Parkingson's Disease Guide

End Stages of Parkinson’s Disease

In most newly diagnosed Parkinson’s patients, the anxiety revolves around the effect that the disease will have on daily functioning. However it should be noted that most Parkinson’s patients can quite comfortably manage with daily activities although there may be some level of difficulty. The symptoms in the initial stages of Parkinson’s disease may be mild, but in the last two stages of the disease or the “end stages”, the symptoms become such that the person becomes totally unable to function without help.

Stage 4 of Parkinson’s Disease

In this stage, the main difficulty is in maintaining balance and posture, so patients need assistance while standing and walking. Increase in tremor, rigidity (increased tone) and bradykinesia (slowness of movement) as the disease progresses make the performance of routine tasks difficult without help. Falls tend to occur more often. The patient is mobile at this stage but needs help to carry on with their daily tasks.

Stage 5 of Parkinson’s Disease

At this stage of the disease, the patient is unable to stand or walk and constant nursing care is needed as they cannot function independently. A number of patients also suffer from dementia, depression or hallucinations, which further aggravates the situation.

Features of the End Stages of Parkinson’s

The end stages of Parkinson’s disease can be extremely difficult and heart-breaking, both for the patient and his close relatives and friends.

  • There is progressive worsening of symptoms despite of drug therapy.
  • Tremor increases gradually, and in the later stages there may be action tremor (like an essential tremor) whereas initially there was tremor only at rest, thus making performance of routine tasks difficult.
  • Unsteadiness in walking or turning, resulting in falls, become more pronounced as the disease progresses and ultimately the patient can only stand or walk with help, while in the end stage he becomes completely bedridden.
  • Dementia and depression occur in a large number of patients of Parkinson’s disease towards the end stages of the disease and anxiety, mood changes and insomnia may be an associated symptom.
  • Dysphagia or difficulty in swallowing often leads to less intake of food and nutrients, causing weight loss, weakness and tiredness.
  • Constipation is often troublesome and may be a side effect of anticholinergic treatment.
  • Recurrent infections occur such as pneumonia.
  • Improper bladder control may lead to urgency and frequency.
  • Hypersalivation or drooling is common due to difficulty in swallowing and may lead to choking.
  • Memory loss – both recent and long term.
  • Confusion and hallucinations become more pronounced in elderly patients being treated with anticholinergics.
  • Pain and discomfort in the lower part of the body and limbs.
  • There is progressive difficulty in speech with slow, soft, monotonous voice and the patient may have problem finding words.
  • There may be dyspnea or difficulty in breathing.

In the end stages, the patient becomes totally helpless and cannot survive without a care-giver. They are unable to sit, talk, walk, turn around in bed, control bladder or bowel movements, or conduct any bodily function on their own. Combined with their gradually declining health status, both physical and mental, the end stage leads to death ultimately. Unfortunately, there are no medicines yet that can cure Parkinson’s disease but  only help to alleviate the symptoms or delay progression of the disease.

11 Responses to “End Stages of Parkinson’s Disease”

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  7. Peggy Keilhack says:

    My husband was diagnosed approx. 10 years ago with Parkinsons; however, he has never shown the classic “tremor” synptom. He has been on Leva-dopa for years. Approximately 2 1/2 years ago he began having balance problems/falling, urinary incontinence, hallucinations, became quite aggressive and was diagnosed with dementia. As symptoms progressed he was diagnosed as psychotic.
    Five months ago a neurologist refined the dementia to lewy body with ALS symptoms.

    His legs are contracting and he is wearing braces almost constantly. My question: please explain the contractions. When I ask I am told
    “it is simply a progression of the illness”.

    Thank you.

  8. vivek says:

    My father aged 79 suffering from Parkinsonism for the past 6 months. now totally bedridden due to the difficulty in swallowing.Now maintining in bed with home nurse with the control of my mother. Totally in depression- the whole family.

  9. christie hester says:

    my aunt is in the last stages of parkinsons. been in last stages at least a year.how long to you think she will live like this.she has had parkinsons 13 yrs.

  10. Tonya Reynolds says:

    The lady I have cared for since she was 83 is now 91.90 was the down ward spiral.She can no longer feed her self .Has to be turned every 2 hours .We have 24 hour care .At times she swallows ok .Then others she is so out of it we give her baby food yogurt .Soft foods only.Thicken liquids only .She can be coma tos one day neon the next Dementia and haucinations are also there .No pain thank God but its like watching someone die alittle each day .

  11. Michael From Revivalbootcamp says:

    Thanks for the very informative post. Parkinson’s disease is terrible and the best one can and should do for their loved one is to give their very best when they have the chance.

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