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Palliative Care in Parkinson’s Disease

  • Movement Disorders (SA Factor, Section Editor)
  • Published:
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Abstract

Palliative care for Parkinson disease (PD) is a new concept in neurodegenerative care. Abundant evidence exists supporting PD as increasing risk of death, most commonly from aspiration pneumonia despite improvements in motor and non-motor symptom management. Palliative care emphasizes an interdisciplinary and holistic approach to symptom management. In the following, the timing for considering palliative care, the communication surrounding this stage of illness, and assessing patients and caregivers will be discussed. Evaluation using the Edmonton Symptom Assessment Scale-PD can help practitioners identify symptoms requiring intervention and track their response to interventions. Adopting palliative care principles will allow neurologists to fulfill the needs of PD patients in advanced stages to the end of life.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ishihara L, Cheesbrough A, Brayne C, Schrag A. Estimated life expectancy of Parkinson’s disease patients compared with the UK population. JNNP. 2007;78:1304–9.

    Google Scholar 

  2. •• Hassan A, Wu SS, Schmidt P, et al. What are the issues facing Parkinson’s disease patients at ten years of disease and beyond? Data from the NPF-QII study. Parkinsonism Relat Disord. 2012;18:S10–4. A cross-sectional study of 1835 people with PD >10 years duration.

    Article  Google Scholar 

  3. Hely MA, Morris JGL, Reid WGJ, Trafficante R. Sydney multicenter study of Parkinson’s disease: non-L-dopa responsive problems predominate at 15 years. Mov Disord. 2005;20:190–9.

    Article  Google Scholar 

  4. Hely MA, Reid WGH, Adena MA, et al. The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord. 2008;837–44.

  5. Higginson IJ, Gao W, Saleem TZ, Chaudhuri KR, et al. Symptoms and quality of life in late stage Parkinson syndromes: a longitudinal community study of predictive factors. PLoS One. 2012;7:e46327.

    Article  CAS  Google Scholar 

  6. Saleem TZ, Higginson IJ, Chaudhuri KR, et al. Symptom prevalence, severity and palliative care needs assessment using the Palliative Outcome Scale: a cross-sectional study of patients with Parkinson’s disease and related neurological conditions. Palliat Med. 2012. doi:10.1177/0269216312465783

  7. Worden JW. Grief counseling and grief therapy. New York: Springer Publishing; 2008.

    Book  Google Scholar 

  8. Fall PA, Saleh A, Fredrickson M, et al. Survival time, mortality and cause of death in elderly patients with Parkinson’s disease. A 9-year follow-up. Mov Disord. 2003;18:1312–6.

    Article  Google Scholar 

  9. Wennberg JE, Fisher ES, Goodman DC, Skinner JS. Tracking the care of patients with severe chronic illness: the Dartmouth Atlas of health care 2008. 2008 Lebanon, NH: Dartmouth Medical School; 2008. Available at: http://www.dartmouthatlas.org. Accessed 4 June 2013

  10. Coventry PA, Grande GE, Richards DA, Todd CJ. Prediction of appropriate timing of palliative care for older adults with non-malignant life-threatening disease: a systematic review. Age and Ageing. 2005;34:218–27.

    Article  Google Scholar 

  11. Gill TM, Gahbauer EA, Han L, Allore HG. Trajectories of disability in the last year of life. N Engl J Med. 2010;362:1173–80.

    Article  CAS  Google Scholar 

  12. • Miyasaki JM, Long J, Mancini D, et al. Palliative care for advanced Parkinson disease: an interdisciplinary clinic and new scale, the ESAS-PD. Parkinsonism Rel Disord. 2012;18:S6–9. A study of 65 patients with advanced PD using the Edmonton Symptom Assessment Scale demonstrating significant improvement in symptoms using a holistic approach to treatment.

    Article  Google Scholar 

  13. Ford B. Pain in Parkinson’s disease. Mov Disord. 2010;25(S1):S98–S103.

    Article  Google Scholar 

  14. Pacchetti C, Albani G, Martignoni E, et al. “Off” painful dystonia in Parkinson’s disease treated with botulinum toxin. Mov Disord. 1995;10:333–6.

    Article  CAS  Google Scholar 

  15. Lagalla G, Millevolte M, Capecci M, et al. Long-lasting benefits of botulinum toxin type B in Parkinson’s disease-related drooling. J Neurol. 2009;256:563–7.

    Article  CAS  Google Scholar 

  16. Ghoche R. The conceptual framework of palliative care applied to advanced Parkinson’s disease. Parkinsonism Relat Disord. 2012;18:S2–5.

    Article  Google Scholar 

  17. Zangaglia R, Martignoni E, Glorioso M, et al. Macrogol for the treatment of constipation in Parkinson’s disease: a randomized placebo-controlled study. Mov Disord. 2007;22:1239–44.

    Article  Google Scholar 

  18. Gort AM, Mingot M, Gomez X, et al. Use of the Zarit scale for assessing caregiver burden and collapse in caregiving at home in dementias. Int J Geriatr Psychiatry. 2007;22:957–62.

    Article  Google Scholar 

  19. •• Zesiewicz TA, Sullivan KL, Arnulf I, et al. Practice parameter: treatment of nonmotor symptoms of Parkinson disease. Neurology. 2010;74:924–31. Evidence-based review of non-motor symptom treatments.

    Article  CAS  Google Scholar 

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Janis M. Miyasaki declares that she has no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Janis M. Miyasaki.

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This article is part of the Topical Collection on Movement Disorders

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Miyasaki, J.M. Palliative Care in Parkinson’s Disease. Curr Neurol Neurosci Rep 13, 367 (2013). https://doi.org/10.1007/s11910-013-0367-y

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  • DOI: https://doi.org/10.1007/s11910-013-0367-y

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