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Advanced Parkinson's disease palliative care — DGM MCQ

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HardEnd-of-life careAdvanced Parkinson's disease palliative careDGM

An 86-year-old woman with advanced Parkinson's disease has recurrent aspiration, weight loss and distressing rigidity despite careful medication timing. Her family want support with future feeding decisions and preferred place of care. What is the most appropriate referral?

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Correct answer: B — Parkinson's specialist and palliative care multidisciplinary review

Advanced Parkinson's disease with dysphagia, aspiration and complex medication needs benefits from specialist Parkinson's and palliative multidisciplinary review. PEG insertion without goals-of-care discussion may not address aspiration or comfort. Neurological palliative care should be introduced before end-stage crisis.

Reference: NICE NG71; NICE NG31