title: Experiences of dying, death and bereavement in motor neurone disease: a qualitative study.
abstract: OBJECTIVE
  to explore the experiences of people with Motor Neurone Disease (MND), current and bereaved carers in the final stages of the disease and bereavement period.
  
  
  METHODS
  a qualitative study using narrative interviews was used to elicit accounts from 24 people with MND and 18 current family carers and 10 former family carers.
  
  
  RESULTS
  the needs of patients and carers are not being adequately met in the final stages of MND and there appears a need for increased, co-ordinated support from palliative care services. The use of advance care planning tools is regarded as beneficial for patients and carers, but health professionals demonstrate a limited understanding of them. Anxiety and distress in patients, carers and bereaved carers is heightened during this period. Carer burden is excessive and may exacerbate patient distress and desire for hastening death.
  
  
  CONCLUSIONS
  this study has identified a number of issues people with MND and their carers face in the final stages of the illness, indicating some ways in which health, social and palliative care services could be improved or co-operate more effectively in order to better meet their needs.
authors.affiliation: Preston MND Care and Research Centre, Royal Preston Hospital, Preston, UK. bridget.whitehead@edgehill.ac.uk
authors.forename: Bridget
authors.initials: B
authors.lastname: Whitehead
authors.forename: Mary R
authors.initials: MR
authors.lastname: O'Brien
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Jack
authors.forename: Douglas
authors.initials: D
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D032722:Advance Care Planning / Q000592:standards; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000592:standards; D005065:Euthanasia / Q000523:psychology; D005260:Female; D005678:G(M2) Ganglioside / Q000031:analogs & derivatives; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000523:psychology* / Q000628:therapy; D010353:Patient Education as Topic / Q000592:standards; D036301:Qualitative Research; D013315:Stress, Psychological / Q000209:etiology; D013727:Terminal Care / Q000592:standards*
chemical_list: D005678:G(M2) Ganglioside; C064051:NGM-1