Memory care when Parkinson's starts affecting thinking
You have had years of practice at this. You know the medication schedule to the minute, which chair he can get out of and which he cannot, how long the walk from the car really takes. Then something else begins. He loses the thread of a conversation. The evenings get confused. He tells you there is a man in the hallway. And the condition you had learned to manage is no longer the main problem.
When cognitive changes appear after Parkinson's disease has been established for some years, doctors generally call it Parkinson's disease dementia. It does not happen to everyone with Parkinson's. This page is about what it means practically rather than medically, and his neurologist remains the person for the clinical questions. Parkinson's disease is one of the conditions Gianna Homes cares for.
Two problems at once
The body still needs everything it needed. Getting up out of a chair, balance, the walk to the bathroom, freezing in a doorway, a voice that has gone quiet enough that people stop hearing what he asks for, swallowing that has slowed. None of that goes away because something else has started.
On top of it now sits attention, planning, and the evenings. A place has to be genuinely good at both, and a lot of places are good at one. When you visit somewhere, watch whether the people there are set up for physical help as well as for memory, because the two need different things at different hours.
The medication clock
Parkinson's medication is timed, and the timing is not approximate. A dose given an hour late is visible in how somebody moves, and families who have managed this at home know that better than anyone. In a house where medications go around at set times for everyone, an individual schedule can quietly get absorbed into the round.
So ask it concretely rather than generally. At what times exactly would he get his. Who gives them. What happens if he is asleep at that time, or in the bathroom, or refusing. Who notices if a dose is late, and what do they do about it. This is not a question about competence, it is a question about how the house is organized, and the answer should be specific.
The thinking changes look different from Alzheimer's
Attention and planning are commonly affected earlier and more visibly than memory. Days fluctuate: clear in the morning, muddled by evening, clear again tomorrow. Visual hallucinations are common, often of people or animals, and are frequently not frightening to the person having them. Vivid dreams, and acting them out, are common too.
This is close to Lewy body dementia, closely enough that the two are usually discussed together and are linked to the same underlying changes in the brain. If what you are seeing includes strong fluctuation and hallucinations, the page here on Lewy body dementia will be worth reading alongside this one.
Falls, and what happens after one
Parkinson's and dementia together make falls a practical planning question rather than an abstract risk. When you go to look at a home, do not accept a description of it. Walk the route from the bed to the bathroom yourself, at the pace he would walk it, and look at the doorways and the floor coverings and where the light is at night.
Then ask what actually happens after a fall at two in the morning: who is in the house, who they call first, when they call you, and how the decision to send someone to the hospital gets made and by whom. A full-time registered nurse supports each of our houses and an RN is on call 24 hours a day. Ask everywhere else what their version of that sentence is.
Where Gianna Homes fits
Gianna Homes has run memory care homes since 1999. There are two: Sursum Corda in Minnetonka and Gladys' Place in Plymouth, where six people live. Everyone has a private room, and care continues through the end of life.
Whether a small house is the right answer for someone who needs a lot of physical help is a real question and worth asking bluntly. Call Cari Doucette on 952-443-6113, describe the transfers as they actually are on a bad day, and ask her to be straight with you. It is a better use of an afternoon than a visit that avoids the subject.