To compare demographic characteristics, disease history, symptom burden, and advance care planning between patients in the Advanced Interdisciplinary Movement Disorders Supportive Care (AIMS) clinic who died with or without hospice involvement.

The AIMS clinic provides interdisciplinary care for patients with advanced Parkinsonism. The team includes neurology, palliative care, social work, dietetics, and nursing.

We conducted a retrospective chart review of 175 AIMS patients seen between October 2019 to December 2023. Data was collected on demographics, disease history, Edmonton Symptom Assessment Scales (ESAS), Parkinson’s Disease Questionnaires (PDQ-8), hospice referrals, mortality (if applicable), and advance care planning (Physician Orders for Life Sustaining Measures (POLST), Healthcare Power of Attorney (HCPOA)). 

18 patients died without hospice and 39 died with hospice. Median AIMS visits prior to death were 1 (IQR 1–2) for non-hospice and 2 (IQR 1–4) for hospice patients (p = 0.01). Median time from last visit to death was 9 months (IQR 5–12) without hospice versus 2 months (IQR 1–6) with hospice (p = 0.005). Completion of POLST/MOLST forms occurred in 23.1% of hospice patients and 0% without hospice (p = 0.045). HCPOA review was more frequent among hospice patients (71.8% vs 38.9%; p = 0.02). Hospice patients reported higher depression scores on the ESAS (median 5 [IQR 0–6] vs 0 [IQR 0–4]; p = 0.048) and PDQ-8 (median 1.6 [IQR 1–3] vs 0 [IQR 0–1.3]; p = 0.03).

Hospice enrollment was associated with closer clinical follow-up, greater engagement in advance care planning and higher rates depression symptoms.  These findings suggest that mood symptoms and patterns of healthcare utilization may serve as early indicators of transition and readiness for hospice, which highlights the need for proactive palliative care integration into advanced Parkinson’s management.