“We must speak with patients in the end of life,” recommends Dr. Jean-Philippe Brandel, head of the Parkinson unit and involuntary movements at the Rothschild Ophthalmology Foundation Hospital.
Parkinson’s disease reaches the motor skills of people affected. In France, 25,000 new cases of this neurodegenerative disease are declared each year. It is linked to a “Loss of cells in a small area of the brain called the black substance”explains Dr. Jean-Philippe Brandel, head of the Parkinson unit and involuntary movements of the Rothschild Ophthalmology Foundation Hospital. Like all neuro-evolutive diseases, the appearance of the first signs is done insidiously, generally between 60 and 70 years old. “Some people will notice a difficulty in making quick alternative gestures. Others will realize that they have a tremor on one side and not on the other, that when they walk there is a leg more hanging out than the other. “ The disease evolves in several stages, treatments improve symptoms but have no effect on evolution. A patient suffers until the end of his life.
“Gradually, signs will increase” warns the specialist. The first phase or “start phase” is characterized by the appearance of symptoms (rests at rest, slowness in the realization of movements, stiffness) and implementation of a treatment to channel them. The disease will continue to evolve over several years with sometimes the appearance of fluctuations in symptoms depending on the drug taking. In the advanced phase, the symptoms of the disease and the complications linked to aging will lead to the “engine and cognitive decline phase”, the last.
But “Parkinson’s disease is not deadly, Correct the expert, She is especially disabling. Studies have also shown that she did not reduce life expectancy. “ Most of the time, patients die from a complication linked to Parkinson’s disease but not directly from the disease. “For example, an 85 -year -old person who has Parkinson’s disease is more likely to fall than another 85 -year -old person, who is not affected by the disease”illustrious Dr. Brandel. The fall can cause a fracture of the femur pass and its complications can lead to death. Another example, the disease can cause difficulties in swallowing responsible for false sudden roads that can lead to suffocation or cause pulmonary infections.
Dr. Brandel believes that “We must speak with patients about the organization of the end of life” And recommends anticipating the problem of engine and cognitive decline inseparable from the disease. For example, a patient living in a upstream house should expect to have trouble mounting the stairs as the disease evolves. “We ask patients to predict. It’s better to anticipate, but it is not always easy “concludes Dr. Brandel.