Neurological disorders other than dementia
The significance of a palliative care approach for patients with neurological disorders other than dementia is increasingly recognized. Whereas the care for these patients, for example, those with amyotrophic lateral sclerosis (ALS) or motor neuron disease, had been incorporated in the initial concept by Dame Cicely Saunders, recent scientific evidence supports this position. The need for palliative care in these patients is underpinned by their frequent wish for hastening death. This chapter describes palliative care approaches for a number of neurological disorders other than dementia. For ALS, palliative care management including specific issues such as respiratory insufficiency or malnutrition are fairly well established. Also, in parkinsonian syndromes, a lot of palliative care needs can be recognized and managed effectively. For patients with multiple sclerosis, the first randomized controlled trial showed clearly positive effects on symptoms as well as usage of health-care resources. The chapter also summarizes the drug use for specific symptom management, accounting for alternative application routes.