title: Parkinson disease in long term care facilities: a review of the literature.
abstract: Parkinson disease (PD) is common in long term care (LTC) facilities. The number of institutionalized patients with PD will rise sharply in the coming decades because of 2 concurrent phenomena: aging of the population leads to an increased PD prevalence and improved quality of care has led to a prolonged survival in advanced disease stages. Only a few studies have investigated the prevalence and clinical characteristics of patients with PD in LTC facilities. Even fewer studies have addressed the treatment strategies used to support these institutionalized patients, who are mostly in advanced stages of the disease. The available evidence suggests that current management of patients with PD in LTC facilities is less than optimal. In the Netherlands, and we suspect in many other countries, there are no formal guidelines for treating patients with PD who have been admitted to a LTC facility. In this review, we describe the epidemiology, clinical characteristics, and clinical management of patients with PD in LTC settings. We also address potentially modifiable elements of care and provide several recommendations to improve the management of PD in these facilities. We conclude by suggesting a possible guide for future research in this area.
authors: Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands; Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors: Nico J
authors: NJ
authors: Weerkamp
authors: Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands.
authors: Gerrit
authors: G
authors: Tissingh
authors: Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors: Petra J E
authors: PJ
authors: Poels
authors: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Syste U
authors: SU
authors: Zuidema
authors: Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors: Marten
authors: M
authors: Munneke
authors: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors: Raymond T C M
authors: RT
authors: Koopmans
authors: Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: b.bloem@neuro.umcn.nl.
authors: Bastiaan R
authors: BR
authors: Bloem
mesh_terms: D000367:Age Factors; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003704:Dementia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D006212:Hallucinations / Q000453:epidemiology; D006801:Humans; D008134:Long-Term Care; D019957:Motor Skills Disorders / Q000209:etiology; D009735:Nursing Homes; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D012307:Risk Factors; D013038:Specialization
chemical_list: D000978:Antiparkinson Agents
keywords: Parkinson disease; diagnostic accuracy; long term care facilities; nursing homes; prevalence; review