Although Parkinson’s disease isn’t fatal, it can eventually lead to serious complications and significant disability. End stage Parkinson’s often includes severe motor symptoms and cognitive issues like dementia.

The most advanced stage of Parkinson’s is called end stage or stage 5. People with end stage Parkinson’s may experience severe motor symptoms, making it difficult for them to stand or walk.

Severe nonmotor symptoms can also make daily functioning difficult in the late stages of Parkinson’s. Other symptoms and complications can include cognitive and mental health issues.

This article explores what you can expect in the most advanced stages of Parkinson’s.

Parkinson’s disease develops differently from one person to the next. Some people’s Parkinson’s pass quickly through the stages, while others maintain their mobility for years or even decades. It’s unclear why this is the case, but factors such as age, genes, and sex may play a role.

Similarly, end stage Parkinson’s isn’t the same for everybody. For example, some people might experience dementia while others won’t.

Still, it can help to familiarize yourself with some of the more common later stage Parkinson’s symptoms.

Motor symptoms

People with end stage Parkinson’s may experience severe difficulties with movement, balance, and coordination. Common symptoms include:

These symptoms can make it difficult to stand or walk safely. Most people with end stage Parkinson’s require a wheelchair to move around without falling. They’re also likely to need help with daily activities, such as getting out of bed or taking a shower.

Cognitive symptoms

Cognitive symptoms of Parkinson’s disease affect your executive functions: your attention, thinking, memory, and planning and problem-solving abilities.

While cognitive changes can occur at any stage of Parkinson’s, a 2021 research review notes that they’re more common as the disease progresses. Cognitive symptoms also tend to be more advanced in the later stages of Parkinson’s.

Dementia and Parkinson’s

According to a large 2022 Swedish study, people with Parkinson’s are about four times more likely to develop dementia than the larger population, with dementia risk increasing as Parkinson’s progresses.

In a smaller 2017 study, about 2 in 5 participants developed dementia within a 5-year period. Dementia risk was higher (about 59%) among people who already had mild cognitive impairment within the study’s first year, but much lower (about 7%) among those who had typical cognitive abilities in the first year.

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Mental health symptoms

Among people with Parkinson’s, the risk of experiencing mental health problems and the severity of symptoms increase over time, according to a 2022 review. People with end stage Parkinson’s are also more likely to have two or more psychiatric conditions.

In advanced Parkinson’s, mental health problems can include:

Other nonmotor symptoms

End stage Parkinson’s is associated with a wide range of symptoms that often look different from one person to the next. You might experience:

Parkinson’s disease treatments are likely to change as the disease progresses.

Most people with Parkinson’s take a medication like carbidopa/levodopa (Sinemet, Rytary) to increase dopamine levels. A doctor might suggest more frequent dosing.

Another option for people with late stage Parkinson’s is an intestinal infusion of a levodopa gel. It allows you to receive a continuous dose of the drug.

Other medications for advanced Parkinson’s include:

People with advanced Parkinson’s might also benefit from a surgical treatment called deep brain stimulation (DBS).

In DBS, a surgeon implants a tiny device in your brain. Similar to a pacemaker, this device delivers electrical stimulation to areas of your brain affected by Parkinson’s, which may relieve motor symptoms.

Palliative care for advanced Parkinson’s aims to maintain quality of life for as long as possible. Approaches might include:

  • treatments for nonmotor symptoms, such as depression, fatigue, or pain
  • emotional support for both those living with Parkinson’s and their caregivers and loved ones
  • assistance at home from a healthcare professional, such as a nurse or nurse aide

Hospice care is similar to palliative care, but it’s for people in their last 6 months of life. This type of care focuses on relieving pain and improving comfort as death approaches.

It can be incredibly challenging to care for a loved one with Parkinson’s, especially in the later stages. Your loved one will likely be limited in their daily activities and might require around-the-clock care.

Here’s what you can do to help:

  • Shift your expectations: Try your best to accept that your loved one can’t do as much as they once did.
  • Notice thinking and mood changes: If your loved one has dementia, you might need to adapt your communication style.
  • Implement basic routines: You can ensure your loved one stays hydrated, well fed, and well rested by following a simple daily routine.
  • Plan for the future: Your loved one will need your support to make important decisions as they transition toward the end of life.
  • Work with healthcare professionals: Members of your loved one’s care team can assist you in your role as a caregiver.
  • Seek support: It’s typical for primary caregivers to experience strong emotions, fatigue, or loneliness. Talking with other caregivers and asking for assistance when you need it can help.

Resources for support

Support is available for people living with Parkinson’s and their caregivers, often through charitable organizations.

The Parkinson’s Foundation provides a national helpline at 800-4PD-INFO (800-473-4636) that’s staffed by healthcare professionals. It’s a good place to start if you want to learn more about Parkinson’s symptoms and treatments, as well as community-based resources, events, and support groups.

The American Parkinson Disease Association (APDA) is another charitable organization supporting people with Parkinson’s and their caregivers. You can use their search tool to find and contact your local chapter.

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Can Parkinson’s deteriorate suddenly?

Parkinson’s usually progresses gradually, but it’s possible to experience a sudden deterioration. This is often linked to another medical problem, such as a bad fall, urinary tract infection, or stroke.

How long does the final stage of Parkinson’s last?

It’s impossible to say exactly how long end stage Parkinson’s lasts since it presents very differently from one person to the next. It can range from several months to several years.

What is the most common cause of death in people with Parkinson’s?

Aspiration pneumonia is one of the most common causes of death in people with Parkinson’s. Other common causes include complications from falls, circulatory diseases, and infections.

What is the life expectancy for someone with Parkinson’s?

Parkinson’s can reduce life expectancy, but many factors are involved. The authors of a large 2020 study reported that, on average, 65-year-olds with Parkinson’s lived for approximately 7 years fewer than their peers.

End stage Parkinson’s involves severe motor symptoms, including muscle stiffness and freezing. Nonmotor symptoms may include cognitive changes, depression, and psychosis.

Although Parkinson’s doesn’t cause death, it can cause fatal complications. For example, people with advanced Parkinson’s disease have an increased risk of serious falls or aspiration pneumonia.

If you have end stage Parkinson’s disease or care for someone who does, remember that you are not alone. Consider asking a member of your healthcare team for more information about resources available in your area.