Palliative care for Parkinson’s disease: A summary of the evidence and future directions

Abstract

Research examining access to palliative care and management of terminal symptoms will assist development of sustainable, integrated palliative care services for Parkinson's disease.

A consensus review on the development of palliative care for patients with chronic and progressive neurological disease

“…These are being further evaluated but there is evidence that these triggers may help in the recognition of the end of life – with increasing numbers of triggers identified as death approaches (, Class III). In PD there is evidence that loss of weight and a lessening in effectiveness of medication may suggest that palliative care should be considered (, Class III).…”

Why Palliative Care Applies to Parkinson's Disease

“…We recommend that all team members (ie, from multiple different professional disciplines) should be trained in palliative care principles, allowing them to work as an interdisciplinary team and to provide palliative care interventions in less complex situations, such as engaging in discussions about treatment goals, prognosis, and future care planning. Specialized palliative care interventions, delivered by professionals with advanced training in palliative care modern principles and neurodegenerative diseases should be able to train and support all other members of the team in relation to more complex or specific palliative care needs of patients, for example, treatment of grief and existential distress . The caregiver should also be a key member of this interdisciplinary team, providing invaluable insights into the complex and individual experience of patients, especially when they manifest cognitive deficits …”

Need for palliative care for neurological diseases

“…An early palliative approach seems to be largely recommended to face the different aspects of the loss of autonomy [39], such as reduced motor activity and postural impairment in Parkinson's, autonomic disorders in MSA, falls in the PSP, hallucination and fluctuations in dementia with Lewy body, and cognitive impairment in subcortical vascular parkinsonism. These symptoms lead to serious disability.…”