Sarah R Jordan1, Benzi Kluger2, Roman Ayele3, Adreanne Brungardt1, Anne Hall4, Jacqueline Jones5, Maya Katz6, Janis M Miyasaki7, Hillary D Lum8. 1. Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 2. Departments of Neurology and Medicine, University of Rochester Medical Center, Rochester, NY, USA. 3. Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA; College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 4. Research Stakeholder, University of California, San Francisco, CA, USA. 5. College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 6. Movement Disorders and Neuromodulation Center, University of California, San Francisco, CA, USA. 7. Division of Neurology, University of Alberta, Edmonton, Alberta, Canada. 8. Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado, USA. Hillary.lum@cuanschutz.edu.
Abstract
BACKGROUND: Living with Parkinson disease (PD) is complicated by an unpredictable disease course which can delay planning for future needs. This study explores patient and care partner needs related to future planning using a palliative care framework with physical, psychological, social, cultural, end-of-life, and ethical aspects of care in PD to guide analysis. METHODS: Secondary analysis of patient and care partner interviews from a randomized clinical trial comparing interdisciplinary outpatient palliative care versus standard care for individuals with PD and care partners in an academic setting. Sixty participants were interviewed (30 patients and 30 care partners) about needs related to future planning. Team-based thematic analysis was used to identify key themes. RESULTS: Many care partners and patients living with PD described a desire for information about what to expect and how to plan for the future. Participants posed multiple questions about PD progression and devised the metaphor of a "roadmap" as a guide for decision making and planning. When exploring the concept of a PD roadmap, five themes emerged: (I) desire for a comprehensive tool for future planning, such as a roadmap, (II) care partner preferences for specific future planning, (III) PD-related life changes as opportunity for future planning and decision-making, (IV) cues from family, peers, and medical professionals about "location" on the roadmap, and (V) opportunities and challenges to integrating a PD roadmap into patient-centered care. CONCLUSIONS: Patients and care partners described key needs related to future planning that can inform a comprehensive roadmap to assist with education, communication, and decision making. A roadmap tool can promote individualized anticipatory guidance and multidimensional shared decision-making discussions between patients, care partners, and the healthcare team related to PD progression.
BACKGROUND: Living with Parkinson disease (PD) is complicated by an unpredictable disease course which can delay planning for future needs. This study explores patient and care partner needs related to future planning using a palliative care framework with physical, psychological, social, cultural, end-of-life, and ethical aspects of care in PD to guide analysis. METHODS: Secondary analysis of patient and care partner interviews from a randomized clinical trial comparing interdisciplinary outpatient palliative care versus standard care for individuals with PD and care partners in an academic setting. Sixty participants were interviewed (30 patients and 30 care partners) about needs related to future planning. Team-based thematic analysis was used to identify key themes. RESULTS: Many care partners and patients living with PD described a desire for information about what to expect and how to plan for the future. Participants posed multiple questions about PD progression and devised the metaphor of a "roadmap" as a guide for decision making and planning. When exploring the concept of a PD roadmap, five themes emerged: (I) desire for a comprehensive tool for future planning, such as a roadmap, (II) care partner preferences for specific future planning, (III) PD-related life changes as opportunity for future planning and decision-making, (IV) cues from family, peers, and medical professionals about "location" on the roadmap, and (V) opportunities and challenges to integrating a PD roadmap into patient-centered care. CONCLUSIONS: Patients and care partners described key needs related to future planning that can inform a comprehensive roadmap to assist with education, communication, and decision making. A roadmap tool can promote individualized anticipatory guidance and multidimensional shared decision-making discussions between patients, care partners, and the healthcare team related to PD progression.
Authors: Benzi M Kluger; Maya Katz; Nicholas Galifianakis; Steven Z Pantilat; Jean S Kutner; Stefan Sillau; Mark Gritz; Jacqueline Jones; Diane Fairclough; Malenna Sumrall; Kirk Hall; Janis Miyasaki Journal: Contemp Clin Trials Date: 2019-02-16 Impact factor: 2.226
Authors: Maya Katz; Yuika Goto; Benzi M Kluger; Nicholas B Galifianakis; Janis M Miyasaki; Jean S Kutner; Christopher A Jones; Steve Z Pantilat Journal: J Palliat Med Date: 2018-09-11 Impact factor: 2.947
Authors: Lars Lau Raket; Daniel Oudin Åström; Jenny M Norlin; Klas Kellerborg; Pablo Martinez-Martin; Per Odin Journal: Sci Rep Date: 2022-01-11 Impact factor: 4.379
Authors: Laura D Scherer; Daniel D Matlock; Larry A Allen; Chris E Knoepke; Colleen K McIlvennan; Monica D Fitzgerald; Vinay Kini; Channing E Tate; Grace Lin; Hillary D Lum Journal: MDM Policy Pract Date: 2021-07-02
Authors: Benzi M Kluger; Cornelia Drees; Thomas R Wodushek; Lauren Frey; Laura Strom; Mesha-Gay Brown; Jacquelyn L Bainbridge; Sarah N Fischer; Archana Shrestha; Mark Spitz Journal: Epilepsy Behav Date: 2020-11-24 Impact factor: 3.337