Lorna Gillies Parkinson’s Nurse Specialist

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Presentation transcript:

Lorna Gillies Parkinson’s Nurse Specialist Palliative care case study Lorna Gillies Parkinson’s Nurse Specialist

Idiopathic Parkinson's is a progressive neurological condition Symptoms are due to lack of dopamine due to cell death Symptoms –bradykinesia, rigidity and tremor-plus non motor symptoms Cause, many theories, likely a combination of genetic and environmental factors Atypical Parkinson's and parkinsonism's No cure or disease modifying therapy yet

Phases of Parkinson’s Maintenance Diagnosis Education Education Support Drug therapy MDT Diagnosis Education Support MDT Acceptance Reduce symptoms Carer support Complex Complex drug regimes Side effects Co morbidities Wider MDT Reduce symptoms Maintain normal activities Anticipatory care plan DNACPR Palliative Palliative care referral Drug withdrawal Alternative drug route Symptom control PEG

Case Study 87 year old gentleman Parkinson’s diagnosed 2012 Gradual deterioration Cognitive impairment Medication less effective-co morbidities PKAVs and care package involved Admitted to care home for respite-permanent

Case Study cont Referral to psychiatry Frail Reduced appetite Increased somnolence Swallow intact Approaching Christmas............

Case Study cont Request GP to prescribe Rotigotine 2mg patch to replace oral meds if swallow deteriorates Rotigotine obtained by care home Peaceful death on Sunday

Learning points Anticipatory care planning Team work Management of Parkinson’s in acute settings(NBM Guidelines) need adapted and rolled out to Primary care

Thank you Gill Finlay Parkinson’s Nurse Specialist Royal Victoria Hospital Tel 01382 423140 e mail gillian.finlay@nhs.net Lorna Gillies Parkinson’s Nurse Specialist Perth Royal Infirmary Tel 01738 473172 e mail lorna.gillies@nhs.net Linda Patterson Parkinson’s Nurse Specialist Stracathro Hospital Tel 01356 665091/665083 e mail lindapatterson@nhs.net Catherine Young Movement Disorder Nurse Specialist Ninewells Hospital Tel 01382 660111 ex 36063 e mail c.young2@nhs.net