[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.191.0. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 1,677
Citations 0
Editorial
February 10, 2020

Palliative Programs for Persons With Parkinsonism—The Next Frontier

Author Affiliations
  • 1Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
  • 2Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
JAMA Neurol. Published online February 10, 2020. doi:10.1001/jamaneurol.2019.4697

The challenges facing people with Parkinson disease (PD) become increasingly complex as the disease advances. Despite optimal medical treatment, many individuals experience mounting unmet needs, including problems with mobility and cognition.1,2 This situation occurs perhaps because most management approaches revolve around disease-based models, which tend to disregard the person and family living with the disease. It is therefore worthwhile to consider alternative approaches. One option is palliative care, which is a holistic way of looking at a person and family in the context of a serious illness. The World Health Organization definition described palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”3 Because of this association with life-threatening illnesses, most clinicians—when asked about palliative care—will predominantly consider terminally ill patients with cancer and end-of-life issues occurring in hospices. There is, of course, ample positive experience with such palliation in the setting of terminal diseases like cancer, but there is growing awareness that palliative care may also benefit persons with neurodegenerative diseases like PD.4,5 Yet, in current practice, palliative care is either not introduced at all to persons with PD, or it is introduced very late, in the final disease stages before death.6 This reluctance to consider palliative care likely exists because PD is generally not conceptualized as a terminal illness because of its slowly progressive nature and typically long survival. However, another explanation relates to scientific underpinning; we do not fully understand which components of palliation are useful for persons with PD,7,8 in which disease phase these palliations should be applied, and how to implement palliative care for this population.9,10

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×