4.3 The management of physical symptoms

Early identification and management of physical symptoms in end of life care are an important element of holistic care.

The EEMMA acronym (Twycross and Wilcock, 2002) may be a useful tool to ensure early identification and management of physical symptoms. It involves the individual’s contribution to the care management of each symptom and ensures client satisfaction, autonomy and dignity.

E – Evaluation – make a clear and accurate assessment of each symptom.

E – Explanation – to the individual and/or family on the cause and possible treatments.

M – Management – an individual treatment plan should be formulated in consultation with the person with Parkinson’s and/or family.

M – Monitoring – each symptom should be continuously reviewed and adjustments in treatments made.

A – Attention to detail – make use of the expertise of the multidisciplinary team and other appropriate experts for example the specialist palliative care team.

Another option of symptom measurement is the Palliative care Outcome Scale [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .

The overall management of both motor and non-motor symptoms relies on a comprehensive, holistic assessment by the multidisciplinary team, with the appropriate referral to specialist palliative care professionals.

Assessment can be time consuming, due to communication and cognitive issues, but with the use of patient centred care planning, the person with Parkinson’s and those most important to them will experience high quality end of life care.

4.2 Developing a holistic approach