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Interdisciplinary care in parkinson disease

Marcus Hollenbach, Jürgen Feisthammel, Joachim Mössner, Albrecht Hoffmeister
Swallowing disorders (dysphagia) comprise a common cause of medical consultation and are defined as a subjective sensation of difficulty or abnormality of swallowing. In the initial step, a clear differentiation of dysphagia from odynophagia and globus sensation for further diagnostic procedures is mandatory. The careful questioning of patients symptoms and complaints is often helpful for the differentiation of oropharyngeal and esophageal dysphagia. Oropharyngeal dysphagia is mainly caused by neurological disorders (cerebral ischemia, Parkinson's disease, dementia) or local compression of malignancies, thyroid gland or lymph nodes...
May 2018: Deutsche Medizinische Wochenschrift
Jori Fleisher, William Barbosa, Meghan M Sweeney, Sarah E Oyler, Amy C Lemen, Arash Fazl, Mia Ko, Talia Meisel, Naomi Friede, Geraldine Dacpano, Rebecca M Gilbert, Alessandro Di Rocco, Joshua Chodosh
Parkinson's disease (PD) is a complex, multisymptom, neurodegenerative disease affecting primarily older adults. With progression, many individuals become homebound and removed from coordinated, expert care, resulting in excess morbidity, mortality, and healthcare expenditures in acute care settings and institutions. Home visit care models have achieved the triple aim of improving individual and population health while reducing costs in many frail, community-dwelling geriatric cohorts. This study details a novel, interdisciplinary home visit program specifically designed for individuals with PD and related disorders and their family caregivers built upon best practice principles in the care of multimorbid older adults...
April 2, 2018: Journal of the American Geriatrics Society
Lindsay P Prizer, Jennifer L Gay, Molly M Perkins, Mark G Wilson, Kerstin G Emerson, Anne P Glass, Janis M Miyasaki
BACKGROUND: A palliative approach is recommended in the care of Parkinson's disease patients; however, many patients only receive this care in the form of hospice at the end of life. Physician attitudes about palliative care have been shown to influence referrals for patients with chronic disease, and negative physician perceptions may affect early palliative referrals for Parkinson's disease patients. AIM: To use Social Exchange Theory to examine the association between neurologist-perceived costs and benefits of palliative care referral for Parkinson's disease patients and their reported referral practices...
October 2017: Palliative Medicine
Stephen W Pedersen, Martin Suedmeyer, Louis W C Liu, Dirk Domagk, Alison Forbes, Lars Bergmann, Koray Onuk, Ashley Yegin, Teus van Laar
A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies...
2017: Journal of Multidisciplinary Healthcare
Diana Crego-Vita, Coral Sanchez-Perez, Jose Adolfo Orellana Gomez-Rico, Celia Clemente de Arriba
BACKGROUND: Hip fractures in the elderly are a common reason for admission to the department of orthopaedic surgery, this condition asks an important part of health resources and is associated with high levels of co-morbidity and mortality. Many improvements have been introduced in the treatment of these patients, preoperative regional analgesia, intensive physical therapy, interdisciplinary care program; but still remain unresolved gaps. The aim of this study is to document the natural history of early versus delayed surgical intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge...
March 2017: Injury
Isabel Boersma, Jacqueline Jones, Julie Carter, David Bekelman, Janis Miyasaki, Jean Kutner, Benzi Kluger
BACKGROUND: A growing body of literature suggests that patients with Parkinson disease (PD) have many unmet needs under current models of care that may be addressed through palliative care approaches. A first step in improving care for patients with PD through palliative care principles is to better understand patient perspectives on their perceived needs and care preferences. METHODS: A total of 30 in-depth individual interviews and 4 focus groups were held to elicit the perspectives of patients with PD on unmet palliative care needs and preferences for addressing these needs...
June 2016: Neurology. Clinical Practice
Roland Nau, Marija Djukic, Manfred Wappler
The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e...
