Parkinson’s disease is a progressive nervous system disorder that affects movement. Certain nerve cells called neurons in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical in the brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms such as thinking difficulties, depression/emotional changes, swallowing problems, chewing and eating problems, sleeping issues, bladder control, constipation to name a few. Symptoms start gradually, perhaps just a tremor to just one hand, but the disorder progresses causing stiffness or slowing of movement. Sadly, there is no cure for Parkinson’s disease.
Parkinson’s Disease: Criteria need to qualify for hospice services
The patient must meet the following criteria:
Rapid disease progression and either a or b below:
- Progression from independent ambulation to wheelchair or bed-bound status
- Progression from normal to barely intelligible or unintelligible speech
- Progression from normal to pureed diet
- Progression from independence in most or all Activities of Daily Living (ADL) to needing major
assistance by caretaker in all ADL
AND
- Severe nutritional impairment demonstrated by all of the following in the preceding 12 months:
- Oral intake of nutrients and fluids insufficient to sustain life
- Continuing weight loss
- Dehydration or hypovolemia
- Absence of artificial feeding
OR
- Life-threatening complications demonstrated by one or more of the following in the preceding
12 months:
- Recurrent aspiration pneumonia (with or without tube feedings)
- Upper urinary tract infections, e.g., Pyelonephritis
- Sepsis
- Recurrent fever after antibiotic therapy
- Stage 3 or Stage 4 pressure ulcer(s)
In the absence of one or more of these findings, rapid decline or comorbidities may also support eligibility for hospice care.