Palliative care and Parkinson's disease: managing the chronic-palliative interface.

The increasing numbers of individuals needing palliative services and changing the nature of these services bring about new challenges for the delivery and accessibility of timely and appropriate palliative care services. Socioeconomic factors are known to affect access but disease type is a factor which can negatively impact the availability of adequate palliative services. The purpose of this article is to examine the barriers to palliation for chronic illnesses that span long periods of time. My analysis centers on palliation for Parkinson's disease because it illustrates the difficulties of managing the chronic-palliative interface, and it also demonstrates how care is situated in an evolving network of professional and non-professional actors. I argue that insuring the availability of adequate palliative services entails negotiating the chronic-palliative interface, which, in turn, requires continued multi-disciplinary professional involvement as well as the integration and recognition of the care provided by family caregivers.