If you or someone you love has Parkinson’s disease and has begun experiencing unusual, involuntary movements, you may wonder: “Is this Parkinson’s, or is something else happening?” Dyskinesia is a common concern for many people living with Parkinson’s, particularly those who have been taking levodopa for several years.
The good news? Dyskinesia does not mean you simply have to live with uncontrolled movements. Understanding why it happens is the first step toward finding a treatment approach that works for you.

What Is Dyskinesia in Parkinson’s?
Dyskinesia is involuntary, uncontrolled movement that can occur in people with Parkinson’s disease, often as a complication of long-term levodopa treatment.
Unlike Parkinson’s tremor, which typically involves rhythmic shaking, dyskinesia may look more like flowing, twisting, writhing, fidgeting, swaying, or jerking movements.
Dyskinesia can affect the:

• Arms and hands
• Legs and feet
• Head and neck
• Trunk
• Face

For some people, the movements are mild and barely noticeable. For others, dyskinesia can interfere with walking, balance, eating, writing, speaking, or other everyday activities.

Why Does Dyskinesia Happen?
Levodopa is one of the most effective medications for treating Parkinson’s movement symptoms. Over time, however, the brain's ability to store and regulate dopamine can change.
As Parkinson’s progresses and dopamine-producing cells are lost, the brain may respond differently to fluctuations in levodopa levels.
This can contribute to levodopa-induced dyskinesia, particularly when medication levels are rising or at their peak.
Not everyone who takes levodopa develops troublesome dyskinesia, and the timing and severity can vary considerably from person to person.
​
What Does Parkinson’s Dyskinesia Feel Like?
Dyskinesia can feel very different from one person to another.
Some people describe movements as:

• Restlessness
• Wiggling or fidgeting
• Twisting
• Jerking
• Swaying
• Rocking
• Difficulty keeping a limb still

Sometimes a person may not realize how much they are moving until someone else points it out.
Dyskinesia can also fluctuate throughout the day depending on medication timing.
That's why keeping track of when the movements occur in relation to your medication can be extremely helpful.

Is Dyskinesia the Same as a Parkinson’s Tremor?
No.
A Parkinson’s tremor is typically a rhythmic shaking movement and often occurs when a limb is at rest.
Dyskinesia is generally less rhythmic and can involve larger, flowing, twisting, or unpredictable movements.
However, Parkinson’s symptoms can overlap, and it isn't always easy to determine what's causing a particular movement.
If you develop new or worsening involuntary movements, talk with your Parkinson’s healthcare team rather than trying to diagnose the movement yourself.
​
How Can Dyskinesia Be Managed?
There isn't one treatment that works for everyone.
Your healthcare professional may consider several approaches.
Adjusting Levodopa
Your doctor may change the dose, timing, or frequency of levodopa to reduce periods when medication levels contribute to troublesome dyskinesia.
Never change your Parkinson’s medication schedule on your own.
Even small changes can affect both dyskinesia and Parkinson’s symptoms such as stiffness, slowness, and tremor.
Changing or Adding Medications
Depending on your symptoms, your healthcare provider may consider other Parkinson’s medications or formulations.
Amantadine is one medication that may be prescribed specifically to help reduce dyskinesia in some people.
The appropriate medication depends on your symptoms, other medications, health conditions, and treatment goals.
Keeping a Symptom and Medication Diary
A medication diary can help identify patterns.
Record:

• Medication name and dose
• Time you take each medication
• When dyskinesia begins
• How long it lasts
• What the movements look or feel like
• Whether Parkinson’s symptoms improve or worsen at the same time
• Meals or activities that seem to affect symptoms

A short video recorded safely at home can sometimes also help your healthcare professional understand what happens between appointments.

Could Deep Brain Stimulation Help?
For some people with Parkinson’s who experience significant motor fluctuations or medication-related dyskinesia, deep brain stimulation (DBS) may be an option.
DBS uses surgically implanted electrodes to deliver electrical stimulation to specific areas of the brain involved in movement.
It isn't appropriate for everyone, and it does not cure Parkinson’s disease.
However, for carefully selected patients, DBS can reduce certain motor symptoms and may reduce medication requirements, which can in turn decrease troublesome dyskinesia.
A movement disorder specialist can help determine whether someone might be an appropriate candidate.
​
When Should I Talk to My Doctor About Dyskinesia?
Contact your healthcare team if involuntary movements:

• Are becoming more frequent
• Are interfering with daily activities
• Make walking or balance more difficult
• Cause discomfort
• Are affecting eating or speaking
• Are making you afraid to leave home
• Seem connected to changes in your medication

Don't assume that worsening dyskinesia is simply something you have to accept.
There may be ways to adjust your treatment plan.

Questions People Ask About Dyskinesia
1.  Does everyone with Parkinson’s develop dyskinesia?
No. Dyskinesia does not occur in everyone with Parkinson’s, and its likelihood and severity vary among individuals.
2.  Does dyskinesia mean Parkinson’s is getting worse?
Not necessarily. Dyskinesia is often related to the interaction between Parkinson’s disease and levodopa treatment. Its presence does not automatically indicate that Parkinson’s is rapidly progressing.
3.  Can dyskinesia be stopped?
Dyskinesia can sometimes be reduced substantially, although the results vary. Medication adjustments and other treatments may help.
4.  Should I stop taking levodopa if I develop dyskinesia?
No. Do not stop or change Parkinson’s medication without medical guidance. Your healthcare professional can adjust treatment safely.
5.  Can exercise help dyskinesia?
Exercise is an important part of Parkinson’s management overall, but it isn't a substitute for medical treatment of troublesome dyskinesia. Ask your healthcare team about exercises appropriate for you.

Conclusion: Dyskinesia Can Be Managed
Seeing involuntary movements after living with Parkinson’s can be unsettling, especially when you aren't sure what is causing them.
But dyskinesia is a recognized complication of Parkinson’s treatment, and there are management strategies available.
Start by tracking when the movements occur and how they relate to your medications. Then share that information with your neurologist or movement disorder specialist.
Your treatment plan is not necessarily permanent. As Parkinson’s changes, your treatment can change with it.
The goal isn't simply to control one symptom. The goal is to help you move, function, participate, and live as well as possible.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
​
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

“I have Parkinson’s. What do I do now?”
If you were recently diagnosed with Parkinson’s disease, you may be feeling frightened, overwhelmed, confused—or even relieved to finally have an explanation for symptoms you've been experiencing. There is no single “right” way to react. The important thing to remember is that you do not have to figure everything out at once.
Your diagnosis is the beginning of a new chapter—not the end of the life you know. Here are eight practical steps that can help you move forward with confidence.

1. Give Yourself Time to Process the Diagnosis
A Parkinson’s diagnosis can bring a flood of emotions and questions.
You don't need to become an expert overnight.
Start by learning the basics from reliable medical and Parkinson’s organizations. Write down questions as they come to you, and take someone you trust to appointments when possible.
Be cautious about websites, supplements, or treatments that promise a cure.
2. Build the Right Parkinson’s Care Team
One of the most important early steps is establishing a healthcare team you trust.
Your care may involve a:

• Neurologist
• Movement disorder specialist
• Physical therapist
• Occupational therapist
• Speech-language pathologist
• Mental health professional
• Other specialists as needed

A movement disorder specialist is a neurologist with specialized training in Parkinson’s disease and other movement disorders. A consultation can be particularly helpful after a new diagnosis, if the diagnosis is uncertain, or when treatment becomes complicated.
3. Learn About Your Treatment Options
Not everyone with Parkinson’s needs medication immediately, and treatment is highly individualized.
When medication is recommended, your healthcare provider will consider your symptoms, their impact on your daily life, your age, other health conditions, and your goals.
Treatment may include medications as well as exercise, physical therapy, occupational therapy, speech therapy, and other approaches.
Don't compare your medication plan with someone else's.
Parkinson’s affects each person differently.
4. Start an Appropriate Exercise Program
Exercise is one of the most important lifestyle strategies for people with Parkinson’s.
Depending on your abilities and medical guidance, activities may include:

• Walking
• Strength training
• Stretching
• Balance exercises
• Cycling
• Dancing
• Swimming
• Parkinson’s-specific exercise programs

If you're new to exercise or have balance problems, falls, or other limitations, ask your healthcare team or physical therapist for guidance.
Starting sooner can make exercise a regular part of your routine rather than something you postpone until symptoms become more challenging.

5. Pay Attention to Non-Motor Symptoms
Parkinson’s isn't only about tremor.
Non-motor symptoms can include:

• Constipation
• Sleep problems
• Fatigue
• Depression
• Anxiety
• Apathy
• Pain
• Blood pressure changes
• Urinary problems
• Cognitive changes
• Speech or swallowing difficulties

Some of these symptoms can have a major impact on quality of life.
Tell your healthcare team about symptoms—even if they don't seem related to Parkinson’s.
There may be treatments or strategies that can help.
6. Keep a Parkinson’s Symptom and Medication Journal
A simple notebook or phone note can become an extremely useful tool.
Track:

• Symptoms
• Medication names and doses
• Medication times
• When medications seem to start working
• When symptoms return
• Sleep
• Exercise
• Falls or near-falls
• Changes in walking
• Other symptoms or concerns

Over time, patterns may become easier to see.
Bring your notes to medical appointments so your healthcare team can make decisions based on what is actually happening between visits.

7. Connect With Other People Living With Parkinson’s
A diagnosis can feel isolating.
Connecting with other people who understand Parkinson’s can provide encouragement, practical information, and a sense of community.
Support groups can also be valuable for care partners and family members.
You don't have to wait until you're struggling to seek support.
Support is not a sign that you can't cope. It's a resource that can help you cope better.
8. Think About Your Future—But Don't Assume the Worst
It's reasonable to think about work, finances, driving, home safety, exercise, relationships, and future care needs.
But avoid assuming that someone else's Parkinson’s journey will become yours.
Parkinson’s progression varies considerably from person to person.
Your healthcare team can help you make plans based on your individual symptoms and circumstances.
Planning ahead can provide peace of mind without requiring you to predict exactly what the future will look like.
What Should I Do Immediately After a Parkinson’s Diagnosis?
If you're looking for a simple starting point, focus on these five things:
1. Schedule appropriate neurological care.
2. Learn about Parkinson’s from reliable sources.
3. Ask about an individualized exercise program.
4. Begin tracking symptoms and medications.
5. Find a Parkinson’s support community.
You don't need to solve everything in one week.

Questions People Ask After a Parkinson’s Diagnosis
Should I see a movement disorder specialist?
Consider a specialist consultation, particularly after a new diagnosis, if you want a second opinion, if symptoms are unusual or changing, or if treatment becomes complicated.
Should I start exercising after a Parkinson’s diagnosis?
For most people, physical activity is an important part of Parkinson’s management. Ask your healthcare provider about an exercise program appropriate for your abilities.
Do I need medication immediately?
Not necessarily. Treatment decisions are individualized and should be made with your healthcare professional based on your symptoms and how much they affect your daily life.
Can Parkinson’s get worse quickly?
Parkinson’s progression varies widely. Some people experience relatively gradual changes, while others have more significant challenges. Your healthcare team can help you understand your individual situation.
What should I tell my doctor?
Tell your doctor about both motor and non-motor symptoms, medication effects, sleep, mood, constipation, pain, balance, walking changes, and anything affecting your daily life.
Conclusion: You Don't Have to Navigate Parkinson’s Alone
Being diagnosed with Parkinson’s can change the way you think about the future. But a diagnosis does not tell you everything about how your individual journey will unfold.
Focus on what you can do today: build a trusted care team, learn about your options, stay physically active, track your symptoms, address non-motor symptoms, and connect with people who understand.
Most importantly, give yourself permission to take this one step at a time.
There is still plenty of life to live, goals to pursue, relationships to enjoy, and ways to stay engaged and active.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
​
Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

Parkinson’s and Gut Health: Constipation, Digestion & How to Improve It
When people think about Parkinson’s disease, they often think about tremor, stiffness, and problems with movement. But Parkinson’s can affect much more than movement. Gut and digestive problems—including constipation—are common non-motor symptoms of Parkinson’s and can significantly affect comfort and quality of life.
Could your digestive system be telling you something about Parkinson’s? Understanding the connection between Parkinson’s and gut health may give you practical ways to feel better and support your overall well-being.

​How Does Parkinson’s Affect Gut Health?
Parkinson’s can affect the autonomic nervous system, which helps regulate automatic body functions, including digestion.
The nervous system also plays an important role in coordinating the movement of the gastrointestinal tract. Parkinson’s-related changes can contribute to slower gastrointestinal motility, meaning food and waste may move through the digestive system more slowly.
This can lead to symptoms such as:

• Constipation
• Fewer bowel movements
• Hard or difficult-to-pass stools
• Bloating
• Abdominal discomfort
• A feeling of incomplete bowel emptying
• Nausea or changes in appetite

Constipation may occur before the classic movement symptoms of Parkinson’s appear in some people.
​
Why Is Constipation So Common With Parkinson’s?
There isn't necessarily one single reason.
Parkinson’s itself can slow gastrointestinal movement. Reduced physical activity can also contribute to constipation.
Some medications can affect bowel function as well. In addition, people with Parkinson’s may drink less fluid or consume less fiber than they need.
Difficulty moving around, changes in routine, swallowing problems, fatigue, and other Parkinson’s symptoms can make maintaining regular bowel habits more challenging.
That means constipation should not simply be dismissed as an unrelated digestive problem.

How Can I Improve Gut Health With Parkinson’s?
1. Drink Enough Fluids
Adequate hydration can help keep stool softer and easier to pass.
Water is generally the best choice, but individual fluid needs vary.
Some people with Parkinson’s also experience blood pressure problems, so fluid recommendations may need to be individualized. Talk with your healthcare professional if you have been told to restrict fluids or have medical conditions that affect fluid intake.
2. Increase Fiber Gradually
Fiber can help promote regular bowel movements.
Good sources include:

• Fruits
• Vegetables
• Whole grains
• Beans and lentils
• Nuts and seeds

Increase fiber gradually rather than suddenly adding a large amount.
Important: Increasing fiber without drinking enough fluid can sometimes make constipation worse.
If constipation is persistent, ask your healthcare provider or a registered dietitian how much fiber is appropriate for you.
3. Stay Physically Active
Movement can help support bowel function.
Walking, stretching, strength training, dancing, cycling, aquatic exercise, and Parkinson’s-specific fitness programs may all be useful depending on your abilities.
Regular physical activity also provides benefits beyond digestion, including supporting strength, balance, mobility, mood, and overall health.
If you have significant balance problems or a history of falls, ask your healthcare team which activities are safest for you.
4. Establish a Regular Bathroom Routine
Try giving yourself enough time to use the bathroom without rushing.
Some people find that attempting a bowel movement at approximately the same time each day—often after a meal—helps establish a routine.
Don't routinely ignore the urge to have a bowel movement.
5. Review Your Medications
Some medications can contribute to constipation.
If constipation began or worsened after starting a medication, don't stop taking it on your own.
Instead, tell your healthcare professional. They can determine whether a medication could be contributing and whether an adjustment or different treatment is appropriate.
6. Ask About Treatments for Constipation
Lifestyle changes aren't always enough.
Depending on the cause and severity of constipation, a healthcare professional may recommend a bowel regimen or medication specifically for constipation.
Because treatment should take into account your other medications and health conditions, it's best to discuss persistent constipation with your healthcare team rather than repeatedly trying over-the-counter products without guidance.

