Introduction

The successful nursing assessment and management of Parkinson's disease (PD) in elderly patients requires a sound knowledge not only of the natural history of PD in older people, but also the important principles that underpin geriatric medicine and social aspects of aging. The role of the nurse will be considered specifically in relation to PD though much of the discussion is equally applicable to other causes of parkinsonism. Parkinsonism due to multisystem degenerative disease is usually more rapidly disabling than PD and also has a shorter natural history. Rehabilitation is at the core of successful management in PD and involves a joint effort between the patient, carer and multidisciplinary team.

Nursing care provision in PD

Best nursing care depends upon an understanding of the impairments, disabilities and handicaps that result from PD. This is not always easy to achieve as PD is, except in extreme old age, a relatively rare disorder. Many nurses in primary health care and in hospital service may have little experience or knowledge of this disease. However, the principles underlying the planning of nursing care in PD are common to chronic progressive neurological disease in general. This is an important area for nurse education, as the prevalence of Alzheimer's disease, PD and motor neurone disease will substantially increase in the twenty-first century. The continuity of care for the elderly patient with PD (and other coexisting illness) is also a nursing priority – whether the care provision setting is the person's own home, a residential or nursing home, the GP surgery, the hospital outpatient department or during a period of inpatient care.