Late-Stage Parkinson's Disease
When Parkinson's Disease (PD) progresses to advanced stages, "treatment" usually moves to "management," and caregivers play an increasingly important role. Advanced PD brings complex challenges including motor fluctuations, cognitive changes, swallowing difficulties, and increased fall risk that require specialized approaches and often a multidisciplinary care team. Understanding what to expect, when to consider palliative care, and how to navigate decisions about advanced treatments becomes crucial for families. These resources help caregivers manage late-stage PD complexities with practical strategies and expert guidance.
Overviews
Advanced Parkinson’s
By Davis Phinney Foundation, April 3, 2024
In this episode of The Parkinson's Podcast, Cherian Abraham Karunapuzha, MD, covers multiple interpretations of what “advanced Parkinson’s” means, what symptoms are associated with advanced Parkinson’s, and possible ways to manage those symptoms.
Advanced Parkinson’s: Symptoms, Complications, and Care Strategies
Published by Davis Phinney Foundation, August 18, 2023
This blog post begins with a discussion of the symptoms scales doctors use to define advanced Parkinson's as well as proposed changes to those scales. Advanced Parkinson's symptoms associated with significant complications are explained, along with strategies that can help each.
Advanced-Stage Parkinson's Disease
By M Health Fairview, January 2025
This series of five short videos offers an introduction to advanced-stage Parkinson's Disease (PD), some thoughts about planning ahead, information about palliative care, thinking and mood changes common to this stage of disease, and how to cope with day to day caregiving.
Caring for a Person with Advanced Parkinson’s Disease
By Invigorate Physical Therapy and Wellness, November 26, 2018
In this 47-minute webinar, Anne Wallis, Associate Director of Education at the Parkinson’s Foundation, talks with doctor of physical therapy, Sarah King, about when to look for outside help, how to lasso the power of your friends and family (even when you think you're alone), and how to build an allied healthcare team that decreases your stress and improves your loved ones care.
End Stage Parkinson’s: What to Expect
Published by Crossroads Hospice and Palliative Care, April 4, 2018
A summary of end stages of Parkinson’s symptoms, how to care for someone in end stages, and eligibility criteria for hospice for someone with PD.
Challenging Late-Stage Symptoms
Bowel and Bladder Issues in Advanced Parkinson’s Disease
Published by American Parkinson Disease Association, July 7, 2020
Bowel and bladder issues can be problematic throughout the course of PD, but can also pose unique challenges in advanced disease. This page focuses on urinary and gastro-intestinal issues in advanced PD, including abdominal pain and fecal incontinence.
Falls, Extreme Immobility and Secretion Management
Published by American Parkinson Disease Association, February 4, 2020
In this blog post, movement disorders neurologist Pravin Khemani, MD, addresses three difficult topics of advanced PD: falls, extreme immobility, and drooling and swallowing difficulties. He emphasizes a team-based comprehensive approach as imperative in recognizing and addressing disabling motor and nonmotor symptoms.
Mental Health Concerns in Advanced Parkinson’s Disease - Psychosis and Behavioral Problems
Published by American Parkinson Disease Association, December 3, 2019
This comprehensive page outlines general principles when facing mental health issues in PD and discusses in some detail psychosis and behavior problems in advanced PD, including treatment approaches. There's a quick tips & takeaways section at the end.
Motor Fluctuations in Parkinson's Disease: What You Need to Know
Published by American Parkinson Disease Association, March 2025
This two-page fact sheet outlines what motor fluctuations are and six ways they may manifest as Parkinson's progresses, as well as causes, and and several treatment options.
More than PD - Managing Multiple Chronic Conditions
By Parkinson's Foundation, November 9, 2024
In this one-hour webinar, a movement disorders specialist discusses Parkinson's symptoms that can lead to complications, such as falls and pneumonia. At the same time, people with Parkinson’s disease experience other medical conditions that occur in the general population, including heart disease, arthritis, and diabetes. The speaker talks about coordination of care, medication management and what to know to achieve the best long-term outcomes.
Sleep Disorders & Advanced Parkinson’s Disease
Published by the American Parkinson Disease Association, August 4, 2020
There are many sleep disorders that are associated with PD and that can be problematic throughout the disease course. This blog post focuses on an extreme form of fatigue, or excessive daytime sleepiness (EDS), that can develop in advanced PD. The author addresses possible causes, strategies for improving nighttime sleep and wakefulness during the day.
Professional Training
Managing Advanced Parkinson’s Disease
Published by A Train Education
Module 13 of a continuing education course on Parkinson’s disease for health care professionals outlines the complications of advanced of Parkinson’s disease. Topics covered include medication issues, motor issues, nonmotor complications, sleep disorders, orthostatic hypotension, severe dysphagia, gastric dysfunction, constipation and urinary problems, managing falls, malnutrition and dehydration, impaired communication and the benefit of palliative care and hospice at home over nursing home care.
Taking Care of the Person with Advanced Parkinson's Disease
By American Parkinson Disease Association
This free, one-hour APDA Training & Certification is intended to educate home health aides and nursing home staff about PD symptoms and treatments, specific challenges of PD as the disease advances, and strategies about how best to take care of a person with advanced PD. Professionals who complete the course can claim one continuing education unit (CEU).
Long Guides
CareMAP. Your Guide to Managing Advanced Parkinson’s
By Parkinson's Foundation
A series of 24 videos on home care, outside help, caring from afar, caring for you, end of life and resources, which provide practical suggestions for coping with the complex problems that arise as a result of advanced Parkinson’s disease.
Thinking About Advanced Parkinson’s
Published by Parkinson’s UK, August 2014
This 104-page booklet defines advanced Parkinson’s disease with chapters about managing Parkinson’s through its many stages, personal relationships, employment and financial support, personal care and housing, end of life decisions, counseling and support.
Causes of Death
End-Stage Parkinson’s Disease & Risk of Death
Published by American Parkinson Disease Association, February 8, 2022
This blog post explains the symptoms of advanced Parkinson's Disease (PD) that put a person at an increased risk of dying and explains the steps you can take to manage advanced PD symptoms and minimize certain risks. In addition, enrollment with palliative care and hospice is encouraged.
Parkinson's Progression Palliative and End of Life Issues
By Parkinson's Canada, February 23, 2016
This 38-minute webinar provides an overview of Parkinson's symptoms, and treatment challenges due to disease progression. The topic turns to planning a good death, the euphemisms even doctors use to avoid discussing death, the most common cause of death in those with PD, putting your end-of-life preferences in writing. Palliative care can help families face these end-of-life issues.
Last updated September 2025 by Stanford Parkinson's Community Outreach.