What About Probiotics and the Gut Microbiome?
The gut microbiome—the community of microorganisms living in the digestive tract—is an area of active Parkinson’s research.
Scientists are studying possible relationships between the gut microbiome, inflammation, the nervous system, and Parkinson’s disease.
However, research into probiotics and specific microbiome treatments for Parkinson’s is still developing.
There is currently no single probiotic or “gut cleanse” proven to prevent or cure Parkinson’s.
Be cautious about products that promise to treat Parkinson’s by “healing the gut.” Talk with your healthcare professional before starting supplements, particularly if you take multiple medications.

Can Gut Health Affect Parkinson’s Medications?
Digestive problems can sometimes complicate medication management.
For example, changes in gastrointestinal movement may affect how quickly medications are absorbed. Some people also notice that their Parkinson’s symptoms fluctuate along with meals or medication timing.
If you notice that your medication seems to work inconsistently, takes longer to kick in, or wears off unpredictably, tell your healthcare team.
Do not change medication timing or dosage without medical guidance.
​
When Should I Call My Healthcare Provider?
Talk with your healthcare professional about persistent or worsening constipation, significant abdominal pain, vomiting, unexplained weight loss, blood in the stool, or a major change in bowel habits.
Severe abdominal pain, repeated vomiting, significant abdominal swelling, or inability to pass stool or gas can require urgent medical evaluation.
​

Questions People Ask About Parkinson’s and Gut Health
Is constipation an early symptom of Parkinson’s?
It can be. Constipation is a recognized non-motor symptom and may occur before noticeable movement symptoms in some people.
Does Parkinson’s cause digestive problems?
Parkinson’s can affect gastrointestinal function and may contribute to constipation, slower digestion, bloating, and other digestive symptoms.
What should I eat for constipation with Parkinson’s?
Foods rich in fiber—including fruits, vegetables, whole grains, beans, nuts, and seeds—can help support regularity. Fiber should generally be increased gradually and accompanied by adequate fluid unless your healthcare professional has advised otherwise.
Are probiotics good for Parkinson’s?
Research into the gut microbiome and probiotics in Parkinson’s is ongoing. There is not currently one probiotic proven to treat or cure Parkinson’s.
Can exercise help constipation?
Regular physical activity can support gastrointestinal movement and may help with constipation while providing important benefits for mobility and overall health.
Conclusion: Gut Health Is Part of Parkinson’s Care
Parkinson’s disease is more than a movement disorder. Gut health and gastrointestinal symptoms are important parts of the Parkinson’s picture and deserve attention.
If constipation or digestive problems are affecting your daily life, don't assume you simply have to live with them.
Hydration, appropriate fiber, regular physical activity, a consistent bathroom routine, medication review, and appropriate medical treatment can all be part of a strategy for better digestive health.
And remember: your non-motor symptoms matter, too.
Talking openly with your healthcare team can help identify problems, find appropriate treatments, and improve your quality of life.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
​
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

When most people hear “Parkinson’s treatment,” they immediately think about medication. Medication is an important part of managing Parkinson’s disease, but it is not the only tool available. Exercise, physical and occupational therapy, speech therapy, rehabilitation, lifestyle strategies, and advanced treatments such as deep brain stimulation (DBS) may all have a role in helping people manage Parkinson’s.
Could something beyond medication help you move better, communicate more easily, remain independent, or regain better control of your symptoms? Understanding your options is the first step.

Why Look Beyond Medication for Parkinson’s Treatment?
Parkinson’s affects people differently. Symptoms can include tremor, stiffness, slowness of movement, balance problems, walking difficulties, dystonia, speech changes, swallowing difficulties, and involuntary movements.
Medication can help many Parkinson’s symptoms, but it may not completely address every challenge.
That's where a multidisciplinary Parkinson’s treatment plan can become important.
Your healthcare team may recommend different therapies based on your symptoms, abilities, treatment goals, and stage of Parkinson’s.

Exercise: One of the Most Important Parkinson’s Treatments
Regular exercise is an important part of Parkinson’s management.
Depending on your abilities and medical recommendations, exercise may include:

• Walking
• Strength training
• Stretching
• Balance exercises
• Cycling
• Dancing
• Swimming or aquatic exercise
• Parkinson’s-specific fitness programs

Exercise can help support strength, flexibility, balance, mobility, cardiovascular health, and overall physical function.
It is important to choose activities appropriate for your abilities, particularly if you experience falls, freezing, significant balance problems, or other mobility concerns.
​
​Physical Therapy for Parkinson’s
A physical therapist familiar with Parkinson’s can help address movement and mobility challenges.
Physical therapy may focus on:

• Walking and gait
• Balance
• Strength
• Flexibility
• Posture
• Transfers
• Freezing of gait
• Fall prevention
• Safe use of assistive devices

A physical therapist may also teach strategies for getting out of a chair, turning safely, navigating obstacles, and maintaining mobility.
​
Occupational Therapy Can Help With Daily Life
Occupational therapy focuses on helping people safely and independently perform everyday activities.
An occupational therapist may help with:

• Dressing
• Bathing
• Eating
• Writing
• Household activities
• Work-related tasks
• Driving considerations
• Home safety
• They may also recommend adaptive equipment or modifications that make everyday activities easier and reduce fall risks.

Speech and Swallowing Therapy
Parkinson’s can affect the muscles involved in speaking and swallowing.
Speech-language pathologists can help address:

• Soft or quiet speech
• Slurred speech
• Difficulty projecting the voice
• Communication challenges
• Swallowing difficulties

Specialized speech therapy programs can help people work on voice, speech, and swallowing function.

What Is Deep Brain Stimulation (DBS)?
Deep brain stimulation, or DBS, is an advanced treatment for Parkinson’s disease that uses implanted electrodes to deliver electrical stimulation to specific areas of the brain.
A small device, similar to a pacemaker, generates electrical impulses that are delivered through the implanted electrodes.
DBS does not cure Parkinson’s or stop the underlying disease from progressing.
However, for appropriately selected patients, DBS can improve certain motor symptoms and may reduce medication-related fluctuations and some medication needs.
​
Who Might Be a Candidate for DBS?
DBS isn't appropriate for everyone with Parkinson’s.
A specialized medical team evaluates several factors, including:

• Parkinson’s diagnosis
• Response to levodopa
• Motor symptoms
• Medication fluctuations
• Dyskinesia
• Overall health
• Cognitive function
• Mental health
• Individual treatment goals

DBS is generally considered when Parkinson’s symptoms remain troublesome despite optimized medication treatment, rather than simply because someone has had Parkinson’s for a particular number of years.
A movement disorder specialist can help determine whether an evaluation is appropriate.
What Are the Benefits and Limitations of DBS?
For appropriately selected patients, DBS may improve certain symptoms such as tremor, rigidity, and slowness of movement and may help reduce motor fluctuations and dyskinesia.
However, DBS has limitations.
It does not generally eliminate every Parkinson’s symptom, and symptoms such as balance problems, speech difficulties, or cognitive changes may not improve—and some symptoms may continue to progress.
DBS also requires surgery and ongoing programming and medical follow-up.
Patients should discuss potential benefits, risks, and alternatives with an experienced movement disorder team.
Are There Other Advanced Parkinson’s Treatments?
DBS is not the only advanced treatment option.
Depending on the individual, specialists may consider other approaches for managing motor fluctuations and medication delivery, including specialized medication-delivery systems.
The appropriate option depends on the person's symptoms, medication response, overall health, preferences, and treatment goals.
Why a Team Approach Matters
Parkinson’s care often works best when healthcare professionals work together.
A Parkinson’s care team may include:

• Movement disorder specialists
• Neurologists
• Physical therapists
• Occupational therapists
• Speech-language pathologists
• Nurses
• Social workers
• Mental health professionals
• Other specialists

You don't necessarily need every type of professional. Your care team can change as your needs change.

Questions People Ask About Parkinson’s Treatment
1.  Can Parkinson’s be treated without medication?
Medication is an important treatment for many people with Parkinson’s, but exercise, rehabilitation, physical therapy, occupational therapy, speech therapy, and other approaches can complement medication and help address specific symptoms.
2.  Is DBS a cure for Parkinson’s?
No. DBS does not cure Parkinson’s or stop the underlying disease from progressing. It can, however, significantly improve certain symptoms in appropriately selected patients.
3.  When should someone consider DBS?
DBS may be considered when troublesome motor symptoms, medication fluctuations, or dyskinesia continue despite optimized medication treatment. A movement disorder specialist can determine whether an evaluation is appropriate.
4.  Does DBS help every Parkinson’s symptom?
No. DBS is primarily intended to treat certain motor symptoms. Some symptoms, particularly certain balance, speech, cognitive, or autonomic problems, may not respond as well.
5.  Is exercise really a treatment for Parkinson’s?
Exercise is an important component of Parkinson’s management. A personalized exercise program can help support mobility, strength, flexibility, balance, and physical function.

Conclusion: Parkinson’s Treatment Is More Than Medication
Parkinson’s treatment doesn't have to be viewed as medication versus everything else.
For many people, the most effective approach combines medication with exercise, rehabilitation, physical therapy, occupational therapy, speech therapy, lifestyle strategies, and appropriate specialist care.
For some individuals with more advanced motor complications, treatments such as deep brain stimulation may provide another option.
The key is personalization.
Talk with your healthcare team about your symptoms, what is working, what isn't, and what matters most to you. Ask whether additional therapies or a movement disorder specialist could help.
Knowing your options can help you take a more active role in your Parkinson’s care—and living well with Parkinson’s is about much more than controlling tremor.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
​
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

A Parkinson’s diagnosis can bring a long list of questions: Is this definitely Parkinson’s? Are my medications working properly? Why are my symptoms changing? What can I do about walking, balance, tremor, pain, or other problems? While a general neurologist can provide Parkinson’s care, a movement disorder specialist has additional expertise in conditions such as Parkinson’s disease.
And you don't necessarily have to wait until Parkinson’s becomes difficult to manage. Knowing when specialized care could help may make a meaningful difference in diagnosis, treatment, and quality of life.

What Is a Movement Disorder Specialist?
A movement disorder specialist is a neurologist with specialized training and experience in diagnosing and treating neurological conditions that affect movement.
These conditions include:

• Parkinson’s disease
• Essential tremor
• Dystonia
• Huntington’s disease
• Tic disorders
• Other movement disorders

Because movement disorders can be complex, a specialist may have extensive experience recognizing subtle symptoms, distinguishing Parkinson’s from other conditions, and managing medications and therapies over time.

When Should You Consider Seeing One?
1. When Parkinson’s Is Newly Diagnosed.
A consultation can be especially helpful soon after diagnosis.
A movement disorder specialist can review your symptoms, medical history, medications, and examination findings and help confirm whether the diagnosis is consistent with Parkinson’s.
An early specialist consultation can also provide an opportunity to establish a treatment plan and discuss exercise, rehabilitation, medications, and what to monitor as the condition changes.

2. When You're Not Sure About the Diagnosis.
Parkinson’s is not diagnosed using one single test.
Several neurological conditions can produce symptoms that resemble Parkinson’s, including tremor, stiffness, slowness, and walking difficulties.
If you're uncertain about your diagnosis—or if symptoms don't fit the typical pattern—a movement disorder specialist may provide valuable expertise or a second opinion.

​3. When Medications Aren't Working Like They Used To
Parkinson’s medications can be highly effective for many people, but treatment needs can change.
Consider consulting a specialist if you notice:

• Medication wearing off before the next dose
• Increasing “off” periods
• Unpredictable symptom control
• New or worsening side effects
• Dyskinesia
• Symptoms returning despite treatment

A movement disorder specialist can evaluate medication timing, dosage, combinations, and other treatment options.

4. When Walking or Balance Becomes More Difficult
Walking problems can significantly affect independence and safety.
Tell your healthcare team if you develop:

• Freezing of gait
• Frequent stumbling
• Falls
• Difficulty turning
• Smaller or shuffling steps
• Increasing difficulty getting out of a chair
• New balance problems

A specialist can evaluate whether these changes are related to Parkinson’s and determine whether medication adjustments, physical therapy, assistive devices, or other strategies may help.

5. When New Symptoms Appear
Parkinson’s can involve much more than tremor.
Symptoms may also include:

• Sleep problems
• Constipation
• Depression or anxiety
• Fatigue
• Changes in speech
• Swallowing difficulties
• Blood pressure changes
• Cognitive changes
• Pain
• Urinary symptoms

A movement disorder specialist can help determine whether these symptoms are related to Parkinson’s, treatment, another medical condition, or a combination of factors.

6. When You Develop Motor Fluctuations or Dyskinesia.
As Parkinson’s changes, some people experience motor fluctuations—periods when medication works well followed by periods when symptoms return.
Others develop dyskinesia, which involves involuntary movements.
These symptoms can sometimes be managed through medication adjustments or other treatments.
A movement disorder specialist may be particularly helpful when treatment becomes more complicated.

7. When Advanced Treatments Are Being Considered
If medications no longer provide adequate or predictable symptom control, your healthcare team may discuss advanced treatments.
These can include therapies such as deep brain stimulation (DBS) or certain medication-delivery systems for appropriate candidates.
A movement disorder specialist can help determine whether an advanced treatment might be appropriate and explain potential benefits, risks, and alternatives.

Do You Have to Stop Seeing Your Regular Neurologist?
No.
A movement disorder specialist can work alongside your existing healthcare team.
Some people receive their primary neurological care from a general neurologist and periodically consult a movement disorder specialist. Others choose to have their ongoing Parkinson’s care managed primarily by a specialist.
The best arrangement depends on your symptoms, access to specialists, personal preferences, and healthcare needs.

How Often Should You See a Movement Disorder Specialist?
There is no universal schedule.
The frequency of visits depends on factors such as disease stage, symptom changes, treatment complexity, medication response, and other health conditions.
Your specialist can recommend an appropriate follow-up schedule.
If your symptoms suddenly change or become significantly worse, don't wait for a routine appointment. Contact your healthcare provider.

​What Should You Bring to Your Appointment?
You can make a specialist visit more productive by bringing:

• A complete medication list
• Medication doses and schedules
• A symptom diary
• Questions from you and your care partner
• Information about falls or walking changes
• Notes about medication “off” periods
• Information about dyskinesia or other involuntary movements

If possible, write down when symptoms occur and how they relate to medication timing.

Questions People Ask
1. Is a movement disorder specialist better than a regular neurologist for Parkinson’s?
Not necessarily “better,” but a movement disorder specialist has additional specialized expertise in Parkinson’s and other movement disorders.
2. Should I see a specialist after a Parkinson’s diagnosis?
A consultation can be valuable, particularly for confirming the diagnosis, establishing treatment goals, and developing a long-term management plan.
3. Can a movement disorder specialist change my Parkinson’s medications?
Yes. Specialists can evaluate medication effectiveness, side effects, wearing-off, dyskinesia, and other treatment concerns and recommend adjustments when appropriate.
4. Can a specialist help with symptoms other than tremor?
Yes. Parkinson’s care can include movement, walking, balance, sleep, mood, cognitive, autonomic, speech, swallowing, and other symptoms.
5. Can a movement disorder specialist determine whether I'm a candidate for DBS?
A specialist can evaluate your symptoms and treatment history and determine whether an evaluation for advanced therapies such as DBS may be appropriate.

