Crest

Care for Parkinsons patients nearing the end of life is often not optimal due to the unique challenges of the disease that many non-specialists may not fully understand. Past studies have shown that many patients stop antiparkinsonian treatments before death without specialist advice, leading to severe withdrawal symptoms that cause significant discomfort and can hasten death. Parkinsons patients frequently receive care at home, especially through Home Hospitalization HH services, highlighting the need for specialized, multidisciplinary end-of-life care. This research evaluates the use of a continuous subcutaneous apomorphine pump in Parkinsonian patients receiving palliative care at home. The pump aims to improve both motor and non-motor symptoms and ease nursing care. Patients in the study will receive the apomorphine pump as part of their routine treatment, and their condition will be monitored through various questionnaires assessing motor rigidity, pain, alertness, agitation, communication, nursing care, and caregiver burden at multiple time points up to 45 days. Participants will be involved in completing several questionnaires at scheduled intervals days 0, 2, 4, 6, 12, 18, 24, 30, and 45. These assessments include measures of stiffness, pain, agitation, social support, caregiver strain, and side effects such as nausea, hypotension, skin reactions, and hallucinations. The study focuses on tracking changes over time to better understand the impact of the apomorphine pump on patient comfort and care quality during end-of-life management for advanced Parkinsons disease.