Palliative and end-of-life care in advanced Parkinson's disease and multiple sclerosis

DÉBUT DE L'ARTICLE CAR IL N'Y A PAS DE RÉSUMÉ : Key Points Palliative care in advanced Parkinson's disease (PD) and multiple sclerosis (MS) recognises the need to move from attempting to control function to affording comfort measures Admission to an acute hospital can be highly disruptive to the nursing and drug routines for these patients Advanced disease can lead to cognitive changes in MS, and in PD to dementia and hallucinations, each of which can rob patients of the opportunity to express their wishes and preferences as their disease progresses further It can be empowering for those patients who still have capacity, sensitively to discuss whether they would wish to receive life-prolonging treatments as their disease progresses, such as intravenous antibiotics, percutaneous endoscopic gastrostomy feeding tubes and artificial ventilation The terminal phase of PD and MS usually occurs against a backdrop of more rapid global decline and increasingly severe disability. The terminal event is often an acute episode of sepsis causing death over a few days KEY WORDS: best interests, multiple sclerosis, palliative, Parkinson's disease, terminal