A Detailed Case Study of Parkinson’s Disease with Emphasis on Comprehensive Nursing Care

 

Chikku S

Associate Professor, Medical Surgical Nursing Department, Holycross College of Nursing,

Kottiyam, Kerala, India.

*Corresponding Author E-mail: daschikku826@gmail.com

 

ABSTRACT:

Background: Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disorder characterized by motor and non-motor symptoms resulting from degeneration of dopaminergic neurons in the substantia nigra. The disease significantly affects functional independence and quality of life. Case Presentation: A 62-year-old male presented with progressive tremors, rigidity, bradykinesia, postural instability, and difficulty in performing activities of daily living for four years. Clinical evaluation and neuroimaging supported the diagnosis of Parkinson’s disease. Management: The patient received pharmacological therapy along with multidisciplinary supportive care. Nursing management focused on mobility enhancement, fall prevention, medication adherence, nutritional support, bowel and bladder care, communication assistance, and psychosocial counselling. Conclusion: Parkinson’s disease leads to progressive disability and psychosocial challenges. Early diagnosis and comprehensive nursing care are crucial in minimizing complications, promoting functional independence, and improving quality of life.

 

KEYWORDS: Parkinson’s disease, Neurodegenerative disorder, Nursing management, Movement disorder, Case study.

 

 

INTRODUCTION:

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease and primarily affects older adults. It results from progressive loss of dopaminergic neurons in the substantia nigra pars compacta, leading to dopamine deficiency in the basal ganglia1.

 

 

Clinically, PD is characterized by cardinal motor features including resting tremor, rigidity, bradykinesia, and postural instability, along with non-motor symptoms such as depression, cognitive impairment, autonomic dysfunction, sleep disturbances, and constipation2.

 

Although no curative treatment exists, appropriate medical therapy combined with comprehensive nursing care plays a vital role in symptom control and maintenance of functional ability.

 

Case Presentation:

Patient Information:

A 62-year-old male was admitted to the neurology ward with complaints of progressive slowness of movements, tremors of both hands, stiffness, and frequent falls for the past four years.

 

Past Medical and Family History:

·       History of hypertension for 10 years, on regular medication

·       No family history of Parkinson’s disease

·       No history of head injury or exposure to neurotoxins

 

Clinical Examination and General Condition:

The patient was conscious, oriented, and cooperative. He required assistance for ambulation and self-care activities.

·       Speech: Low-volume, monotonous speech (hypophonia)

·       Facial expression: Mask-like facies

·       Gait: Shuffling gait with reduced arm swing

·       Posture: Stooped posture

·       Nutrition: Reduced appetite with mild weight loss

 

Neurological Examination:

Motor system:

·       Resting pill-rolling tremor in both hands

·       Cogwheel rigidity in upper and lower limbs

·       Bradykinesia evident during finger tapping

Reflexes: Normal

Sensory system: Intact

Cognition: Mild impairment in attention and executive functions

 

Diagnostic Assessment:

·       Routine blood investigations: Within normal limits

·       MRI brain: No structural abnormalities

·       Clinical diagnosis based on UK Parkinson’s Disease Society Brain Bank criteria1,3

 

Differential Diagnosis:

·       Essential tremor

·       Drug-induced parkinsonism

·       Progressive supranuclear palsy

·       Multiple system atrophy

 

Therapeutic Intervention:

Medical Management:

·       Levodopa–carbidopa therapy initiated

·       Dopamine agonists added for symptom control

·       Anticholinergic agents for tremor

·       Management of constipation and sleep disturbances⁴

 

Nursing Management:

Identified Nursing Diagnoses:

·       Impaired physical mobility related to rigidity and bradykinesia.

·       Risk for falls related to postural instability.

·       Self-care deficit related to motor dysfunction.

·       Impaired verbal communication related to hypophonia.

·       Imbalanced nutrition less than body requirements.

·       Constipation related to autonomic dysfunction.

 

Nursing Interventions:

·       Assisted ambulation and use of mobility aids.

·       Fall-prevention strategies and environmental safety modifications.

·       Medication administration at scheduled times to optimize motor function.5

·       Encouragement of small, frequent meals with adequate fiber intake.

·       Speech therapy referral and communication aids.

·       Range-of-motion exercises and physiotherapy.

·       Education and counselling for patient and caregivers regarding disease progression.6,7

 

Outcome and Follow-Up:

The patient demonstrated moderate improvement in motor symptoms with pharmacological therapy. However, disease progression continued gradually. Regular follow-up was planned with neurology, physiotherapy, and nursing services. The family was counselled regarding long-term care needs and coping strategies.

 

DISCUSSION:

Parkinson’s disease is a slowly progressive disorder with a wide spectrum of motor and non-motor manifestations. Early recognition of symptoms and initiation of therapy can significantly improve functional outcomes³.
Nursing care plays a central role in managing daily activities, preventing complications such as falls and malnutrition, and addressing psychological issues including depression and caregiver stress6,8. Continuous education and emotional support are essential components of holistic care.

 

DECLARATIONS:

PATIENT CONSENT: Informed consent for anonymized publication should be obtained from the patient surrogate/legally authorized representative prior to submission.

 

ETHICAL CONSIDERATIONS:

Institutional ethical approval may be exempt for a single anonymized case report depending on local policy; authors should verify institutional requirements.

 

CONFLICT OF INTEREST:

None declared.

 

CONCLUSION:

This case study highlights the chronic and progressive nature of Parkinson’s disease and the essential role of comprehensive nursing care. Through coordinated multidisciplinary management, nurses contribute significantly to symptom control, complication prevention, and enhancement of quality of life in individuals with Parkinson’s disease.

 

REFERENCES:

1.      Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015; 386(9996): 896–912.

2.      Poewe W, Seppi K, Tanner CM, et al. Parkinson disease. Nat Rev Dis Primers. 2017; 3: 17013.

3.      Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015; 30(12): 1591–601.

4.      Fox SH, Katzenschlager R, Lim SY, et al. International Parkinson and movement disorder society evidence-based medicine review. Mov Disord. 2018; 33(8): 1248–66.

5.      Olanow CW, Stocchi F. Levodopa: a new look at an old friend. Mov Disord. 2018; 33(6): 859–66.

6.      MacMahon DG, Thomas S. Practical approach to quality of life in Parkinson’s disease. J Neurol. 1998; 245(Suppl 1):  S19–22.

7.      National Institute for Health and Care Excellence. Parkinson’s disease in adults. NICE guideline NG71. London; 2017.

8.      World Health Organization. Neurological disorders: public health challenges. Geneva: WHO; 2006.

 

 

 

Received on 22.06.2026         Revised on 06.07.2026

Accepted on 19.07.2026         Published on 05.08.2026

Available online from August 10, 2026

A and V Pub Int. J. of Nursing and Med. Res. 2026; 5(3):126-128.

DOI: 10.52711/ijnmr.2026.27

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