Conclusion: Specialized Care Can Be an Important Part of Parkinson’s ManagementYou don't have to wait until Parkinson’s becomes severe before seeking specialized care.
A movement disorder specialist can be helpful when you're newly diagnosed, uncertain about your diagnosis, experiencing medication problems, developing balance or walking difficulties, dealing with dyskinesia or motor fluctuations, or considering advanced treatment options.
Most importantly, you are an important member of your Parkinson’s care team.
Ask questions. Track changes. Speak up when something isn't working. And seek specialized expertise when you need it.
The goal is not simply to treat Parkinson’s symptoms. It is to help you maintain mobility, independence, confidence, and quality of life for as long as possible.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

Pain is a surprisingly common symptom of Parkinson’s disease, yet it is sometimes overlooked because Parkinson’s is often associated primarily with tremor, stiffness, and slow movement. Parkinson’s-related pain can affect the muscles, joints, back, neck, feet, or other areas of the body and may significantly interfere with sleep, mobility, mood, and quality of life.
The important thing to know is that you don't simply have to “live with” Parkinson’s pain. Understanding what is causing it is the first step toward finding the right treatment.

Why Does Parkinson’s Cause Pain?
Parkinson’s can contribute to pain in several different ways. Muscle stiffness, abnormal muscle contractions, changes in posture, reduced movement, and altered walking patterns can all put additional stress on the body.
Pain can also occur for reasons that aren't directly caused by Parkinson’s, such as arthritis, injuries, nerve problems, or other medical conditions.
That is why identifying what type of pain you have is so important.
What Types of Pain Are Associated With Parkinson’s?
Musculoskeletal Pain
Musculoskeletal pain is related to muscles, joints, bones, posture, or movement.
Parkinson’s stiffness and changes in movement can cause discomfort in areas such as the:

• Back
• Neck
• Shoulders
• Hips
• Knees
• Legs

Changes in posture can also place additional strain on muscles and joints.
Dystonia-Related Pain
Dystonia involves involuntary muscle contractions that can cause abnormal or repetitive movements or postures.
For someone with Parkinson’s, dystonia can be painful, particularly when a foot, toe, hand, or another body part becomes unusually contracted or twisted.
Dystonia may sometimes occur at specific times related to Parkinson’s medication.
Neuropathic Pain
Some people with Parkinson’s experience neuropathic pain, which is related to the nerves.
It may feel like:

• Burning
• Tingling
• Electric or shooting pain
• Numbness
• Pins and needles

Neuropathic pain may require a different treatment approach than muscle or joint pain.

Keep Track of When Your Pain Occurs
One of the most useful things you can do is pay attention to when the pain happens.
Ask yourself:

• Does it occur before medication?
• Does it improve when medication starts working?
• Does it occur when medication is wearing off?
• Is it worse in the morning?
• Does exercise improve or worsen it?
• Does it interfere with sleep?
• Is it always in the same location?
• Is there swelling, redness, weakness, or numbness?

A pain and medication diary can help your healthcare provider identify patterns.
​
Talk With Your Healthcare Provider
Don't assume that pain is simply an unavoidable part of Parkinson’s.
Tell your neurologist or other healthcare provider about persistent or worsening pain.
Your provider may evaluate whether the pain is related to Parkinson’s symptoms, medication timing, dystonia, nerve problems, arthritis, an injury, or another condition.
If pain appears to be connected to medication “off” periods, adjusting Parkinson’s treatment may sometimes help.

Physical Therapy Can Help
Physical therapy is an important part of managing Parkinson’s-related pain and mobility problems.
A physical therapist familiar with Parkinson’s can help address:

• Muscle stiffness
• Posture
• Walking mechanics
• Balance
• Strength
• Flexibility
• Range of motion
• Movement patterns

A therapist can also teach exercises and strategies that can be incorporated safely into your daily routine.

Exercise and Stretching
Regular physical activity can be beneficial for many people with Parkinson’s.
Depending on your abilities and healthcare recommendations, exercise may include walking, cycling, strength training, stretching, balance exercises, dancing, aquatic exercise, or Parkinson’s-specific fitness programs.
Gentle stretching may be particularly helpful for stiffness and maintaining flexibility.
If you have significant balance problems, weakness, severe pain, or a history of falls, ask your healthcare provider or physical therapist to recommend appropriate exercises.
​
Heat, Massage and Other Non-Medication Approaches
Some people find relief from approaches such as:

• Heat
• Gentle stretching
• Massage
• Relaxation techniques
• Physical therapy
• Exercise
• Improved positioning during sleep
• Adaptive equipment

These approaches may be particularly useful when pain is associated with muscle tightness or stiffness.
However, what works for one person may not work for another.

Can Parkinson’s Medication Help With Pain?
Sometimes.
If pain is related to Parkinson’s rigidity, dystonia, or “off” periods, adjusting Parkinson’s medication may improve symptoms.
Other medications may also be considered depending on the type of pain.
For example, treatment for nerve pain can differ from treatment for muscle or joint pain.
Never change or stop Parkinson’s medication without speaking with your healthcare provider.

What About Over-the-Counter Pain Relievers?
Some people with Parkinson’s use over-the-counter pain medications, but these aren't appropriate for everyone.
Medications can interact with other prescriptions or may not be safe for people with certain medical conditions.
Before regularly taking an over-the-counter pain reliever, ask your healthcare provider or pharmacist whether it is appropriate for you.

When Should You Seek Medical Attention?
New or severe pain should not automatically be attributed to Parkinson’s.
Contact your healthcare provider about persistent, worsening, or unexplained pain—particularly if it is accompanied by symptoms such as weakness, numbness, swelling, fever, an injury, or significant changes in mobility.
Sudden severe pain or other serious new symptoms may require prompt medical evaluation.

Questions People Ask About Parkinson’s Pain
1.  Is pain a common symptom of Parkinson’s disease?
Yes. Pain can affect many people with Parkinson’s, although the type, severity, and location vary.
2.  What does Parkinson’s pain feel like?
It depends on the cause. Pain may feel like muscle aching, stiffness, cramping, burning, tingling, shooting pain, or painful involuntary muscle contractions.
3.  Can Parkinson’s cause joint pain?
Parkinson’s can contribute to joint and musculoskeletal discomfort through stiffness, reduced movement, posture changes, and altered walking patterns. However, joint pain can also have other causes, such as arthritis.
4.  Can exercise reduce Parkinson’s pain?
Exercise may help improve flexibility, strength, mobility, posture, and overall physical function. A healthcare professional or physical therapist can help determine which activities are appropriate.
5.  Should I tell my neurologist about my pain?
Yes. Pain can provide important information about your Parkinson’s symptoms and treatment response. Your healthcare provider can help determine the cause and identify appropriate treatment.
​
Conclusion: Don't Ignore Parkinson’s Pain
Pain can be one of the most frustrating and disruptive parts of living with Parkinson’s—but it doesn't have to be something you simply accept.
The first step is figuring out what is causing the pain.
Keep track of when it occurs, where you feel it, how it feels, and whether it changes with medication or movement. Then share that information with your healthcare team.
Treatment may involve medication adjustments, physical therapy, exercise, stretching, treatment for dystonia or nerve pain, or other approaches.
The goal isn't simply to tolerate Parkinson’s. The goal is to help you move more comfortably, remain active, protect your independence, and live as well as possible.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

Retirement planning can feel complicated for anyone, but a Parkinson’s diagnosis can add another layer of questions. How long will you be able to work? Will healthcare costs increase? What happens if you need help with daily activities someday? And how can you plan for the future without allowing Parkinson’s to take over your vision of retirement?
The good news is that planning early can give you more choices—not fewer. You don't have to predict exactly what the future will look like to make a thoughtful retirement plan today.

Why Should You Plan Early for Retirement With Parkinson’s?
Parkinson’s disease progresses differently for every person. Some people continue working and living independently for many years after diagnosis, while others eventually need to make changes to their employment or daily routines.
That uncertainty is one reason early retirement planning can be valuable.
Planning does not mean assuming the worst. Instead, it gives you an opportunity to prepare for several possible scenarios while you still have flexibility.
Review Your Financial Situation
Start by getting a clear picture of your current finances.
Review:

• Retirement savings and investments
• Social Security benefits
• Pensions
• Monthly expenses
• Debt
• Housing costs
• Insurance premiums
• Emergency savings
• Healthcare expenses

Consider working with a qualified financial professional who understands retirement planning and can help you evaluate your individual circumstances.
A useful question is:
“What would my finances look like if I needed to stop working earlier than expected?”
You don't necessarily need to retire early. But knowing what would happen financially if you had to can reduce uncertainty.

Consider Healthcare and Medication Costs
Healthcare can become one of the largest retirement expenses, particularly when managing a chronic condition.
Think beyond your monthly insurance premium.
Potential expenses can include:

• Prescription medications
• Neurology appointments
• Physical therapy
• Occupational therapy
• Speech therapy
• Dental care
• Vision care
• Medical equipment
• Transportation to appointments
• Home modifications
• Long-term care

Medicare and supplemental insurance can play important roles for eligible retirees, but coverage varies. Review your benefits carefully and consider discussing your situation with a qualified insurance or benefits professional.

Understand Disability and Social Security Options
If Parkinson’s symptoms make it difficult or impossible to continue working, you may want to learn about potential disability benefits.
Depending on your circumstances, Social Security Disability Insurance (SSDI) or other programs may be relevant.
Eligibility depends on factors such as work history, disability status, and whether your medical condition meets Social Security requirements.
Do not assume you won't qualify—or that you will.
Instead, learn about the requirements and consider speaking with a qualified benefits professional if you're unable to work because of Parkinson’s.

Think About Your Housing Needs
Your home may work perfectly today but become more challenging if Parkinson’s symptoms affect balance, walking, mobility, or strength.
You don't need to remodel your home immediately.
Instead, consider what might eventually make your home safer and easier to navigate.
Potential modifications include:

• Improved lighting
• Grab bars
• Handrails
• Reduced fall hazards
• Easier-to-use bathroom fixtures
• Accessible entrances
• Bedroom and bathroom arrangements that minimize stairs

Planning ahead can make future changes less stressful.
Consider Long-Term Care and Caregiving
One of the most difficult topics to discuss is what happens if you eventually need help.
That does not mean you will need extensive care. But it is worth discussing possibilities before a crisis occurs.
Consider:
Who could help me if I needed assistance?
Would that person live nearby?
Would paid home care be an option?
Would assisted living or another setting ever make sense?
How would those services be paid for?
Having these conversations early allows families to consider options before decisions have to be made under pressure.

Don't Forget Your Care Partner
Retirement planning affects more than the person with Parkinson’s.
If you have a spouse, partner, family member, or other care partner, include them in the conversation.
Discuss:

• Finances
• Healthcare decisions
• Employment
• Insurance
• Housing
• Transportation
• Caregiving responsibilities
• Emergency plans
• Retirement goals

The goal is not to turn your relationship into a patient-and-caregiver relationship. It is to make sure both people understand the plan and have opportunities to maintain their own health, interests, and independence.

Plan for the Retirement You Want
Financial and medical planning are important, but retirement isn't only about money.
Think about what you actually want your retirement to look like.
Maybe you want to:

• Travel
• Spend more time with family
• Garden
• Volunteer
• Exercise
• Pursue hobbies
• Take classes
• Spend time outdoors
• Participate in your community

Then ask:
“What can I do now to make that future possible?”
Exercise, social connection, treatment, rehabilitation, and maintaining meaningful activities can all be part of living well with Parkinson’s.
Don't Let Fear Make the Decisions
A Parkinson’s diagnosis can make the future feel uncertain.
It's easy to imagine the most difficult possible outcome.
But Parkinson’s does not follow one universal path.
Retirement planning should therefore focus on flexibility rather than fear.
Create a plan that can adapt if your health, finances, work situation, or care needs change.
Review it periodically and update it as your circumstances change.

Questions People Ask About Retirement and Parkinson’s
Should I retire early if I have Parkinson’s?
Not necessarily. Many people continue working after diagnosis. The decision depends on symptoms, job demands, finances, treatment response, personal goals, and overall health.
Can I receive disability benefits because of Parkinson’s?
Some people with Parkinson’s may qualify for disability benefits, but eligibility is based on specific requirements. A diagnosis alone does not automatically guarantee benefits.
Will Parkinson’s make retirement more expensive?
It can. Medication, healthcare, therapy, transportation, home modifications, and potential caregiving can add expenses. Planning for these possibilities can strengthen your financial plan.
Should I buy long-term care insurance?
This is an individual financial decision. Coverage availability and eligibility can depend on health history and other factors, so discuss your options with a qualified insurance or financial professional.
When should I start planning?
The earlier, the better. You don't need to know exactly how Parkinson’s will progress. Starting early gives you more time to understand your options and make adjustments.
​
Conclusion: Plan for Possibilities, Not the Worst-Case Scenario
Retirement planning with Parkinson’s is ultimately about creating choices and flexibility.
You don't need to assume that Parkinson’s will prevent you from having the retirement you imagined. At the same time, ignoring potential healthcare, financial, housing, or caregiving needs can create unnecessary stress later.
Start with what you know today.
Review your finances. Understand your healthcare coverage. Learn about potential benefits. Talk with your family. Consider your housing and future care needs. And most importantly, continue planning for the activities and relationships that make life meaningful.
Parkinson’s may be part of your future, but it does not have to define your future.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
​

One of the first questions many people have after a Parkinson’s diagnosis is, “How quickly will this get worse?” It is a completely understandable question. Parkinson’s disease is progressive, but that does not mean everyone follows the same timeline or experiences the same symptoms in the same order.
​
Here’s the part that may bring some reassurance: a Parkinson’s diagnosis does not come with a stopwatch. Understanding what can affect progression can help you focus on what you can do today to live as well as possible.

How Quickly Does Parkinson’s Disease Progress?
Parkinson’s disease generally progresses gradually over time. However, the rate of progression can be very different from one person to another.
Some people experience relatively slow changes and maintain independence and an active lifestyle for many years. Others may develop more noticeable movement, balance, cognitive, or other symptoms sooner.
​
This is why it can be difficult—and sometimes misleading—to predict exactly what Parkinson’s will look like five, 10, or 20 years after diagnosis.
Your healthcare provider can discuss your individual symptoms and circumstances, but no doctor can accurately predict the exact course of Parkinson’s for every person.

What Causes Parkinson’s to Progress?
Parkinson’s disease is associated with changes and loss of dopamine-producing nerve cells in an area of the brain involved in movement. As the disease progresses, symptoms can become more noticeable or new symptoms can develop.
However, Parkinson’s is much more than a movement disorder.
Symptoms can include:

• Tremor
• Stiffness
• Slowness of movement
• Changes in walking
• Balance problems
• Freezing of gait
• Speech changes
• Swallowing difficulties
• Sleep problems
• Constipation
• Depression or anxiety
• Fatigue
• Cognitive changes
• Not everyone experiences these symptoms, and they may appear at different points in the disease.
                                                                                                                                                                       

What Factors Affect Parkinson’s Progression?
Researchers continue to study why Parkinson’s progresses differently among individuals.
Factors that may influence a person's experience include:
1.  Age at Diagnosis
Parkinson’s that begins at a younger age can have a different pattern from Parkinson’s diagnosed later in life.
2.  Symptoms and Disease Characteristics
The types of symptoms a person develops and how those symptoms change over time can influence their individual disease course.
3.  Overall Health
Other medical conditions and general health can affect mobility, independence, recovery from illness, and quality of life.
4.  Response to Treatment
Medications and other therapies can significantly improve symptoms and daily functioning for many people.
5.  Balance, Walking and Cognitive Changes
Changes involving balance, falls, walking, or thinking can have a greater effect on independence than some other Parkinson’s symptoms.

