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many licensed practical nurses, and how many nurses
aides are employed, and whether they are permanent
employees or are provided by a temporary agency. If
the staff is from a temporary agency, they may not be
as committed to the home as regular staff employees.
Ask whether there is a social worker on staff and try to
meet that person. Ask about the doctor on staff and
find out if he/she will work with the patient s doctor,
especially on the PD issues. Ask your own doctor
about his/her recommendations for nursing homes and
whether he knows the doctors at a particular home
you re considering. Make a list of questions you feel are
important regarding the care of your parent or partner
and compare the answers from several nursing homes.
Find out what services are covered and if there are any
additional charges for some services that you may need
to pay for. Find out about their charges and how to pay
for their services. Consider carefully the financial
implications for the patient and the family. Know as
much as you possibly can before making a decision on
which nursing home or care facility you choose.
96. How can I protect my assets?
Planning ahead for future care and establishing health
care directives is a thoughtful consideration for your
family. Having someone to talk to about it is impor-
tant. When it comes to medical care, a living will can
not only make your wishes known, but will guarantee
that they will be followed. If you feel you may be
unable to make decisions about future health care, you
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can create a durable power of attorney for health care
(also known as a health care proxy) and designate a
person you trust to make those decisions for you. A
form for a living will can be obtained from a lawyer, a
hospital, a stationery store or even off the Internet. Be
sure it is properly filled out. You must sign the docu-
ment in the presence of witnesses (which, depending
on state laws, might need to be different people from
the person named in the document), and some states
also require that the signatures be notarized.
If taking care of financial matters is a concern, a
durable power of attorney for finances can be useful.
Again, check the requirements of your state for filing
and registering these instruments. This instrument will
allow you to appoint someone to handle paying your
bills and managing your accounts while you are ill. It
can give as broad or specific duties as you specify.
However, the power granted in a durable power of
attorney for finances ends at your death; the person
you appointed will not be able to make arrangements
for your funeral expenses. To do this requires a will. A
will can be basic, no frills or it can be complex; it does
not necessarily need to be prepared by a lawyer, but it
may be helpful to have the advice of a lawyer if your
estate or wishes are more complex. It does need to
appoint an executor, whose job it is to make sure your
instructions are carried out; it must be dated and
signed by you in front of several witnesses who are not
named in the will. Much more information on this
topic is easily available, either on the Internet, in
libraries, or from your attorney.
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PART NINE
Hope
How long before a cure?
What are my chances of developing PD?
What can I do to help find a cure for PD?
More . . .
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97. How long before a cure?
Before a cure for PD is found, its cause must be
known. One problem in finding this cause for PD is
that PD may not have a single cause; it could have mul-
tiple causes. There may be an environmental compo-
nent, such as exposure to a toxic chemical, but the
chemical may affect only those people that have a par-
ticular genetic predisposition. There may be an infec-
tious component, exposure to some relatively benign
virus that, in time, alters the genetic composition of
your brain resulting in a loss of dopamine cells. It is
important to note that at present no such virus has
been identified, but the more we learn about viruses,
the more humble we become as to what they can do.
Although the cause or causes of PD are unknown,
much is known about how specific substances injure
cells in the brain, including the dopamine cells. And,
since the introduction of levodopa and the dopamine
agonists, much has been learned about how the brain
works. Drugs such as levodopa and the dopamine ago-
nists Mirapex and Requip alleviate and improve PD.
As more is learned about the brain, these approaches
will be improved. Thus it has been learned that the
early use of the dopamine agonists reduces and delays
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