What can we expect at this stage of Parkinson's disease?

A fellow caregiver asked...

My Mother has had Parkinsons disease for about 6 years now and I would like to know what the stages of this disease are. The visiting nurses have commented that she is on the verge of needing hospice care so I guess Im just wondering what to expect now. She lives wtih my husband and I. She has really good days and some not so good days. She has been having hallucinations, "stuck foot," whisper voice, loss of appetite and weight loss also. She will be 82 years old in October. Any help will be greatly appreciated. Thank you!

Expert Answer

Graham A. Glass, MD, is the co-founder of PEAK Neurology and Sleep Medicine, LLC with multiple locations across Alaska. Previously, he was deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center PADRECC and assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

Although we "stage" Parkinson's disease for research studies, this often doesn't help predict how patients will progress and what type of assistance/living situation they will need. From your description, it sounds like she is at a later stage of disease and may have some cognitive involvement as well. Although we can never tell how things will go (as doctors are notoriously bad at prognosticating), typically when one enrolls in hospice, the expectation is that everyone thinks that the patient may have 6 months or less and that the goals of care are comfort and compassion. Working with a movement disorders specialist to make sure that her medications are tuned up (as meds can cause or worsen hallucinations) could be helpful and also may help you and your family prepare for the future.