Does Parkinson’s Always Become Severe?
No.
A Parkinson’s diagnosis does not mean that a person will inevitably become severely disabled or lose independence quickly.
Many people continue to work, exercise, travel, socialize, pursue hobbies, and participate in family activities for years after diagnosis.
The goal of treatment is not simply to treat symptoms today. It is also to help maintain mobility, independence, safety, participation, and quality of life over time.

Can Treatment Slow Parkinson’s Progression?
Currently, there is no cure that stops the underlying progression of Parkinson’s disease.
However, there are many treatments and strategies that can help manage symptoms and support quality of life.
Treatment may include:

• Parkinson’s medications
• Physical therapy
• Occupational therapy
• Speech therapy
• Exercise
• Balance and mobility training
• Treatment for sleep problems
• Management of mood symptoms
• Nutrition support
• Surgical treatments such as deep brain stimulation for appropriate candidates

Regular medical follow-up is important because treatment needs can change as Parkinson’s changes.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

At first, Parkinson’s medication may seem to provide reliable relief. But over time, you may notice that a dose doesn't last as long, symptoms return before your next dose, or movement becomes less predictable. These changes can be frustrating and sometimes frightening—but they do not necessarily mean that treatment has stopped working.
If your medication seems to be “wearing off,” there are several things your healthcare team can do. Keep reading to learn what may be happening, what information to track, and what treatment options may be available.

Why Do Parkinson’s Medications Sometimes Become Less Effective?
Parkinson’s disease changes over time. As the disease progresses, the brain may have less ability to store and use dopamine, which can make the effects of medications such as levodopa less consistent.
One common change is called motor fluctuation.
A person may experience periods when medication is working well, known as “on” time, followed by periods when Parkinson’s symptoms return, known as “off” time.
This can happen even when the medication initially worked very well.

What Does “Wearing Off” Feel Like?
Wearing off occurs when the benefit of a medication dose begins to disappear before the next scheduled dose.
You might notice:

• Tremor returning
• Increased stiffness
• Slower movement
• Difficulty walking
• Trouble getting out of a chair
• Smaller steps
• Freezing
• Increased fatigue

Some people can recognize a predictable pattern—for example, symptoms returning 30 to 60 minutes before their next dose.
Others experience more unpredictable changes.

Step 1: Don't Change Your Medication on Your Own
If your Parkinson’s medication doesn't seem to be working as well, contact your healthcare provider.
Do not increase, decrease, skip, or stop Parkinson’s medication without medical guidance.
Sudden medication changes can cause significant problems and, in some situations, can be dangerous.
Your neurologist or movement-disorder specialist can determine whether the medication needs to be adjusted or whether something else may be contributing to the change.

Step 2: Keep a Medication and Symptom Diary
One of the most useful things you can bring to an appointment is a detailed record.
For several days, write down:
Medication

• Name
• Dose
• Time taken

Symptoms

• When symptoms improve
• When they return
• Which symptoms return
• How severe they are

Other changes

• Meals
• Sleep
• Exercise
• Stress
• Involuntary movements

This information can help your healthcare provider recognize patterns that aren't obvious during a short office visit.

Step 3: Pay Attention to Food and Medication Timing
For some people taking levodopa, meals—particularly meals high in protein—can affect how the medication is absorbed or how consistently it works.
However, dietary recommendations should be individualized.
Instead of changing your diet on your own, ask your healthcare provider or pharmacist whether the timing of your medication and meals could be affecting symptom control.

Step 4: Ask Whether Your Medication Schedule Needs Adjustment
Your doctor may be able to improve symptom control by changing the timing or dosage of medication.
Depending on your individual situation, treatment may involve adjusting levodopa schedules or adding other Parkinson’s medications designed to extend or smooth its effects.
The goal is often to increase useful “on” time while reducing troublesome “off” periods and medication-related side effects.

Step 5: Tell Your Doctor About Dyskinesia
Some people develop dyskinesia, which refers to involuntary, uncontrolled movements.
Dyskinesia can sometimes occur when Parkinson’s medication is working, particularly after years of levodopa treatment.
Tell your healthcare provider if you notice:

• Twisting movements
• Jerking
• Rocking
• Fidgeting
• Involuntary movements of the head, trunk, arms, or legs

There are treatment strategies specifically aimed at managing dyskinesia.

Step 6: Look for Other Reasons Symptoms May Have Changed
Not every change in Parkinson’s symptoms means the medication has stopped working.
Illness, infection, dehydration, constipation, poor sleep, stress, changes in activity, medication interactions, or other health problems can sometimes temporarily worsen Parkinson’s symptoms.
Your healthcare team can help determine whether a new or worsening symptom is related to Parkinson’s, medication, or another issue.

Step 7: Ask About Advanced Treatment Options
When medication adjustments no longer provide adequate or predictable symptom control, specialists may discuss advanced treatment options.
Depending on the individual, these can include deep brain stimulation (DBS) or medication-delivery therapies such as infusion treatments.
These approaches aren't appropriate for everyone, but they may provide another option for people experiencing significant motor fluctuations or medication complications.

Step 8: Consider Seeing a Movement-Disorder Specialist
A movement-disorder neurologist has specialized training in Parkinson’s disease and other movement disorders.
If your symptoms are becoming difficult to manage, ask whether a consultation with a movement-disorder specialist would be appropriate.
A specialist can evaluate your symptoms, medications, daily schedule, treatment response, and goals to develop a more individualized plan.

Questions People Ask
1.  Does Parkinson’s medication eventually stop working?
Not necessarily. The effects of medication can become less predictable as Parkinson’s changes, but treatment can often be adjusted to address wearing-off and other motor fluctuations.
2.  How do I know if levodopa is wearing off?
You may notice Parkinson’s symptoms returning before your next dose, such as stiffness, tremor, slowness, walking difficulty, or freezing.
3.  Should I take more medication if my symptoms return?
No. Contact your healthcare provider before changing your dose or schedule.
4.  Can exercise help when Parkinson’s medication wears off?
Exercise is an important part of Parkinson’s management and can support mobility, strength, balance, and overall health. It should complement—not replace—your prescribed treatment plan.
5.  What happens if medication adjustments aren't enough?
Your healthcare team may discuss additional medications, infusion therapies, DBS, rehabilitation, or other approaches depending on your symptoms and overall health.

Conclusion: Don't Assume You're Out of Options
If your Parkinson’s medication doesn't seem to work as well as it once did, don't assume that nothing else can be done.
Wearing-off and motor fluctuations are recognized parts of Parkinson’s for some people, and treatment can often be adjusted.
The most important step is to communicate what you're experiencing. Keep a symptom diary, bring specific examples to your medical appointments, and ask about the full range of treatment options available to you.
Parkinson’s treatment is not a one-time decision. It is an ongoing process that can change as your needs change.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community. 

​A Parkinson's diagnosis can feel like it rewrites your whole story overnight. But according to Dr. Neil Koppel, DC, a chiropractor and acupuncturist with more than 25 years of experience, your diagnosis is only one chapter — not the whole book. In a recent PD Talk hosted by the Parkinson's Association of Southwest Florida, Dr. Koppel broke down what Parkinson's disease actually changes in the brain and body, and what you can still influence starting today.

Curious what the research really shows about posture, exercise, and Parkinson's disease — and where the evidence still has limits? Keep reading, because the answers may change how you think about your next walk, your next appointment, and your next conversation with your care team.

​Can Exercise Improve Parkinson's Symptoms?
Yes — with real evidence behind it. A 2022 American Physical Therapy Association clinical practice guideline, along with a review of roughly 40 randomized controlled trials involving more than 1,600 people with Parkinson's disease, found that targeted exercise can improve walking speed, stride length, balance, and posture. Exercise can't cure or reverse Parkinson's disease, but it's one of the most evidence-backed tools available for maintaining function and independence.

What Parkinson's Disease Really Changes
Most people associate Parkinson's disease with tremor, but tremor is only part of the picture. Parkinson's disease can also cause bradykinesia (slower, smaller movements), rigidity (muscle stiffness), shuffling steps, and reduced balance and coordination. These changes rarely happen in isolation — one shift, like a change in gait, can ripple into posture, balance, and how the brain interprets signals from the body.

The Brain-Body Connection Behind Movement
Your brain relies on constant input from your eyes, inner ear, feet, muscles, and joints — a process called sensorimotor integration — to decide how to move. Dr. Koppel compared it to GPS: good information in means good directions out. When posture or movement patterns shift, as they often do with Parkinson's disease, the information reaching the brain can change too, which is why posture, balance, and movement are so closely linked.

​What the Research Shows
Dr. Koppel shared real-world examples: a 59-year-old man who maintained posture improvements 21 months after a structured gait-training program, and a 68-year-old woman whose pain dropped from 8 out of 10 to 2 out of 10 after multi-method rehabilitation. A larger, controlled study of 37 people found targeted trunk and posture training outperformed standard rehabilitation for balance.
​
Dr. Koppel was clear about the limits, though: case studies show what's possible for one person, not proof of a cure. The strongest evidence remains for exercise and rehabilitation broadly — not any single treatment.

Where Chiropractic Care May Fit In
Chiropractic care doesn't replace your neurologist, medication, or physical therapy, and it isn't a treatment for Parkinson's disease itself. But people with Parkinson's disease can also develop separate mechanical issues, like joint stiffness or back pain, that may be safely evaluated alongside neurological care — one possible piece of a larger, team-based approach.
​
Six Ways to Start Building Strength Today

1. Movement — keep moving safely, even if you need to slow down or adapt.
2. Strength — build the muscle you need for daily tasks like standing up and climbing stairs.
3. Balance and walking — practice these as skills, using cues that work for you.
4. Posture and mobility — don't ignore stiffness; have it evaluated.
5. Adaptation — find new ways to do familiar things.
6. Connect — lean on your full care team, including support organizations near you.

​Questions People Ask
Does posture really affect Parkinson's disease symptoms? Emerging research suggests posture can influence how the nervous system processes sensory information, though more Parkinson's-specific research is still needed.
Can chiropractic care help someone with Parkinson's disease? It may help address separate mechanical issues like stiffness or joint pain, but it does not treat or cure the underlying neurological condition.
What's the best type of exercise for Parkinson's disease? Clinical guidelines support a mix of aerobic exercise, strength training, balance training, gait training, and task-specific practice.
Is Parkinson's disease reversible with therapy or exercise? No. Therapy and exercise can improve function, comfort, and quality of life, but they do not reverse or cure Parkinson's disease.

Conclusion:
Parkinson's disease changes things — but it doesn't erase who you are or what you can still work toward. Whether that means walking a little farther, standing a little taller, or simply feeling more confident in daily life, small, evidence-informed steps add up. You don't have to figure it out alone, and you don't have to wait for a perfect moment to start.

​Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
​
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners, or family members.

For some people living with Parkinson’s disease, medications eventually become less predictable. Tremors may return between doses, stiffness and slowness may fluctuate, or involuntary movements called dyskinesias may become difficult to control. When medication adjustments are no longer providing consistent symptom control, deep brain stimulation (DBS) may be an option worth discussing with a Parkinson’s specialist.
​
Could DBS help you or someone you love regain more predictable “on” time and better control over troublesome movement symptoms? Here’s what you should know before considering this advanced Parkinson’s treatment.

What Is Deep Brain Stimulation?
Deep brain stimulation is a surgical treatment that uses a small implanted device to send electrical signals to specific areas of the brain involved in movement.
Thin electrodes are placed in targeted areas of the brain and connected to a neurostimulator, usually implanted under the skin near the collarbone. The device can then be programmed to help regulate abnormal brain activity associated with Parkinson’s movement symptoms. 
DBS has been used to treat Parkinson’s disease for decades and is an established treatment option for appropriately selected patients.

What Parkinson’s Symptoms Can DBS Help?
DBS is primarily used to treat movement-related symptoms.
It may help reduce:

• Tremor
• Muscle stiffness or rigidity
• Slowness of movement
• Dyskinesia
• Motor fluctuations or “wearing off”
• Certain medication-related movement problems

Symptoms that respond well to levodopa often respond well to DBS, although tremor can sometimes improve with DBS even when it does not respond adequately to levodopa.

Is DBS a Cure for Parkinson’s?
No. DBS does not cure Parkinson’s disease or stop the underlying disease from progressing.
Instead, it is a treatment designed to improve specific symptoms and, for some people, provide more consistent control of movement.
Many people continue taking Parkinson’s medications after DBS, although some may be able to reduce their medication doses. 

Who Might Be a Candidate for DBS?
DBS is not right for everyone with Parkinson’s.
A movement-disorder specialist may consider DBS when a person has a confirmed Parkinson’s diagnosis and continues to experience significant motor symptoms or medication-related complications despite medication adjustments.
Doctors may evaluate:

• How symptoms respond to levodopa
• Tremor, stiffness, and slowness
• Motor fluctuations
• Dyskinesias
• Overall physical health
• Memory and thinking
• Depression and other mental-health concerns
• Ability to undergo surgery
• Available family or care-partner support

A comprehensive evaluation often includes neurological assessment, brain imaging, medication review, and neuropsychological testing. 

When Should Someone Consider DBS?
One important misconception is that a person must wait until Parkinson’s medications completely stop working.
In fact, DBS may be considered when medications still help but become difficult to manage because of wearing-off periods, dyskinesias, or other troublesome fluctuations. 
The timing is highly individual, which is why discussing DBS with a movement-disorder specialist before symptoms become extremely difficult to control may be worthwhile.

What Happens During DBS Surgery?
DBS treatment involves implanting the stimulation system.
The procedure generally involves placing electrodes into carefully selected areas of the brain and connecting them to a neurostimulator implanted beneath the skin. Depending on the approach and medical center, the procedure may involve one or more surgical sessions. 
Brain imaging is used as part of planning and positioning the electrodes.

What Happens After Surgery?
DBS is not simply “turned on” and finished.
After the surgical sites heal, the device is activated and programmed. The medical team adjusts stimulation settings to find the combination that provides the most symptom improvement while minimizing side effects.
Several programming appointments may be needed, particularly during the early months. Follow-up continues over time because symptoms and treatment needs can change. 

What Are the Risks of DBS?
Because DBS involves brain surgery and an implanted medical device, there are potential risks.
Surgical complications can include infection, bleeding, seizures, confusion, or other neurological complications. Stimulation itself can sometimes contribute to problems such as speech changes, balance difficulties, involuntary movements, or other side effects. Many stimulation-related effects can be addressed by changing the device settings, but not every complication is reversible. 
The decision should therefore involve a careful discussion of potential benefits and risks with an experienced DBS team.

What Symptoms May Not Improve With DBS?
DBS is primarily a treatment for certain movement symptoms. It should not be viewed as a treatment for every symptom of Parkinson’s.
For example, symptoms such as mood problems, fatigue, and some walking difficulties may not improve, particularly if they did not previously respond to levodopa. Balance, speech, and swallowing problems can also be challenging and may sometimes worsen with stimulation.
This is why having realistic expectations before surgery is extremely important.

