AAN 2026 | Managing dysphagia during hospital admission in Parkinson’s disease

So the key points from the paper that focused on management of dysphagia in patients with Parkinson’s disease who are admitted to the hospital, where we really need a multidisciplinary group who are familiar with Parkinson’s disease and the nature of the beast, especially during hospital admissions where patients usually don’t get their medications on time because of being in the hospital or have another reason that could actually make all their Parkinson’s symptoms worse. We also touched base on important notes on elective admissions for these patients and the fact that they should indeed take their first dose of medication of the day with a little sip of water before going to the surgery on the day of surgery, although they are going to be NPO, which means that they shouldn’t take anything by mouth. So we put a lot of recommendations in that paper, meaning that the group that are taking care of patients when they are admitted to the hospital should really be familiar with how to take care of these patients. This group ideally includes a speech and language pathologist, a neurologist who’s familiar with Parkinson’s disease, nurses who are familiar with Parkinson’s disease, and then also very important to do during workup for discharge and where the patient’s going to be discharged, all the evaluations for modifications of diet is discussed with the caregiver and the next place the patient is going to be discharged to just so they know how the medications were changed and what is the new diet recommendation, how the patient should take their medications. These are all important notes that the group taking care of patients with Parkinson’s disease should be aware of.

We briefly talked about a speech and swallowing evaluation and when you have to do it. This screening for swallowing evaluation for patients with Parkinson’s disease should have started bedside screening, could start by the nurse taking care of a patient with Parkinson’s disease. And then based on those screenings, other groups should be involved with speech and language pathology should be consulted early on if there is a problem with swallowing. And we also mentioned that if they, for whatever reason, can’t take medications by mouth, there are some adjustments that can be made for some of these dopaminergic medications to be given through an NG tube or other routes. Some of these medications can’t just be stopped and they need to be changed to other forms. And if they’re stopped abruptly, patients can have bad outcomes, poor side effects, and that could complicate the course of hospitalization. So it’s important that the nurses who are involved in care of patients with Parkinson’s disease know exactly what these patients are taking and at what times during the day and try to modify the times of medication giving to adapt what the patient was getting at home and make it as close to it as possible. And then the inpatient hospital team taking care of these patients should have a low threshold to call neurology, especially if there is a change that needs to be made to their Parkinson medications. And then if these patients develop hallucinations or other psychiatric problems during the hospital admission, again, neurology should be on board for management of that because there are some medications that could potentially worsen these Parkinson’s symptoms, specifically some dopamine blockers that are commonly used in hospital when patients are agitated, like Haldol, like Olanzapine. These medications could worsen Parkinsonian symptoms and therefore worsen swallowing. So we could fall into a negative loop of trying to achieve some improvement while making most of the symptoms worse, and that could prolong the hospitalization. So that was the focus of this multidisciplinary consensus recommendations paper that was published in Journal of Parkinson’s Disease.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.