Palliative medicine
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Palliative medicine · Jan 1993
Multidisciplinary management from day one: the Neuro-care approach to motor neurone disease.
The Neuro-care approach offers a holistic, multidisciplinary, patient-centred, continuous strategy of care to unselected groups of neurological patients and their families including those with motor neurone disease (MND). The strategy for MND patients is an adapted version of one piloted on patients with Parkinson's disease. Between April 1990 and September 1992 12 MND patients were diagnosed, of whom five have died. ⋯ The maintenance of patients in the community and the lack of resort to permanent institutional care are also recorded. Ethical issues arising during the project are discussed and the problems of measuring outcomes of care are acknowledged. General conclusions for MND management are drawn.
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There are many ethical decisions to be made during palliative care of a patient with motor neurone disease. These may concern the physical and psychosocial care of the patient and will become highlighted when death approaches. By close involvement of the patient and his/her family with the interdisciplinary team the most appropriate decisions on the patient's care can be made.