Ms Richelle Flanagan:

People with Parkinson's disease have a lack of levodopa which affects their muscle movement. It also means there are bowels do not move as well and therefore constipation is a big issue. In the pilot study at Beaumont Hospital, 70% of the patients with Parkinson's disease who were admitted had constipation. For patients with constipation, their medication does not get absorbed well, which means they do not turn on. Basically, people are frozen. In the movie "Awakenings", people wake up. That is basically what levodopa does; it allows us to switch on our muscles. Some people are unable to get out of the chair. They cannot swallow or talk very well. It is very important that this medication gets from their intestines to their brain. Naturally, for somebody with constipation that does not happen. It is very simple to get on top of that constipation, meaning that suddenly people turn on more and they can function better. In those cases, it is important that people see a dietitian to get on top of that constipation.

Orthostatic hypotension is where the blood pressure drops. Again, it relates to Parkinson's disease symptoms. It requires very simple interventions from a diet point of view in terms of fluid and salt with exercise alongside that. Postprandial, after they eat a meal, they get a blood pressure drop which creates a big risk of falling. Education on that helps people avoid that happening. People with a Mediterranean-style diet have better control of their symptoms. It simply needs a healthy diet. Many people do not have access to a dietitian to give them personalised advice on what types of foods they should be taking in.

Malnutrition is a big issue for people with Parkinson's disease and other neurological conditions. A high level of patients admitted to St. James's Hospital are suffering from malnutrition. People who lose weight in the first year after their diagnosis of Parkinson's disease have worse outcomes and die earlier. We need to ensure that they do not lose weight and maintain their weight. That is also important for their muscle strength, which stops them from falling and getting fractures. With dysphasia, people with Parkinson's disease and other neurological conditions cannot swallow well. As a result, they are put on a modified diet which needs to be analysed by a dietitian to make sure it contains enough calories and nutrition so that they do not lose weight on these modified diets. Dieticians can make many interventions for people with Parkinson's disease and other neurological conditions. From a physio point of view if people with neurological conditions have lost weight, it is very hard to do those exercises right. It is important to get the baseline right so that people have enough energy to do the therapies they have been prescribed.