Parkinson’s disease currently affects up to one million Americans. With increasing longevity as we better manage the complications of conditions of middle age such as diabetes, hypertension, and hypercholesterolemia, that number is expected to double globally over the next 25 years. Until there is a cure for the disease, a growing proportion of this increasing number of people with Parkinson’s disease will live to experience the later stages of their disease, needing hands-on assistance with activities of daily living, either in the home or in a care facility. It is useful, therefore, to review the common symptoms and complications of late-stage Parkinson’s, focusing particularly on the practical issues that primary care physicians typically address, such as medications, rehabilitation team referrals, prognosis, and end-of-life discussions and care.