September 12, 2026

@michaelokun

What resonates with me most about this paper is something we see far too often in Parkinson’s care: as the disease progresses and people need us the most, they can become the very people we lose from care. Advanced Parkinson’s and parkinsonism bring falls, cognitive changes, swallowing problems, caregiver strain, transportation challenges and increasing disability, making the traditional model of “come back to my clinic in six months” progressively less workable. The Husain and Fleisher AIMS Clinic experience is important because it shows another path: longitudinal, interdisciplinary movement disorders and neuropalliative care, supported by care partners and telemedicine, can keep people connected rather than allowing advancing disability to push them out of the healthcare system. Nearly 70% maintained continuity with at least one follow-up, and 69% of those who died had hospice in place, remarkable numbers in a population we too often underserve. Progression should trigger more access to care, not less. https://www.neurology.org/doi/pdf/10.1212/CPJ.0000000000200652