While Parkinson's disease is not lethal, it can eventually result in severe consequences and substantial impairment. Severe motor symptoms and cognitive problems like dementia are common in end-stage Parkinson's disease patients.
The end stage, often known as stage 5, is the most advanced stage of Parkinson's disease. Severe motor symptoms can make it difficult for those with end-stage Parkinson's disease to walk or stand.
In the latter stages of Parkinson's disease, severe nonmotor symptoms can also make day-to-day functioning challenging. Aside from these symptoms, mental and cognitive health problems might also be problems.
This article discusses what to anticipate when Parkinson's disease reaches its most advanced stages.
Symptoms of end-stage Parkinson’s
Individual differences exist in the course of Parkinson's disease development. While some Parkinson's patients move through the stages of the disease swiftly, others can remain mobile for years or even decades. Although the exact cause of this is unknown, variables including sex, age, and genetics might be important.
In a similar vein, not everyone experiences end-stage Parkinson's disease. For instance, some people may not develop dementia, while others may.
Nonetheless, being aware of some of the most typical signs of Parkinson's disease in its later stages might be helpful.
Motor symptoms
Individuals with end-stage Parkinson's disease may have extreme challenges with their balance, coordination, and movement. Typical signs and symptoms include:
- freezing
- muscle stiffness
- involuntary movements
- tremors
Having these symptoms can make it unsafe to stand or walk. To get around without falling, the majority of persons with end-stage Parkinson's disease use a wheelchair. Additionally, they may want assistance with everyday tasks like taking a shower or getting out of bed.
Cognitive symptoms
Parkinson's disease cognitive symptoms impair your executive processes, which include your capacity for planning, reasoning, memory, attention, and problem-solving.
A 2021 study review points out that although cognitive alterations can happen at any stage of Parkinson's, they become more frequent as the illness worsens. In addition, cognitive problems typically worsen as Parkinson's progresses.
Dementia and Parkinson’s
A significant 2022 Swedish study found that the risk of dementia increases with the progression of Parkinson's disease, with those with the disease around four times more likely to experience dementia than the general population.About 2 out of every 5 patients in a smaller 2017 study experienced dementia over 5 years. During the first year of the trial, the risk of dementia was significantly lower (about 7%) in individuals with typical cognitive ability, but greater (about 59%) in those with pre-existing mild cognitive impairment.
Mental health symptoms
According to an analysis published in 2022, the likelihood of mental health issues among Parkinson's patients as well as the intensity of their symptoms rises with time. It is also more common for those with end-stage Parkinson's disease to additionally suffer from two or more mental health issues.
Mental health issues in advanced Parkinson's disease may include:
- problems with motivation
- impulse-control disorders
- mood disorders, like depression and anxiety
- psychosis, accompanied by hallucinations, usually brought on by drugs that alter dopamine levels
Other nonmotor symptoms
Final phase Numerous symptoms are linked to Parkinson's disease, and these symptoms frequently vary from person to person. You could encounter:
- aches and pains
- constipation
- erectile dysfunction
- excessive sleepiness
- difficulty swallowing
- dizziness and vertigo
- fatigue
- inability to smell
- low blood pressure
- orthostatic hypotension
- incontinence
- insomnia
- tooth decay
- vision and eye problems
Treatment options for end-stage Parkinson’s
Treatments for Parkinson's disease may alter as the condition worsens.
To raise their dopamine levels, most Parkinson's patients use carbidopa/levodopa (Sinemet, Rytary). A physician could advise taking doses more frequently.
An intestinal infusion of levodopa gel is an additional treatment option for patients with late-stage Parkinson's disease. It enables you to take the medication continuously.
For advanced Parkinson's disease, additional drugs include:
- dopamine agonists
- amantadine (Gocovri)
- anticholinergics
- MAO-B inhibitors
- COMT inhibitors
Deep brain stimulation (DBS) surgery may also be beneficial for patients with severe Parkinson's disease.
A small device is inserted into your brain by a surgeon during DBS. This gadget, which works similarly to a pacemaker, stimulates certain parts of your brain damaged by Parkinson's disease, potentially relieving movement symptoms.
Palliative and hospice care for end-stage Parkinson’s
Maintaining quality of life for as long as feasible is the goal of palliative care for advanced Parkinson's disease. Methods could consist of:
- therapies for non-motor symptoms such as pain, exhaustion, or depression
- emotional support for Parkinson's patients, their loved ones, and carers
- help from a medical expert, such as a nurse or nursing aide, at home
Hospice care is for those who are in their final six months of life and is comparable to palliative care. As death draws near, the goal of this kind of care is to increase comfort and relieve discomfort.
Caring for a loved one with end-stage Parkinson’s
Taking care of a loved one with Parkinson's disease can be very difficult, particularly in the advanced stages. Your loved one may need 24-hour care and will probably be limited in their everyday activities.
Here's how you can contribute:
- Shift your expectations: Make every effort to acknowledge that your loved one's abilities have diminished.
- Notice thinking and mood changes: You may need to change the way you communicate with your loved one if they have dementia.
- Implement basic routines: By sticking to a straightforward daily schedule, you can make sure your loved one stays hydrated, nourished, and gets enough sleep.
- Plan for the future: As their life nears its end, your loved one will require your assistance in making crucial decisions.
- Work with healthcare professionals: You can get help from other members of your loved one's care team in your capacity as a carer.
- Seek support: Primary carers frequently feel intense emotions, exhaustion, or loneliness. It can be beneficial to speak with other carers and request aid when necessary.
Resources for support
Parkinson's disease patients and their carers can get support, frequently from nonprofit organisations.A nationwide helpline manned by medical specialists can be reached at 800-4PD-INFO (800-473-4636) by the Parkinson's Foundation. If you're looking for information on Parkinson's disease symptoms, therapies, local resources, events, and support groups, this is a wonderful place to start.Another nonprofit that helps Parkinson's patients and their carers is the American Parkinson Disease Association (APDA). To locate and get in touch with your local chapter, use their search function.
FAQs
Can Parkinson’s deteriorate suddenly?
Parkinson's disease often worsens gradually, although it can also worsen suddenly. This is frequently connected to another health issue, including a stroke, UTI, or an unpleasant fall.
How long does the final stage of Parkinson’s last?
The length of time end-stage Parkinson's disease lasts is impossible to predict because each person's symptoms vary greatly. It could last anywhere from a few months to a few years.
What is the life expectancy for someone with Parkinson’s?
Several variables can affect life expectancy, including Parkinson's. According to the authors of a sizable 2020 study, 65-year-olds with Parkinson's disease lived an average of around 7 years shorter than their counterparts.
Takeaway
Severe motor signs of end-stage Parkinson's disease include freezing and stiffness of the muscles. Psychosis, sadness, and cognitive abnormalities are examples of nonmotor symptoms.
Parkinson's disease doesn't cause death, but it can have deadly side effects. For instance, there is a higher chance of aspiration pneumonia and significant falls in individuals with severe Parkinson's disease.
Remind yourself that you are not alone if you have end-stage Parkinson's disease or you are caring for someone who does. To learn more about the resources in your area, think about requesting information from a member of your healthcare team.
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