Later implications
Discussions with patients should include the type of medication they would be willing to take in certain circumstances and whether they would be willing to consider a feeding tube.3
In time, surgical intervention may be necessary. This can include percutaneous gastrostomy to enable feeding as dysphagia develops, and tracheostomy with or without ventilatory support to aid breathing as respiratory muscle weakness increases.21
Among the considerations for MND in its later stages is the need for palliative care and advanced care planning.
This can include discussing when the palliative care team should be involved, providing anticipatory medicines to have on hand in the home, Advance Decisions to Refuse Treatment (ADRT) and Do Not Attempt Resuscitation (DNACPR) orders, and Lasting Power of Attorney.1