Carlos is 64 and retired. He had to retire because the effects of Parkinson disease prevented him from continuing to work as a foreign language professor. His wife, 3 years younger, has also retired in order to take care of her husband. About 15 years ago, Carlos noticed tremors in his hands, usually when he was at rest. At first, they were intermittent, and he thought they were caused by nervousness, stress, or muscle GBUJHVF “T UIFZ CFDBNF NPSF GSFRVFOU $BSMPT GPVOE JU harder and harder to ignore the symptoms. Carlos’s disease has progressed to the point where he walks by shuffling his feet, and he can climb stairs only with assistance and support. In danger of falling when he walks, Carlos has found that even getting over the upturned edge of a carpet can offer a genuine challenge. For this reason, he and his wife rarely go out, although they daily walk the lightly traveled road in front of their house, which is flat and easy for him to manage. Carlos calls it his “workout routine.” Carlos finds meals less satisfying than he used to because the consistency of some foods makes them difficult for him to chew. Although Carlos eats independently, his food must be cut beforehand into small pieces. If he uses a knife at all, it is for spreading, not cutting. Although his speech is affected and is spoken in TIPSU RVJFU CVSTUT $BSMPT IBT NBJOUBJOFE IJT TFOTF PG humor and his sarcastic wit. He still loves to tell stories of growing up in New York City. Along with resting tremors and decreased range of movement, Carlos has experienced other physiological changes related to Parkinson disease. He tires easily, RVJDLMZ CFDPNFT TIPSU PG CSFBUI BOE IBT EJGGJDVMUZ concentrating. At other times, he seems to become lost in seemingly repetitive tasks, such as picking up lint. Medication that raises his dopamine level gives him smoother movement but provides only temporary relief. He is sometimes frustrated by his response to the medication and his inability to time its effect on his movement for special times, such as a visit by his grandchildren.
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