The Interdisciplinary Home Visit Program for Individuals with Advanced Parkinson’s Disease

Parkinson’s disease (PD), the second most common neurodegenerative disease and the fastest-growing neurological disorder globally, is projected to affect 12 million individuals by 2040 [1]. PD is categorized as a movement disorder. Its severity is characterized entirely by motor symptoms using the Hoehn and Yahr (HY) staging system encompassing mild unilateral symptoms (HY 1); mild bilateral symptoms (HY 2); moderate bilateral symptoms, independent ambulation, though with postural instability (HY 3); moderate to severe symptoms necessitating an assistive device to ambulate (HY 4); and wheelchair-dependent or bedbound (HY 5). However, numerous non-motor symptoms dramatically impact the quality of life and synergize to significantly disrupt the daily function of patients and caregivers [2]. Non-motor symptoms include, but are not limited to, dysautonomia with orthostatic hypotension, constipation, urinary dysfunction, and incontinence; multiple types of pain; depression, anxiety, and apathy; and delusions, hallucinations, cognitive impairment, and dementia.