The Parkinson patient in expert social medicine assessment with special reference to the nursing care law

Approximately 15,0000 to 200,000 people in Germany suffer from Parkinson's disease. It is one of the most frequent neurological conditions and typical of advanced age. Effective therapy and prognostic predictions hinge on considerations of differential aetiology; comorbidity is frequent. Advanced disease calls for individually tailored management with and without drugs. Rehabilitative measures should be introduced at an early stage to maintain and improve patient's autonomy. Nursing in the home or in institutions takes over as the disease progresses and patients become immobile. Parkinsonian patients form a sizeable group within the population assessed for purposes of the Pflegeversicherung (German Nursing Care Insurance). This article analyses the care required by Parkinsonian patients as determined in individual home visits by the MDK Hessen (in 1995). Problems in evaluation arising from fluctuation of the disease are discussed.