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New paper outlines wellness-based strategies to overcome barriers to care and social support
Inequalities in mental healthcare and lack of social support are persistent challenges for people with Parkinson disease (PD), but they can be combatted with holistic wellness interventions targeted to patients, their caregivers and their communities.
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That’s the central takeaway from a recent “Point of View” article in Parkinsonism and Related Disorders (2021;93:97-102) by an international group of Parkinson’s disease clinicians and researchers. They reviewed the mental healthcare and social support challenges for people with PD and then developed recommendations for addressing them based on 90 interviews of people with PD and other PD stakeholders and thought leaders.
“Too many people with PD suffer from social disconnectedness, loneliness, economic hardship and barriers to accessing care,” says neurologist Hubert H. Fernandez, MD, Director of the Center for Neurological Restoration at Cleveland Clinic and a co-author of the paper. “The degree to which mental healthcare needs of people living with PD are unmet has been revealed and exacerbated by the COVID-19 pandemic. This prompted us to propose a framework to systematically and proactively address the mental health needs of this at-risk population.”
The paper begins by reviewing the following major barriers to improving mental healthcare for people with PD:
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As a solution to these barriers, the authors propose wellness, which they define as “the active pursuit or activities, choices and lifestyles that lead to a state of holistic health.” Dr. Fernandez emphasizes that this is in contrast to “misconceptions propagated by the commercialization of the so-called wellness industry,” involving the purchase of expensive products, spa memberships and the like.
The authors note that while some proposals for holistic health in people with PD have focused on motor issues, the foundation of their model is education and empowerment, with the ultimate goal of wellness resulting from improved self-efficacy for people with PD and their caregivers. “Self-efficacy has been demonstrated to improve quality of life in people with PD,” Dr. Fernandez explains. “The goal of our model is to support patients in their ability to participate in activities they view as meaningful and to support them in self-management.”
To realize this goal, the paper calls for the following strategies and changes:
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“One silver lining of the pandemic has been its unmasking of gaps in mental healthcare for many groups of patients with PD,” Dr. Fernandez concludes. “Clinicians caring for these patients have a chance to seize this opportunity to reshape care models to promote a more holistic approach to our patients’ health.”
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