Parkinson's disease as a model for psychosocial issues in chronic neurodegenerative disease

Throughout the course of PD, opportunities abound for psychosocial interventions that can improve a patient's quality of life. The psychosocial challenges accompanying PD vary by stage of illness, though some challenges persist throughout the course of illness. As illustrated in the tables in this chapter, many of these interventions involve empathic listening and inquiry, education, challenging distorted or overly helpless thoughts and self-conceptions, and facilitating social contact and functioning. Others directly address the needs of caregivers who are confronted with the devastating effects of PD on their loved ones. Although many of the recommendations in this chapter are nonspecific and intuitive, their potential effect should not be underestimated. Although we have been unable to address all of the psychosocial issues confronted by patients facing PD, we hope that this chapter serves as a useful guide for providers looking for additional opportunities for psychosocial interventions designed to increase patient quality of life. These interventions can be delegated to other members of the team, and the assistance of psychiatrists or social workers may be warranted, but PD clinicians themselves can have the most dramatic effect on their patients because of their allocated authority and their salutary alliance with the patient.