Ask the Doctor

Q&A with Marie Hélène Saint-Hilaire, MD, FRCP (C), Boston University School of Medicine


Q. My uncle is 57 and has advanced PD. He cannot live alone because he is no longer able to speak intelligibly, is not eating and is not seeing his doctors. I’m looking to move him nearer to where I live. Is there something you could recommend?

A. It is helpful for caregivers to talk with a social worker or case manager to help determine what support is needed. “Aging life care specialists” can help you navigate this process — you can find more information about this at APDA also provides information to assist family members in finding local resources. Learn more at

Q. Are vivid dreams that come on every night a sign of late stage PD, or is it because Sinemet was increased by ½ tablet at 6am and 6pm?

A. Vivid dreams can occur at any time during the disease condition — even before diagnosis. They also can occur as a side effect of an increase of medication. It’s important to get information about the dreams because some people with PD have a condition called REM Behavior Disorder, which might need to be treated. It is also important to know if they are having visual hallucinations during the day, which are usually a side effect of medication. Be sure to discuss the vivid dreams with your doctor.

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