Objective: The Holistic Parkinson’s and Frailty Integration Team (HoPFIT) is a multi-disciplinary in-patient service at Addenbrooke’s Hospital in Cambridge, United Kingdom, aiming to improve outcomes on patient autonomy and palliative care for older persons with advanced Parkinson’s disease.

Background: While Parkinson’s disease remains a progressive neurodegenerative condition with recognised markers of advanced illness, palliative care is often difficult to broach given heterogeneity of trajectory.

Method: Data of all patients with Parkinson’s admitted to our hospital in 2024 were initially reviewed to provide a baseline. HoPFIT launched in early 2025 consisting of a Geriatrician and nurse specialists. Older patients (>75 years) with severe frailty and markers of advanced disease e.g. cognitive impairment, aspiration and repeated admissions (>1) are proactively identified using our electronic patient system weekly and reviewed. Interventions: future care planning and palliative phase recognition, discharge planning and onward handover to community partners of care plans. Data of all patients with Parkinson’s admitted in 2025 were later reviewed to evaluate outcomes.

Results: In 2024, prior to HoPFIT, 295 patients with Parkinson’s were admitted and 43 would have met HoPFIT criteria. 23/43 died by year end (19 aspiration, median age 81, CFS 7 and 2 preceding admissions) with only 8 having prior evidence of future care plan (35%) and only 3 dying in preferred place of death (13%).

Following one year of HoPFIT service and on evaluation of all patient data with Parkinson’s admitted in 2025 (271 patients), 29/42 eligible were seen. 13/42 died by year end (12 aspiration, median age 81, CFS 7, 3 preceding admissions) with 10/13 reviewed by HoPFIT. All 10 received timely recognition of palliative phase and discharge to preferred place of death: 8 care home, 2 hospice (13% to 100%). All 29 welcomed conversations on future care plans and onward community handover were undertaken (100%).

Conclusion: The in-patient setting offers an opportunity for recognising patients with advanced disease and in improving outcomes on specialised end-of-life support. At a time of disease when uncertainty and vulnerability are common, this helps to increase patient control and autonomy. This data will also serve to continue and further shape our service.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hopfit-proactive-recognition-of-older-in-patients-with-advanced-parkinsons-disease-improves-palliative-care-outcomes-and-patient-autonomy/