Contents:
Clinical Guideline for the Management of Patients with Parkinson’s disease who are approaching the end of life.
Introduction
This guideline is intended to provide specific recommendations for symptom and medication management for PD patients in the last days or weeks of life, whether in primary or secondary care. It is not intended to replace the abundant guidance available elsewhere for palliative patients, for example: West Midlands Palliative Care Guidelines.
Scope
These guidelines apply to:
- Patients with Idiopathic Parkinson’s Disease who are approaching the end of their life irrespective of the cause, either in hospital or the community;
- The guideline is not directly intended for patients with other forms of Parkinsonism – such as Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal Degeneration, Dementia with Lewy Bodies or Vascular Parkinsonism – but many principles will be relevant.
Definitions and abbreviations
PD – Parkinson’s Disease
CNS – Clinical Nurse Specialist
MDT– Multidisciplinary team
COMT – Catechol-O-Methyl Transferase
MAO–B – Monoamine Oxidase B inhibitor
TDS – Three times a day
QDS – Four times a day
CR – Controlled Release
ReSPECT – Recommended Summary Plan for Emergency Care and Treatment
ACP – Advance Care Plan
CSCI – Continuous subcutaneous infusion (‘’syringe driver’’)
DBS – Deep brain stimulation
PEG – Percutaneous endoscopic gastrostomy
PEG-J – Percutaneous endoscopic transgastric jejeunostomy
Disclaimer
These Guidelines are intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.
Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.
Whilst SPAGG takes every care to compile accurate information , we cannot guarantee its correctness and completeness, and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.