A Brief Guide to the End-Stage Parkinson’s Disease

A Brief Guide to the End-Stage Parkinson's Disease

Parkinson’s disease is a common illness that affects 60,000 Americans each year. The chances of an individual developing this ailment increase with age.

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What Is the End-Stage of Parkinson’s Disease?

Parkinson’s disease is a progressive disorder caused by the death of the neurotransmitter, Dopamine. It’s both a motor and non-motor disease. In the final stages of Parkinson’s disease, patients commonly experience non-motor symptoms. These can include incontinence, insomnia, and dementia.

What Causes The Death Of The Neurotransmitter?

Currently, there are no established reasons why the loss of nerve cells linked to Parkinson’s disease takes place. However, some researchers have identified possible causes.

Here are the factors believed to be responsible for Parkinson’s disease:


The possibility of having Parkinson’s disease can be traced from parents passing the faulty genes to their child. Though it may be rare, the disease can still be inherited. Therefore, having a family member with Parkinson’s disease increases an individual’s risk of acquiring it.

Environmental Factors

Researchers continue to establish direct links between a patient’s environment and the severity of their ailment. Currently, Parkinson’s disease has a strong link between pesticides and herbicides in farms and industrial pollution.


Drug-induced Parkinson’s can occur after taking medications such as antipsychotic drugs. The symptoms can develop suddenly but usually improve once the medication is stopped.

Other Brain Conditions

Brain conditions, such as progressive supranuclear palsy, multiple systems atrophy, and corticobasal degeneration, increase the risk of Parkinson’s.


Strokes can cause several parts of the brain to die, making the patient more vulnerable to Parkinson’s disease.

Stages Of Parkinson’s Disease

Parkinson’s disease has five stages. Each stage has a different effect on the human body. Here are the differences between the stages of Parkinson’s disease:

Stage 1

A person experiences mild symptoms that don’t stand in the way of daily activities. Some tremors and little movement symptoms are experienced on one side of the body, and changes in posture, walking, and facial expressions can occur.

Stage 2

The individual can still proceed with daily activities. However, the tremors and movement symptoms become worse and can be experienced on both sides of the body.

Stage 3

A person loses balance and coordination for movements that can cause occasional falls. Daily activities are affected, such as dressing and eating.

Stage 4

Symptoms become severe and limit physical activities. Assistance in standing up and walking is needed. An individual needs daily help for eating, dressing, taking showers, and bathroom breaks.

Stage 5

The final stage of the disease is where its impact is the most severe. Legs become stiff, which makes standing and walking impossible. A wheelchair is needed, but most patients are bedridden. A caregiver is a must for all the patient’s daily activities.

What Are The End Stages of Parkinson’s Disease?

The final stages of Parkinson’s disease occur when patients experience severe symptoms. Most of the time, medication only helps a little, and they can experience disabilities that can lead to the patient’s death.

Here are the Parkinson’s death signs of the fourth and fifth stages:

For stage four of Parkinson’s disease:

  • Softer speaking voice
  • Problems with balance and coordination
  • Sudden “freezing” where patient temporarily can’t move
  • Frequent constipation
  • Depression
  • Loss of smell
  • Low blood pressure during sudden movements
For the last stage of Parkinson’s disease (stage five):
  • Leg stiffness, the patient won’t be able to walk or stand without assistance
  • Hallucinations and delusions
  • Limited physical activity, the patient may even be bedridden
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Hospice Eligibility of End-Stage Parkinson’s Disease Sufferers

Since Parkinson’s disease is progressive, patients need hospice care. If your family member or any loved one has been diagnosed with Parkinson’s disease, expect that there will be a decline in their motor abilities. They will need professional nursing care to attend to their needs because it will be harder for them to speak and express their struggles.

Here are the things you need to observe to determine if the patient already needs hospice care:

  • Difficulty in breathing and oxygen supply is necessary
  • Difficulty in walking where a wheelchair is already needed
  • Hard to understand speech
  • Difficulty in eating and drinking
  • More complications occur, such as pneumonia, sepsis, pyelonephritis, decubitus ulcers, and other comorbidities

How Hospice Care Can Help in End-Stage Parkinson’s Disease

Parkinson’s hospice care is an added assistance for patients and their loved ones dealing with end-stage Parkinson’s disease. The care can offer added support and ease in taking care of the patient until the last stages of Parkinson’s before death.

Here are more of the benefits hospice care can provide to a Parkinson’s disease patient:

  • Comprehensive programs are included that can help in physical, emotional, and spiritual aid from therapists, volunteers, and other counselors.
  • The nurse can orient families on end-stage Parkinson’s disease and what to expect for the coming days as the disease progresses.
  • The nurse can also monitor pain and other symptoms experienced by the patient and give the necessary treatments.
  • Families will have peace of mind as the hospice team will provide aid 24 hours a day.

Possible Treatments Provided To Parkinson’s Disease Patients

Treatments are also offered for Parkinson’s disease. However, not all of them work the same for every patient.

Here are the possible treatments provided for Parkinson’s disease:


Therapies vary depending and will depend on the condition of the patient. For example:

  • Physiotherapy helps relieve muscle stiffness and joint pain through movement manipulation and exercise.
  • Speech and language therapy helps with swallowing problems such as dysphagia and helps with a patient’s difficulty in speech.
  • Support therapy aids patients in accepting the disease and living with and can prevent depression.

Diet Advice

Diet advice is given to help improve the symptoms of Parkinson’s. The amount of fiber is increased to reduce constipation. The amount of salt is also increased to prevent low blood pressure that can cause dizziness when standing up and other diet changes to reduce unintentional weight loss.


Doctors also prescribe medications to their Parkinson’s patients. Some of these medicines are:

  • Levodopa, which is absorbed by the nerve cells in the brain and turns into chemical dopamine to transmit messages in different parts of the brain for movement control.
  • Dopamine agonists, which act as a substitute for Dopamine similar to Levodopa but with a milder effect.
  • Catechol-O-methyltransferase (COMT) inhibitors, where Levodopa can be broken down by the enzyme COMT and be neutralized. Therefore, COMT inhibitors are prescribed to prevent Levodopa from breaking down.
  • Non-oral therapies are also prescribed since some tablets are hard to swallow for patients. There are injected medications such as Apomorphine and Duodopa, which act as Dopamine for the brain.


There are surgeries offered for patients with Parkinson’s disease. The physicians discuss the possible risks and benefits, and the family and patient can decide what they want to do.

The method used is deep brain stimulation, where a pulse generator is surgically implanted to a heart pacemaker into the chest wall. They are connected to two fine wires under the skin. Then, they are accurately inserted into specific areas of the brain. The pulse generator will produce a tiny electric current, which runs through the wire and stimulates the part of the brain affected by Parkinson’s disease to ease its symptoms.


Families with their loved ones have a hard time fighting Parkinson’s disease. Hospice care aims to give support and help the patient and their family deal with the disease.

All American Hospice has a team of experts that can help with the physical, emotional, and spiritual needs of the patients, including family counseling to help them process the situation. Reach out to us today.

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