Reshaping palliative care in PD 

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Dr. Angelo Antonini discusses how the Parkinson's disease palliative project is working to develop new standards for multidisciplinary palliative care.

The challenges facing people with Parkinson's disease become increasingly complex as the disease progresses. Despite optimal medical treatment, many people experience increasing unmet needs, including problems with mobility and cognition, which need to be properly addressed by the person and family living with the disease.

In the PD_Pal project, we are in the process of validating a new model of palliative care that would be easily integrated with traditional management when disability limits mobility and independence. The definition of the World Health Organization describes palliative care as "an approach that improves the quality of life of patients and their families coping with the problem associated with life-threatening serious illnesses, through the prevention and relief of suffering through the 'early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.' "

In current practice, palliative care is either not introduced at all in people with Parkinson's or it is introduced very late, in the final stages of the disease. This reluctance to consider an early approach to palliation exists because Parkinson's disease is generally not a terminal disease and because it has slow progression and typically long survival.

In the PD_Pal, we address different aspects of the disease that contribute to frailty and impact the quality of life of people with Parkinson's, justifying an early educational intervention involving those who deal with this pathology. Many disorders in the advanced stages benefit only in part from drug therapy and require an integrated multidisciplinary approach for their management. Only with the implementation of an integrated model of care that allows remote monitoring of the person, and that facilitates home management also through the development of targeted health education programs, will we be able to really change the quality of life of all those who suffer from Parkinson's and who turn to health facilities in search of concrete help for their problems.