End of Life Neuropsychological Impairments and Psychological Care of Persons With Advanced Parkinsonism

Document Type

Article

Abstract

Decline in executive functioning, before frank dementia occurs, has been reported in patients with a history of stroke and malignant brain tumors. This may also be true in patients with advanced Parkinson's disease (PD). In this paper, we summarize the limited research on the motor and cognitive predictors of mortality in advanced PD. We then provide 2 case vignettes of patients with end of life advanced PD who demonstrated a substantial decline in working memory and speech festination. We contrast these patients' neuropsychological features to a third patient with advanced PD who shows no signs of impending death. Monitoring neuropsychological signs of executive dysfunction, explaining the neuropsychological dysfunctions to the patient and spouse while recognizing the past and retained cognitive competencies of the person is an important component of end of life psychological care. In the context of this type of consultation, the patient may experience an opportunity to communicate their emotional concerns prior to death which further reduces the anxiety associated with death.

Publication Date

10-4-2021

Publication Title

The American journal of hospice & palliative care

E-ISSN

1938-2715

First Page

10499091211049798

PubMed ID

34607486

Digital Object Identifier (DOI)

10.1177/10499091211049798

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