Palliative care of patients with Parkinson's disease

Abstract

Parkinson's disease is a progressive neurodegenerative disease that most often affects elderly people. The disease is characterized by a wide range of symptoms, motor (tremor, bradykinesia, postural instability and rigidity) and non-motor (neurological and psychiatric disorders, sleep problems, disorders of the autonomic nervous system, etc.), which as the disease progresses lead to significant disability, dependence in performing daily activities activities and impaired quality of life. Given that there is no therapy that could cure, slow down or stop the further development of the disease, it is necessary to include palliative care and a multidisciplinary team in the treatment of patients. A palliative approach includes recognition of the palliative needs of patients at all stages of the disease, compassion for diagnosis and prognosis, treatment of motor and non-motor symptoms, as well as social, emotional and spiritual aspects, preservation of autonomy, advance care planning and family support. Control of symptoms in Parkinson's disease is carried out by pharmacological treatment, application of complementary non-pharmacological methods and alternative therapy (music, dance, tai chi, massage therapy, application of acupuncture, homeopathy). Also, deep brain stimulation can treat certain symptoms. Treatment varies according to the stage of the disease. Due to the natural course of the disease, individual needs may vary between patients, and for this reason the selection of members of the multidisciplinary team should be based on the needs of each individual. With palliative care with a holistic approach and the involvement of a multidisciplinary team, most symptoms can be controlled. In this way, support can be given to caregivers, which significantly contributes to a better quality of life for both patients and their families, i.e. caregivers.