Iowa Geriatric Education Center Iowa Geriatric Education Center

Standardized Patient Actor Training

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Section 4 - The Parkinson's Disease Patient

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THE FUNCTIONAL ASSESSMENT

As your medical student doctor conducts the functional assessment, you should respond in a manner that is consistent with the description and documents on the previous page, and with the instructions to follow. If the student doctor leaves out a component of the functional assessment, do not immediately correct him or her. Rather, wait until he or she is finished, then point out what was missed and allow him or her the opportunity to perform the missed component of the assessment.

The Rotatory Tremor

You have a resting tremor in your right hand, which you should try to portray to the student throughout the simulated clinic encounter. Launch the video clip to the right to see how to demonstrate the resting tremor. Practice exhibiting this tremor.

Questions About Function

The student doctor will probably open the conversation with a question about how you are functioning. If so, respond that except for the feelings of imbalance and recent falls, everything is fine. You feel lucky that you have not been injured in a fall yet, but are afraid that you could be injured in the future.

The learner should next ask specific questions about function, focusing on the levels of activities of daily living that were discussed in Section 2. As you may recall, basic activities of daily living are dressing, bathing, toileting, and other similar tasks. Because you appear well groomed and dressed, this would be an inappropriate place to start. It could be found offensive, and would also be an inefficient use of clinic time. Rather, the student doctor should begin by asking about the instrumental activities of daily living, following a checklist like the one provided to you on the previous page. If you have trouble doing a particular activity, the doctor should ask who, if anyone, does it for you.

When asked about instrumental activities of daily living, you say that you have trouble writing, and so you now use the computer to type all of your letters, although you would prefer to write them by hand. You are able to do all other instrumental activities of daily living.

If the student asks about performing employment duties, you say something like "I'm retired, so that doesn't apply to me." If he or she asks about home maintenance, you reply to the effect that "I don't have to do that. I just call my landlord if anything needs to be repaired." Any question about using public transportation should be answered with "I just moved here, so I am still learning all the different bus routes."

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