Hi, In reply to your inquiry, I would say if I were 82 I wouldn't worry much about the next step. I'm 55, diagnosed 10 years ago, and plan to use sinemet successfully for the foreseeable future. The trick is to combine it with "helper{" drugs that enable us to take less sinemet and therefore play down the side effects. I used to take parlodel, which for me had limited usefulness, and am now on a trial drug, pramipexole, which looks promising. Others on the Net have written about other drugs being researched, and many use Eldepryl successfully. Talk to your Mom's doctor about prescribing supplemental medications, as sinemet is the most effective and you'll want to prolong its usefuolness.