By Alexis Streetman, MCD, CCC-SLP

Speech-Language Pathologist

As a healthcare provider, you hear a lot about patient-centered care and working together as a team. But what does that mean? How do you even start to manage Parkinson's disease as a member of a team? The Parkinson's Foundation provides training for teams working with patients with movement disorders. Allied Team Training for Parkinson's (ATTP) is an intensive training that guides clinicians working as part of a Parkinson's team. At its core, ATTP is designed to help clinicians build teams with the patient at the center. But it's a big topic. It can be overwhelming to think about all of the factors that affect your patients – the other treating clinicians, medications, symptoms that are seemingly unrelated to Parkinson's. Not to mention the emotional toll Parkinson's takes on our patients and their families.

Where do you start with tackling Parkinson's as a team?

Identify the strengths of each team member. What can your team members teach you? What strengths do you bring to your team?

Our patients are the leaders of the team.

Our patients have goals. As a member of a Parkinson's team, your responsibility is to know your patients' goals and help them achieve the best outcome for their manifestation of symptoms and stage of Parkinson's. Is the patient newly diagnosed, or is this a patient with moderate to severe symptoms who has lived with the disease for years? Is the patient's goal to speak loudly enough to order in a restaurant, or does this patient rely on their voice for their career? Does the patient want to continue to play pickup basketball once a week? Is a patient distraught because she can no longer write weekly letters to her friends and family? As a therapist, it is critical to understand what motivates your patients no matter where they are in their journey.

You know your roles on the team and reach out to others for help.

A patient's team is typically more than just the referring physician and the therapist. Teams often include social workers, dietitians, nurses, and pharmacists. Team members should feel comfortable asking and answering questions. A speech-language pathologist may consult with a nurse practitioner about a swallow study for suspected dysphagia. An occupational therapist may ask a pharmacist or neurologist about medication that may exacerbate dizziness. Clinicians who treat in a patient's home may see hazards and opportunities that other team members may not. You are an expert in your field, but you have to feel comfortable talking to other experts so your patients receive the best care.

You know about best practices in your respective field.

What are the official positions of your governing body for the treatment of Parkinson's? Knowing treatments that are the gold standard for Parkinson's is critical, but you also have to know about emerging treatments and the current state of research. What journals are you reading to ensure that you're up to date?

You help patients advocate for themselves.

You provide your patients with authoritative resources to help them have conversations with team members. The Parkinson's Foundation has free resources for patients and their families. The Parkinson's Foundation provides free Aware In Care kits that include nurse fact sheets, a magnet for medication administration, an ID bracelet, and additional information useful for patients and hospital care teams. The kit is a fantastic resource for Parkinson's patients who are hospitalized, especially during an emergency. Other organizations that provide resources for patients include local support groups, the Davis Phinney Foundation, and the Michael J. Fox Foundation.

You know how to look for answers to the questions your patients and their families ask. And you keep looking for the answers for yourself.

As a clinician, you shouldn't be afraid of what you don't know. No one knows everything, and no one expects you to know everything. But you should know where to look, starting with your governing body. The Parkinson's Foundation has amazing resources for clinicians, including webinars and continuing education. The International Parkinson and Movement Disorders Society also provides education for clinicians and publishes two peer-reviewed journals, position statements, and reviews. Our understanding of PD is constantly evolving. Is your knowledge evolving with it? So where do you start? You start with the patient. Listen to what they are telling you and guide them toward the resources they need to feel empowered and supported. We move forward together.