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Motor Neurone Disease
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Diagnosis :
First symptoms
Path to diagnosis
Immediate reactions to diagnosis
Possible causes of MND (including familial MND)
Telling others
Treatment/ interventions :
Medication, trials and research
PEGs, RIGs and ventilation
Complementary therapies and alternative treatments
Physical therapy and exercise
Information and support :
Information needs
Support groups and meeting others
Work/ career and money :
Work and career
Finances and benefits
Living with MND :
Mobility, arm and leg weakness
Aids, equipment and adaptations
Personal care and care support
Speech and communication
Eating, swallowing and breathing
Tiredness, pain and discomfort
Forgetfulness and thinking
Emotional lability, depression and low mood
Relationships and sex
Leisure, holidays and travel
Impact on family carers
Feelings about life and the future :
Philosophy, attitude to life and messages to others
Hospices, respite and thoughts about future care
Thoughts about death, dying and bereavement
Health and social care professionals :
Coordination of care
Messages for professionals
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Motor Neurone Disease
Subject index
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Nerves & brain
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Motor Neurone Disease
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Rarer forms - familial/inherited
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Ken - Interview 34
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They sit round the table together for meals and Ken does his PEG feed. At Christmas he stuck jokey labels on the bottles. [Ken is unable to speak].
Ken was diagnosed with rare inherited (familial) form of MND less than a year ago (2006). He has limited arm and leg movement, has a PEG and uses a Lightwriter to speak, but carried on working until a month ago. Interviewed through his wife Chris.
Nerves & brain
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Motor Neurone Disease
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Bulbar onset
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Mike - Interview 23
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They want to be as independent as possible. Mike has a portable pump for his PEG so they can take it with them to restaurants to eat with friends. [Mi
Mike was diagnosed with bulbar onset MND 2 years ago in 2005. He is now unable to speak, so was interviewed through his wife Gill. He uses a whiteboard and Lightwriter to communicate. He has a PEG (Percutaneous Endoscopic Gastrostomy).
Nerves & brain
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Motor Neurone Disease
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Carers
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Dick - Interview 42
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He took responsibility for coordinating Di's care himself - it was exhausting, but worth the effort.
Dick was married to Di, who was diagnosed with MND two and a half years ago (2004). She died 6 months ago, aged 64.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Slawomir - Interview 33
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His mother shouted at him when he told her he might have MND.
Slawomir was diagnosed 3 months ago, 18 months after first noticing weakness in his leg. He wonders if he may in fact have Lyme Disease. He can still walk and drive.
Nerves & brain
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Motor Neurone Disease
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Bulbar onset
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Vim - Interview 32
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He couldn't take in how serious the diagnosis was. He had to ring the doctor to ask what he'd been told. He cried for six months, but then began feeli
Vim was diagnosed just over a year ago in 2006 with bulbar onset MND. His speech is affected but he can still talk, and he can still walk independently. He has retired early.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 20-49
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Kim - Interview 10
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She suspected it was MND and wanted the doctor to tell her straight. For a few days she couldn't bear to be alone.
Kim was diagnosed with MND (ALS) about a year ago (2005). Now unable to walk she needs help with most daily tasks, but is still working as an occupational therapist and able to drive. Her speech is not affected.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 65+
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Shyam - Interview 35
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He says he has never felt worried or upset by the diagnosis. What saddens him is feeling that he is a burden on his wife.
Shyam was diagnosed with MND about six months ago (2006). He has difficulty walking and uses a wheelchair. His speech is slowing down and his voice is changing.
Nerves & brain
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Motor Neurone Disease
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Rarer forms - PMA (progressive muscular atrophy)
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Jim - Interview 18
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He was told he might live 3 years. His wife was across the room from him and was crying with shock. But at the next appointment they were told it was
Jim was diagnosed 2 years ago (2005) with Progressive Muscular Atrophy (PMA) form of MND. His legs and arms are affected but not speech.
