ABSTRACT
With advancing disease, many patients with PD need to transition their care
to long-term care environments. In such settings, advanced motor disability,
ever-changing motor and mental states, and enhanced care needs pose a
variety of challenges that can easily strain individual or institutional
resources. For clinicians, optimal patient management will minimize or
control motor and neuropsychiatric dysfunction and maximize overall
function. To achieve this in long-term care settings, clinical care requires
working with an interdisciplinary team of physicians, nursing staff, social
workers, and rehabilitative therapists in order to best meet the needs of
patients and families. This chapter is geared towards nursing staff, medical
staff, and informal care givers. It describes the spectrum of long-term care
options, identifies the issues in patient management that lead to use of long-
term care and the transition from one type of service to the other, and
reviews specific disease management problems encountered in long-term
care settings. Awareness of these issues provides a basis for clinical interven-
tions that improve quality of life for patients and families and can reduce
the impact of neuropsychiatric dysfunction.
