Article Text

The psychological distress of a man with end-stage MND
  1. Helen Scott, Staff Nurse
  1. Inpatient unit, St Christopher’s Hospice, London. Email: hscott{at}


This article examines the assessment and management of the seemingly intractable psychological distress experienced by John, a 59-year-old man with motor neurone disease (MND), who was admitted to a hospice in the last 2 months of his life. The management of John’s psychological distress presented many challenges for the multidisciplinary team. This article will provide a critical analysis of the assessment process and the care given with the aim of influencing the future management of patients with MND admitted to similar care environments. Although MND is a relatively rare condition it is hoped that the principles of managing intractable psychological distress will help inform the nursing care of patients at the end of life with similar psychological symptoms. For the purposes of confidentiality, pseudonyms have been used regarding both the patient and his family. The patient had died by the time of writing. Therefore, permission to access his medical records was requested from, and granted by, the ward manager (Nursing and Midwifery Council, 2004).

  • Depression
  • End of life
  • Motor neurone disease
  • Nursing role
  • Psychological distress

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