Care for Alzheimer’s and Parkinson’s Patients – Lessons from the Field

Today, during an engaging clinical discussion at Centre for Interdisciplinary Studies on Ageing, MMF, with a group of intern nurses from Bibi Halima College of Nursing, one of the students asked an insightful question: “Sir, how do we provide effective nursing care to Parkinson’s patients at home?”

It wasn’t just a question—it was a mirror reflecting a deeply neglected area in home-based caregiving. Having closely worked with geriatric patients, and personally witnessing the lives of those silently battling Alzheimer’s Disease (AD) and Parkinson’s Disease (PD), I’ve come to realize: what most families and even many caregivers know about these conditions barely scratches the surface.

In the last few months, during my home visits under the community health program, I’ve encountered a rising tide of seniors living with AD and PD. While the diagnoses themselves are medical realities, the misconceptions, emotional neglect, and inconsistent care surrounding them are the real culprits causing distress—not just for the patients but for their families and caregivers too.

Misunderstanding AD and PD

Too often, Alzheimer’s patients are mistaken as ‘crazy’, their memory loss and disorientation dismissed as natural aging. In Parkinson’s cases, people focus on the tremors and fail to see the deeper struggle with mood, speech, and movement initiation. Both conditions are neurodegenerative, meaning they gradually rob individuals of their mental and physical faculties—but not their right to dignity.

What many don’t understand is that both AD and PD require a caregiving approach rooted not only in compassion but also in consistency, communication, and creativity. We must recognize that the unusual behaviors and movement difficulties seen in these patients are manifestations of the disease itself—not the person. It’s the illness speaking, not the elderly individual.

DOs for Alzheimer’s Patients (AD) care:

Establish a familiar environment: Place memory cues—family photos, large calendars, clocks, labeled drawers, and signs on doors. Familiarity calms anxiety. Routine brings comfort and security.

Speak in short, clear sentences: Use simple language. Give one instruction at a time. Allow time for them to process. Avoid giving too many choices at once.

Use the power of touch and tone: A calm voice, gentle touch, and reassuring eye contact can ease fear better than medication. Your presence matters more than your words.

Play memory music: Songs from their youth often tap into deep emotional memory. It can bring joy, calm aggression, and sometimes evoke speech in the late stages.

Offer choices, not commands: Say, “Would you like the blue sweater or the green one?” rather than “Wear this.” A sense of control preserves dignity.

Encourage safe independence: Let them brush their own hair or fold towels—even if imperfect. Purposeful tasks reduce frustration and increase self-worth.

Redirect, don’t argue: If they insist on a false memory or story, don’t correct—redirect. For example, “Let’s look at your photo album while we wait.”

Use memory boxes: Create a small personalized “treasure box” filled with tactile items, letters, or objects from their past to spark memory and reduce anxiety.

Prioritize hydration and nutrition subtly: Offer finger foods or colorful plates. Sometimes, verbal prompts work better when paired with visual cues like offering a water bottle or fruit bowl.

Monitor for non-verbal cues: Discomfort, pain, or sadness may show up as restlessness or aggression. Watch facial expressions and changes in routine behavior closely.

DON’Ts for Alzheimer’s Care:

• Don’t argue or correct harshly. They’re not lying; they’re confused.
• Don’t isolate them. Human presence, even silent, is therapeutic.
• Don’t change the environment abruptly.
• Don’t assume they can’t feel. Memory may fade, but emotion stays longer.

DOs for Parkinson’s Patients (PD) care: 

Honor the slowness: Let them take their time. Rushing only increases the risk of falls and frustration.

Simplify fine-motor tasks: Replace buttons with Velcro. Use wide-handled cups and weighted utensils.

Incorporate movement therapies: Chair yoga, guided walks, and even dance help with rigidity and mood.

Watch for “off” periods: Know when medication effect dips and offer extra support during those windows.

Encourage expressive outlets: Drawing, humming, or just rhythmic tapping—anything that keeps the mind and muscles engaged.

 DON’Ts for Parkinson’s Care:

• Don’t yank or pull them while walking. Offer your arm for support instead.
• Don’t assume tremor = weakness. Cognition can remain intact even with severe motor symptoms.
• Don’t ignore signs of depression. PD patients often suffer silently.
• Don’t neglect oral care—swallowing difficulties can lead to aspiration.

Unlearning to Relearn

What struck me most during my interaction with the nursing students was this: They wanted to know more than just procedures—they wanted to understand the patient’s world. And that is what caregiving must be—a conscious walk into someone else’s fading reality, not just managing symptoms but nurturing their soul.

Modern caregivers must shed the role of mere assistants. They must become emotion interpreters, routine designers, and adaptive companions.

Care Ideas

• Memory Garden: Create a small space with familiar plants, scents, and items from the past. A sensory anchor in a drifting world.
• Mirror Conversations: For patients losing speech, encourage miming in front of a mirror—it triggers self-recognition and often unexpected responses.
• ‘Story Circle’ Therapy: Sit with the patient and let them ‘tell’ stories—even if they’re mixed up. It isn’t about accuracy, it’s about connection.
• Movement Prompts for PD: Use clapping rhythms or a metronome to help initiate walking. The brain responds to beats even when it resists commands.

Caring is a Form of Advocacy

Both Alzheimer’s and Parkinson’s demand that we shift from reactive to proactive caregiving. Early interventions, safe spaces, emotional continuity, and respect for identity are essential. Caregivers—especially nurses—hold the key not only to extending life but enhancing its quality in its final chapters.

The question the student asked today should echo louder in our training rooms, clinics, and homes: “How do we care better?” And our answer must go beyond pills and precautions. It must begin and end with empathy, creativity and informed action.

Let us train not just hands, but hearts.