Navigating Parkinson’s in Taiwan: A Guide By Katy Boyden

Katy urges that beginning with therapy programs immediately is important. In an effort to delay the PD’s progression, she has listed out three types of therapies for PwP:

• Occupational Therapy (OT)

This mode focuses on the motor skills of daily activities (occupations)

• Physiotherapy (PT)

This mode focuses on overall body coordination

• Speech Therapy (ST)

This mode focuses on delaying speech decline by exercising the tongue and throat muscles

For Computers:

For some, these devices may be difficult to operate. For assistance, contact the non-profit organization ICE BREAKER.

Examples of devices that help in operating a laptop include:

• Joystick Mouse
• Trackball
• Clicker (single switch mouse)
• Eye-controlled Mouse
• Eye Pointing and E-tran

For Bedroom:

• Bed Guard or Side Rail for safety precautions and to help the PwP sit upright
• Electrical Bed to aid the PwP in changing positions
• Decompression air mattress helps distribute the patient’s weight to prevent bedsores
• Medical Cushions or Assistive Cushions (similar to the decompression mattress) help prevent pressure-caused injuries

For Bathroom:

• Bath Chair
• Raised Seat for Toilet
• Safety Handles
• Anti-slippery mat

For Movement:

• Walking Sticks
• Walker or Walking Frame
• Wheelchairs
• Wheelchair Taxi
  • For the Disability Card holder, there is a grant for the government wheelchair van service.  
  • Otherwise, there are many taxis equipped with wheelchair access. The starting rate is NT$500 in 2024, then the meter runs as a normal taxi.

Feeding and nutrition advice

1. Eat without distractions (talking, devices, etc.)
2. Switch to smaller, more frequent meals if larger meals become tiresome
3. Increase calories by adding cream, butter, sour cream or milk to recipes, and jellies or honey to sweeten foods.
4. Increase protein intake by adding (powdered) milk and eggs
5. Avoid feeding the PwP if they are in a horizontal position
6. The PwP should lower their chin to their chest before shallowing each bite (to prevent choking)
7. Recognise that taste buds may be compromised, causing food preferences to change
8. The ability to smell varies between each PwP
9. Make pureed food look appealing
   1. Milk to soften food
   2. Cornstarch-based products to thicken
   3. Avocado to thicken beverages
   4. Sauces and herbs for flavor
10. Preserve the PwP’s dignity by not serving baby food purees from the jar
11. Be aware of aspiration when ingesting liquids
12. Be extra careful when feeding foods of mixed consistency
13. Oral care after meals is an important step in preventing aspiration
14. Keep a food and weight journal to note nutrition and weight changes

10 of Katy’s favorite Parkinson’s-friendly recipes

1. Coconut Mango Puree

Blend ripe mango with coconut milk or coconut cream out of a can

2. Acorn Squash Banana Milkshake

Roast the acorn squash until tender, and then let it cool and peel before blending

3. Avo-cocoa Pudding

Blend a banana, ripe avocado, milk, and a teaspoon or two of cocoa powder

4. Savoury Beet Puree

Roast, chop, and blend your beet with Greek yogurt, dill, garlic powder, and veggie broth

5. Strawberry Spinach Applesauce

Cook down sliced strawberries and sugar. Add in spinach. Blend it all with applesauce

6. Tomato Basil Soup

Roast whole tomatoes and then simmer for 10 minutes with canned diced tomatoes, garlic, basil, and cream. Blend.

7. Green Goddess Puree

Blend an avocado, plain Greek yogurt, olive oil, lemon juice, lots of leafy herbs (basil, parsley, cilantro, mint)

8. Cheesecake Mousse

In one bowl, mix cream cheese and sugar. In another whip cocoa and espresso powder with coconut milk. Combine with heavy cream and whip on high until it has a smooth mousse consistency.

9. Chia Seed Pudding

Mix chia seeds in coconut milk with a splash of vanilla and maple syrup. Let it sit in the fridge for about an hour to thicken, then blend.

10. Monkey Nut Milkshake

Blend coffee ice cream, peanut butter, and milk.

Read more about Katy and Michael’s experience with hallucinations in the PDF attached above & below.

Hallucinations are one of the side effects of PD that not all patients experience, with only around 8% of PwP experiencing them. 

Examples of common episodes include:

1. “delusions of jealousy” (believing a spouse is having an affair)
2. “persecution” (believing in theft or harm)
3. misidentification (believing someone has been replaced by an imposter)

Upon occurrence, the caretaker should record the incident and inform a doctor.

Certain PD medications can also be the cause of impulsive and compulsive side effects. It is important to be aware of these potential behavior changes and alert the provider upon identification. 

Another common non-motor symptom is Apathy (a lack of interest or motivation), with about 40% of PwP experiencing this shift in morale (per the US Parkinson’s Foundation)

Bedsores (ulcers caused by prolonged pressure/friction) are common among bedridden patients.

To combat this issue:

1. Use a decompression air mattress
2. Rotate the patient every other hour*
3. BLOW DRYER (Katy’s secret weapon)

*Find advice on how to flip the patient in the PDF attached above and below.

To prevent excessive bedsores, do the following three times a day:

1. Flip the patient to the side* to expose the bedsore area
2. Clean the area with saline solution
3. Blow-dry the area to remove any remaining saline
4. Apply antibiotic ointment
5. Blow-dry the area again (make sure the area is completely dry)
6. Spray a thin layer of protection (3M Cavilon) and blow dry again
7. Use the sterilised gauze to cover the area. Wrap with medical tape

Coverage from National Health Insurance and Social Welfare Services

The National Health Insurance (NHI) provides universal healthcare, regardless of nationality. However, anything not covered by NHI falls under Social Welfare Services, including: 

• home visits
• supplements for medical assistive devices
• wheelchair taxi supplements
• respite service to caregivers
• discounted fare for both patients and caregivers in public transportation
• disability parking permit
• discounted hospital fee

These services are generally inaccessible to expats, even those with a Permanent Alien Resident Card. 

The services are included with proof of a disability certificate.

Disability Certification

The basic benefits of the certificate include a waiver of NHI monthly fee and the discounted hospital fee. 

*Update: As of June 2026, foreign nationals with permanent residency and at least 10 years of living in Taiwan are eligible to apply for a disability certificate

Medical Terminology

Assistive Devices

Websites:

• Parkinson’s UK
• Michael J Fox Foundation
• Davis Phinney Foundation for Parkinson’s
• PD Avengers

Podcasts:

• When Life Gives You Parkinson’s
• The Parkinson’s Podcast
• The Michael J. Fox Foundation

Hospitals in Taiwan for Parkinson’s Treatment:

Taipei Veterans General Hospital, Neurologists

National Taiwan University Hospital, Centre for Parkinson’s and Movement Disorders

Tri Services General Hospital, Department of Neurology

Facebook Community:

Parkinson’s and Me in Taiwan