Questions People Ask About Parkinson’s DBS
1. Does DBS stop Parkinson’s from progressing?
No. DBS treats certain symptoms but does not stop the underlying progression of Parkinson’s disease. 
2. Can DBS eliminate tremors?
DBS can significantly reduce tremor in appropriately selected patients. Tremor may respond to DBS even when it does not respond well to levodopa. 
3. Will I still need Parkinson’s medication after DBS?
Usually, yes. Some people can reduce their medication after DBS, but most continue taking some Parkinson’s medications. 
4. Is DBS appropriate for older adults?
Age alone does not automatically exclude someone from consideration. Overall health, cognitive function, symptoms, surgical risk, and individual circumstances are important factors. 
5. How do I find out if DBS is right for me?
The best starting point is a comprehensive evaluation by a neurologist or movement-disorder specialist experienced in DBS.

Conclusion: DBS Is an Option, Not a One-Size-Fits-All Solution
Deep brain stimulation can be a life-changing treatment for some people with Parkinson’s disease, particularly those experiencing troublesome tremor, rigidity, slowness, dyskinesia, or medication fluctuations.
But DBS is not a cure, and it is not right for everyone.
The most important step is learning whether your specific symptoms, health, treatment response, and goals make DBS a reasonable option. A specialized DBS team can help you understand both what the procedure may accomplish and what it cannot.
Most importantly, you don't have to make the decision alone.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

You're at dinner, at church, or running errands, and suddenly there's no warning at all — just an urgent, undeniable need to find a bathroom, right now. If that sounds familiar, you're not imagining it, and you're not alone.
​
Here's the part most people never hear from their neurologist: bladder trouble in Parkinson's disease isn't a plumbing problem — it's a wiring problem. And once you understand the wiring, you can actually do something about it. Keep reading to find out what's really going on, and the treatments urologists use to help patients regain control.

How Does Parkinson's Disease Affect the Bladder?
Parkinson's disease damages the dopamine-producing nerve pathways that help coordinate bladder signals. This can cause the bladder to become overactive (contracting too soon, leading to urgency and leakage) or underactive (not contracting enough, leading to retention) — depending on which nerve signals are disrupted.
​
The Brain-Bladder Connection, Explained
According to Dr. Rolando Rivera, MD, FACS, a urologist who spoke to the Parkinson's Association of Southwest Florida (PASWFL) in a recent PD Talk webinar, the bladder is actually a muscle — the detrusor muscle — that functions independently of the brain. Contrary to what many assume, the brain's main job isn't to turn urination on. It's to turn it off.
​
As a baby's bladder fills, it simply empties. As the brain matures, it learns to send an "it's not appropriate to go yet" signal, giving us voluntary control. In neurological conditions like Parkinson's, that inhibitory signal — the "off switch" — starts to malfunction, and bladder-brain communication breaks down.

​Common Urinary Symptoms in Parkinson's Disease
Parkinson's sits at the top of the list of neurological conditions that affect the bladder, alongside multiple sclerosis, stroke, dementia, Alzheimer's disease, and diabetic neuropathy. Dr. Rivera outlined the symptoms patients most often report:

• Urgency, the sudden "gotta go now" sensation; frequency, needing the bathroom more often than what's typical for you personally, not just a fixed number.
• Nocturia, waking at night specifically because of the urge to void.
• Urinary retention, difficulty emptying the bladder fully.
• Involuntary leakage, when the urge arrives faster than you can reach a bathroom.

How Doctors Diagnose PD-Related Bladder Problems
Diagnosis starts with a detailed patient history and a short bladder diary — typically three days — to track patterns and triggers like caffeine, alcohol, citrus, or spicy foods. Urine testing rules out infection, and in more complex cases, urodynamic testing (similar in concept to a cardiac stress test) measures how the bladder fills, stores, and empties.

Treatment Options: From Lifestyle Changes to Advanced Therapies
Treatment is layered, starting simple and escalating only as needed. First-line steps include reducing bladder irritants and adjusting fluid timing before bed, plus timed voiding schedules that don't rely on an unreliable urge signal. Pelvic floor (Kegel) exercises can help retrain the muscles involved.

When lifestyle changes aren't enough, medication is often the next step — and here's something important for PD patients: many standard overactive bladder medications (anticholinergics) can interact with carbidopa-levodopa. Fortunately, a newer medication class called beta-3 agonists — brand names Myrbetriq and Gemtesa — works through a different pathway and doesn't interfere with Parkinson's medications.

For patients who need more, advanced options include Botox injections directly into the bladder muscle, sacral nerve stimulation (which works much like a pacemaker for the bladder), and catheterization for retention. Dr. Rivera also cautioned that in men with Parkinson's, treating the prostate too aggressively can sometimes worsen incontinence rather than help it — another reason to work with a provider who understands the neurological piece.
​
When to See a Doctor
If bladder symptoms are affecting your quality of life, are new or worsening, involve pain or burning, or leave you feeling like you can't fully empty your bladder, it's time to talk to your doctor. Losing urine control is not something to just live with — effective, safe treatments exist.

​Questions People Also Ask
Does Parkinson's disease cause bladder problems? Yes. Parkinson's affects the dopamine-related nerve pathways that help regulate bladder signals, which can cause urgency, frequency, nocturia, or retention.

Why do I feel like I have to urinate all the time with Parkinson's? This is usually urgency caused by an overactive bladder, where disrupted nerve signals cause the bladder muscle to contract before it's full.

Is it normal to wake up at night to urinate with Parkinson's? Some nighttime urination (nocturia) is common with age and with Parkinson's, but frequent waking, small-volume voids, or associated leakage should be discussed with a doctor.

Are overactive bladder medications safe with carbidopa-levodopa? Not all of them. Anticholinergic medications can interact with carbidopa-levodopa, but newer beta-3 agonists (Myrbetriq, Gemtesa) work through a different pathway and are generally considered compatible.

Can Kegel exercises help with Parkinson's-related bladder issues? Yes, pelvic floor exercises, sometimes guided by a physical therapist, can help retrain bladder control, particularly for milder symptoms.
​
When should someone with Parkinson's see a doctor about bladder symptoms? See a doctor if symptoms affect daily life, involve pain, burning, incomplete emptying, or if you're losing urine control regularly.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
​
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners, or family members.

Why Speech Exercise Is a Game-Changer for Parkinson's Disease
If you or someone you love has Parkinson's disease, you already know it can affect movement — tremors, stiffness, slower steps. But did you know it very often affects your voice, too? A soft voice, slurred words, or trouble swallowing aren't just “getting older.” They're common, treatable symptoms of Parkinson's disease (PD) that up to 90% of people with PD will experience — and most neurologists never bring it up.
​
That's exactly why the Parkinson's Association of Southwest Florida (PASWFL) invited speech-language pathologist Judy Jenner, MS, CCC, to lead a recent PD Talk, “Speech Exercise and PD: Learn the Benefits and Process.” We've turned that full session into an easy-to-read transcript, and below we're breaking down the highlights — what these symptoms look like, why they happen, and, most importantly, what you can do about it starting today. Keep reading to learn more.

Does Parkinson's Disease Affect Speech and Voice?
Yes. Up to 90% of people with Parkinson's disease experience some degree of speech, voice, or swallowing difficulty, including a soft voice, monotone speech, slurred words, or coughing while eating. These symptoms often go undiscussed at diagnosis because neurologists prioritize visible motor symptoms first, but they are common, well-documented, and treatable with speech exercise.

Why Isn't This Discussed at Diagnosis?
According to Jenner, it comes down to priorities in that first appointment. Your neurologist is focused on confirming the diagnosis and treating the motor symptoms that likely brought you in, such as tremor, stiffness, or falling. Speech and swallowing changes are considered “non-motor” and often get pushed to a later conversation that doesn't always happen. Families tend to downplay early changes, too — a softer voice can quietly become the norm long before anyone names it as a symptom of PD.

​Common Speech, Voice, and Swallowing Symptoms of Parkinson'sWatch for these signs in yourself or a loved one:

• A soft voice or reduced volume that requires frequent repeating
• Monotone speech with little pitch variation
• A hoarse, strained, or breathy voice
• Slurred or unclear words
• Trouble finding words or keeping up with fast conversation
• A “masked face,” or reduced facial expression
• Coughing or choking during meals, or unplanned weight loss

If any of these sound familiar, it's worth raising with your care team.

​The Science: Why People With PD Don't Realize They're Speaking Too Softly
One of the most surprising things Jenner shared is that PD can cause a sensory processing disorder affecting how loud people perceive their own voice to be. Someone speaking at 62–63 decibels may genuinely believe they're speaking at a normal 70 decibels. Ask them to speak up and they can, for a sentence or two, but their brain still tells them they're already loud enough. This isn't stubbornness or a hearing problem — it's called “faulty cueing,” a real, physiological part of PD, and it's exactly why targeted speech exercise, not just reminders to “talk louder,” makes such a difference.
​
The Proven Benefits of Early Speech TherapyResearch shared during the talk shows that early, consistent speech exercise can:

• Increase vocal loudness and improve speech clarity
• Improve swallow safety and reduce choking risk
• Take advantage of neuroplasticity, the brain's ability to build new pathways with practice
• Maintain confidence in social settings and reduce isolation and depression
• Improve quality of life (QoL) scores
• Slow the long-term decline in speech function
• Reduce hospitalizations related to aspiration pneumonia

The takeaway: starting speech exercise early, even before symptoms feel serious, is far easier than trying to recover ground later.

​Free Speech Exercise Groups Through PASWFL
You don't need a referral or a formal diagnosis of a speech problem to start. PASWFL offers free speech exercise groups multiple times each week, year-round, live on Zoom, so members can join from home, from anywhere, no computer experience required. Groups include breathing, oral motor, facial expression, swallowing, loudness, and intonation exercises in a supportive, social setting. They're not a substitute for one-on-one speech therapy such as LSVT LOUD or SPEAK OUT!, but they're an excellent, free way to start now.

​Frequently Asked Questions
What is LSVT LOUD?
LSVT LOUD (Lee Silverman Voice Treatment) is a certified, research-backed speech therapy program designed specifically for people with Parkinson's disease to increase vocal loudness.
Do I need a doctor's referral to join a PASWFL speech group?
No. PASWFL's speech exercise groups are free and open to all members; no referral or diagnosis of a speech disorder is required to attend.
Can speech therapy really help Parkinson's disease?
Yes. Research shows early speech therapy and exercise can improve vocal loudness, speech clarity, swallow safety, and overall quality of life for people with Parkinson's disease.
Is PASWFL membership really free?
Yes. Membership and programs are free and confidential, and open to anyone touched by PD, regardless of where they live.

​Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For 30 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
https://parkinsonassociationswfl.org/signup-enews.html
👉 Click here to become a member — it's free and confidential
https://parkinsonassociationswfl.org/signup.html
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners or family members.

Navigating Memory Changes in Parkinson's Disease: What's Normal vs. What's Not
You forgot why you walked into the kitchen. Again. And now you're wondering: is this just getting older, or is this Parkinson's disease talking?

That question sits quietly behind a lot of Parkinson's diagnoses, and it deserves a real answer — not a scary one. Here's what's actually happening in your brain, what's normal, what's worth flagging to your doctor, and the strategies that genuinely help.
​
In Parkinson's disease, memory itself is often less affected than attention, mental processing speed, problem-solving, and word-finding. The brain changes behind PD's motor symptoms can also slow thinking, and stress, medication, and depression compound the effect — but this is different from dementia, and there's a lot you can do about it.

What's Normal Aging vs. What's Worth a Conversation
Occasionally misplacing your keys or blanking on an appointment is ordinary age-related forgetfulness — annoying, not alarming. It doesn't interrupt your ability to pay bills, drive, or live independently.

Serious memory problems look different: asking the same question repeatedly, getting lost in familiar places, trouble following a recipe you've made for years, or confusion about time and people. Those are signs worth discussing with a neurologist — not because something is definitely wrong, but because early conversations lead to better support.
​
Why Parkinson's Disease Actually Affects Thinking
According to speech-language pathologist Judy Jenner, MS, CCC, who presented this topic for the Parkinson's Association of Southwest Florida, Parkinson's disease most often shows up as:

• Slower processing speed — a delay in responding, or needing more time to complete tasks
• Attention difficulty — trouble multitasking or sustaining focus on complex activities
• Word-finding trouble — that "tip of the tongue" feeling, especially under stress
• Visual-spatial changes — misjudging distance or depth, which is why good lighting matters

The Good News: Your Brain Can Still Change
Neuroplasticity — the brain's lifelong ability to rewire itself — means memory challenges aren't a one-way street. Simple changes, like driving a new route to the store or reordering your morning routine, stimulate the hippocampus, the brain's navigation and memory center.
​
Memory Strategies That Actually Work
A few evidence-backed techniques stand out: repetition (saying an appointment time aloud until it sticks), chunking (breaking a phone number or to-do list into small groups), visualization (picturing yourself carrying the three items you need from the store), and mnemonics (short phrases that anchor new information). Regular exercise, quality sleep, and staying socially engaged all support memory too — and exercise in particular is one of the few things proven to help Parkinson's disease directly.

​Questions People Ask
Does Parkinson's disease cause memory loss? Parkinson's disease more commonly affects attention, processing speed, and word-finding than memory storage itself, though memory can be affected too, especially with stress or depression.
What's the difference between normal memory loss and dementia? Normal age-related forgetfulness is occasional and doesn't interfere with daily life. Dementia involves memory loss plus difficulty with language, reasoning, or self-care that disrupts independent living.
Can memory be improved with Parkinson's disease? Yes. Strategies like repetition, chunking, visualization, exercise, and quality sleep can meaningfully support memory and cognitive function.
Should I see a doctor about memory changes? If memory problems begin interfering with daily tasks like driving, managing medication, or finding your way home, it's time to talk to a neurologist.
The Bottom Line
Memory changes with Parkinson's disease are common, often misunderstood, and — in many cases — manageable. Understanding what's happening in your brain is the first step toward feeling less alone with it.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
​
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners or family members.

A Parkinson’s diagnosis often brings an immediate question: “What happens next?” One of the biggest concerns for individuals and families is how quickly Parkinson’s disease will progress and how much it will eventually affect daily life. The truth is that Parkinson’s progression is highly individual, and there is no reliable timetable that applies to everyone.

​Wondering what the next five, 10, or even 20 years could look like? Understanding how Parkinson’s progresses—and what can influence that progression—can replace some of the uncertainty with knowledge and a plan.

Parkinson’s Usually Progresses Gradually
Parkinson’s disease is a progressive neurological disorder, meaning symptoms generally change over time. However, progression does not necessarily happen quickly or at the same rate throughout a person’s life.
Some people continue working, traveling, exercising, and participating in activities they enjoy for many years after diagnosis. Others experience more noticeable changes sooner.
Importantly, Parkinson’s is not a condition where receiving a diagnosis automatically means someone will rapidly lose independence.

Why Does Parkinson’s Progress at Different Rates?
There is no single factor that determines how quickly Parkinson’s will progress.
Researchers and healthcare professionals consider several factors, including:

• Age when symptoms begin
• Overall health
• Type and severity of symptoms
• Balance and walking difficulties
• Cognitive changes
• Response to Parkinson’s medications
• Other medical conditions
• Individual differences in the underlying disease

This is why comparing one person's Parkinson’s journey with another person's can be misleading.
Two people diagnosed with Parkinson’s at the same age can have very different experiences.

What Are the Stages of Parkinson’s Disease?
Healthcare professionals sometimes use staging systems to describe how Parkinson’s symptoms affect a person's movement and independence.
A commonly used system is the Hoehn and Yahr scale, which generally describes Parkinson’s from earlier stages with symptoms primarily affecting one side of the body through more advanced stages involving significant balance and mobility challenges.
However, staging is not a precise prediction of the future.
A person can remain in a particular stage for years, and progression does not always happen in a perfectly predictable sequence.