Nerves & brain
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Motor Neurone Disease
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Bulbar onset
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Ann - Interview 24
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She wishes her daughter had not been invited to come with her, as the diagnosis was a great shock for her. Professionals need to tailor what they say
Ann was diagnosed with bulbar onset MND within the last 6 months (in 2006), after speech and swallowing difficulties. She is about to have a Percutaneous Endoscopic Gastrostomy (PEG).
Nerves & brain
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Motor Neurone Disease
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Bulbar onset
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Mike - Interview 23
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Gill's first thought was how she was going to tell the family. Mike was calmer than she was. It was hard supporting others when still in shock themsel
Mike was diagnosed with bulbar onset MND 2 years ago in 2005. He is now unable to speak, so was interviewed through his wife Gill. He uses a whiteboard and Lightwriter to communicate. He has a PEG (Percutaneous Endoscopic Gastrostomy).
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Sandy - Interview 36
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He told his son first as they were going to a football match after the appointment. He told his wife when he got home and his daughter and colleagues
Sandy was diagnosed 5 years ago (2002) after noticing weakness in one arm. His arms have been worst affected, and now his speech and neck muscles are deteriorating, but he can still walk well.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Jack - Interview 03
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His grown-up children have all reacted differently. One son has been more emotional than he expected.
Jack was diagnosed with MND a year before interview (2003), after some years of leg pain and stiffness. Symptoms have progressed slowly, still mainly leg weakness. He now uses a walking frame. (Wife Mary present, also interviewed separately MND04).
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 20-49
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Michael - Interview 29
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He wants his children (aged 11 and 9) to enjoy their childhood. They have not told them everything about the condition but they do not lie to them.
Michael was diagnosed less than a year ago in 2006 after noticing weakness in his right arm. His arm weakness remains his main symptom, and it has got worse. Currently he is on sick leave from work.
Nerves & brain
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Motor Neurone Disease
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Rarer forms - PLS (primary lateral sclerosis)
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'Speedy' - Interview 19
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She didn't tell her son (now 13) the name of the condition at first but explained she might need a wheelchair soon. He didn't want to talk about it an
'Speedy' was diagnosed with primary lateral sclerosis (PLS) nearly 2 years ago (in 2005) after 2 years of increasing leg weakness. She now uses a wheelchair and a hand-operated car.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 20-49
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Kim - Interview 10
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She wanted to protect her children (now 12 and 10) from worrying about it but in the end told them she wouldn't get better. The hardest thing is seein
Kim was diagnosed with MND (ALS) about a year ago (2005). Now unable to walk she needs help with most daily tasks, but is still working as an occupational therapist and able to drive. Her speech is not affected.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Penny - Interview 11
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Most people were very supportive but her mother was angry at the diagnosis, and one of her friends also found it hard to accept.
Penny was diagnosed three years ago (2003) with ALS, after having arm weakness, pains and coughing fits for three years. The condition has progressed quite slowly so far.
Nerves & brain
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Motor Neurone Disease
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Carers
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Roger - Interview 41
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His wife volunteered for trials and they researched the scientific evidence behind different treatments. It gave him hope, but his wife was less optim
Roger was married to Teresa, who was diagnosed with bulbar onset MND. She died a year ago, aged 64, less than six months after the diagnosis.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Ken - Interview 15
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Physiotherapy on his feet helps, so he's disappointed it's not provided locally. The physios have shown his wife what to do but she already has too mu
Ken was diagnosed with amyotrophic lateral sclerosis (ALS) form of MND 5 years ago (2002). His arm muscles were affected first, followed by his leg muscles. His speech is not affected and his condition has progressed more slowly than he originally expected.
Nerves & brain
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Motor Neurone Disease
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Carers
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Ann & Barry - Interview 48
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She has been depressed about the loss of their future as a couple. She takes an antidepressant, but has also learnt to accept the things she can't cha
Ann's husband Barry was diagnosed with MND about 10 years ago (1997) at the age of 49, after two years of symptoms and tests. (Since identified as primary lateral sclerosis - PLS).
