Akathisia in the Parkinson Patient

[SusanJean]

I care for a woman who is suffering from end stage parkinson's dz. She has recently been exhibiting an increase in restlessness - and says she cannot explain why she wants to move around. (long story short.)

I know that this is difficult to recognize as a side effect, but psych personnel is more readily able to recognize it -

She is not on any neuroleptics, but her parkinson's medications can cause this as a side effect. (cked PDR to verify this.)

Any suggestions on further evaluation? Family and staff (home care) are quick to dismiss any new symptoms as a worsening of her PD, but I would hate to think that she is suffering a medication SE that can be treated - and not have anything done about it.

I am "the new kid on the block" - and all of the caregivers, myself included, are either CNA's or nursing students (me) - there is a visiting nurse once a week. I only consider this as a differential (and I know it is only that) since I worked psych for +4 yrs and managed a caseload of CMI. (We use to joke that if you needed to have akathisia recognized, you would have to visit the psych floor - one RN did just that - was postop and experienced it after surgery from meds to prevent vomiting.)

But symptoms are worsening; there have been no change in meds. I can make this assessment w/ pt w/out PD, but need some help to at least pass along to family, if anyone can help me here.

Thanks,

SJ

PS, if this needs to be posted elsewhere, where?