Optimizing care of residents with Parkinsonism in supervised facilities

Makoutonina, Margarita; Iansek, Robert; Simpson, Pam

doi:10.1016/j.parkreldis.2010.02.010

« Previous Next »Parkinsonism & Related Disorders
Volume 16, Issue 5 , Pages 351-355, June 2010

Optimizing care of residents with Parkinsonism in supervised facilities☆

Margarita Makoutonina
- Elsternwick Private Hospital, Melbourne, Victoria, Australia
- National Parkinson Foundation Center of Excellence, Melbourne, Victoria, Australia
Robert Iansek
- Elsternwick Private Hospital, Melbourne, Victoria, Australia
- Clinical Research Centre for Movement Disorders and Gait, Kingston Centre, Warrigal Road, Cheltenham, Victoria, Australia
- National Parkinson Foundation Center of Excellence, Melbourne, Victoria, Australia
- Corresponding author. Clinical Research Centre for Movement Disorders and Gait, Kingston Centre, Warrigal Road, Cheltenham, Victoria, Australia. Tel.: +61 0 3 9265 1393; fax: +61 0 3 9265 1577.
Pam Simpson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia

Received 24 November 2009; received in revised form 20 February 2010; accepted 22 February 2010.

Abstract

People with Parkinsonism (PWP) in residential facilities are usually elderly, cognitively impaired, physically disabled with poor quality of life and a high mortality rate. This paper aims to determine if the care of PWP in residential facilities could be improved by addressing staff knowledge on Parkinson related issues. A curriculum based on the Victorian Comprehensive Parkinson Program (VCPP) was developed and delivered to 118 staff members in 9 facilities across Melbourne. Measures of staff knowledge were undertaken at baseline, 1, 3 and 12 months. Data from a total of 49 residents were used in the analysis. Measures were taken at baseline, 1, 3 and 12 months included dementia screen (MMSE), geriatric depression scale (GDS), quality of life (PDQ39), fatigue (PDFS16), monthly falls diary, Unified Parkinson Disease Rating Scale (I,II,III) Hoehn & Yahr scale (H&Y) and resident/family questionnaire (RFQ) which focused on quality of care provision. It was found that the staff knowledge assessment scores (max = 37) significantly improved post education (P < 0.01) from baseline mean (11.1) and were maintained to 12 months mean (29.0). The residents group improved significantly for all measures at 1 month and these improvements were maintained up to 12 months (except for UPDRS III). This study demonstrated how a simple intervention, resulting in improved staff knowledge, produced a significant and clinically meaningful improvement in the care of PWP.

Keywords: Parkinson's disease, Residential facility, Improved care, Staff education