Hospice use varies depending on whether a person has [Parkinson’s disease](https://www.mcknights.com/news/parkinsons-patients-face-barriers-to-optimal-care-group-says/), Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds.
Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their [study](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830839?resultClick=1), which was published Tuesday in _JAMA Network Open._ The team evaluated people with Lewy body diseases (which includes Parkinson’s disease and dementia with Lewy bodies), and compared the data to those with Alzheimer’s disease.
The average of participants was just over 85 years old. Of participants, 8.4% had Alzheimer’s disease, 2.1% had Parkinson’s and 0.4% had dementia with Lewy bodies.
Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)
The finding that people with Lewy body disease have a lower risk of disenrollment due to extended prognosis is notable, especially because Parkinson’s disease is a risk factor for longer hospice stay, the authors wrote.
Results draw attention to concerns about the unmet hospice needs of those with Parkinson’s disease, they said.
“Higher likelihood of hospice revocation in Parkinson’s disease raises important questions about unmet needs and highlights the need for more research around the experience of the end of life in this growing population,” the authors wrote.
Investigators pointed out that people who have advanced Parkinson’s disease and dementia with Lewy bodies pose greater challenges for hospice care providers than others. Their disease course has more psychiatric and behavioral symptoms, such as psychosis and attentional fluctuations, that providers of hospice care are less familiar with, the authors pointed out.