The HOEHN&YAHR classification is the fifth item on the Unified Parkinson’s Disease Rating Scale (UPDRS) Grade 0 = No signs of disease. Grade 1 = Unilateral limb symptoms. Grade 1.5= Unilateral limb + trunk symptoms. Grade 2= Bilateral limb symptoms without balance disturbance. Grade 2.5= Mild bilateral limb symptoms with recovery on posterior pull test. Grade 3 = Mild to moderate bilateral limb symptoms, balance disturbance, retained independence. Grade 4 = Severe impairment with ability to walk or stand without assistance. Grade 5 = Patient confined to a wheelchair or bed, requiring care. The higher the grade, the more severe the disease. Usually grade 1-2 is the early stage of Parkinson’s disease and is treated mainly with medication; if the tremor is uncontrollable with medication, grade I can also be considered for surgery; grade 2.5-3 is the middle stage of Parkinson’s disease and is treated mainly with medication and with motor complications caused by medication, consider surgery; grade 4-5 is the late stage of Parkinson’s disease Grade 5 is too late for surgery and the treatment with medication and surgery is poor. At this time, care should be strengthened to prevent complications such as food aspiration, choking and bed sores.