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Palliative care in people with idiopathic Parkinson's disease who die in hospital

Lookup NU author(s): Professor Richard Walker, Dr Deepta Churm, Dr Felicity Dewhurst, Jessica Hill, Dr Brian Wood

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Abstract

Background: The UK National Institute for Health and Clinical Excellence guidelines state that palliative care options for people with Parkinson's disease (PD) should be discussed. Aims: To investigate whether palliative care guidelines are adhered to for people with PD who die in hospital. Setting/participants: The medical notes of all people with a diagnosis of idiopathic PD who were living in two adjacent areas of northeast England and who died over a 3-year period were examined. Demographic data and specific information regarding events around the time of death were recorded. Results: For the 236 patients identified, the average age at death was 82.8 years. Of these patients, 110 (46.6%) died in hospital, 56 (23.7%) at home, 59 (25.0%) in a care home and for 11 patients (4.7%) the place of death was not recorded. For those who died in hospital, only three patients, and seven relatives of patients, had had a recorded discussion with a clinician regarding their preferred place of death and only 15 (13.6%) were referred to a specialist palliative care team. Forty-six patients (41.8%) were placed on the Liverpool Care Pathway. Conclusions: For those dying in hospital, there are few previously documented end-of-life care discussions with patients or their relatives. The use of end-of-life pathways and access to specialist palliative care is variable. Following the Neuberger report, the Liverpool Care Pathway is to be replaced with individual end-of-life care plans. It is important to engage patients, and their relatives, in decision making regarding preferences at the end of life.


Publication metadata

Author(s): Walker RW, Churm D, Dewhurst F, Samuel M, Ramsell A, Lawrie C, Hill J, Threapleton CJD, Wood B, Gray WK

Publication type: Article

Publication status: Published

Journal: BMJ Supportive and Palliative Care

Year: 2014

Volume: 4

Issue: 1

Pages: 64-67

Print publication date: 01/03/2014

Online publication date: 19/11/2013

Acceptance date: 01/10/2013

ISSN (print): 2045-435X

ISSN (electronic): 2045-4368

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/bmjspcare-2012-000412

DOI: 10.1136/bmjspcare-2012-000412

PubMed id: 24644773


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