4.3.4 Artificial nutrition and hydration

The person with Parkinson’s may develop the potential need for artificial nutrition at this advanced stage. This will be governed by the individual’s wishes, perhaps expressed through advance care planning (ACP) or an advance decision to refuse treatment (ADRT).

This may be administered via percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG).

This may not be appropriate if the person with Parkinson’s has a limited life expectancy, poor quality of life or advanced dementia.

At the dying phase of care if the person has a PEG or RIG in situ it may be appropriate to reduce the volume of feed or stop the feed, because of the body’s diminishing ability to manage fluids or nutrition.

4.3.3 Communication, speech and language difficulties