Hi Mary Beth-
I wish I had a daughter asking as many questions as you! I am 62 and seven years since diagnosis.
Anyway, fatigue is my worst symptom. Fatigue has many meanings. For me, I mean that I grow so tired I need to lay down for an hour or more, two or more times a day. It’s not constant, but varies from hour to hour. There is little warning, but I can usually feel it coming on. Things like driving, multi-tasking, focusing, physical exertion, excitement, etc. seem to bring it on quicker. Caffeine doesn’t help much and makes me anxious. Pool aerobics makes me feel better than any medicine, but nothing works as well as a nap. Thus, much planning is required for outings and travel because I need a comfortable, quiet place to lay down when it reveals itself.
Another problem is apathy. Even with naps, good sleep, exercise, good diet, and a handful of medications, I am hardly inspired to do anything. Most people don’t understand the great disabling nature of fatigue and apathy.
Somewhere I read (in many years of researching Parkinson’s) the theory that the greatly reduced numbers of neurons (say over 90%) in the basal ganglia region of the brain stem cause the rest of the brain to work much harder, resulting in fatigue, but who knows?
I’m sure you are a great help to your dad.
Richard