Small but 'life-changing' policy helps Parkinson's patients who need emergency care at Guelph's hospital

When people go to the emergency department, they're not allowed to take their own medications while they wait, which Theresa Daly says can be a huge problem for anyone with Parkinson's disease.

A longtime nurse and social worker who actively works in Parkinson's support groups, Daly said she's thrilled the hospital in Guelph, Ont., has recently made a tweak to a long-standing practice to make it easier for these patients to take their medications on time.

"It's life-changing — life-giving and life-saving, and certainly quality-of-life saving."

Hospitals have a policy that any medication given while there must be through the pharmacy or a physician's order. Hospitals will monitor every patient's medication to avoid mixing, doubling up, choking or even overdosing. But emergency departments can be busy and this can lead to people not getting medications on time.

One of the more common medications for Parkinson's is Levodopa, used to control some of the physical deterioration symptoms. Daly said missing a dose can lead to not feeling "normal" again for days, weeks or even months afterwards. 

The new policy at Guelph General Hospital says, an emergency department nurse is able to give permission to those with Parkinson's to take the medication they brought from home. 

Daly volunteers with Parkinson Society Southwestern Ontario and her brother has the disease. She said she's familiar with the toll the conditions take on both a sufferer and loved ones. 

"To see them move into suffering because they haven't had their medication on time affects two people. The person with Parkinson's and the one who loves them. So it's a big deal," Daly said. 

'Hospitals don't like you bringing your own pills'

Parkinson's disease is a neurological and degenerative condition. It has no cure and can get worse over time. The most commonly known issues from PD include slowness of movement, rigidity, tremors and instability. 

Other symptoms can include insomnia, anxiety, depression, bladder issues, faintness, leg swelling, heavy sweating, double vision and a multitude of other challenges. 

Ian Smith has Parkinson's and in the past few months, he's had to go to Guelph General Hospital three times. 

"[Parkinson's patients] all have different problems, some more than others ... and generally, hospitals don't like you bringing your own pills in," he said. 

While Smith doesn't always feel drastic effects if he misses a pill, he's familiar with how demanding the medication schedule can be. He takes three pills a day with specific food and timing restrictions. 

"My little Parkinson pill isn't high on the priority list because nobody has told them that it should be," Smith said.

By allowing patients to monitor their medication, he said, it amounts to less stress for both them and, he assumes, the medical professionals. 

Not red tape but 'a matter of best practice'

Parkinson Canada spokesperson Emma Gostovic told CBC News the organization wasn't aware of any other hospitals in the country with a directive for Parkinson's patients and their medications that's similar to Guelph General Hospital's. 

Most hospitals are still aware this is a concern and are conscious of medication timing, she said. Gostovic called Guelph General Hospital's model one they'd like to "explore and share with others throughout the clinical community."

Andrea de Jong, director of the emergency department at Guelph General Hospital, said it's become a successful best practice to give emergency room nurses the power and knowledge to administer medications without having to get an order from a physician.

She said there are still restrictions on who is able to administer Parkinson's medication brought in from home, but nurses are familiar with these guidelines.

"This ideally helps them go back home quicker and overall have a better experience here," she said. 

Daly said Guelph General Hospital was quick to approve this directive with their emergency department teams and medical advisory committee, and said it's in line with much of the work Parkinson Canada aims to do within hospitals.

A patient's knowledge of their own rights and their ability to advocate is a separate hurdle, she said. 

"There's a double prong education piece to this ... people with Parkinson's have to know that it was OK, and emerge has to know that they have Parkinson's and that it's important they get their pills on time," Daly said.