What Happens in Early Parkinson’s?
Early Parkinson’s may involve relatively mild symptoms such as:

• Tremor
• Stiffness
• Slowness of movement
• Changes in handwriting
• Reduced arm swing
• Changes in walking
• Loss of smell
• Sleep disturbances
• Constipation
• Depression or anxiety

Some symptoms may be subtle enough that they do not significantly interfere with everyday activities.
This is also a time when establishing a relationship with a neurologist or movement-disorder specialist can be valuable.

​What Happens as Parkinson’s Progresses?
Over time, some people experience increasing difficulty with movement, balance, walking, or daily activities.
Potential changes can include:

• More noticeable stiffness or slowness
• Greater difficulty walking
• Freezing of gait
• Balance problems
• Falls
• Speech or swallowing difficulties
• Increasing need for assistance with daily activities

Not everyone develops all of these symptoms, and they can occur at different times.
Treatment can also change throughout the course of Parkinson’s to address changing symptoms and individual needs.

Can Treatment Slow Parkinson’s Progression?
Currently, there is no cure for Parkinson’s disease and no treatment proven to stop the underlying disease completely.
However, treatment can make a significant difference in managing symptoms and maintaining quality of life.
Medications, physical therapy, occupational therapy, speech therapy, exercise, nutrition, mental-health support, and other approaches may all play important roles in Parkinson’s care.
Regular medical follow-up allows treatment to be adjusted as symptoms change.

Can Exercise Help People With Parkinson’s?
Exercise is an important part of living well with Parkinson’s disease.
Depending on a person's abilities and medical needs, exercise may help support:

• Strength
• Flexibility
• Balance
• Mobility
• Cardiovascular fitness
• Confidence
• Overall quality of life

A physical therapist or qualified exercise professional can help develop an appropriate program.
The goal isn't necessarily to prevent Parkinson’s from progressing. Rather, maintaining strength, mobility, and function can help a person remain active and independent for as long as possible.

Does Parkinson’s Always Lead to Severe Disability?
No.
Parkinson’s affects people differently, and a diagnosis does not tell you exactly how much disability someone will eventually experience.
Some individuals maintain a high level of independence for many years. Others require additional assistance as their symptoms progress.
Because Parkinson’s is so individual, healthcare providers focus on the person's actual symptoms, abilities, goals, and quality of life rather than relying solely on a predicted timeline.

What Can You Do After a Parkinson’s Diagnosis?
Instead of trying to predict exactly what will happen years from now, focus on what can be done today.
That may include:

1. Establishing appropriate medical care.
2. Staying physically active.
3. Addressing symptoms early.
4. Maintaining social connections.
5. Participating in therapy and exercise programs.
6. Planning for changes without assuming the worst.
7. Building a strong support network.

Living with Parkinson’s is not simply about managing symptoms. It is also about maintaining purpose, independence, relationships, and quality of life.

Questions People Ask About Parkinson’s Progression
How long can someone live with Parkinson’s disease?
Parkinson’s itself is not necessarily a rapidly fatal disease. Life expectancy varies considerably depending on age, overall health, complications, and the individual's disease course.
Does Parkinson’s always get worse?
Parkinson’s is progressive, but the rate and nature of progression vary significantly from person to person.
Can Parkinson’s progression be slowed?
There is currently no proven way to stop the underlying progression, but treatment, exercise, rehabilitation, and management of symptoms can help preserve function and quality of life.
How long does each stage of Parkinson’s last?
There is no standard length of time for each stage. Some people remain in earlier stages for many years.
Can someone with Parkinson’s remain independent?
Yes. Many people with Parkinson’s remain independent for years, although the level of independence can change as symptoms progress.
Conclusion: Parkinson’s Does Not Come With a Stopwatch
It is completely understandable to want to know exactly how quickly Parkinson’s will progress. But there is no universal Parkinson’s timeline.
A diagnosis is the beginning of a journey—not a prediction of exactly how that journey will unfold.
With appropriate medical care, physical activity, rehabilitation, education, social connection, and support, people with Parkinson’s can take meaningful steps toward maintaining independence and living well.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member—it’s free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

When most people hear “Parkinson’s disease,” they immediately think of tremors. But tremor is only one possible symptom of Parkinson’s—and some people with Parkinson’s never develop a noticeable tremor. Changes in movement, balance, sleep, smell, mood, speech, and everyday activities may appear before or alongside the more recognizable motor symptoms.

Could changes you've been brushing off as aging actually be worth discussing with your doctor? Keep reading to learn 12 Parkinson’s symptoms beyond tremors that you should know—and why recognizing them early matters.

1. Changes in Walking
Walking may become slower or less natural. A person might take smaller steps, shuffle their feet, have difficulty turning, or experience a feeling that their feet are temporarily “stuck” to the floor. This is called freezing of gait.
Changes in walking can sometimes be subtle at first and may be noticed by family members before the individual recognizes them.
2. Balance Problems
Parkinson’s can affect posture, coordination, and balance. Someone who was previously steady may begin feeling less stable when turning, getting up from a chair, or walking in crowded or unfamiliar environments.
Falls or increasing difficulty recovering balance should be discussed with a healthcare professional.
3. Stiffness or Muscle Rigidity
Muscle stiffness, known as rigidity, is another common motor symptom. It may affect the shoulders, arms, legs, neck, or other areas of the body.
Some people notice stiffness when getting dressed, turning in bed, reaching for objects, or moving after sitting for a while.
4. Changes in Handwriting
A person's handwriting may gradually become smaller and more cramped. This symptom is called micrographia.
You might notice that writing a signature, filling out a form, or taking notes becomes increasingly difficult.
5. Reduced Facial Expression
Parkinson’s can reduce automatic facial movements. A person may appear less expressive or may blink less frequently.
This does not necessarily mean the person is unhappy or uninterested. The change can result from reduced movement of the facial muscles.
6. Changes in Speech or Voice
Speech may become softer, quieter, or more monotone. Some people may begin speaking more quickly, mumbling, or having difficulty making their voice heard.
Speech-language therapy can help many people address communication changes associated with Parkinson’s.

7. Loss or Reduction of Smell
A decreased sense of smell, called hyposmia, or loss of smell, called anosmia, can occur in Parkinson’s disease. In some individuals, changes in smell may appear years before noticeable movement symptoms.
However, loss of smell is common for many reasons, so it does not mean someone has Parkinson’s disease by itself.
8. Sleep Problems
Sleep changes can occur with Parkinson’s and may sometimes appear before a diagnosis.
Possible changes include insomnia, excessive daytime sleepiness, restless sleep, or acting out dreams. A condition called REM sleep behavior disorder can cause a person to physically act out vivid dreams.
Persistent or unusual sleep changes should be discussed with a healthcare professional.
9. Constipation and Other Autonomic Symptoms
Parkinson’s can affect the autonomic nervous system, which controls many functions that happen automatically.
Constipation may occur, along with problems such as changes in blood pressure when standing, urinary symptoms, or sweating changes.
These symptoms have many possible causes, so they should be evaluated in context rather than assumed to indicate Parkinson’s.
10. Depression, Anxiety, or Apathy
Parkinson’s affects more than movement. Depression, anxiety, apathy, and other emotional changes can occur as part of the disease.
A person may lose interest in activities, withdraw socially, experience persistent worry, or have difficulty getting motivated to start tasks.
These symptoms deserve attention because treating mental and emotional health is an important part of living well with Parkinson’s.
11. Slowness of Movement
Bradykinesia, or slowed movement, is one of the major motor symptoms of Parkinson’s disease.
Everyday tasks may gradually take longer, including buttoning clothing, brushing teeth, preparing food, getting out of a chair, or walking.
The change can be so gradual that a person may not immediately recognize it.
12. Changes in Posture or Movement
A person with Parkinson’s may begin standing more stooped or leaning forward. Arm swing while walking may decrease, sometimes more noticeably on one side.
One-sided changes can be particularly important to mention to a healthcare provider.

​Does Everyone With Parkinson’s Have Tremors?
No. Not everyone with Parkinson’s disease develops a tremor.
Parkinson’s symptoms vary significantly from person to person. Some people primarily experience stiffness and slowness, while others may have balance, walking, speech, sleep, or non-motor symptoms.
That is why looking at the entire pattern of symptoms is more useful than focusing on tremor alone.

When Should You Talk to a Doctor?
One symptom by itself does not mean someone has Parkinson’s disease. Many of these symptoms—including constipation, depression, sleep problems, loss of smell, and balance changes—can occur for numerous other reasons.
However, it is worth talking with a healthcare professional if you notice persistent, progressive, or unexplained changes, particularly when several symptoms occur together.
A neurologist, particularly one who specializes in movement disorders, can evaluate symptoms and determine whether additional testing or monitoring is appropriate.
​
Why Early Recognition Matters
Recognizing potential Parkinson’s symptoms does not mean jumping to a diagnosis. Instead, it means paying attention to changes and seeking appropriate medical guidance.
Early evaluation can help identify the cause of symptoms, address treatable problems, and connect individuals with resources that can support physical, emotional, and social well-being.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter:
https://parkinsonassociationswfl.org/signup-enews.html
👉 Click here to become a member—it’s free and confidential:
https://parkinsonassociationswfl.org/signup.html

Aware in Care: How to Protect Yourself During a Hospital Stay With Parkinson's Disease
Most people assume a hospital is the safest place to be. For people with Parkinson's disease, that assumption can be dangerous. At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida, Annie Brooks, director of education for the Florida Chapter of the Parkinson's Foundation, explained why hospital stays carry outsized risk for the Parkinson's community, and what a free kit can do about it.
​
Of every 12 people with Parkinson's disease, about four will be hospitalized this year. Of those four, three won't receive their medication on time, every single time. Keep reading to see why that happens, and the free tools built to stop it.
​

Why Are Hospitals Risky for People with Parkinson's Disease?
Hospital staff often don't know that Parkinson's medication timing is critical, that certain common medications are unsafe for Parkinson's patients, or that symptoms like hallucinations and blood pressure drops can be part of the disease. This leads to missed, delayed, omitted, or substituted medications, which the Parkinson's Foundation's free Aware in Care program is designed to help prevent.

The Data: Why Parkinson's Disease Raises Hospital Risk
Brooks shared research showing that people with Parkinson's disease are hospitalized more often than their peers and stay longer once admitted, sometimes by two days, sometimes by two weeks. Over 60 percent are discharged to a long-term care facility rather than home, and nearly 4 percent of Parkinson's-related hospital visits result in death. Brooks was direct about why: avoidable medication errors are common, and hospital staff frequently don't recognize how serious the consequences can be.
​
Four Ways Medication Errors Happen
Brooks broke hospital medication errors into four categories: missed (a dose overlooked because staff didn't know to give it), omitted (skipped on purpose based on a mistaken assumption, such as before surgery), delayed (given outside the precise timing a neurologist has fine-tuned), and substituted (swapped for a different formulation, such as generic or continuous-release versions, that don't behave the same way). She compared Parkinson's medication to insulin for someone with diabetes: mistimed doses aren't a minor inconvenience, they can trigger real physical and cognitive complications.

What's Inside the Free Aware in Care Kit
The Parkinson's Foundation's Aware in Care kit includes a hospital fact sheet on medications to avoid, a wallet-sized medical alert card, a fillable medication form, a hospital action plan with admission and emergency checklists, and information cards for deep brain stimulation and Duopa. A pre-drafted doctor's letter, ready for a physician's signature, instructs hospital staff not to change medications without consulting the patient's doctor. The full kit is free to download at parkinson.org/awareincare, and a physical version with a carrying bag is available for an $8 shipping fee, which the Foundation will waive for anyone who calls its helpline.

Special Considerations Worth Flagging in Advance
Brooks highlighted two conditions hospital staff frequently overlook: hallucinations or delusions related to Parkinson's disease or its medications, and neurogenic orthostatic hypotension, a sudden drop in blood pressure upon standing that can cause lightheadedness. The kit includes space to flag both, so care teams aren't caught off guard.
​
It's Not Just Hospitals: Rehab Facilities Face the Same Risk
During the Q&A, one attendee described a 21-day rehab stay where it took nearly a week to get medications correctly recorded. Brooks confirmed this is a known gap. All of the Aware in Care tools apply equally to rehab facilities, assisted living, and nursing homes, not just hospitals.

Questions People Ask
What is the Aware in Care program? Aware in Care is a free Parkinson's Foundation program that provides tools, including a medical alert card, medication form, and doctor's letter, to help people with Parkinson's disease and their care partners advocate for safe hospital care.

Why are Parkinson's patients more likely to be discharged to long-term care? Avoidable medication errors during hospitalization can worsen symptoms and complications, which the Parkinson's Foundation says contributes to fewer patients being well enough to return directly home.

Should I bring my medications in original bottles to the hospital? Yes. Most hospitals and long-term care facilities require original bottles to verify and safely dispense a patient's actual prescriptions.
Is the Aware in Care kit free? Yes. All materials are free to download at parkinson.org/awareincare, and a physical kit is available for an $8 shipping fee, which can be waived by calling the Foundation's helpline.
​
Conclusion
A hospital visit with Parkinson's disease doesn't have to mean losing ground. As Brooks emphasized, the tools that make the biggest difference, a medication list, a doctor's letter, and a plan, take only a few minutes to prepare and can be used from admission through discharge. Preparing before a crisis, not during one, is what gives patients and care partners the best chance of leaving the hospital in the same shape they arrived.

​Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.
​
For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners or family members.

Nearly one million Americans are living with Parkinson's disease today, and every 11 seconds, an older adult is treated in an emergency room for a fall. At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida, certified trainer and Balance University founder Chris Williams shared research that reframes falls entirely: they are not an inevitable part of aging or Parkinson's disease.
​
Here's the test Williams uses to predict life expectancy in seconds: can you stand on one foot for ten seconds? Keep reading to find out why that matters, and what you can do about it.

Can Balance Training Really Help Prevent Falls in Parkinson's Disease?
Yes. Balance depends on three trainable systems, vision and inner ear (vestibular), foot pressure sensors (mechanoreceptors), and limb-position sensors (proprioceptors), working together with muscle strength. Because the brain remains adaptable at any age, regular balance and strength exercises can measurably improve stability and reduce fall risk in people with Parkinson's disease.

Why Falls Are a Serious Risk with Parkinson's Disease
Williams opened with sobering numbers: nearly 90,000 Americans are diagnosed with Parkinson's disease each year, and an older adult dies from a fall-related injury roughly every 19 minutes. For adults over 80, a significant fracture from a fall, such as a broken hip, carries only about a 50 percent survival rate.

He illustrated the stakes with a story from his own career: his first client, a former Navy minesweeper captain, used a towel bar for leverage to stand up and fell when it gave way, fracturing his shoulder and hip. He passed away about 16 months later.
​
The Simple Test That Predicts Life Expectancy
A peer-reviewed study published in the British Journal of Sports Medicine found that adults who cannot stand on one foot for at least 10 seconds have a notably shorter life expectancy than those who can. Williams uses a 15-second single-leg stance as one of several quick self-assessments; needing to steady yourself twice or more suggests an elevated fall risk, he said, and that's exactly the population balance training is designed to help.

How Your Body Balances: Three Systems Working Together
Balance relies on three systems feeding information to the brain: the vestibular system (inner ear and vision), mechanoreceptors (pressure sensors in the feet), and proprioceptors (sensors that track limb position). Williams also described "freezing" episodes, which have no single known cause but can be triggered by medication, stress, or crowded spaces; physical contact, like touching a person's arm, can sometimes help the brain re-engage.

