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Activity Description and Purpose

Parkinson’s disease (PD) is a debilitating neurodegenerative condition that primarily affects movement but can also cause a host of “nonmotor” symptoms, including disrupted sleep, constipation, and even psychiatric effects such as depression and psychosis. Nonmotor symptoms of PD are increasingly recognized for their effect on function and quality of life, yet psychotic symptoms—including hallucinations and delusions—are often overlooked and undertreated. Parkinson’s disease psychosis (PDP) is estimated to occur in more than one-half of persons with PD and is now considered part of the neurodegenerative disease process for many of those with PD. Recognizing the signs and symptoms of PDP and training staff to use effective communication techniques to assess the cause of troublesome behaviors is crucial for the early detection and management of PDP. Otherwise, the disease can often worsen if untreated or undertreated. Although nonpharmacologic interventions can be effective in managing behaviors that are caused by unmet needs and may help with some aspects of PDP, pharmacologic treatment is often required to manage hallucinations or delusions in PD. When pharmacologic treatment is necessary, the choice of antipsychotic should consider both current guidance and evidence for safety and efficacy. This educational activity captures the proceedings of an expert roundtable discussion among faculty who specialize in the management of challenging issues in long-term care. The desired results of this activity are for long-term care clinicians to recognize psychosis as part of the disease process in PDP and treat symptoms effectively while maintaining safety and patient quality of life.