June 2016: Der Nervenarzt
Wolfgang H Oertel, Guenther Deuschl, Karla Eggert
The Competence Network Parkinson (CNP) is a research infrastructure for disease-oriented translational and clinical research in the field of Parkinson syndromes (PS). It was initiated in 1999 and funded until 2008 by the German Ministry for Education and Research (BMBF). The CNP created a highly frequented website with information on PS for the general public and for experts. The CNP designed and established one of the first electronic internet-based data entry systems (secuTrial®) - fulfilling the legal standards of data safety and security - a material bank for genetic research on Parkinson's disease (PD), implemented and investigated new methods for early diagnosis of PD and related atypical PS including in vivo dopamine transporter imaging (DAT SPECT), established the German Parkinson Study Group (GPS-Pharma) with 40 certified trial centres for pharmacotherapeutical trials and the German interdisciplinary Parkinson Study Group (neurology and neurosurgery) for deep brain stimulation (GPS-DBS), and carried out several pharmacoeconomic and health care studies on PD in Germany...
April 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Rejko Krüger, Rüdiger Hilker, Christian Winkler, Michael Lorrain, Matthias Hahne, Christoph Redecker, Paul Lingor, Wolfgang H Jost
During the last decades, symptomatic treatment of motor symptoms of Parkinson's disease (PD) improved continuously and is reflected by long-range independency of the patient during the disease course. However, advanced stages of PD still represent an important challenge to patients, caregivers and treating physicians. In patients with advanced PD, interventional therapy strategies are increasingly applied. These device-related treatment strategies using pump-based continuous dopaminergic stimulation (CDS) or deep brain stimulation (DBS) opened new treatment options especially if motor complications predominate...
January 2016: Journal of Neural Transmission
Nawaz Hack, Umer Akbar, Erin H Monari, Amanda Eilers, Amanda Thompson-Avila, Nelson H Hwynn, Ashok Sriram, Ihtsham Haq, Angela Hardwick, Irene A Malaty, Michael S Okun
Objective. (1) To evaluate the feasibility of implementing and evaluating a home visit program for persons with Parkinson's disease (PD) in a rural setting. (2) To have movement disorders fellows coordinate and manage health care delivery. Background. The University of Florida, Center for Movement Disorders and Neurorestoration established Operation House Call to serve patients with PD who could not otherwise afford to travel to an expert center or to pay for medical care. PD is known to lead to significant disability, frequent hospitalization, early nursing home placement, and morbidity...
2015: Parkinson's Disease
Péter Kincses, Norbert Kovács, Kázmér Karádi, János Kállai
This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson's disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient's quality of life. An interdisciplinary approach is best suited for mitigating these effects...
March 22, 2015: Orvosi Hetilap
Sebastian Voigt-Radloff, Britta Lang, Gerd Antes
In order to address the increasing complexity and continuously changing needs and demands in the German healthcare system, there is a need to strengthen knowledge translation, evidence-based practice and the conduct of clinical trials in the field of allied health professions. An interdisciplinary working group representing the fields of nursing, midwifery, physiotherapy, occupational therapy and speech therapy developed a guide and a concept for seminars to provide potential analyses for research and innovations in the allied health professions in Germany...
2014: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Nathalie Cornet Lemoine, Marie Laure Bossis, Sandrine Giffaud, Marie Guitteny, Samuel Bulteau, Jean-Marie Vanelle, Anne Sauvaget, Matthieu Volkaert
From suicide risk prevention to treatment, the suicidal crisis process must be known to all carers to ensure appropriate and effective care. The psychiatry liaison team at the Nantes University Hospital advocates it with somatic teams through its liaison and consultation work. At the heart of this care network, the clinical expertise of the psychiatric liaison nurse educates nursing colleagues in identifying suicide risk. The nurse's clinical assessment and knowledge of the care system optimises the overall management and the path of patient care...
