ABSTRACT: Parkinson disease (PD) is a progressive neurological condition, usually occurring among older individuals. Along with increasing handicaps in daily life, patients with PD also face problems with psychosocial adjustment. This study explored the experiences of older Taiwanese individuals at different stages of PD. Qualitative design with in-depth interviews was conducted with participants being treated at the neurology outpatient department in a teaching hospital in northern Taiwan. The study included nine men and six women, aged 65–80 years, with PD at stages 1–4. Comparative analysis of the interviews revealed four themes: ignorance of symptoms, loss of control, gradual deterioration, and a deep sense of helplessness. In stage 1, symptoms were not significant at the onset of PD. For most participants, others first detected the symptoms, rather than themselves. During stage 2, although they could still care for themselves, they became very anxious when the effects of medication disappeared and their reactions slowed before they took the next dose. During stage 3, the physical capacity of the body decreased gradually and affected the patient’s participation in social activities. In stage 4, older patients gradually became dependent on others in their daily lives. They were upset and worried that the symptoms would worsen and make them become a burden for their children. By understanding the perceptions of elderly patients at different stages of PD, this study has organized the key care requirements into four stages. These include the following: (1) provide more information on the disease in stage 1, (2) increase guidance on regular medication usage and establish a support system in stage 2, (3) highlight the importance of a safe living environment and encourage participation in support groups in stage 3, and (4) assist patients to find the meaning of life and value of existence in stage 4.
Ying-Chun Liao, MSc RN, is a Head Nurse, Department of Nursing, Chang Gung Memorial Hospital, Taipei, Taiwan.
Yih-Ru Wu, MD, is a Neurologist and Professor, Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Lee-Ing Tsao, DNS RN, is a Professor and Dean, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Questions or comments about this article may be directed to Hung-Ru Lin, RN PhD, at firstname.lastname@example.org. She is an Associate Professor and Director, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
The authors have no funding or conflicts of interest to disclose.