Nerves & brain
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Motor Neurone Disease
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Carers
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Una & Bill - Interview 49
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Becoming a carer has crept up on her. Each step feels like a mini-bereavement but it's amazing what she has got used to. A practical focus helps.
Una's husband Bill first noticed symptoms at the end of 2005 and was diagnosed aged 63. A ventilator greatly improved his energy levels for nearly a year. He had a PEG fitted but does not yet use it for feeding.
Nerves & brain
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Motor Neurone Disease
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Carers
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Tess - Interview 44
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Sometimes she tends to look on the dark side, but her partner's positive attitude rubs off on her.
Tess met her partner, who had already been diagnosed with MND, when volunteering at a sailing club for disabled people. She now lives with him and is his main carer. (See Marcelin, MND37)
Nerves & brain
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Motor Neurone Disease
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Carers
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Ann & Barry - Interview 48
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It is sad to have changed from being just a wife to being a carer. She misses him being able to hold her hand. Becoming a carer is a progression.
Ann's husband Barry was diagnosed with MND about 10 years ago (1997) at the age of 49, after two years of symptoms and tests. (Since identified as primary lateral sclerosis - PLS).
Nerves & brain
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Motor Neurone Disease
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Carers
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Una & Bill - Interview 49
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The hospice has been fantastic and set up a carers' course. Her MND Association befriender knows how she feels and helps her deal with guilt and negat
Una's husband Bill first noticed symptoms at the end of 2005 and was diagnosed aged 63. A ventilator greatly improved his energy levels for nearly a year. He had a PEG fitted but does not yet use it for feeding.
Nerves & brain
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Motor Neurone Disease
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Carers
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Dick - Interview 42
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The generosity and selflessness of friends who helped him care for his wife has made him see the world differently.
Dick was married to Di, who was diagnosed with MND two and a half years ago (2004). She died 6 months ago, aged 64.
Nerves & brain
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Motor Neurone Disease
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Carers
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Roger & Luise - Interview 45
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Roger found strength from somewhere. It was wonderful to see his sons involved in caring for their mother. Parishioners from her church rallied round.
Roger's wife Luise was diagnosed in 2004 aged 59, after a year of weakness in her fingers and leg. Roger and his sons cared for Luise at home until her death in 2006.
Nerves & brain
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Motor Neurone Disease
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Rarer forms - familial/inherited
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Ken - Interview 34
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He gave the speech at his daughter's wedding using a laptop computer and a projector. [Ken is unable to speak].
Ken was diagnosed with rare inherited (familial) form of MND less than a year ago (2006). He has limited arm and leg movement, has a PEG and uses a Lightwriter to speak, but carried on working until a month ago. Interviewed through his wife Chris.
Nerves & brain
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Motor Neurone Disease
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Carers
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Harry - Interview 43
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The uncertainty of how his wife's condition will progress causes him great anxiety.
Harry's wife was diagnosed with bulbar onset MND two and a half years ago. She is now unable to speak. She finds swallowing very difficult, and has a PEG fitted.
Nerves & brain
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Motor Neurone Disease
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Bulbar onset
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Sue - Interview 31
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She misses being able to talk, laugh and shout, but she loves her voice software and the freedom it gives her to express herself. [Voice software inte
Sue was diagnosed with bulbar onset motor neurone disease less than a year ago (2006). She is now unable to speak and uses a laptop with voice software. Her arms and legs are still relatively strong.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Phil - Interview 28
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Means-testing is unfair. He'll miss years of pension, and worries about his wife's financial security. Equipment prices are high and not easy to disco
Phil was diagnosed just over a year ago, after nearly 2 years of leg weakness. He is still able to walk at home but uses a wheelchair and scooter outdoors. He has some weakness in his right arm.
Nerves & brain
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Motor Neurone Disease
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Rarer forms - familial/inherited
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Liz - Interview 39
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People seem to feel awkward about reaching out to touch her hand or place something in it. The most helpful thing is when people anticipate her needs.
