title: The psychosocial impact of late-stage Parkinson's disease.
abstract: The late stage of Parkinson's disease (PD) can be protracted with inexorable changes in physical and mental health, loss of autonomy and self-esteem, altered relationships, and social isolation. Severely affected patients (Hoehn & Yahr stage 4-5) present a challenge to nurses who care for them; addressing their needs takes time and patience. Changes in mental status have profound implications for the welfare of the late-stage PD patient as well as of the caregiver(s). Depression and dementia in patients with PD are two factors that interfere with the ability to deliver effective care in late-stage PD as they lead to loss of initiative and cooperation. Primary caregivers often have their own medical problems, with limited stamina and support; relationships may change, leading to sadness or conflict. Nurses can be powerful advocates for the physical and mental health of both the patient with late-stage Parkinson's disease and the primary caregiver.
authors.affiliation: Pacific Parkinson's Research Centre, Vancouver, BC, Canada. scalne@interchange.ubc.ca
authors.forename: Susan M
authors.initials: SM
authors.lastname: Calne
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology; D017028:Caregivers / Q000523:psychology; D003704:Dementia / Q000209:etiology; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009723:Nurse-Patient Relations; D010300:Parkinson Disease / Q000523:psychology*; D026684:Personal Autonomy; D011584:Psychology; D011618:Psychotic Disorders / Q000209:etiology; D012649:Self Concept; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D012934:Social Isolation