Why Exercise Physically Changes the Brain
Williams pointed to decades-old research showing that exercise and social engagement trigger the release of brain-derived neurotrophic factor (BDNF), a protein that supports the growth of brain cells, including in regions tied to learning and memory. A 2007 German study found that people who exercised learned new information roughly 20 percent faster than those who didn't. The takeaway: regular movement doesn't just strengthen muscles, it helps the brain relearn where the body's balance limits are.

The Four Pillars of Better Balance
Williams structures his Balance University program around four pillars: leg strength, posture, flexibility, and balance itself. Leg strength, he said, is "gold," since it affects everything from standing up safely to digestion. Posture determines whether the body can shift its center of mass to stay upright. Flexibility, especially in the hamstrings and chest, supports proper movement patterns. Balance exercises, done last, take advantage of a brain already primed by exercise.
​
A Simple Daily Exercise Worth Trying
One favorite: sitting down in slow motion instead of dropping into a chair, which works the leg muscles differently than standing up does. Williams recommends doing it five to ten times daily. His broader advice: never let more than two days pass without some form of movement, and walk whenever possible.

​Questions People Ask
Can Parkinson's disease patients improve their balance with exercise? Yes. Because the brain remains adaptable, regular balance and strength exercises can help people with Parkinson's disease reduce fall risk over time.

What causes freezing episodes in Parkinson's disease? There's no single known cause, but medication changes, stress, and crowded environments are common triggers. Physical touch can sometimes help a person start moving again.


Are falls a normal part of aging or Parkinson's disease? No. Falls are common but not inevitable; targeted balance and strength training can meaningfully reduce risk.

What type of shoes are best for balance? Firm, minimally cushioned, supportive shoes, combined with regular barefoot practice at home, allow the feet's pressure sensors to work most effectively.
​
Conclusion
Balance isn't fixed. Like Williams put it, improving it is closer to learning a new language than following a diet: it takes consistent daily repetition, but the brain and body respond. For people living with Parkinson's disease, that means fall risk isn't just something to accept. It's something to train against.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners or family members.

Most families think of estate planning as a single document: a will. But for families navigating a Parkinson's disease diagnosis, a will alone can leave dangerous gaps. At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida (PASWFL), elder law attorney Ted Wolfendale, Esq. explained why the real risk isn't dying without a will. It's becoming incapacitated without the right documents in place first.
​
Wolfendale has watched families lose the ability to plan simply because they waited too long. Here's what he says every Parkinson's family needs, and why timing matters more than most people realize.

​What Estate Planning Documents Do Parkinson's Families Need?
Beyond a will, families affected by Parkinson's disease typically need a durable power of attorney, a health care surrogate designation, a living will, a blanket HIPAA authorization, and, in some cases, a trust and a Medicaid plan. These documents must be created while the person with Parkinson's still has legal capacity, since courts will not allow them to be signed later.

Why Estate Planning Can't Wait with a Parkinson's Diagnosis
Wolfendale explained that a power of attorney lets a person, the "principal," name someone else, the "agent," to manage finances or health decisions on their behalf. The catch: it can only be created while the principal has legal capacity. Once a court determines someone lacks capacity, that window closes permanently.

Florida law does offer some flexibility. Under Florida Statute 117, a principal who cannot physically sign their name may make an "X," and Florida also recognizes an "overt act," such as pointing to indicate an intended agent, if capacity is otherwise present. Wolfendale has used both provisions with Parkinson's clients. But he was direct: waiting until symptoms are advanced is a gamble.

The Backup Plan Nobody Talks About: A Blanket HIPAA Authorization
One of the most overlooked documents, Wolfendale said, is a general HIPAA authorization listing every person who might need to advocate for you, not just your official health care surrogate. He described a case involving a couple who had lived together for decades without marrying; when one partner was hospitalized, the other was barred from her bedside because his name wasn't on a HIPAA form. A blanket authorization prevents that.

Living Will, Last Will, or Trust: Which Do You Need?
A living will governs decisions while you're alive, such as life support preferences. A last will directs where assets go after death but must pass through probate, a court process that can take months or years. A trust accomplishes the same goal privately and typically faster, without probate, though it costs more to set up initially.

Guardianship: The Costly Outcome of Waiting Too Long
Without a power of attorney, an incapacitated person's family must petition the court for guardianship, a process requiring evaluation by three doctors and separate attorneys for both the ward and the petitioner. Wolfendale said this route often costs tens of thousands of dollars, expenses that proper planning can avoid entirely.
​
Medicaid Planning: Protecting Savings Without Losing Care
Many families assume they have "too much" money to qualify for Medicaid, or too little to bother planning. Wolfendale said neither is necessarily true. Legal strategies, such as personal service contracts and Florida's home equity exemption, can protect significant savings while still qualifying a family member for benefits like Florida's Home and Community-Based Services (HCBS) program, which supports in-home care.

​Questions People Ask
Does a person with Parkinson's disease need a power of attorney even if they feel fine? Yes. A power of attorney can only be created while the person has legal capacity, so Wolfendale recommends creating one early, well before it might be needed.

What's the difference between a living will and a last will? A living will states your wishes for life support while you're alive; a last will directs who receives your assets after you die and must go through probate.

Can a power of attorney from another state be used in Florida? Generally yes, under the U.S. Constitution's Full Faith and Credit Clause, but Florida institutions often require Florida-specific language, so a Florida-drafted document is usually more reliable.

Does having savings disqualify someone from Medicaid? Not necessarily. Legal planning strategies can protect assets, including home equity up to a set limit, while still qualifying a person for Medicaid-funded care.
​
Conclusion
A Parkinson's diagnosis doesn't just change day-to-day life. It changes the calendar for legal and financial planning. As Wolfendale put it, the documents that matter most, powers of attorney, health care surrogates, and a blanket HIPAA authorization, only work if they're created while there's still time. Waiting isn't a neutral choice; it's a decision that can cost families their options.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

When someone is diagnosed with Parkinson's disease, one of the first things that changes often has nothing to do with movement or medication. At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida (PASWFL), licensed clinical social worker (LCSW) Ann Fisher shared a line she hears again and again from the people she works with.

One member put it simply: "One of the first things that happens when you get Parkinson's disease is the phone stops ringing." Here's why that happens — and what actually helps.

Why Do Parkinson's Support Groups Matter?
Parkinson's disease support groups help people with PD and their care partners feel less isolated, share practical information, and learn from others navigating similar challenges. Research shows social connection can improve mood, motivation, and overall well-being, making support groups an important part of a complete Parkinson's care plan.

Why Isolation Is a Real Risk After a Parkinson's Diagnosis
Parkinson's disease is now the fastest-growing neurological disorder in the world, having overtaken Alzheimer's disease in recent years. Between 1990 and 2015, the number of people living with Parkinson's doubled, and that number keeps climbing. As diagnoses rise, so does the risk of something less visible: isolation. Fisher explained that after a diagnosis, a person's social circle can quietly shrink — friends aren't always sure what to say, or the person with Parkinson's feels less confident reaching out. Left unaddressed, isolation can spiral into loneliness and low mood, which research links to worse outcomes for both physical and emotional well-being.

The Two Biggest Benefits of a Support Group
Support groups offer two things at once. The first is practical: members share real, lived experience — medication names, doctors, and coping strategies not always found in a pamphlet. As one popular saying in the Parkinson's community goes, "If you've met one person with Parkinson's disease, you've met one person with Parkinson's disease," since the condition looks different for everyone.
The second benefit is emotional: the simple realization that you are not alone.

Support Groups Aren't Just for the Person Diagnosed
Parkinson's changes life for care partners too, and caregiving stress can lead to its own kind of isolation. PASWFL offers groups built around this reality, including separate groups for male and female care partners, a Women with Parkinson's group, a general group open to anyone touched by PD, and a couples group for partners who want to attend together.

Building Your Parkinson's Care Team
Fisher encouraged newly diagnosed members to think of support groups as one piece of a larger care team that also includes a neurologist (often a movement disorder specialist), physical and occupational therapists, and a speech therapist — specialties PASWFL can help connect members to.

Beyond Support Groups: Music, Drumming, and Improv
Guest facilitator Margo Scott, LCSW, who has taught improv for people with Parkinson's for eight years, explained that classes like hers and PASWFL's drumming program build connection and cognitive engagement while easing facial rigidity, a common Parkinson's symptom, through playful work with expression and movement.

Keeping Your "Pie" Full
Fisher closed with an image she returns to often: life as a pie. Parkinson's disease may take a growing slice over time, but the rest of the pie — golf, opera, mahjong, dinner with friends — still belongs to you. As Michael J. Fox has said, "I didn't have any choice whether or not I have Parkinson's, but surrounding that non-choice are a million other little choices that I can make."

Questions People Ask
Are Parkinson's support groups only for people with Parkinson's disease? No. Many groups, including PASWFL's, welcome care partners, spouses, and family members, and some are designed specifically for caregivers.

What's the difference between a support group and therapy? A support group is a space for members to share experience and encouragement; it isn't a substitute for individual or couples counseling, though both can be valuable together.

How do I find a Parkinson's support group near me? Local Parkinson's associations typically offer groups by category — care partners, couples, gender-specific, and general — both in person and online. Check a local association's newsletter or call its office.

Can support groups help with Parkinson's-related isolation? Yes. Connecting with others facing similar challenges is one of the most consistently cited ways to counter the isolation that can follow a Parkinson's diagnosis.
​
Conclusion
A Parkinson's diagnosis can feel like joining a club no one wants to join, but no one has to navigate it in isolation. Whether through a support group, a care team, or a creative outlet like improv or drumming, connection is one of the most powerful tools for living well with Parkinson's disease.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

Ask any registered dietitian what to eat for brain health, and one pattern comes up again and again: the Mediterranean diet. At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida (PASWFL), registered dietitian nutritionist (RDN) Carolyn Bivans explained why this centuries-old way of eating is drawing serious attention from Parkinson's disease (PD) researchers.

Here's the number that stopped the room: in one study, women who followed a Mediterranean-style diet delayed their Parkinson's onset by more than 17 years. Keep reading to see how — and what to put on your plate first.

What Is the Mediterranean Diet, and How Does It Help Parkinson's Disease?
The Mediterranean diet is an eating pattern built around olive oil, fish, vegetables, fruits, whole grains, and legumes, with roughly 40% healthy fats, 40% complex carbohydrates, and 20% protein. Its anti-inflammatory fats and antioxidants may help protect dopamine-producing brain cells, which is why researchers are studying it specifically for Parkinson's disease prevention and symptom management.

Where the Diet Comes From
The Mediterranean diet isn't a trend. Researcher Ancel Keys studied it decades ago in Naples, Italy, as part of the landmark Seven Countries Study, which found dramatically lower rates of heart disease in Mediterranean regions than in the typical Western diet. That same eating pattern is now being studied for its effects on the brain.

​How the Mediterranean Diet May Protect the Brain
Parkinson's disease is linked to oxidative stress, a kind of cellular damage that harms the neurons responsible for producing dopamine. The Mediterranean diet is rich in antioxidants and anti-inflammatory fats — found in olive oil, fatty fish, nuts, and colorful produce — that may help reduce this damage and support the neurons Parkinson's disease affects most.

Can Diet Really Delay Parkinson's Onset?
Bivans shared research suggesting a Mediterranean-style diet was associated with delaying Parkinson's onset by as much as 17.4 years in women and 8.4 years in men. Diet is not a cure and results vary by individual, but the research points to food as one meaningful, modifiable factor in the Parkinson's disease timeline.

The MIND Diet: A More Targeted Approach
The MIND diet — short for Mediterranean-DASH Intervention for Neurodegenerative Delay — combines the Mediterranean diet with the DASH diet and emphasizes foods specifically linked to brain health, such as leafy greens and berries. A 2022 study found the MIND diet may be roughly twice as effective as the Mediterranean diet alone at reducing Parkinson's-related symptoms.

One Important Caution: Protein and Your Parkinson's Medication
For people taking levodopa, timing matters. Dietary protein can compete with levodopa for absorption, potentially reducing the medication's effectiveness. Bivans recommends separating protein-rich meals from levodopa doses by about an hour, and checking timing changes with your care team first.

Practical Ways to Start Today
You don't have to overhaul your diet overnight. Simple swaps help: a Greek yogurt parfait with berries for breakfast, a farro and chickpea salad for lunch, grilled salmon with quinoa and asparagus for dinner, and a handful of almonds or a square of dark chocolate for a snack. Gut-friendly foods like asparagus and bananas can also ease Parkinson's-related constipation, a common and often under-discussed symptom.

Questions People Ask
Can the Mediterranean diet slow Parkinson's disease progression? Research suggests it may help protect dopamine-producing neurons and delay symptom onset, though it is not a cure or a replacement for medical treatment.

Does diet affect when Parkinson's symptoms start? Some studies link Mediterranean-style eating to a later onset of Parkinson's disease, with a more pronounced effect in women than in men.
Can eating protein interfere with Parkinson's medication? Yes. Protein can compete with levodopa for absorption, so many care teams recommend spacing protein-rich meals about an hour from medication doses.

What's the difference between the Mediterranean diet and the MIND diet? The MIND diet builds on the Mediterranean diet by emphasizing specific brain-protective foods like berries and leafy greens, and may offer added benefit for neurodegenerative symptoms.

What foods help with Parkinson's-related constipation? Fiber- and prebiotic-rich foods such as asparagus, bananas, legumes, and whole grains can support gut health, which is commonly affected by Parkinson's disease.

Conclusion
No single food will prevent or cure Parkinson's disease, but the research is clear that what's on your plate matters. The Mediterranean diet offers a realistic, flavorful, way to support brain health — one meal at a time. As Bivans emphasized, small, sustainable changes made with your care team are often the most powerful place to start.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

If you love someone with Parkinson's disease, you've probably had this moment: you ask them to speak up, they insist they already are, and the conversation stalls in frustration on both sides. You're not imagining it, and neither are they. Between 80 and 90 percent of people with Parkinson's disease and their care partners experience real, measurable changes in how they communicate.

Here's the twist most care partners never hear: it isn't a matter of effort. It's a trick Parkinson's disease plays on the brain — and once you understand how, nearly every frustrating conversation starts to make sense. Keep reading to learn more >

At a recent PD Talk hosted by the Parkinson's Association of Southwest Florida, speech-language pathologist Judy Jenner, MS, CCC, explained why. Parkinson's disease changes how the brain monitors its own voice. A typical brain automatically adjusts volume for a crowded restaurant or a person across the room. A Parkinson's-affected brain usually can't self-correct without an outside cue. So when someone says, "I heard you fine," and their voice was barely audible, they're not being difficult. Their brain genuinely believes they were loud and clear.

Jenner compared it to driving every day with a broken speedometer: if your feedback is wrong, how could you possibly judge your own speed accurately? The same disconnect applies to facial expression. Parkinson's disease can cause a "masked face," reducing outward signs of emotion even though the person's inner emotional experience is completely intact. It also causes real, physical communication fatigue, since simply carrying a conversation requires conscious, exhausting effort most of us never have to think about.

Left unaddressed, these changes can quietly chip away at a relationship.
Conversations that once felt effortless become fewer and farther between, and isolation can creep in for both partners. But understanding the "why" behind these changes tends to replace blame with patience, which is often the first real turning point.

