Signs and symptoms of end-stage Idiopathic Parkinson's disease

Clinical review
First published in print journal End of Life Care by HealthComm UK
Declaration of interests: 
Helen Scott
Author profile (accurate when this article was originally published): 
Helen Scott is Editor, End of Life Care and Bank Staff Nurse, St Christopher’s Hospice, London, and is currently undertaking an MSc in Palliative Care, Department of Palliative Care, Policy and Rehabilitation, King’s College London. Email:

Idiopathic Parkinson’s disease (IPD) is a progressively disabling, neurological condition, resulting in multiple signs and symptoms and reduced quality of life. It is the second most common neurodegenerative disorder after Alzheimer’s disease. Although not traditionally considered a terminal condition, guidelines recommend the early involvement of palliative care services in IPD management. Limited evidence exists pertaining to the dying trajectory in IPD. However, the research that is available indicates an increasing symptom burden at the end of life. People with IPD rarely die in hospices. Therefore, the majority of patients with end-stage IPD will be cared for in hospitals, care homes and community settings. This article will focus on the main signs and symptoms of IPD that lead to morbidity and which are predictors of mortality. A case example of a man with advanced IPD admitted to a hospice is examined. The article aims to provide nurses caring for people with IPD in all environments with a broad overview of the effects of the disease. It is not its intention to discuss treatment strategies.

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