Nutrition dilemma: gastrostomy in a patient with parkinson's disease : Collaboration of a palliative care specialist and a neurologist
Abstract
Advanced Parkinson's disease (PD) is characterized by many complications: motor fluctuations and dyskinesias, but also non-motor symptoms. From the palliative point of view the concept of advanced PD refers to a situation when non-motor symptoms surpass motor symptoms in severity and movement disability does not respond any more to therapeutic interventions.
We present an illustrative case report demonstrating the utility and benefit of interdisciplinary collaboration of neurologists and palliative care specialists in a chronic disease with irreversible progression. The palliative care specialist's opinion is helpful in current medical decision making and definition of real goals of treatment based on the patient's or his relative's preferences, and adequate management of complications.
The neurologist may contribute to better orientation in the clinical situation, the progression rate of neurodegeneration and in prediction of complications.