How does Parkinson's disease affect HMPV management?

Question

Hello doctor,

My father in the nursing home was diagnosed with HMPV (human metapneumovirus). He has Parkinson's disease and already has swallowing difficulties. Now with this infection, he is coughing more during meals and seems more confused than usual. His care team mentioned aspiration risk. How do we manage his feeding safely? What complications should we watch for? How long until we expect improvement?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

With your father having Parkinson’s disease, swallowing difficulties, and now HMPV ((human metapneumovirus), he is at high risk for aspiration pneumonia.

Switch his solid foods to soft, pureed, or thickened liquid. Avoid thin liquids as they are easiest to aspirate.
Keep him upright while eating and for 30 to 60 minutes after meals. If he is weak, someone can hold him from behind, or usually nursing homes have adjustable beds. Adjust his bed so that he is at 90 degrees.
Encourage slow eating with small bites and sips. Supervise his every meal.
If swallowing worsens, a temporary NG (nasogastric) tube or PEG (percutaneous endoscopic gastrostomy) feeding may be needed.

HMPV and poor oxygenation can worsen cognitive function. That can be confusing. As he is having difficulty swallowing, he might be getting less hydration. Dehydration can also be confusing. Water can easily be aspirated. See if IV (intravenous) fluid transmission is possible or not. If he has a heart issue, IV fluid should be given in a hospital because in that case proper monitoring will be needed.

If he starts showing signs of aspiration pneumonia (fever, worsening breathing, and increased sputum), take him to the hospital immediately.
HMPV symptoms can last one to three weeks, but recovery may be slower in elderly patients with underlying conditions.

You can consider a swallow study to guide safe feeding. Ask his speech therapist about it.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.