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Monday, August 30, 2010

Co-pay assistance for PT/OT/ST

Does anyone know of any organizations out there that help patients with co-pay cost for PT/OT/ST?  I met a patient today that is having trouble paying the co-pays for his LSVT appointments.


Friday, August 20, 2010

PD, Depression, and Pharmacology

Prevalence estimates of Depression in PD is highly variable; studies indicate these rates vary from 7-76%.  But most providers would probably place the actual prevalence towards the latter end of that range; probably anywhere from 50-70%.

We actively screen for indicators of depression in our clinic using the Center for Epidemiological Studies-Depression (CES-D) scale.  If they haven't already done so our providers then have the conversation with our patients about the issue of Depression and PD.  First-line treatments are usually pharmacological; the SSRIs, SNRIs, and occasionally the Tricyclic antidepressants.  Depending on the circumstances they will then refer the patient to see me.  We also refer patients for counseling, particularly if they are not getting much symptomatic benefit from pharmacology.

A 2010 study in the Journal of American Medicine seems to call into question the effects of pharmacology on mild to moderate depression.  This is very interesting considering the wide-spread use of pharmacology in the treatment of depression.

Another interesting factor in the treatment of depression are the recent findings that pharmaceutical companies were selective in their publishing of articles demonstrating the effects of drugs to treat depression.

Depression has been found to have the greatest influence on quality of life in PWP, making the role of the SW in working with PD that much more important.


Tuesday, August 17, 2010

Parkinson's disease Social Work Survey

Gladys Gonzalez-Ramos and Elaine Cohen have updated their survey on the role of Social Work in Parkinson's disease and are asking all PD Social Workers to help out by filling out the updated survey.  If you haven't already filled out the survey, you can do so online by going to this site:

There are only a few days left to complete this important survey. 


Friday, August 13, 2010

Social Relationships & Mortality Risk

If you are like me when someone asks you what comes to mind when you think about risk factors for early mortality you probably think about factors such as smoking, diet, inactivity, obesity, or possibly one's genes. 

A colleague of mine recently introduced me to a great study that sheds light on another factor that was found to be a comparable or an even greater risk factor for mortality than the risk factors we typically think of:  Social Relationships.  The importance of social connectedness and social relationships cannot be understated with PD and with carers of people with PD.   Isolation due to depression, apathy, anxiety, or just due to having PD is a common problem for people with PD and their carers. 

It is well known that social connectedness provides a psychological buffer to chronic stress, depression and anxiety.  This meta-analytic study illustrates how social connectedness and social relationships also provide a health buffer to early mortality.    A take away quote from the Conclusion section of the article is telling:

"Data across 308,849 individuals, followed for an average of 7.5 years, indicate that individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient relationships.  The magnitude of this effect is comparable with quitting smoking and it exceeds many well-known risk factors for mortality (e.g., obesity, physical inactivity)."

As Social Workers we are the professionals that have the time, skills, and expertise to assist patients and families in becoming and staying more socially connected.

To read the entire article or download the PDF:


Thursday, August 5, 2010

Helping PD patients apply for Social Security Disability.

We are all probably pretty familiar with assisting and supporting people with PD when they have made the decision to apply for federal disability insurance.  Each case varies, but when I assist patients and families with this usually daunting task I typically do the following things in assisting them:

  1. Interview the patient (and spouse if possible) to find out more about their occupation, their symptoms, and how their symptoms impair their ability to work.  I utilize the PAN work-related disability assessment form during this process.
  2. Provide education about the federal social security disability insurance process and timelines here in the U.S. I also discuss health insurance options.
  3. Work with the patient's neurologist to write a letter detailing what PD is and what symptoms the patient is experiencing.  I use the criteria language that the SSA uses to describe PD in their listing of conditions.
  4. If appeal is needed, refer the patient to a good, local SSDI attorney.
I'm curious to know what you all do to support patients and families in this process.  Does anyone else write letters in support?  Do you work with neurologists to ensure appropriate language is used in the chart when documenting the neurology appointments?  What have you found useful in helping patients and families with this?


Wednesday, August 4, 2010

First of it's kind national neurorehabilitation "helpline"

The American Parkinson Disease Association (APDA) in partnership with Boston University's Center for Neurorehabilitation has launched a toll free neuro-rehab "helpline."  People living with PD and their loved ones (as well as professionals) can call and speak directly to a licensed Physical Therapist.  Patients can call to get information about PD and exercise, information about programs in the caller's area, and general information and resources.  Social Workers and other professionals can call to get information on the latest evidence-based management of PD symptoms through exercise and rehabilitation interventions. 

I have not yet tried this service out but it seems like it could be a good service. 

Here's the link:


Tuesday, August 3, 2010

This is a great idea...thanks for setting it up. Sue (in Philadelphia)