Our expert says:
I know, from personal experience, that directly caring for someone who has lost bowel and bladder function is enormously exhausting, and can only work if based on really major love for the individual. Dealing with adult nappies is really hard work, especially if the person doesn't fully understand what's going on ; and often along with incontinence, they lose the sense of when they need to empty bowels or bladder, and of whether they have done so. It gets very complex.
Maybe it'd be wise to consult with a good local Geriatrician, who can review the whole picture and consider whether anything can be done to improve that situation, and whether there is a good local home which could provide quality care.
YOu need a good diagnosis of his mental state, too, and his prognosis - outlook in terms of likely duration of life. The Parkinsons may be opnly a part of a more general dementia.
Treatment is difficult and controversial. Some of the drugs most helpful in reducing the confusion and agitation which can make their lives, and the lives of their carers, so awful, have been shown to increase the risk of heart attacks and strokes. Personally, I feel this is often acceptable, as the relief these drugs provide all round can be dramatic, and the risk of both those complications is already high in such people. I have preferred using Risperidone ( now available in a generic form, also, but I think the original Risperdal is the only one ( last time I heard ) which is available in a liquid form. That can be most valuable, both because it can be added to coffee or juice ( not to tea, which damages the drug ) which is espeially helpful in someone who doesn't swallow pills easily ( and the pills are rather small and awkward ) ; and it is easy to titrate, to very delicately vary the dose according to the effect needed. It is usually noticeably effective in around 10 minutes.
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