Nursing home and end-of-life care in Parkinson disease

Abstract

A large proportion of the Medicare PD population resides in an LTCF. There is substantial unmet need for palliative care in the PD population. Increased efforts to provide specialist care to dependent individuals with PD may improve end-of-life care.

National Randomized Controlled Trial of Virtual House Calls for People with Parkinson's Disease: Interest and Barriers

“…12 Individuals have Parkinson's disease for approximately 14-16 years after diagnosis, 13,14 and it leads to progressive disability, cognitive impairment, limited mobility, 15 and impaired driving ability. 16 Parkinson's disease also burdens caregivers, 17 frequently requires institutional care, [18][19][20] generates high healthcare costs, 21,22 and benefits from specialty care. [23][24][25][26] However, over 40% of Medicare beneficiaries with Parkinson's disease do not receive care from a neurologist within the first 4 years after diagnosis, 26 and those who do not have worse health outcomes, including a 22% increased risk of death within 6 years.…”

Ablative surgery for Parkinson’s disease: Is there still a role for pallidotomy in the deep brain stimulation era?

“…The overall expenditure for diagnostic procedures and hospitalization are not always available or are not evaluated along with other issues. It is worth mentioning that it is very likely that there are differences between different cultures and countries around the world concerning all types of costs, adding an extra difficulty in calculating costs in PD [71,103,104].…”

Parkinson disease and cognitive impairment

“…In a recent retrospective study utilizing Medicare data from nearly 500,000 patients with PD, dementia was the strongest predictor of nursing home placement. 30 Given the societal costs of caring for patients with dementia, any intervention that improves cognition has the potential for meaningful benefit in terms of reducing cost of care and improving quality of life. Cognitive training is broadly defined to include "structured and theoretically driven teaching of strategies or guided practice on tasks that target particular cognitive domains."…”