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Motor neurone disease: a hospice perspective
T O'Brien1, M Kelly, C Saunders
1St Christopher's Hospice, London.
BMJ (Clinical Research Ed.)
|February 22, 1992
Summary
Hospice care effectively managed motor neurone disease (MND) symptoms, with opioids proving safe and effective for pain, dyspnoea, and insomnia. Most patients died peacefully, with opioids aiding symptom management during the dying process.
Area of Science:
- Palliative Care
- Neurology
Background:
- Motor neurone disease (MND) presents complex symptom management challenges.
- Hospice care plays a crucial role in supporting patients with advanced neurological conditions.
Purpose of the Study:
- To evaluate hospice-based management strategies for patients with motor neurone disease.
- To assess symptom control, functional status, and end-of-life care in MND patients.
Main Methods:
- Retrospective analysis of hospice medical and nursing records.
- Inclusion of 124 patients with motor neurone disease admitted between 1980 and 1990.
- Evaluation of patient profiles, functional status, symptom control, and mode of death.
Main Results:
- Patients experienced significant functional dependence and common symptoms like pain, dyspnoea, and insomnia.
- Opioids were highly effective in managing these symptoms, with 89% receiving them during the dying period.
- The majority of patients (94%) experienced a peaceful death, and the term "choking" was deemed inappropriate for MND deaths.
Conclusions:
- Active symptom management is essential for motor neurone disease patients.
- Opioids are a safe and effective therapeutic option for symptom control in palliative care.
- The inaccurate term "choking" should be abandoned when describing death in motor neurone disease.