Personalized Care in Late-Stage Parkinson's Disease: Challenges and Opportunities

Overview

Journal J Pers Med

Date 2022 May 28

PMID 35629235

Authors

Margherita Fabbri

Miguel Coelho

Michela Garon

Roberta Biundo

Tiago A Mestre

Angelo Antonini

iCARE-Pd Consortium

Affiliations

Soon will be listed here.

Abstract

Late-stage Parkinson's disease (LSPD) patients are highly dependent on activities of daily living and require significant medical needs. In LSPD, there is a significant caregiver burden and greater health economic impact compared to earlier PD stages. The clinical presentation in LSPD is dominated by motor and non-motor symptoms (NMS) that most of the time have a sub-optimal to no response to dopaminergic treatment, especially when dementia is present. Non-pharmacological interventions, including physiotherapy, cognitive stimulation, speech, occupational therapy, and a specialized PD nurse, assume a key role in LSPD to mitigate the impact of disease milestones or prevent acute clinical worsening and optimize the management of troublesome NMS. However, the feasibility of these approaches is limited by patients' cognitive impairment and the difficulty in delivering care at home. The present care challenge for LSPD is the ability to offer a person-centered, home-delivered palliative care model based on Advanced Care Planning. An ongoing European multicentric project, PD_Pal, aims to address this challenge.

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