A qualitative study : the experience of geriatricians with active ageing of older adults with Parkinson’s disease

Abstract

Background: Parkinson’s disease is a neurodegenerative condition commonly affecting older adults in the community. There is a "demographic transition" leading to an ageing population; making this disease more relevant. There are various stages of disease, with patients in the later stages of the condition requiring more help, even with activities of daily living (ADLs). Management of this condition varies from rehabilitative to palliative approaches. Local and international active ageing policies are set to promote successful ageing in general. Aim: The main aim of this qualitative research was to study about how geriatricians manage older adults with Parkinson’s disease holistically in the light of current active ageing policies. The effects of the condition on patients and caregivers will be explored in the biopsychosocial-spiritual model. The idea is to analyse the geriatricians’ perspectives about the local services and resources and any possible improvements. Methods: Interpretative phenomenological analysis (IPA) was used as it allows the researcher to understand and study the evidence provided by each individual participant. Five geriatricians volunteered to participate through the Geriatric Medicine Society of Malta (GMSM); and they fulfilled the criteria. Snow balling was used to recruit the other two participants. Semi-structured interviews were then conducted, transcribed and analysed. Five superordinate themes were identified with various themes and subthemes. Results: There was a common feeling that dealing with such a common disease within the community is still challenging and there is a need for better interdisciplinary approach and community services. The need for a Parkinson’s disease Specialist Nurse was mentioned by all the participants; but interest amongst nurses seems to be limited. While highlighting some of the limitations of the local active ageing policy, the majority did not see the need for a specific policy for persons with Parkinson’s disease. Conclusion: Parkinson’s disease is a common, challenging condition which is managed best by an interdisciplinary team approach. Having Parkinson’s disease specialist nurses would be an added benefit to the patients and caregivers.