Adapting to Change

09/23/2010

Adapting to Parkinson’s and the Change it Brings

It is known that life satisfaction or happiness can still be strong even in the later stages of Parkinson’s. How we adapt to change and the steps we take to adjust to change are important to feeling well when faced with a diagnosis such as Parkinson’s.

Just as there are stages of Parkinson’s disease, there are stages of adjustment or coping that one goes through. People progress through different reactionary stages leading to different levels or adjustment or adaptation when dealing with physical health changes. Some liken these stages to the stages of grief defined by Kubler-Ross. These stages (a modified version in the spirit of change) are: might apply to a person with Parkinson’s:

1. Denial.

2. Anger.

3. Fear.

4. Depression or Setbacks.

5. Acceptance and Adaptation.

Not everyone experiences every stage nor do people progress from stage one than two and so on. Although living with Parkinson’s is more complex that these simple stages they do high light an interesting point. Just as Parkinson’s changes, so does our reaction to these changes. The important thing is that we have, to some degree, a choice as to how we adapt to and live with Parkinson’s. These reactions or stages can be as different as the people who have the disease. Some of the reactions may lead to a more comfortable acceptance while others may make it difficult to move on. Examples of different reactions at different stages are illustrated below.

Stage	Response	Response
Denial	I’ll ignore my symptoms and they will go away	I’ll seek help from my doctor and others
Anger	This is not fair, why did it happen to me?	I’ll try and focus on what I have and my own inner strength
Fear	I am so worried about my future	I am worried but I’ll make plans for the future so that I am in control even with changes
Setbacks	I’m getting worse, it’s hopeless.	I’ll work on the things that I know I can improve
Acceptance	I’ll never get better.	I can get better with treatment, and with support adjust to the ups and downs that come with this condition and the things I cannot fix.

The following steps that help many adjust and cope to change are based on experiences of PWP and lessons I have learned when listening to the many patients I treat with Parkinson’s daily.

Be Aware. Knowledge helps you anticipate, prepare for, fight off or reduce the impact of change. Learn your condition, symptoms and treatment. Understand how the disease affects you, options available for treatment and expectations for change, side effects, etc. Be aware of things that you can do to help reduce or delay problems with balance, posture, speech or other symptoms.

Remain in Control. It may be hard to feel in control when you are worried about change. One way to stay in control is to get a clear idea of what you can do to feel better. The comprehensive care worksheet is just one tool that highlights the many specialists that can help. Life planning workshops exist and may be available in your community.

Set realistic goals.

Know what you can change or improve and take active steps to work on that. For example, this may mean an exercise program focused on physical strength, balance and stamina if walking is difficult.

Know what you cannot change and make adjustments to live well and in your best interest even with these problems. If balance is causing many falls and you can barely get around, a walker can give new independence letting you walk with confidence and do much more.

Know Yourself. We all have unique personalities. Some of us our optimists. Others are pessimists. If you know that you are a glass half empty kind of person take note. This is neither good nor bad simply something to be aware of. Something to be aware of so that you can ‘catch’ yourself when you are in the middle of negative or defeating thoughts. Lear more about the power of positivity.

Treat depression. Depression is treatable. Depression can be a symptom of Parkinson’s, a long-term problem, reaction to life changes or a combination. Depression changes how you feel and perceive your symptoms just as sunglasses change how you see the world. Treating depression will help you stay active and engaged in your care. Both medication and counseling can be helpful. Cognitive behavioral therapy helps people work through the negative thoughts that can intrude into our daily life.

Think Positively. This is not really a separate theme but really one that is interwoven in all the others. Cognitive behavioral therapy, positive self- talk and simply being around happy people can make a difference. Have you ever heard the saying laughter is contagious?

Gather Support. Reach out to family friends and others with Parkinson’s to get support and give support. This is important whether you have Parkinson’s or a loved one does. It may be comforting to know you are not alone, that others have been where you are now and may even have found a solution or adaptation to the problem. Support groups are one way to get support.

Gather your Resources. Know what is available in your community. Is there a community center, spiritual program, financial assistance programs or friendly neighbor or other resource that you can draw on?

Reset your Priorities. Are the things that were important to you a decade ago the same now? Have relationships or your life values grown and matured along with you. This can help you see the positive in the negative. See Reinvent the Wheel for more information.

Establish a Legacy. This is done by living compassionately- staying true to your values (life’s meaning), sharing, supporting or lending a hand to others, volunteering and connecting with others.

Author: Monique Giroux, MD

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