Letters Living and dying with COPD

What happens in neurological disease

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d994 (Published 15 February 2011) Cite this as: BMJ 2011;342:d994
  1. Peter Foley, neurology registrar1
  1. 1Western General Hospital, Edinburgh EH4 2XU, UK
  1. peterfoley{at}nhs.net

Pinnock and colleagues highlight the difficulty, and often inappropriateness, of trying to identify a transition point to palliative care in non-malignant disease.1

Many patients seen in neurology services with non-malignant disease have incurable disease, and progression of illness may be associated (as in Parkinson’s disease or multiple sclerosis) with impairment of cognition. This added consideration can complicate discussions on any change in emphasis of care.

In the preterminal phase, supportive multidisciplinary management of the patient and family (or carers) in the clinic, and a “palliative care” approach, can overlap considerably. For these reasons, ongoing evaluation of the patient’s needs may be more appropriate than a sharp transition in care.


Cite this as: BMJ 2011;342:d994


  • Competing interests: None declared.


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