Veterans With Parkinson's Disease: A Shared Care Model Between Movement Disorder and Rehabilitation Specialists

Parkinson's disease (PD) is a neurological disorder that Veteran populations are at a disproportionately higher risk for developing compared to the general population. There is a growing appreciation of the efficacy of nonpharmacological intervention for both motor and nonmotor symptoms of PD, particularly the relationship between rehabilitation interventions and positive outcomes. PD care by a multidisciplinary team (MDT) in particular can enhance outcomes and improve quality of life throughout the PD journey. To date, the literature is replete with guidelines and considerations for MDT PD care, but very few papers describe how an established integrated program functions. This paper describes an expanded, rehabilitation-focused MDT caring for Veterans with PD at the Minneapolis Veterans Affairs Healthcare System (MVAHCS). The Parkinson's disease and movement disorders program at MVAHCS uniquely provides neurorehabilitation-focused care via a lifelong, shared care model between neurology and rehabilitation medicine, with consultation to neurosurgery as indicated. The MDT at MVAHCS is further enhanced by referrals to specialized, neuro-based rehabilitation therapies (physical, occupational, and speech therapy) and other ancillary services (geropsychiatry, rehabilitation psychology, social work) and programs (Caregiver Support Program, Comprehensive Pain Center). Conclusions: This network of disciplines and providers maximize the Veteran's quality of life through a cohesive, integrated, team approach.