MND Care Centre Website
Treatments
Unfortunately there is at present no known cure for MND but treatments are used to improve symptoms.
Riluzole is a medication which has been shown to have a small effect in slowing down the progression of MND. It is taken in tablet form twice each day. A small number of people do develop side effects. These may include nausea, vomiting, tiredness and dizziness. Again in a small number of people the medication can also cause problems with liver function and therefore blood tests need to be done on a regular basis. It can also make people more prone to getting infections and therefore you should see your GP if you have any signs of infection. The majority of people do not experience any side effects but if they do, it is usually best to stop the drug.
Support is available with managing any symptoms or difficulties a person living with MND may experience. This may involve
- getting aids to assist you with daily activities
- having equipment to help with symptoms
- medications
- hands on treatment
- adaptations within the home
A number of healthcare professionals can help you with symptom management.
Physiotherapists
Dependent on your needs, we can offer advice/treatment in a number of areas, including such things as:
- Assessment
Initial assessment is very important to highlight any developing problems.
- Exercise programmes
It is important that you know which kind of exercises to do and when
They may include active exercises, stretches or assisted exercises. Strenuous exercises are usually avoided.
Appropriate exercises can help optimise working muscles,maintain balance, reduce muscle stiffness and preserve flexibility of muscles and joints.
It is better to do a few exercises well, and not overtire yourself. We will regularly review and update exercise programmes with you.
- Provision of simple aids that improve function or posture
e.g. foot drop splints, simple wrist/hand supports, shoulder braces, collars to support the head if you experience neck weakness, walking aids etc.
- Fatigue management strategies.
- Advice regarding falls, including reducing the risks.
- Positioning and postural advice to help maintain comfort and preserve joint flexibility.
This may include advice regarding sitting or sleeping positions
It may also address specific parts of the body e.g. hands, where customised resting splints may be helpful.
- Moving and handling advice.
- Advice regarding overcoming functional difficulties
e.g. dressing, turning over in bed, showering, carrying.
- Assist in provision of useful specialist equipment
e.g. riser recliner chairs, profiling beds, aids to assist eating/drinking, wheelchairs.
Other professionals will also be involved in providing specialist equipment, and we liaise closely with Occupational Therapists and other members of the team.
- Other physiotherapy techniques to address specific individual needs e.g. Joint stiffness, musculoskeletal pain etc.
See MNDA information sheet movement and mobility
Dietitian
People with MND may have difficulties eating because the muscles of the mouth and throat are weakened, or because arm muscles are affected making eating physically difficult, or simply through fatigue or a lack of appetite. Early food fortification (increasing calories in your food) and oral supplementation is important when appetite or weight begins to decline. If symptoms progress people may find it increasingly difficult to meet their nutritional requirements from food and drink alone. As a result people may consider feeding through a tube (enteral feeding). – see link to information sheet 11 PEG feeding making the decision). The Dietitian helps to determine whether enteral feeding is required. For those people who undergo Percutaneous Endoscopic Gastrostomy (PEG) or Radiologic-Inserted Gastrostomy (RIG), the dietitian selects an enteral feeding formula based on the person’s daily calorie, protein, and fluid requirements before the procedure, immediately afterward, and for the remainder of the disease course. The Dietitian and Speech and Language Therapist work closely to determine the degree of dysphagia (swallowing difficulty), recommends strategies to modify swallowing and alternative methods to prepare food to maximise nutrition.
The dietitian monitors the person’s nutritional status at each clinic visit.
Support the Dietitian can offer:
- Fortifying normal foods to maximise nutritional intake
- Adapting the textures of normal foods and fluids. This can range from soft –moist, fork mashed, puree foods, naturally thick fluids and how to thicken fluids with thickening powders.
- Advice on suitable nutritional supplements
- Feeding through a tube refer (link to information sheet 11 Peg feeding Making the decision)
- Tube and stoma care
See MNDA information sheet Eating and Drinking
See MNDA information sheet PEG feeding making the decision and eating and drinking
Speech and language therapist
A speech and language therapist can assess for any changes in your ability to swallow or any changes in your speech and can advice on how to manage this. As noted above the muscles of the mouth and throat may become weak which can make speaking and swallowing more difficult. It is important you maintain enjoy eating foods and try to maintain a stable weight. The dietitian and speech and language therapist work together to help you do this. The speech and language therapist will assess for any weakness in the muscles which are involved in swallowing and advise yu on the types of foods which may be easier and safer for you to eat.
