The physical act of consuming nourishment, which becomes difficult for people with Parkinson’s as the disease progresses to involve the muscles of the mouth and throat, making chewing and swallowing difficult. As anti-parkinson’s medications become less effective in controlling symptoms in the later stages of Parkinson’s, most people need assistance with eating and drinking. if the muscles of the mouth and throat are severely affected, it often becomes necessary to decide whether to provide nutritional support through a feeding tube. As well, the person’s tastes and food preferences often change as Parkinson’s progresses, and those changes may limit what the person is willing to eat. Certain kinds of foods affect the efficacy of anti-parkinson’s medications, sometimes making it necessary to change the diet when medication regimens change.
Rremors and bradykinesia (slowed movements) affect fine motor control, limiting the ability to hold and use eating utensils. As a result, mealtimes can be messy events that are frustrating and embarrassing to the person with Parkinson’s. Problems with chewing and swallowing are common in mid to late Parkinson’s. rigidity and dyskinesias affecting the muscles of the face, mouth, tongue, and throat can create difficulty keeping food in the mouth. People experiencing dry mouth as a side effect of anticholinergic medications may not produce enough saliva to moisten food adequately as they are chewing it; the result is a potentially serious choking hazard when they swallow. Even small quantities or pieces of food can become stuck in the throat when saliva is in short supply. some people can overcome these problems for a time by taking a drink before putting food into the mouth and by consciously focusing effort on the functions of chewing and swallowing. It is a good idea for family members, caregivers, and others who share meals with the person with Parkinson’s to know how to do the heimlich maneuver, a technique for quickly dislodging pieces of food that become stuck in the airway.
Impaired intestinal mobility (slowed peristalsis), a consequence of bradykinesia that affects the smooth muscle tissues of the intestinal tract, causes the digestive system to function much more slowly than normal, with resulting intestinal discomfort and constipation. Some of the anti-Parkinson’s medications, particularly anticholinergics, can exacerbate this problem. Drinking plenty of fluids and walking can help reduce the severity of constipation but are not always easy in the later stages of Parkinson’s, in which gait disturbances and neu-romuscular symptoms make movement difficult. Dehydration is a serious concern for many people with Parkinson’s, as drinking becomes as difficult as eating.
Helping the person with Parkinson’s to eat nutritiously balanced meals is both important and challenging. The need to accept help with eating represents a significant loss of independence and can create much distress. Caregivers and family members can make the process easier by doing as much as possible to support the functions and abilities the person with Parkinson’s still has. Support can include providing utensils with oversized handles, plates with distinct edges or compartments, and lidded drinking cups with straws and choosing foods that can be cut before serving to make putting the pieces onto a fork or spoon easier.
Challenges of eating often prevent people with Parkinson’s from socializing by eating out with family and friends. Many of the same approaches that work at home are useful in restaurants. order food items that are already bite-size when possible. if it is necessary to cut the person’s food, do so discreetly, such as in the guise of sampling. Straws can make drinking easier. Having extra napkins handy makes it possible to clean up any spills quickly and without drawing attention to them. As with many of Parkinson’s symptoms, maintaining a sense of humor and compassion about the situations those symptoms can create is often helpful.
