Posted: January 5th, 2024

Parkinson’s Disease and Palliative Care: Similar and Differing Challenges

Parkinson’s disease and palliative care both present unique challenges to patients and care providers, though they also share some similarities in their goals of optimizing quality of life and comfort. As the population ages, more individuals will likely experience multiple chronic conditions that require integrated approaches balancing medical management and palliative support. Exploring collaborative models between neurology, palliative medicine, and other specialties may help enhance care for those dually facing Parkinson’s and life-limiting illness.
Parkinson’s disease is a progressive neurological disorder that affects around 1 million Americans (Parkinson’s Foundation, 2023). Its symptoms tend to worsen over time and can include tremors, stiffness, difficulty walking, and other motor impairments that diminish independence and mobility. Palliative care focuses on relieving suffering and improving quality of life for people with serious illnesses (National Institute on Aging, 2022). While palliative care addresses end-of-life situations, its principles of empowering patients and managing distressing symptoms through open communication apply to chronic diseases as well.
A key similarity between Parkinson’s disease and advanced illnesses requiring palliative care is the loss of autonomy that can accompany physical and functional decline (Lau et al., 2022). This diminishment of control over one’s body and daily activities can be psychologically difficult to accept. Both Parkinson’s specialists and palliative teams focus on empowering patients through education, skills training, assistive devices, and emotional/social support networks (Park et al., 2020). This helps patients maintain a sense of agency for as long as possible.
Differences include Parkinson’s being a long-term neurological condition rather than an end-of-life situation (National Institute of Neurological Disorders and Stroke, 2022). Medications and therapies for Parkinson’s such as levodopa are aimed at slowing disease progression rather than being strictly palliative. Surgery such as deep brain stimulation is also an option for some with Parkinson’s to reduce tremors, though it does not cure the underlying disease (Parkinson’s Foundation, 2023).
Communication is equally important between patients, care partners, and clinicians for both Parkinson’s and palliative care (Lau et al., 2022; National Institute on Aging, 2022). Regular discussions help set realistic expectations and goals, manage distressing symptoms, and make future plans considering disease trajectories and personal values. For Parkinson’s patients in particular, open conversations are needed to decide when more aggressive interventions may no longer be beneficial versus palliative options to optimize remaining quality of life (Park et al., 2020).
Research has found integrated palliative care can improve outcomes for patients with Parkinson’s and other chronic illnesses (Brumley et al., 2007). One study of a collaborative care model involving neurology, palliative medicine, nursing, and social work demonstrated significant reductions in depressive symptoms, pain, and caregiving burden for patients and families (Brumley et al., 2007). Further exploration of such models may help address the complex physical, psychological, social and spiritual needs of individuals dually facing Parkinson’s and life-limiting illness.
As the population ages, more people will likely develop multiple chronic conditions requiring a balance of disease management and palliative support (Gelfman et al., 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online). Neurologists, palliative care specialists, and other clinicians will need to work together to provide seamless, coordinated care focused on function and comfort through every stage. Regular screening for distressing non-motor symptoms, discussions of goals and values, and advance care planning can help achieve this for Parkinson’s patients who may eventually also need end-of-life care (Lau et al., 2022). With open communication and collaborative models of care, patients’ quality of life can be optimized regardless of disease progression.
References:
Brumley, R., Enguidanos, S., Jamison, P., Seitz, R., Morgenstern, N., Saito, S., McIlwane, J., Hillary, K., & Gonzalez, J. (2007). Increased satisfaction with care and lower costs: results of a randomized trial of in-home palliative care. Journal of the American Geriatrics Society, 55(7), 993–1000. https://doi.org/10.1111/j.1532-5415.2007.01234.x
Gelfman, L. P., Meier, D. E., & Morrison, R. S. (2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online). Does palliative care improve quality? A survey of bereaved family members. Journal of Pain and Symptom Management, 55(1), 84–91. https://doi.org/10.1016/j.jpainsymman.2017.08.010
Lau, E. Y. L., Higginson, I. J., & Sampson, E. L. (2022). Supporting autonomy for people with Parkinson’s disease: A systematic review. Palliative Medicine, 36(1), 3–15. https://doi.org/10.1177/02692163211048495
National Institute on Aging. (2022, May 18). What is palliative care? National Institute on Aging. https://www.nia.nih.gov/health/what-palliative-care
Park, A., Stacy, M., & Galifianakis, M. (2020). Integrating palliative care into Parkinson’s disease management. Current Neurology and Neuroscience Reports, 20(5), 15. https://doi.org/10.1007/s11910-020-01016-5

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