Let's Think About It Again
Treating Distress in a Patient with Parkinson's Disease
Mr. Jones is a 70-year-old man, happily retired from a long career as a chef, who lives in a rural area with his wife. His grandchildren and children live nearby, and he enjoys the outdoors, especially hiking. Food and eating with family bring him joy. He had been otherwise healthy until he began to develop a tremor and difficulty initiating movement. He was diagnosed with Parkinson's disease. Unfortunately, he suffers a rapid clinical decline, and within 2 years of diagnosis, he begins to have difficulty swallowing his medications. He is told by his physician that he can no longer drive, and he is unable to hike. He finds it increasingly difficult to prepare simple foods. He is adamant that he would never want a feeding tube. Within several months, he begins to lose weight. His family notes that he no longer appears to be his "happy, joyful self" and that he spends more time alone. He becomes increasingly disconnected from his faith community and on several occasions notes that he "doesn't know how long I can live like this." His neurologist refers him to palliative care for help.