Abstract
The aging of the US population poses complex management issues for the health care provider in the acute and subacute setting. Although management guidelines exist to guide the treatment of individual disease processes, addressing goals of care in an aging patient with multiple comorbidities requires conversations unique to each patient and family. This case study examines the care of a patient with Parkinson's disease, dementia, and pneumonia admitted to the intensive care unit for altered mental status and metabolic encephalopathy. The pathophysiology and management of Parkinson's disease, dementia, community-acquired pneumonia, and dysphagia will be reviewed.