Patient discussions

Include the patient in judgments and choices about their care. Discuss the benefits and risks of treatments with each patient based on their disease characteristics, including the option of not starting treatment straight away ("watch and wait") for patients with mild PD symptoms that are not causing disability.

Provide information about the disease course and prognosis to patients and their families in a sensitive manner.[99] Engage patients and their families in advance care planning before the onset of cognitive impairment.[172]

Advise patients to take medications as instructed, at regular intervals on a regimented schedule. For example, levodopa should be taken 1 hour before or 2 hours after eating food containing protein to maximize efficacy.

Explain to patients and their caregivers that:

  • If postural instability exists, activities requiring good balance should be avoided

  • Patients should consider not driving if symptoms are severe or any cognitive deficits exist

  • Regular exercise is beneficial (this can include progressive resistance exercise such as weightlifting, endurance exercise, balance training, activities such as Tai Chi and dance, or water-based therapy)

  • A symptom diary may assist in treating complications

  • Joining a local support group may be of benefit.

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