September 2014: Soins. Psychiatrie
Nir Giladi, Yael Manor, Ariela Hilel, Tanya Gurevich
Parkinson's disease (PD) is a chronic progressive neurodegenerative and multidimensional disease that involves a range of disabling motor and nonmotor symptoms. These symptoms can have a major impact on the quality of life of PD patients. The focus of this article is to stress the importance of the interdisciplinary team intervention approach in the treatment of patients with PD. The team approach uses experts in PD from different health care professions, including a neurologist, a nurse, a speech and language therapist, a physiotherapist, a social worker, a psychiatrist, an occupational therapist, a sexologist, and a dietician...
November 2014: Current Neurology and Neuroscience Reports
Seyed-Mohammad Fereshtehnejad, Johan Lökk
Active aging has been emerged to optimize different aspects of health opportunities during the aging process in order to enhance quality of life. Yet, most of the efforts are on normal aging and less attention has been paid for the elderly suffering from a chronic illness such as Parkinson's disease (PD). The aim of this review was to investigate how the concept of "active aging" fit for the elderly with PD and to propose a new model for them using the recent improvements in caring models and management approaches...
2014: Parkinson's Disease
Nolan R Williams, Kelly D Foote, Michael S Okun
When formulating a deep brain stimulation (DBS) treatment plan for a patient with Parkinson's disease (PD), two critical questions should be addressed: 1- Which brain target should be chosen to optimize this patient's outcome? and 2- Should this patient's DBS operation be unilateral or bilateral? Over the past two decades, two targets have emerged as leading contenders for PD DBS; the subthalamic nucleus (STN) and the globus pallidus internus (GPi). While the GPi target does have a following, most centers have uniformly employed bilateral STN DBS for all Parkinson's disease cases (Figure 1)...
April 1, 2014: Movement Disorders Clinical Practice
Daniel Martinez-Ramirez, Michael S Okun
BACKGROUND: Deep brain stimulation (DBS) is a surgical treatment involving the implantation of a brain lead connected to a chest-based neurostimulator similar to a cardiac pacemaker. The device can be programmed to deliver electrical impulses to neuromodulate abnormal brain circuitry in disorders such as Parkinson's disease (PD), essential tremor (ET), and dystonia. As the number of patients receiving DBS surgery increases, it will be important for primary care doctors to identify reasonable DBS candidates for referral to an experienced center...
2014: Gerontology
Lindsay P Prizer, Nina Browner
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, and it is characterized by a complex variety of both motor and neuropsychiatric issues. Effective treatment of PD symptoms requires a combination of pharmacotherapy and allied health therapies; however, treatment is generally monodisciplinary, with the neurologist referring out to varied therapists as needed. In order to more effectively manage PD as it progresses over time, clinics are beginning to implement and advocate the use of more integrative models of care for PD...
2012: Journal of Parkinson's Disease
Erin E Emery
Parkinson's disease can rob an individual of their most prized roles, and symptoms of the disease itself can make finding new ways to enact existing roles or developing new roles very challenging. The chaplain's case study is reviewed from the perspective of a clinical geropsychologist through the lens of identity theory. The line between chaplain intervention and psychotherapy is addressed. The patient's significant improvement in depression symptoms over the course of his participation in the BRIGHTEN program and with the chaplain are presented to suggest that chaplain intervention can be a central and effective part of an interdisciplinary treatment approach...
2013: Journal of Health Care Chaplaincy
Martijn van der Eijk, Marjan J Faber, Johanna W M Aarts, Jan A M Kremer, Marten Munneke, Bastiaan R Bloem
BACKGROUND: Our health care system faces major threats as the number of people with multiple chronic conditions rises dramatically. OBJECTIVE: To study the use of Online Health Communities (OHCs) as a tool to facilitate high-quality and affordable health care for future generations. METHODS: OHCs are Internet-based platforms that unite either a group of patients, a group of professionals, or a mixture of both. Members interact using modern communication technologies such as blogs, chats, forums, and wikis...
June 25, 2013: Journal of Medical Internet Research
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