Patient selection: Parkinson's disease
Complications of Parkinson's disease may include:
(1) frequent falls or fall with fracture
(2) significant weight loss or progressive dysphagia
(3) recurrent infection or aspiration pneumonia
(4) significant neuropsychiatric problems or cognitive deficits
Indicators for advance care planning:
(1) signals or request for advance care planning or end-of-life care discussions
(2) loses hope or dreads the future
(3) frequent falls
(4) dysphagia or first episode of aspiration pneumonia
(5) cognitive deficits and/or neuropsychiatric problems
(6) unplanned hospital admission
Indicators that when to start of the patient's palliative phase:
(1) preferred goals of care moves towards maximization of comfort
(2) transition in care needs
(3) drug therapy for Parkinson's disease less effective or becoming more complex
(4) severe symptoms or complications of Parkinson's disease
Advanced care planning should start when >= 2 "planning" indicators present.
Palliative care should start when >= 1 "start" indicators present.
