The course of the terminal phase in patients with amyotrophic lateral sclerosis

Title

The course of the terminal phase in patients with amyotrophic lateral sclerosis

Creator

Neudert C; Oliver D; Wasner M; Borasio GD

Publisher

Journal Of Neurology

Date

2001

Subject

Female; Humans; Male; Palliative Care; Terminal Care; Adult; Aged; Middle Aged; Death; Disease Progression; Fear; Anxiety; quality of life; 80 and over; retrospective studies; Health Surveys; caregivers; Airway Obstruction/etiology/pathology/psychology; Amyotrophic Lateral Sclerosis/complications/pathology/psychology; Cough/etiology; Dyspnea/etiology

Description

The fear of "choking to death" is on the mind of most patients suffering from amyotrophic lateral sclerosis (ALS). So far, however, there have been no systematic surveys concerning the dying phase in a general ALS population. We therefore performed a structured telephone interview with the relatives of 121 patients who died from ALS and were followed by the Motor Neuron Outpatient Clinic of the Department of Neurology, University of Munich, Germany. These data are compared with those obtained by a retrospective analysis of medical records of 50 ALS patients who were followed by the Wisdom Hospice, Rochester, UK. The data show that most ALS patients (Germany 88%, UK 98%) died peacefully, and no patient "choked to death". The symptoms most frequently reported for the last 24 hours were dyspnoea, coughing, anxiety and restlessness. Around half (G 55%, UK 52%) of the patients died at home. The main palliative measures in place during the terminal phase were: home mechanical ventilation (G 21%, UK 0%), percutaneous endoscopic gastrostomy (G 27%, UK 14%), morphine (G 27%, UK 82%) and benzodiazepines (G 32%, UK 64%). The use of these palliative measures was judged to be beneficial by almost all relatives. These data support the hypothesis of a peaceful death process in ALS and should be communicated to patients and their relatives, at the latest after the onset of dyspnoea, to relieve unwarranted fears.
2001

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

612-616

Issue

7

Volume

248

Citation

Neudert C; Oliver D; Wasner M; Borasio GD, “The course of the terminal phase in patients with amyotrophic lateral sclerosis,” Pediatric Palliative Care Library, accessed October 18, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12309.

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