Nursing Care of Motor Neurone Disease (MND)
Published: 06 October 2020
Published: 06 October 2020
How has the management of this condition advanced since then?
The term MND refers to a group of progressive neurological diseases that attack motor neurons in the body, eventually causing the muscles to waste away (Healthdirect 2020; QBI 2020).
To date, there is no known cure or effective treatment for MND, with two Australians dying from the disease every day (QBI 2019).
MND causes simple limb movements, swallowing, talking and even breathing to become increasingly difficult (Better Health Channel 2018).
The cause of MND remains relatively unknown.
Researchers have found that hereditary factors account for around 5 to 10% of cases, but most cases remain unidentified. Current research into this area is looking at not only genetic factors, but also nerve growth factors, the repair and ageing of motor neurons, and immune-mediated damage, as well as viruses, toxins, and chemical interactions with nerve cell control and communication (Better Health Channel 2018).
MND affects both adults and children. In children, MND is often genetic, and the symptoms are usually present at birth or appear in early childhood. In adults, the symptoms often appear after the age of 50. Men are slightly more susceptible to the disease than women (NINDS 2020).
The symptoms and the rate of progression vary between individuals. Early symptoms may present as a mere weakness or tingling in the hands and feet. Individuals may have trouble holding objects and may notice they are stumbling more. Some people may notice they are beginning to slur their speech and may have difficulty swallowing. These weaknesses then progress to widespread muscle wastage (NeuRA 2016).
The average life expectancy of someone with MND is 27 months from diagnosis (QBI 2019). In addition to physical symptoms, up to 50% of people with MND will also display changes in their cognition, language, behaviour, and personality as the disease progresses (Better Health Channel 2018).
Due to the physical effects of MND, people with the condition may become dependent on others for all aspects of their day-to-day life - from mobility to eating (Better Health Channel 2018).
People with MND may experience pain, constipation, pressure injuries, psychological distress and other difficulties (NHS n.d.).
The most common cause of death among people with MND is respiratory failure (Oliver 2019).
The nurse’s role becomes increasingly important as MND progresses and patients may require increasing support and assistance for their day-to-day activities. The nurse will also be a member of the interprofessional team caring for the person if the individual is hospitalised.
As a nurse, you will need to be aware of the potential complications of the disease’s progression - such as aspiration - and ensure care is targeted to prevent these complications from eventuating. This could be as simple as ensuring the patient is sitting upright when eating.
The carers of those with MND may struggle with the physical and emotional demands and stress from their role, so be considerate to the needs of carers and support them during the disease’s progression.
Although MND is currently incurable, some medicines are effective in helping patients remain in the milder stages of the disease for longer, possibly prolonging their survival by two to three months. Symptoms can also be managed by the help of an interprofessional healthcare team who assists with interventions to improve quality of life during the disease’s progression (QBI 2020).
Current research focuses on a multitude of areas within MND - from what causes it, to how to treat it. Funding is essential to ensure this research continues.
No doubt we’ve all heard about - or perhaps even participated in - the Ice Bucket Challenge. This particular initiative raised more than 115 million dollars (USD) for MND worldwide in 2014. Research funded by this campaign has already led to the identification of the gene NEK1, which is associated with about 3% of MND cases (Rogers 2016).