One research finding stood out: 66 percent of communication breakdowns between people with Parkinson's disease and their care partners had nothing to do with speech clarity or volume at all. They came from care partner habits instead — rushing the conversation, finishing sentences, or quietly giving up too soon.

The good news is that small adjustments make a measurable difference:
Get your partner's attention before speaking, stay four to six feet apart, use short sentences, offer specific choices instead of open-ended questions, and avoid trying to talk in a moving car. Celebrating small wins matters too — a simple "I understood every word" can go a long way. Speech therapy helps enormously, yet Jenner noted that only 3 to 4 percent of people who could benefit ever try it, often because the growing body of Parkinson's disease resources focuses heavily on motor symptoms, leaving communication support overlooked.

You don't have to navigate this alone, and neither does your partner.

Why Support Matters
A diagnosis of any form of Parkinson's can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson's and related conditions, contact the Parkinson's Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson's disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson's or have been recently diagnosed, you don't have to face it alone.
👉 Click here to sign up for the PASWFL newsletter
👉 Click here to become a member…it's free and confidential
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

When most people think about Parkinson’s disease (PD), they often think about tremors, stiffness, and movement changes. However, Parkinson’s can also affect emotions, motivation, and mental health. Depression, anxiety, apathy, and irritability are common non-motor symptoms that may occur before or after a Parkinson’s diagnosis.

These emotional changes are not simply “part of getting older” or a sign that someone is not coping well. Keep reading to learn why Parkinson’s can affect mood, what symptoms to watch for, and how support and treatment can help.

How Does Parkinson’s Disease Affect Mood and Emotions?
Parkinson’s disease is a neurological disorder that affects more than movement. It occurs when certain brain cells that produce dopamine become damaged or lost. Dopamine helps regulate movement, but it also plays an important role in motivation, mood, reward, and emotional responses.
Changes in dopamine and other brain chemicals can contribute to emotional and behavioral symptoms. In addition, adjusting to the challenges of living with a chronic condition can understandably affect mental health.

Depression and Parkinson’s Disease
Depression is one of the most common non-motor symptoms of Parkinson’s disease. It is not simply a reaction to receiving a diagnosis—it can be part of the disease itself.
Signs of depression may include:

• Persistent sadness or low mood
• Loss of interest in activities once enjoyed
• Feelings of hopelessness
• Changes in sleep or appetite
• Fatigue or lack of energy
• Difficulty concentrating
• Feelings of guilt or worthlessness

Depression can make Parkinson’s symptoms feel more difficult to manage, which is why recognizing and treating it is an important part of Parkinson’s care.

Anxiety and Parkinson’s Disease
Anxiety is also common among people with Parkinson’s. Some individuals experience constant worry, nervousness, panic-like feelings, or fear related to movement challenges, falls, or changes in independence.
Anxiety may appear as:

• Excessive worrying
• Restlessness
• Feeling overwhelmed
• Rapid heartbeat or physical tension
• Avoiding activities because of fear

Treating anxiety can improve confidence and help individuals remain engaged in daily life.

What Is Apathy in Parkinson’s Disease?
Apathy is a loss of motivation, interest, or emotional engagement. It is different from depression because a person may not necessarily feel sad—they may simply feel less driven to start activities or participate.
Signs of apathy may include:

• Less interest in hobbies
• Reduced desire to socialize
• Difficulty starting tasks
• Appearing emotionally distant
• Needing more encouragement to participate

Apathy can be challenging for both individuals with Parkinson’s and their care partners because it may be misunderstood as laziness or lack of effort.

Irritability and Mood Changes
Some people with Parkinson’s experience increased irritability, frustration, or emotional changes. These symptoms may be related to changes in the brain, medication effects, fatigue, stress, sleep problems, or difficulty coping with daily challenges.
Recognizing that these changes may be connected to Parkinson’s can help families respond with patience and understanding.

What Can Help Manage Emotional Symptoms?
Emotional health is an important part of Parkinson’s treatment.

​Helpful strategies may include:
1.  Talk With Your Healthcare Team
Doctors can evaluate mood changes, review medications, and recommend treatments or referrals when needed.
2.  Stay Physically Active
Exercise can support brain health, improve mood, reduce stress, and help maintain mobility.
3.  Stay Connected
Support groups, friendships, and community programs can reduce isolation and provide encouragement.
4.  Consider Counseling or Therapy
Mental health professionals can provide tools for managing anxiety, depression, grief, and life changes.
5.  Maintain Healthy Daily Routines
Regular sleep, meaningful activities, proper nutrition, and social connection can support emotional well-being.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter:
https://parkinsonassociationswfl.org/signup-enews.html
👉 Click here to become a member…it’s free and confidential:
https://parkinsonassociationswfl.org/signup.html
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

For people living with Parkinson’s disease (PD), home should be a place of comfort, safety, and independence. However, changes in balance, walking, coordination, and movement can increase the risk of falls. Making thoughtful adjustments to the home environment can help reduce hazards and support confidence in daily activities.

A few simple changes can make a major difference. Keep reading to discover practical Parkinson’s home safety modifications that can help prevent falls, improve mobility, and create a safer living space.

Why Are Falls More Common With Parkinson’s Disease?
Parkinson’s disease affects areas of the brain responsible for movement, balance, and coordination. Symptoms such as slower movements, muscle stiffness, changes in posture, freezing of gait, and difficulty turning can make everyday activities more challenging.
Some people with Parkinson’s may experience:

• Trouble starting or stopping walking
• Shuffling steps
• Balance problems
• Dizziness or blood pressure changes when standing
• Difficulty navigating tight spaces
• Increased fatigue

Because many falls happen during routine activities, adapting the home can be an important part of Parkinson’s care and fall prevention.

Improve Lighting Throughout the Home
Good lighting is one of the easiest ways to improve safety.
Consider:

• Adding nightlights in hallways, bedrooms, and bathrooms
• Using brighter bulbs in frequently used areas
• Installing motion-activated lights
• Keeping stairways well lit
• Removing dark areas or shadows that make obstacles harder to see

Clear visibility helps individuals recognize changes in flooring, furniture placement, and potential tripping hazards.

Remove Tripping Hazards
Small obstacles can become major risks when balance or walking changes.
Look for:

• Loose rugs or throw rugs
• Electrical cords across walkways
• Clutter on floors
• Uneven flooring
• Pet toys or objects left in walking paths

Secure rugs with non-slip backing or remove them completely if they create a hazard.

Make the Bathroom Safer
Bathrooms are one of the most common areas for falls because surfaces can become slippery.
Helpful modifications include:

• Installing grab bars near the toilet and shower
• Using a non-slip bath mat
• Adding a shower chair if needed
• Installing a handheld showerhead
• Raising the toilet height if recommended
• Keeping frequently used items within easy reach

These changes can help maintain independence while reducing the risk of injury.

Improve Bedroom Safety
Many falls occur when getting up at night.
Consider:

• Placing a nightlight between the bed and bathroom
• Keeping a clear pathway around the bed
• Using a stable bedside table
• Avoiding low furniture that is difficult to rise from
• Keeping necessary items within reach

A safe nighttime routine can reduce rushing and improve confidence.

Make Walking Areas Easier to Navigate
People with Parkinson’s may experience freezing of gait, where the feet temporarily feel “stuck.” Certain home layouts can make this more challenging.
Helpful strategies include:

• Removing clutter from hallways
• Creating wider walking paths
• Avoiding furniture arrangements that require tight turns
• Using contrasting colors to make important areas easier to identify

Some individuals benefit from visual cues, such as floor markings, to help initiate movement.

Consider Mobility and Assistive Devices
A physical therapist can help determine whether a cane, walker, or other mobility aid would improve safety. Using the right device at the right time can help prevent falls and support continued independence.
Occupational therapists can also provide valuable recommendations for adapting the home based on an individual’s specific challenges.
​
Review Medications and Health Factors
Falls may also be influenced by medication side effects, vision changes, low blood pressure, or dizziness. Regular conversations with healthcare providers can help identify factors that may increase fall risk.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
👉 Click here to sign up for the PASWFL newsletter:
https://parkinsonassociationswfl.org/signup-enews.html
👉 Click here to become a member…it’s free and confidential:
https://parkinsonassociationswfl.org/signup.html
To learn more, visit www.paswfl.org and discover the power of support, education, and community.

Legendary singer-songwriter Carly Simon has revealed that she has been living with Parkinson’s disease, sharing an honest and deeply personal account of the challenges, uncertainty, and resilience that have shaped her journey. Best known for timeless hits like You're So Vain and Nobody Does It Better, Simon’s story reminds us that while Parkinson’s changes life, it does not define it. Keep reading to hear her personal statement about PD.

Learning to Live with Parkinson’s
In a heartfelt public statement, Simon explained that she initially attributed her difficulty walking to recovery from multiple joint replacement surgeries for arthritis. Even after replacing both knees and one hip, her mobility continued to decline. She struggled to stand from chairs, experienced worsening balance, and eventually required assistance to walk.

After undergoing an extensive evaluation at the Mayo Clinic, she received a diagnosis of Parkinson’s disease.

"It has taken me some time to understand the diagnosis, to adjust to it, and to decide how much I wanted to say publicly," Simon wrote.

Like many people living with Parkinson’s, she discovered that symptoms are unpredictable. Some days she has energy and can work, think, and create. Other days, fatigue and stiffness make even simple tasks difficult.

Read Carly Simon's Full Statement about Living with PD
"So many people have written to me, kindly wondering about my relative silence, asking how I am and what I have been doing. The truth is, I’ve been learning how to live with Parkinson’s disease.

It has taken me some time to understand the diagnosis, to adjust to it, and to decide how much I wanted to say about it publicly. Parkinson’s is different for everyone, and it can be unpredictable. Some days I’m so tired I can’t get the day moving at all. On others, it gives me a little more room to move, think, work, and feel like myself.

The problems began with arthritis in both knees and one hip. I eventually had all three joints replaced, out with the old and in with delicate bouquets of metal and plastic. After three replacement surgeries, I assumed my difficulty walking was simply an unfortunate and rather ironic part of the recovery process.

But my mobility continued to worsen. I had trouble standing up from low chairs and deep couches without someone offering me an arm. Overstuffed furniture became my enemy. Once seated, I could feel as though I had been swallowed by the chair and might remain there permanently, like a guest who had badly overstayed her welcome.

Eventually, there were periods when I could not walk without considerable help. My family and I knew that something more was going on. After an extensive evaluation at the Mayo Clinic, I was diagnosed with Parkinson’s.

I began treatment, including taking medication to help with stiffness and other symptoms. There is no tidy or predictable schedule to the illness. It does not consult my calendar before deciding what kind of day I am going to have.

Parkinson’s is usually associated with movement, tremors, and balance, but it can affect much more than the body. It can bring anxiety, depression, exhaustion, and apathy. The apathy is particularly strange. You can find yourself lying there like a starfish drying in the sun, arms pointing in all directions, while nothing inside is telling you to get up, read, watch, write, sing, call someone, or do much of anything at all.

That has been one of the hardest things to explain. It is not simply sadness or laziness. It is as though the part of the brain that sends out invitations to participate in life has temporarily misplaced the guest list.

During this same period, I was also treated for basal cell carcinoma on my face. The cancer was removed, but the surgery affected my appearance and made me more self-conscious about being seen in public. I have always been more critical of my appearance than anyone else could possibly imagine (check out the irony of having written “You’re So Vain.”), and this gave my inner critic quite a lot of new material.

Between my mobility issues, the Parkinson’s diagnosis, the surgery, and the emotional effects of it all, withdrawing from public view was the most palatable reaction. If a person is allowed to hibernate during both winter and summer, then I have become an all-season bear.
But I have not stopped living, and I have not stopped working.

In the middle of all this, I began recording a new album, Comes in Waves. That still feels mysterious to me. Music has always known when to arrive. It has rescued me more times than I can count. It is like a cat or dog that quietly appears beside you when it senses you are not quite yourself.

The album includes songs and fragments of songs that had been waiting for me, some for years. There were melodies, verses, and ideas written down and tucked away for some unknown future when I would have the time and attention to finish them.
 
Apparently, that future is now.

Working on the music gave shape to days that did not always have much shape. It gave me somewhere to go without having to leave the room. It reminded me that illness can change your life without becoming the whole of your life.

I do not consider Parkinson’s a gift or a blessing. It is neither. It is difficult, frustrating, and sometimes frightening. I am still learning how to live with it and how to accept it without feeling that I have surrendered something essential.\

I am still writing, singing, imagining, laughing, worrying, remembering, and occasionally getting trapped in an overstuffed chair.

I am deeply grateful to my children, my family, my friends, my caregivers, and the medical professionals who have helped me through this. Their love and patience have carried me through days when my own reserves were not enough.

I wanted to share this now because so many people have reached out with genuine concern. I am touched by that concern, even when I have not known how to respond.

These days I move more slowly, I lean on others more than I once did, and I have learned to accept that every day will look a little different. But I am still very much here.

With love, Carly"

Parkinson’s Is More Than a Movement Disorder
While Parkinson’s is often associated with tremors, stiffness, slowed movement, and balance problems, Simon emphasized that many of the most difficult symptoms are invisible.
She described experiencing overwhelming fatigue, anxiety, and periods of apathy—times when she simply lacked the motivation to do things she loved.

"It is not simply sadness or laziness," she explained. "It is as though the part of the brain that sends out invitations to participate in life has temporarily misplaced the guest list."

Her words echo the experiences of countless people living with Parkinson’s who often struggle to explain the disease's emotional and cognitive effects.

Creativity Became Part of Her Therapy
Despite her diagnosis, Simon has not stopped creating. During treatment, she began recording Comes in Waves, her first album of original music since 2008.

She credits music with helping her through some of her most difficult days.
"Working on the music gave shape to days that did not always have much shape," she said. "It reminded me that illness can change your life without becoming the whole of your life."

Her story highlights an important lesson for anyone living with Parkinson’s: continuing activities that bring joy and purpose—whether music, art, exercise, gardening, or volunteering—can help improve emotional well-being and quality of life.

Finding Strength Through Support
Simon also shared her gratitude for the family, friends, caregivers, and medical professionals who have helped her navigate life with Parkinson’s. Their encouragement and support carried her through days when her own strength was limited.
​
Her experience reinforces something the Parkinson’s community has long understood: no one should face Parkinson’s alone.

​Living Well with Parkinson’s
Although there is currently no cure for Parkinson’s disease, early diagnosis, exercise, medication, education, and a strong support network can help people maintain independence and quality of life for many years.

Carly Simon's openness joins that of other well-known individuals—including Michael J. Fox, Neil Diamond, Ozzy Osbourne, and Linda Ronstadt—who have helped raise awareness about Parkinson’s disease and the importance of research, treatment, and support.
As Simon beautifully reminds us, Parkinson’s may change how someone lives, but it does not have to stop them from living.

You Don't Have to Face Parkinson’s Alone
The Parkinson’s Association of Southwest Florida (PASWFL) provides more than 25 free programs each week for people living with Parkinson’s disease and their care partners, including exercise and wellness classes, speech therapy, support groups, educational PD Talks, and caregiver resources. Membership is free and confidential.

Whether you are newly diagnosed or have been living with Parkinson’s for years, support, education, and community can make all the difference.
Learn more at: www.paswfl.org
Become a free member: https://parkinsonassociationswfl.org/signup.html
Sign up for the PASWFL newsletter: https://parkinsonassociationswfl.org/signup-enews.html