{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:13:24Z","timestamp":1785644004390,"version":"3.56.0"},"reference-count":53,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Late-stage Parkinson\u2019s disease (LSPD) patients are highly dependent on activities of daily living and require significant medical needs. In LSPD, there is a significant caregiver burden and greater health economic impact compared to earlier PD stages. The clinical presentation in LSPD is dominated by motor and non-motor symptoms (NMS) that most of the time have a sub-optimal to no response to dopaminergic treatment, especially when dementia is present. Non-pharmacological interventions, including physiotherapy, cognitive stimulation, speech, occupational therapy, and a specialized PD nurse, assume a key role in LSPD to mitigate the impact of disease milestones or prevent acute clinical worsening and optimize the management of troublesome NMS. However, the feasibility of these approaches is limited by patients\u2019 cognitive impairment and the difficulty in delivering care at home. The present care challenge for LSPD is the ability to offer a person-centered, home-delivered palliative care model based on Advanced Care Planning. An ongoing European multicentric project, PD_Pal, aims to address this challenge.<\/jats:p>","DOI":"10.3390\/jpm12050813","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T11:59:37Z","timestamp":1652875177000},"page":"813","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Personalized Care in Late-Stage Parkinson\u2019s Disease: Challenges and Opportunities"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7250-592X","authenticated-orcid":false,"given":"Margherita","family":"Fabbri","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park\/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, 31062 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4008-8110","authenticated-orcid":false,"given":"Miguel","family":"Coelho","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, 1649-028 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Garon","sequence":"additional","affiliation":[{"name":"Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Biundo","sequence":"additional","affiliation":[{"name":"Department of General Psychology, University of Padova, 35131 Padova, Italy"},{"name":"Study Center for Neurodegeneration (CESNE), University of Padua, 35131 Padova, Italy"},{"name":"IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago A.","family":"Mestre","sequence":"additional","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Institute, Ottawa, ON K1Y 4E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1040-2807","authenticated-orcid":false,"given":"Angelo","family":"Antonini","sequence":"additional","affiliation":[{"name":"Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, 35131 Padova, Italy"},{"name":"Study Center for Neurodegeneration (CESNE), University of Padua, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of iCARE-PD Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/nrneurol.2012.126","article-title":"Late-stage Parkinson disease","volume":"8","author":"Coelho","year":"2012","journal-title":"Nat. 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