What is planning for the future

The first reaction many people have when they learn they have Parkinson’s disease is the feeling that their future has been taken away. Indeed, the future has been altered. But most people will enjoy years and even decades of near-normal function and activities. Honest and candid discussions and assessments of plans and life circumstances can help make those years as pleasant as possible.

On a pragmatic level, it is essential to evaluate financial circumstances and stability early after diagnosis, because as Parkinson’s progresses they will become increasingly important. The person who is employed at the time of diagnosis should consider factors such as mEdicaL insurance, life insurance, disability insurance, long-term care insurance, and pension or retirement funds. The person who is retired should consider the limitations of his or her fixed income in the context of increasing medical expenses and begin planning to accommodate these shifts. Planning may necessitate consulting an attorney who specializes in elder law to assess matters such as mEdicaid spend down. Even though this may seem a long way off, the course of Parkinson’s is unpredictable and can veer drastically without warning. Only careful strategic planning can protect financial resources.

On the medical front, it is important to consider the kinds of treatments the person may desire, and where he or she wants to draw the line. The mainstay of treatment is currently LEvodopa therapy, with adjunct therapies incorporating other medications as necessary. But there is much research under way, and there are many opportunities to participate in clinical testing for new drugs and methods. Surgical options such as deep brain stim-uLation (DBS) and experimental cell replacement techniques are also gaining renewed interest as technology allows greater refinement of results. Although the person with Parkinson’s cannot fully evaluate these options until they become viable for his or her circumstances, it is important to learn as much as possible about Parkinson’s disease, current treatments, potential treatments, and ongoing research and to remain informed.

Planning for the future also should include an evaluation of what is important to the person with Parkinson’s and to his or her loved ones. Many people reevaluate plans such as retirement and travel and engage in those activities sooner rather than later. Other people prefer not to make fundamental changes in such plans, especially those who are close to fulfilling them, but to continue working toward them with the resolve to follow them through. Factors such as other health problems affecting the person with Parkinson’s or a spouse or partner may further shape choices and decisions.