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Nervenheilkunde 2010; 29(06): 368-371
DOI: 10.1055/s-0038-1628778
Parkinson
Schattauer GmbH

Palliative Versorgung

Palliative care and Parkinson’s disease
S. Lorenzl
1   Interdisziplinäres Zentrum für Palliativmedizin und Neurologische Klinik, Klinikum der LMU, Campus Grosshadern
› Institutsangaben
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Publikationsverlauf

Eingegangen am: 29. Januar 2010

angenommen am: 03. März 2010

Publikationsdatum:
24. Januar 2018 (online)

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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.

Schlüsselwörter

M. Parkinson - Palliativmedizin - Symptomkontrolle - Sterbephase

Keywords

Parkinson’s disease - palliative care - symptom control - end stage
 

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