好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

A Retrospective Analysis of Advance Care Planning in an Interdisciplinary Movement Disorders Supportive Care Clinic
Movement Disorders
P7 - Poster Session 7 (5:00 PM-6:00 PM)
5-017

This study analyzes trends in advance care planning (ACP) in the Advanced Interdisciplinary Movement Disorders Supportive Care (AIMS) Clinic for patients with late-stage parkinsonism.

Individuals with late-stage parkinsonism are frequently lost to care despite high symptom burden. Furthermore, hospice enrollment remains near 4% nationally for this population, which may be partially due to lack of ACP discussions with healthcare providers. Established in 2019, AIMS clinic patients and families meet with a movement disorders neurologist, neuropalliative physician, nurse, dietitian, and social worker at each visit. In addition to symptom management, AIMS ACP discussions focus on goals of care (GOC), healthcare power of attorney (HCPOA), and completion of physician orders for life-sustaining treatment (POLST) forms.

We analyzed longitudinal data from AIMS patients (October 2019 to December 2023), including demographics, diagnosis, ACP discussions, and mortality/hospice use, if applicable.

Among 175 patients (57.7% male, mean 72.8 years at visit 1 (SD 11.9), 12.6% Black/African American, 8.7% Latinx, 41.1% with Parkinson’s Disease, 19.4% with Dementia with Lewy Bodies, 24.6% with atypical parkinsonism), 62.1% discussed GOC, 67.2% discussed HCPOA, and 12.6% completed POLST at any visit. POLST discussions were more likely to occur in follow-up (n = 16, 72.7%) vs. initial AIMS visit (n = 6, 27.3%). Among 57 AIMS patients now deceased, 67.9% died with hospice in place.

Most patients seen in an interdisciplinary neuropalliative-movement clinic participated in GOC discussions, with formal POLST completion more likely to happen in follow-up visits, suggesting patients may need more time and relationship building to make pivotal end-of-life decisions. This clinic model yielded a higher rate of death with hospice in place compared to national averages (67.9% vs. 4%). Continuity of interdisciplinary care and revisiting ACP discussions may improve goal-concordant care. Ongoing work will explore associations between ACP, symptom burden, place of death, and caregiver burden.
Authors/Disclosures
Angela A. Hong, MD (University Commons)
PRESENTER 		Dr. Hong has nothing to disclose.
Mariya Husain, MD (Rush University) Dr. Husain has nothing to disclose.
Sarah Kee Ms. Kee has nothing to disclose.
Deepa H. Shankar Miss Shankar has nothing to disclose.
Neha M. Kramer, MD (Rush University Medical Center) Dr. Kramer has nothing to disclose.
Sarah M. Chen, LCSW Ms. Chen has nothing to disclose.
Kristin h. Gustashaw, Clinical Dietitian An immediate family member of Ms. Gustashaw has received personal compensation for serving as an employee of Hormel Health Labs.
Grace Hong, RN Ms. Hong has nothing to disclose.
Bichun Ouyang Bichum Ouyang has nothing to disclose.
Jori Fleisher, MD, MSCE, FAAN (Rush University Parkinson's and Movement Disorders Program) The institution of Dr. Fleisher has received research support from Parkinson's Foundation. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIA/NINDS. The institution of Dr. Fleisher has received research support from NIA/NINDS. Dr. Fleisher has received publishing royalties from a publication relating to health care. Dr. Fleisher has received personal compensation in the range of $0-$499 for serving as a Speaker with Parkinson's Foundation. Dr. Fleisher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Lewy Body Dementia Association. Dr. Fleisher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Davis Phinney Foundation. Dr. Fleisher has a non-compensated relationship as a Editorial Board Member with AAN Brain & Life Magazine that is relevant to AAN interests or activities.