Table 5:

Summary of recommendations for palliative care

Recommendation numberRecommendationSourceGrade
C93People with PD and their family members and caregivers (as appropriate) should be offered opportunities to discuss the prognosis of their condition. These discussions should promote people’s priorities, shared decision-making and patient-centred care.NICE8D
C94People with PD and their family members and caregivers should be given appropriate verbal and written information about the following, and it should be recorded that the discussion has taken place:
  • Progression of PD

  • Possible future adverse effects of medicines for PD

  • Advance care planning, including orders for advanced decisions to refuse treatment and do not attempt resuscitation, and lasting power of attorney for finance and health and social care

  • Options for future management

  • What could happen at the end of life

  • Available support services; for example, personal care, equipment and practical support, financial support and advice, care at home and respite care.

C95When discussing palliative care, it should be recognized that family members and caregivers may have different information needs from the person with PD.NICE8D
C96Consideration should be given to referring people at any stage of PD to the palliative care team to give them and their family members or caregivers (as appropriate) the opportunity to discuss palliative care and care at the end of life.NICE8D
C97Palliative care requirements of people with PD should be considered throughout all phases of the disease; this includes an option of medical assistance in dying.CANGPP
  • Note: CAN = new Canadian Guideline recommendation, GPP = good practice point, NICE8 = National Institute for Health and Clinical Excellence — 2017 PD Guidelines,8 PD = Parkinson disease.