Danielle M Gillard1, James A Proudfoot2, Rita M Simões3, Irene Litvan4. 1. Parkinson and Other Movement Disorders Center, University of California San Diego, Department of Neurosciences, San Diego, CA, USA. 2. Clinical & Translation Research Institute, University of California San Diego, San Diego, CA, USA. 3. Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal; CNS-Campus Neurológico Sénior, Torres Vedras, Portugal. 4. Parkinson and Other Movement Disorders Center, University of California San Diego, Department of Neurosciences, San Diego, CA, USA. Electronic address: ilitvan@ucsd.edu.
Abstract
INTRODUCTION: The utilization of advance directives in individuals with Parkinson's disease (PD) and atypical parkinsonian disorders (APD) and their caregivers requires further investigation. This study determined the utilization rates of four forms of advance directives: living will, durable power of attorney, durable power of attorney for healthcare, and medical orders in these individuals. We hypothesized that having a neurodegenerative parkinsonian disorder or exposure to these disorders would increase the likelihood of having advance directives. METHODS: 50 PD participants, 49 APD participants, 50 caregivers and 50 non-caregiver controls were surveyed regarding advance directives. RESULTS: The median number of advance directives was 1 in controls, 2 in caregivers and PD participants and 3 in APD participants. Patients with PD were 4.08 times more likely to have durable power of attorney (p < 0.001) and 2.08 times more likely to have durable power of attorney for healthcare (p = 0.011) than controls. Patients with APD were 1.66 times more likely to have a living will (p = 0.006), 4.81 times more likely to have a durable power of attorney (p < 0.001) and 2.47 times more likely to have a durable power of attorney for healthcare (p = 0.003) than controls. Caregivers were1.58 times more likely to have a living will (p = 0.012) and 2.21 times more likely to have a durable power of attorney for healthcare than controls. CONCLUSION: Having or being exposed to parkinsonian disorders significantly increases the likelihood of utilizing advance directives. Additionally, exposure to a parkinsonian disorder as a caregiver increases advance directive use.
INTRODUCTION: The utilization of advance directives in individuals with Parkinson's disease (PD) and atypical parkinsonian disorders (APD) and their caregivers requires further investigation. This study determined the utilization rates of four forms of advance directives: living will, durable power of attorney, durable power of attorney for healthcare, and medical orders in these individuals. We hypothesized that having a neurodegenerative parkinsonian disorder or exposure to these disorders would increase the likelihood of having advance directives. METHODS: 50 PDparticipants, 49 APDparticipants, 50 caregivers and 50 non-caregiver controls were surveyed regarding advance directives. RESULTS: The median number of advance directives was 1 in controls, 2 in caregivers and PDparticipants and 3 in APDparticipants. Patients with PD were 4.08 times more likely to have durable power of attorney (p < 0.001) and 2.08 times more likely to have durable power of attorney for healthcare (p = 0.011) than controls. Patients with APD were 1.66 times more likely to have a living will (p = 0.006), 4.81 times more likely to have a durable power of attorney (p < 0.001) and 2.47 times more likely to have a durable power of attorney for healthcare (p = 0.003) than controls. Caregivers were1.58 times more likely to have a living will (p = 0.012) and 2.21 times more likely to have a durable power of attorney for healthcare than controls. CONCLUSION: Having or being exposed to parkinsonian disorders significantly increases the likelihood of utilizing advance directives. Additionally, exposure to a parkinsonian disorder as a caregiver increases advance directive use.
Authors: Emma Viscidi; Irene Litvan; Tien Dam; Maneesh Juneja; Li Li; Henry Krzywy; Susan Eaton; Susan Hall; Joseph Kupferman; Günter U Höglinger Journal: Front Neurol Date: 2021-06-17 Impact factor: 4.003
Authors: Leonard L Sokol; Michael J Young; Jack Paparian; Benzi M Kluger; Hillary D Lum; Jessica Besbris; Neha M Kramer; Anthony E Lang; Alberto J Espay; Ornella M Dubaz; Janis M Miyasaki; Daniel D Matlock; Tanya Simuni; Moran Cerf Journal: NPJ Parkinsons Dis Date: 2019-11-22
Authors: Brent Bluett; Alexander Y Pantelyat; Irene Litvan; Farwa Ali; Diana Apetauerova; Danny Bega; Lisa Bloom; James Bower; Adam L Boxer; Marian L Dale; Rohit Dhall; Antoine Duquette; Hubert H Fernandez; Jori E Fleisher; Murray Grossman; Michael Howell; Diana R Kerwin; Julie Leegwater-Kim; Christiane Lepage; Peter Alexander Ljubenkov; Martina Mancini; Nikolaus R McFarland; Paolo Moretti; Erica Myrick; Pritika Patel; Laura S Plummer; Federico Rodriguez-Porcel; Julio Rojas; Christos Sidiropoulos; Miriam Sklerov; Leonard L Sokol; Paul J Tuite; Lawren VandeVrede; Jennifer Wilhelm; Anne-Marie A Wills; Tao Xie; Lawrence I Golbe Journal: Front Neurol Date: 2021-07-01 Impact factor: 4.003