Liz was diagnosed with inherited form of MND in 2004. (Her father and uncle both had MND). Weakness in her legs progressed to her arms; she is now in a wheelchair. Her speech is unaffected.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Ken - Interview 15
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Gradually he found it harder to get up from sitting, and he had several falls. His wife can't lift him but buying a lightweight mobile hoist has helpe
Ken was diagnosed with amyotrophic lateral sclerosis (ALS) form of MND 5 years ago (2002). His arm muscles were affected first, followed by his leg muscles. His speech is not affected and his condition has progressed more slowly than he originally expected.
Nerves & brain
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Motor Neurone Disease
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Carers
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Roger & Luise - Interview 45
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Luise had a drug to help her relax in the last days. She died at home with the support of family and palliative care nurses.
Roger's wife Luise was diagnosed in 2004 aged 59, after a year of weakness in her fingers and leg. Roger and his sons cared for Luise at home until her death in 2006.
Nerves & brain
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Motor Neurone Disease
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Carers
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Bev - Interview 47
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Towards the end she was unhappy that her mother was given higher doses of morphine which sent her into a strange dream-like state. She and her sister
Bev's mother died about a year after developing speech and swallowing difficulties and being diagnosed with bulbar onset MND, aged 72. Her family were unhappy with many aspects of the care received.
Nerves & brain
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Motor Neurone Disease
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Carers
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Dick - Interview 42
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After Di's death he felt she was both present and absent. It has changed his beliefs about death. Friends and his stepson were supportive, and the hos
Dick was married to Di, who was diagnosed with MND two and a half years ago (2004). She died 6 months ago, aged 64.
Nerves & brain
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Motor Neurone Disease
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Carers
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Peter & Olivia - Interview 46
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They will never lose their love for the daughter, or fill the gap she has left. They decided early on to have a busy social life, which has supported
Peter's daughter Olivia (aged 22) died within a year of developing pain and weakness in her leg, in late 2006. Diagnosis of MND remained uncertain, as aspects of her condition were unusual.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Stuart - Interview 05
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The professional staff are fantastic but they sometimes don't have the facilities to do their job properly. Hospital closures mean longer, tiring jour
Stuart first noticed symptoms (legs shaking) almost 20 years ago. MND diagnosed 9 years ago (1997), after years of tests and investigations. Now uses a wheelchair.
Nerves & brain
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Motor Neurone Disease
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ALS- amyotrophic lateral sclerosis/MND aged 50-64
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Ken - Interview 15
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He worries about the physical and emotional burden on his wife and how she will cope in future.
Ken was diagnosed with amyotrophic lateral sclerosis (ALS) form of MND 5 years ago (2002). His arm muscles were affected first, followed by his leg muscles. His speech is not affected and his condition has progressed more slowly than he originally expected.
Nerves & brain
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Motor Neurone Disease
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Rarer forms - PMA (progressive muscular atrophy)
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Pauline - Interview 30
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She does not want her daughters to feel they should look after her - that is not why she had children. She wants them to lead their own lives.
Pauline was diagnosed with PMA (progressive muscular atrophy) about 2 years ago (2005), after several years of leg weakness. She cannot walk far and uses a wheelchair, but is still able to work full-time.
Nerves & brain
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Motor Neurone Disease
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Carers
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Peter & Olivia - Interview 46
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He and his wife did a lot of lifting. It was hard physically, but as parents they just did whatever it took to make their daughter comfortable.
Peter's daughter Olivia (aged 22) died within a year of developing pain and weakness in her leg, in late 2006. Diagnosis of MND remained uncertain, as aspects of her condition were unusual.
Nerves & brain
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Motor Neurone Disease
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Carers
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Bev - Interview 47
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She needed a break but was very unhappy about the quality of care at the hospice. She came home early and felt her mother had deteriorated in the hosp
Bev's mother died about a year after developing speech and swallowing difficulties and being diagnosed with bulbar onset MND, aged 72. Her family were unhappy with many aspects of the care received.
