2.5 Why is it important to apply these principles early in the trajectory of Parkinson’s?

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As we have worked our way through section 2 we have made several references to the need for palliative care principles to be introduced early in the trajectory of Parkinson’s. The key reasons for early introduction are summarised below:

• Research has highlighted the benefits of early introduction of palliative care principles in management of Parkinson’s (Tuck et al, 2015).
• It encourages professionals to have open and honest conversations about the advanced phase of Parkinson’s and to have early discussions about the client’s preferences and wishes for their care and management in the advanced and end of life stages.
• It supports the benefits of advance care planning and allows the client to discuss issues around lasting power of attorney, Advance Decision to Refuse Treatment (ADRT) and decisions around resuscitation. (There are different names for this in each of the UK nations, more information can be found on the Parkinson’s UK website.)
• Empowering the health professional to have these conversations earlier with clients promotes person-centred care and a holistic approach to end of life care.
• There is a high incidence of cognitive impairment and dementia in Parkinson’s as the condition progresses. Therefore the early introduction of the principles of palliative care, which allows them to discuss wishes, fears and concerns for their future, will provide the client with a sense of control and ownership of their future care.