKINSON ASSOCIATION OF NORTHERN CALIFORNIA
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Multidisciplinary Care for Parkinson’s Disease
by Norika Malhado-Chang, MD, Associate Professor of Neurology, UC Davis School of Medicine


​One important aspect of Parkinson’s Disease (PD) that sets it apart from other conditions is its complexity. Twenty years ago, PD was purely considered a “movement disorder,” resulting in symptoms affecting mobility, such as stiffness, slowness, and difficulty walking.  Now, we know that only scratches the surface! In addition to motor symptoms, PD involves an array of non-motor symptoms like constipation, sleep disturbance, depression, anxiety, cognitive impairment, and trouble with speech and swallowing to name a few.  Therefore, it really makes sense to approach this from a multidisciplinary care perspective.
 
​What does multidisciplinary care entail? It is a model of healthcare that harnesses the expertise of a variety of specialists to provide truly comprehensive care for the whole person. Fifty years ago, a patient would have all their medical issues managed by their primary care physician. As the medical field has evolved, we have subspecialists trained in a variety of diseases to provide expert care in a certain area. Within the realm of Parkinson’s, we should capitalize on the talents and skills of others in the healthcare field by employing a “team” approach. If I were to recruit an all-star team for PD, it would include:

1. Parkinson’s Neurologist (may include a Movement Disorders Fellow and a Nurse Practitioner)
 
2. Neuro Physical Therapist (unlike most PT’s who are orthopedics-focused, Neuro PT’s have special training in neurologic conditions, like PD. They may even have certification in LSVT BIG or PWR-Parkinson’s Wellness Recovery)
 
3. Speech / Swallow Therapist (some specialize in PD, with certification in LSVT LOUD to help with both voice and swallowing)
 
4. Psychiatrist or Geri-psychiatrist (doctors who are experts in depression, anxiety, and psychosis)
 
5. Psychologist or counselor (both for the person with PD and the spouse)
 
6. Social Worker (An MSW provides valuable information about community resources, caregiver assistance, medication financial assistance programs, etc)
 
7. Occupational therapist (OT’s help with hand and finger dexterity, specialized utensils, and assistive devices for getting around)
 
8. Personal Trainer
 
9. Gastroenterologist and/or urologist (constipation and bladder dysfunction can become challenging and require a specialized approach)
 
10. Dietician or Nutritionist (Maintaining proper nutrition while optimizing the effect of one’s medications can be a tough balancing act, and nutritionists can be quitehelpful in this regard)
 
11. Palliative care specialist

12. Financial planner
 
This may look like a fantasy sports team line-up, but this is the future of Parkinson’s care. The days when you saw a neurologist alone will be gone, and the “clinic of the future” will have all these specialists in one place to help you from all different angles.  For the time being, getting all these specialists in the same place, at the same time, is a challenge (but we’re working on it!).  So, for now, each person should assume the role of Team Manager and look to recruit these specialists to work in their corner.  With a condition as complex as Parkinson’s, enlisting the help of professionals across this spectrum ensures a holistic and comprehensive approach that, in all likelihood, might slow the complications of PD or even slow progression of the disease. This, in turn, will help you stay proactive and live your best life with Parkinson’s.
Parkinson Path Spring 2019

COVID-19: There is still limited information about the effects of COVID-19 specifically regarding Parkinson’s disease, having said that, given the frailty associated with Parkinson’s disease, it would be prudent to be cautious, prepared and follow the precautions recommended by public health departments/ CDC.   During these challenging times, it cannot be emphasized enough the need for all, PD community specifically and the
​community at large, to reach out to each other, offer support and assistance to those most vulnerable and share our resources.

​Our Mission

​​The Parkinson Association of Northern California is an organization dedicated to enhancing the lives of people with Parkinson's, their families, and care partners throughout our region. 

La Asociación de Parkinson del Norte de California se dedica a mejorar la vida de las personas con Parkinson, sus familias y los compañeros de cuidado. 

​Contacts

Email: panc@panctoday.org
Mailing Address:
Parkinson Association of Northern California
1024 Iron Point Road, #1046
​Folsom, CA 95630


Phone: (916) 357-6641
If you'd like more information please call the office 
(hours vary, so leave a message and we'll get back to you)
Para realizar una llamada a través de California Relay,
​sólo tiene que llamar al número de teléfono siguiente sin cargo: 

Español: 1-800-855-3000 
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Copyright © 2020 Parkinson Association of Northern California. All rights reserved.
​PANC is a 501(c)(3)   Tax ID #68-0372037
  • PANC Home
  • About Us
    • Staff
    • Board of Directors
    • Medical Advisory Panel
    • Privacy Policy
    • Annual Report & 990's
  • Contact Us
  • About Parkinson's
    • COVID-19 Resources
    • Recently Diagnosed
    • PD Carepartners
    • Clinical Trials
    • Exercise!
    • Helpful Resources
    • PD Webinars & Classes
    • Guide to Specialist
    • Summer Heat and PD
    • Local Transportation Information
    • Reflections from the Parkinson's Community
    • Articles
  • Español
    • Sobre PANC
    • Clases y recursos
  • Ways to Support
    • Donate Online
    • Donate by Mail or Phone
    • Sponsorships
    • CAREPARTNER RESPITE SUPPORT
    • Be A Sustaining Donor
    • Planned Giving
    • AmazonSmile
    • Become a Support Group Facilitator
    • Other Ways to Give
  • Programs/Support Groups
    • Support Groups
    • Respite Care
    • Parkinsonwise
    • Parkinsonwise Trained Professionals
    • Rebuilding Together
    • Other PD Support Groups in CA
    • Shelter in Place Info series
    • Past Conference videos/info >
      • CA PD Registry 9/20 Conference Video
      • 2019 Videos
      • 2017 Conference Video
      • 2021 Conference
  • Newsletter
  • Other PD classes/events
    • Brian Grant Foundation May 2022 Classes
    • Davis Phinney Foundation 5/17 Medical Myths, 5/19 YOPD Council, 5/25 Trans/non-Binanry PwP, 6/24 Motor Symptoms
    • Family Caregiver Alliance Webinairs - May 2022
    • Michael J Fox Foundation 5/19/22 Understanding PD Genetics, Podcast Sex, Sleep Intimacy, PD IQ & You (on demand)
    • Parkinson 's Foundation Webinars, zoom mtgs
    • Parkinson Voice Project - Speech exercises Daily 8 AM Info session 2nd Tu
    • Shining Care-Redding CA Lunch and Learn events
    • PD Active 5/14 Annual Info Fair and Spring Gathering, 6/11 Speaker Forum, Brain Training class Zoom Calendar of exercise, dance, singing & speech classes
    • PMD Alliance May & Jun Classes
    • World Parkinson Coalition 2022 Research spotlight 5/25, 7/12, 9/13, 11/15/22 Sing-A-Long 6/8/22
  • PANC Events
    • Save the Date 8/19 & 20/2022 SG Facilitator Workshop
    • Save the Date 10/22/22 PANC Annual Education Conference
  • DONATE