Nerves & brain
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Motor Neurone Disease
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Carers
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Harry - Interview 43
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He doesn't feel he can ever have time off from being a carer, and his wife relies on him for communication. Leisure activities without her wouldn't fe
Harry's wife was diagnosed with bulbar onset MND two and a half years ago. She is now unable to speak. She finds swallowing very difficult, and has a PEG fitted.
Nerves & brain
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Motor Neurone Disease
>>
Rarer forms - PLS (primary lateral sclerosis)
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Peter - Interview 20
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Everyone has to find their own way of coping. They both feel it is important to maintain their own interests. [Peter cannot speak much].
Peter was diagnosed with primary lateral sclerosis (PLS) 8 years ago (1998). Symptoms progressed quickly at first, but now more slowly. His speech was severely affected, so he was interviewed through his wife Ann. His mobility is also affected.
Nerves & brain
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Motor Neurone Disease
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Carers
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Bev - Interview 47
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She advises other carers to try not to be obsessed with the condition, and to enjoy each day as much as possible. Learning bridge gave her a chance to
Bev's mother died about a year after developing speech and swallowing difficulties and being diagnosed with bulbar onset MND, aged 72. Her family were unhappy with many aspects of the care received.
Nerves & brain
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Motor Neurone Disease
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Carers
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Ann & Barry - Interview 48
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It helps her to have hospice respite care for her husband. The care is excellent but he'd probably prefer to stay at home. She still visits him every
Ann's husband Barry was diagnosed with MND about 10 years ago (1997) at the age of 49, after two years of symptoms and tests. (Since identified as primary lateral sclerosis - PLS).
Nerves & brain
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Motor Neurone Disease
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Carers
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Una & Bill - Interview 49
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She wonders if the hospice staff realise how tiring MND can be. She feels lonely when he has respite care, and worries that he may be losing some func
Una's husband Bill first noticed symptoms at the end of 2005 and was diagnosed aged 63. A ventilator greatly improved his energy levels for nearly a year. He had a PEG fitted but does not yet use it for feeding.
Nerves & brain
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Motor Neurone Disease
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Carers
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Roger & Luise - Interview 45
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When he had an operation he needed help. Luise had two weeks in a wonderful Sue Ryder home, but was moved to a less satisfactory nursing home when hom
Roger's wife Luise was diagnosed in 2004 aged 59, after a year of weakness in her fingers and leg. Roger and his sons cared for Luise at home until her death in 2006.
Nerves & brain
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Motor Neurone Disease
>>
Rarer forms - familial/inherited
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Ken - Interview 34
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Ken is happy to have day care at the hospice, but she finds it hard to see him there and thinks the volunteers are sometimes a bit over-enthusiastic.
Ken was diagnosed with rare inherited (familial) form of MND less than a year ago (2006). He has limited arm and leg movement, has a PEG and uses a Lightwriter to speak, but carried on working until a month ago. Interviewed through his wife Chris.
Nerves & brain
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Motor Neurone Disease
>>
ALS- amyotrophic lateral sclerosis/MND aged 20-49
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Michael - Interview 29
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Coming to terms with the loss of a future is one of the hardest things, especially not seeing his children into adulthood.
Michael was diagnosed less than a year ago in 2006 after noticing weakness in his right arm. His arm weakness remains his main symptom, and it has got worse. Currently he is on sick leave from work.
Nerves & brain
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Motor Neurone Disease
>>
Rarer forms - familial/inherited
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Liz - Interview 22
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She has planned her funeral with the funeral director so her children don't have to worry about it. She was surprised how much detail she needed to co
Liz was diagnosed with rare inherited (familial) form of MND 8 years ago (1998). Sixth member of her family to be diagnosed. Has weakness in her arms and legs, and some speech difficulties. Has a PEG but does not use it yet.
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Nerves & brain
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Motor Neurone Disease
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Impact on family carers
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Impact on family carers
Impact on family carers
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