What it is

Parkinson's disease is a progressive neurological condition caused by the loss of dopamine-producing cells in the brain. Dopamine is central to smooth, automatic movement, so as those cells are lost, movement becomes slower, stiffer and harder to initiate.

It is a movement disorder, but it is not only a movement disorder. Sleep disturbance, constipation, low blood pressure on standing, loss of smell, depression, anxiety and, in later stages, changes to thinking are all part of the condition and often bother people more than the tremor does.

Common symptoms

  • Tremor - classically in a hand at rest, often on one side first. Not everyone has it.
  • Bradykinesia - slowness and shrinking of movement. Smaller handwriting, less arm swing, reduced facial expression, a quieter voice.
  • Rigidity - stiffness in the limbs and trunk, often with aching.
  • Postural instability - balance problems, usually later, and a major falls risk.
  • Freezing of gait - feet feel stuck to the floor, particularly in doorways, when turning, or when starting to walk.
  • Non-motor symptoms - fatigue, constipation, disturbed sleep, urinary urgency, low mood.

Medication timing is not flexible. Parkinson's medication works within narrow windows. A dose given an hour late can mean an hour of not being able to move properly. This matters enormously for how care visits are scheduled, and it is one of the few areas where a rigid roster genuinely serves the person better than a flexible one.

How it is usually treated

Treatment is specialist-led, usually by a neurologist, and centres on replacing or mimicking dopamine. Levodopa-based medication remains the mainstay. Doses and timing are adjusted over years as the condition changes, and some people later become suitable for advanced therapies such as deep brain stimulation.

Alongside medication, the evidence for exercise in Parkinson's is unusually strong. Physiotherapy focused on gait, balance and amplitude of movement, along with speech pathology for voice and swallowing, are mainstream parts of treatment rather than optional extras.

Where aged care fits

The core problem at home is that Parkinson's fluctuates. A person can be capable at 9am and barely mobile at 4pm, and the same task is easy in an "on" period and impossible in an "off" period. Care that is planned around this works. Care that ignores it does not.

  • Personal care scheduled around medication windows rather than around the roster, so showering and dressing happen when the person can participate.
  • Help with self-administering medication - prompting at the right times, which is where a great deal of avoidable deterioration comes from.
  • Occupational therapy for home modifications, equipment, and practical strategies for freezing, transfers and bathroom safety.
  • Podiatry, since altered gait, reduced foot clearance and shuffling change how feet wear and increase both falls risk and skin problems.
  • Meal preparation - eating becomes slower and more tiring, and protein timing can interact with levodopa absorption. Worth asking the neurologist about.
  • Direct transport and accompanied activities, because driving often stops well before independence needs to.
  • Psychology - depression and anxiety are part of the disease process in Parkinson's, not simply a reaction to it, and they respond to treatment.

Falls

Falls are the complication that most often ends independent living. Freezing, festinating gait, low blood pressure on standing and reduced ability to correct a stumble combine badly. If falls have started, treat that as urgent rather than as an expected part of ageing. Our page on falls and frailty goes into practical prevention.

General information only, not clinical advice. Speak to a GP or neurologist about any individual situation. Parkinson's NSW HealthLine: 1800 727 567. My Aged Care: 1800 200 422.