The Menagerie of Professions
Caregiving Tips. March 6, 2017
This is the first post in a new category: caregiving tips. In these posts, I will present real, on-the-ground ideas for improving caregiving, not just for you, but also for the person you're caring for. There won't be any theory here, just tips that I've learned from experience and that I hope can help you.
Among the sometimes frustrating and confusing aspects of caregiving is the wide range of medical and professional roles you will encounter. Before being thrust into the role of caregiver, I had assumed—if I ever thought of it at all—that medicine was a general practitioner and maybe a couple of specialists for conditions the GP couldn't handle. Was that ever a mistake.
You are about to enter a world teeming with people who bring various skills to the care of patients: doctors, of course, but also different types of therapists, nurses, care aides, and others. Let me introduce you to the menagerie of specialists, what each one does, and what you can expect from them. In this list, I have included medical specialties that are significant in Parkinson's, but not others such as cardiologists or internists.
- Neurologists are medical doctors who specialize in conditions of the central nervous system, including the brain. Many neurologists don't focus on Parkinson's (although most of them have had to deal with it). Their primary interest may be disorders resulting from brain tumors or head injuries.
- Movement disorder specialists are neurologists who deal with diseases that impair movement, such as Parkinson's.
- Physiatrists (note: not psychiatrists) are medical doctors who deal with disorders of the muscules
and bones, in particular, the management of pain.
- Geriatricians vs. gerontologists. Geriatricians are medical doctors who specialize in diseases of the elderly. Gerontologists are non-medical specialists who study aspects of aging.
- Psychiatrists vs. neuropsychiatrists vs. psychologists. Psychiatrists are medical doctors who specialize in disorders of the mind such as dementia or psychoses. Neuropsychiatrists are medical doctors who combine neurology and psychiatry. Psychologists are non-medical professionals who study, among other things, the mind and behavior.
- Physiotherapists vs. occupational therapists. These are non-medical professions. There is some overlap, but broadly, a physiotherapist treats conditions such as injuries or physical disabilities, while an occupational therapist reviews and makes recommendations on the patient's environment including devices to assist in what they call the "activities of daily living" or ADL.
- Speech language pathologists are non-medical professionals who focus on speech and voice, but also conditions such as swallowing and feeding disorders. Some are qualified to provide specialized voice training for people with Parkinson's.
- Nurses: Registered, licensed, practical, and practitioners. The differences between the levels of nursing are those of education and the services the nurse is qualified to provide. Registered nurses (RNs) have the highest level of training and the most responsibilities. In some jurisdictions, nurse practitioners are RNs who have taken advanced courses and are authorized to provide some functions usually restricted to doctors, particularly in remote or small communities. Licensed and practical nurses (LPNs or RPNs) have less theoretical training, but in many cases, the practice of nursing they provide is indistinguishable from that of RNs.
- Care aides are professionals who provide hands-on care, either in an institution or as part of home services.
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