Patients' and communication partners' experiences of communicative changes in Parkinson's disease

Purpose: The aim of the present study was to investigate the experiences of people with Parkinson's disease and their close communication partners regarding disease-related communicative changes and participation in everyday conversations.Materials and methods: Semi-structured qualitative interviews were conducted with six dyads consisting of a person with Parkinson's disease and a close communication partner. The interview material was analysed through thematic analysis.Results: The main theme was the experiences of barriers and facilitators for participation in conversations. Subthemes were experiences related to changes in voice and articulation, language and cognition, body language and facial expressions, fatigue, self-image, communicative initiative, and familiarity with conversation partner. The results show individual variation. A change observed in almost all dyads was the person with Parkinson's disease participating less in conversations.Conclusions: Assessment and interventions should be based on a broad perspective on communication, and individuals' priorities should be foregrounded in intervention planning. Both the person with Parkinson's disease and communication partners need to make adjustments for communication to work. Therefore, close communication partners should be included in assessment and intervention of communication in Parkinson's disease from an early stage.Implications for rehabilitationInterventions targeting communication in Parkinson's disease should be individually tailored and be based on a holistic perspective on communication.Communicative functions and participation should be assessed already at an early stage of the disease in order to minimize and slow down adverse effects, and to enable the development of effective, personalized strategies.Since changes in communicative abilities might affect self-perception and self-confidence, these aspects need to be taken into account when assessing and planning interventions targeting communication.Close communication partners should be included early in both assessment and intervention.