Supportive care that focuses on relieving symptoms as much as possible and making a person comfortable when a medical condition and health status will not improve. End of life care and hospice care are forms of palliative care given to sustain comfort when death is imminent. The point at which it is appropriate to shift from treatment to palliative care is indistinct in Parkinson’s disease and often relates more to other problems and resulting decline than to the Parkinson’s.
As Parkinson’s is a progressive disease, however, it is helpful for the person with Parkinson’s and loved ones to have frank and honest discussions early in the course of the disease about what the person wants with regard to nutritional support, medication, and other interventions so that when the situation arises the decisions have already been made. Such decisions may also include the most appropriate location to meet the person’s care needs. Most people want to remain at home, but this choice is not always practical when the person has become totally dependent. advance directives can formalize these choices.
Typically, the physician and family members make the determination that palliative care has become appropriate, on the basis of the person’s medical condition and expectations for further decline. Family members often need emotional support and reassurance that they are making the right choices for their loved one’s best interests.