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May 22, 2020

Parkinson disease affects 1% to 2% of people older than 65 years. Most known for its distinctive motor symptoms, other distressing symptoms are pain, fatigue, depression, and cognitive impairment. About 2/3rds of individuals with Parkinson's will die from disease-related complications, making it the 14th leading cause of death in the United States. While there are great palliative care needs for this population, little has been published on how best to meet these needs. On today's podcast we talk with Benzi Kluger from the University of Rochester Medical Center and the lead author of a JAMA Neurology paper that compares outpatient integrated palliative care with standard care alone in 210 patients and 175 caregivers. Every 3 months for a year, participants received palliative care visits either in person or via telemedicine from a neurologist, social worker, chaplain, and nurse with guidance from a palliative medicine specialist. Benzi's study demonstrated the palliative care group had better quality of life, symptoms burden, and advance directive completion. In addition to talking about the study, we get tips on how best to care for Parkinson's patients, both in palliative care and geriatrics. We also discuss some of these other helpful articles (visit our blog post at for the links): - Implementation issues relevant to outpatient neurology palliative care. Ann Palliat Med. 2018 - Top Ten Tips Palliative Care Clinicians Should Know About Parkinson's Disease and Related Disorders. J Palliat Med. 2018 - Palliative care and Parkinson's disease: outpatient needs and models of care over the disease trajectory. Ann Palliat Med. 2020 - Palliative Care and Parkinson's Disease: Caregiver Perspectives. J Palliat Med. 2017 - Parkinson disease patients' perspectives on palliative care needs: What are they telling us?