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DOI: 10.1055/s-0038-1628778
Palliative Versorgung
Palliative care and Parkinson’s diseasePublication History
Eingegangen am:
29 January 2010
angenommen am:
03 March 2010
Publication Date:
24 January 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034916/201006/lookinside/thumbnails/10-1055-s-0038-1628778_de-1.jpg)
Zusammenfassung
Die letzte Lebensphase eines Patienten mit M. Parkinson ist nicht nur für den Patienten, sondern auch für sein Umfeld einschließlich der ärztlichen Betreuung eine sehr schwierige Phase. Die Symptomkontrolle gelingt nicht mehr mit den bislang verwendeten Medikamenten, die Unbeweglichkeit nimmt zu und es treten Schmerzen, Bettlägerigkeit und psychische Veränderungen auf. Die Angehörigen, die über Jahre hinweg die Pflege übernommen haben, sind in dieser Situation oft überfordert. Aber auch die betreuenden Ärzte haben wenig Kenntnis von medikamentösen und nicht medikamentösen Maßnahmen zur Symptomkontrolle. Daraus resultieren vermehrte, oft unnötige Krankenhauseinweisungen und die Verlegung des Patienten in ein Pflegeheim. Beides bedeutet für den Patienten häufig nach einem kurzen Aufenthalt den Tod in fremder Umgebung. Durch gezielte Inanspruchnahme von ambulanten Diensten und palliativer stationärer Versorgung (Palliativstation und Hospiz) könnten möglicherweise mehr Patienten gut symptomkontrolliert sterben.
Summary
End-Stage Parkinson’s disease is challenging not only for the patient but also for the relatives and the physicians. Medication previously used, often does not sufficiently affect symptom control in end stage disease. Immobility increases and symptoms like pain and personality changes, including dementia, occur. Relatives and the physicians who often have delivered care for years are unable to handle these situations which often result in hospital admission and dead of the individual after a short time of hospitalization. However, using individual care planning across the trajectory of the disease and with the help of hospice services more patients might be able to end their lives within the family and with effective relief of their symptoms.
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Literatur
- 1 Annic A, Devos D, Sequy D, Dujardin K, Destée A, Defebvre L. Continuous dopaminergic stimulation by Duodopa in advanced Parkinson´s disease: Efficacy and safety. Rev Nurol 2009; 165: 718-727.
- 2 Antonini A, Tolosa E. Apomorphine and levodopa infusion terapie for advanced Parkinson´s disease: selection criteria and patient management. Expert Rev Neurother 2009; 09: 859-867.
- 3 Bingham V, Habermann B. The influence of spirituality on family management of Parkonson´s disease. J Neurosci Nurs 2006; 38: 422-427.
- 4 Bunting-Perry LK. Palliative care in Parkinson’s disease: implications for neuroscience nursing. J Neurosci Nurs 2006; 38: 106-113.
- 5 Daniele A, Moro E, Bentivoglio AR. Zolpidem in progressive supranuclear palsy. N Engl J Med 1999; 341: 543-544.
- 6 Duda JE, Stern MB. Moderate parkinson’s disease. In: Ebadi M, Pfeiffer RE. (eds.) Parkinson’s disease. New York: CRC Press; 2005
- 7 Giles S, Miyasaki J. Palliative stage Parkinson’s disease: patient and family experiences of health-care services. Palliat Med 2009; 23: 120-125.
- 8 Goy ER, Carter JH, Ganzini L. Parkinson disease at the end of life: caregiver perspectives. Neurology 2007; 69: 611-612.
- 9 Hughes AJ, Bishop S, Kleedorfer B, Turjanski N, Fernandez W, Lees AJ, Stern GM. Subcutaneous apomorphine in Parkinson´s disease : response to chronic administration for up to five years. Mov Disord 1993; 08: 165-170.
- 10 Kolls BJ, Stacy M. Apomorphine: a rapid rescue agent for the management of motor fluctuations in advanced Parkinson disease. Clin Neuropharmacol 2006; 29: 292-301.
- 11 Lee MA, Walker R, Prentice W. The role of palliative care in Parkinson’s disease. Geriatic Medicine 2004; 34: 51-54.
- 12 Nath U, Ben-Shlomo Y, Thomson RG, Lees AJ, Burn DJ. Clinical features and natural history of progressive supranuclear palsy: a clinical cohort study. Neurology 2003; 60: 910-916.
- 13 Papapetropoulos S, Singer C, McCorquodale D, Gonzalez J, Mash DC. Cause, seasonality of death and co-morbidities in progressive supranuclear palsy (PSP). Parkinsonism Relat Disord 2005; 11: 459-463.
- 14 Rubin BK, Henke MO. Immunomodulatory activity and effectiveness of macrolides in chronic airway disease. Chest 2004; 125: 70S-78S.
- 15 Shimizu T, Shimizu S, Hattori R, Gabazza EC, Majima Y. In vivo and in vitro effects of macrolide antibiotics on mucus secretion in airway epithelial cells. Am J Respir Crit Care Med 2003; 168: 581-587.
- 16 Snell K, Pennington S, Lee M, Walker R. The place of death in Parkinson’s disease. Age Ageing 2009; 38: 617-619.
- 17 MacMahon T. Parkinson’s disease, palliative care and older people: Part 1. Nurs Older people 2004; 16: 22-26.
- 18 Waseem Gwinn-Hardy. Pain in Parkinson’s disease. Common yet seldom recognized symptom is treatable. Postgrad Med 2001; 110: 33-34.
- 19 WHO Definition. 2005
- 20 Ebersbach G. Langzeitverlauf der Parkinsonerkrankung. Nervenheilkunde 2010; 29: 345-350.