The conceptual framework of palliative care applied to advanced Parkinson's disease.

With the incidence of Parkinson's disease rising, while imposing a large cost on health care systems around the world, optimizing care has become crucial. The complexity of our patients increases dramatically in the advanced stages. Recently our understanding of advanced Parkinson's disease has led to the question of whether Palliative care approaches would be complementary to the care of these patients. The experience of Parkinson's patients mirrors that of advanced cancer patients in many important ways. The predominant symptoms of these patients are often non-neurological. Pain has become recognized as a common symptom that can be difficult to treat. Given the success of early Palliative care involvement in cancer populations, it should not be surprising that our specialized Palliative Parkinson's Clinic at the Toronto Western Hospital has become indispensable for our patients. This article will describe the rational for combining the expertise of the Neurology department with that of Palliative care in the care of patients suffering from Parkinson's disease.