See link to diet booklet
If the muscles concerned with speaking are affected it may be more difficult for you to talk especially in crowded places or at the end of the day when you may be more tired. The speech and langauge therapist can also advise you on how to manage this and even provide equipment that will make speaking less effortful.
Support the speech and language can offer:
- Assessment of swallowing
- Advise on apprpriate textures of food and fluid
- Advise on how to reduce coughing when eating and drinking
- Assessment of speech
- Provide strategies to help communicate more effectively
- Provide aids or equipment to assist with communication
See link to MNDA information Speech and Communication
MND specialist nurse
A specialist nurse can help by assessing your symptoms on a regular basis. As changes occur the specialist nurse will co-ordinate your care by speaking with other professionals who can provide their expertise. It is important to discuss changes regularly and plan how to manage these practically. It may also be difficult to come terms with how the condition is changing and it often helps to discuss this with a nurse.
Support the specilaist nurse can offer:
- Offer advice and information about MND
- Review symptoms on a regular basis
- Advise on symptom managment
- Liaise with your GP and consultant regarding treatments and medications
- Liaise with other healthcare professionals who may be able to help you
- Co-ordinate your care
- Act as a single point of contact
Occupational therapist
Occupational therapists work with people to maintain their independance as much as possible. They can advise on providing aids, equipment or adaptations within the home to help manage your symptom. If you are finding difficulty performing a specific everyday task the occupational therapist will assess how best to manage this
Support the occupational therapist can offer:
- Assess your individual needs and review them as needed
- Assess how everyday taks can be done differently
- Advise on managing activities around the house
- Advise on bathing and dressing difficulties
- Provide aids and equipment
- Help with work related issues
Social worker
As your needs change you may find it is more difficult to manage well at home or within the work environment. Social workers can help with issues around housing, care, work related issues and benefits
Support the social worker can offer:
- Assessing needs together with the rest of the team
- Liaising with other agencies, home care and support staff
- Organising a package of support, care and resources
- Helping patients to adjust and adapt to a changed lifestyle
- Helping people find alternative accomodation
Respiratory physiotherapist
One of the symptoms of MND is weakness of the breathing muscles and it may be useful to know if changes are occuring early and this can be identified by performing breathing tests. The respiratory physiotherapist can help by offering information and advice on all issues regarding breathing and secretion managment.
Support the respiratory physiotherapist can offer:
- Advise on breathing exercises
- Advise on secretion managment
- Advise on using ventilators
- Discuss all issues regarding breahting difficulties
- Perform breathing tests
- Review your symptoms regularly
Respiratory specialist nurse
If changes in breathing mean you start to feel unwell it may be helpfulto manage symtpms by using a ventilator (NIV). the respiratory specialist nurse can advise whether this is apporpriate and if so the typpe of machine which may be best for you to use.
Support the respiratory specialist nurse can offer:
- Assess whether a ventilator is needed
- Help you to manage using a ventilator
- Review your symptoms regularly
See link to MNDA information sheet Understanding how MND might affect your breathing
Local branch of the Motor Neurone Disease Association
The local branch is there to offer you, your family, friends and carers help and advice in lving with MND
Support the group can offer
- Social outings and meetings
- Practical help and advice
- Liaise with the MND team to co-odinate care
The Motor Neurone Disease Association
The MNDA is the only charity which supports people with MND. It aim is to ensure that people affected by MND receive the care and support they need and want. The MNDA also provides and support research into a cause and cure
Support the MNDA can offer:
- Provide specific pieces of equipment
- Can provide informationon all aspects of MND
- Provide local support
- Provide volounteer visitors
- Is sometimes able to loan equipment
- Is sometimes able to provide financial help.
- Fund research into treatments.
- MND connect - Helpline