STAGES OF CORTICOBASAL DEGENERATION( CBD)
Advanced Stage
At this stage in the disease, individuals are no longer able to complete most or any daily activities on their own. Those with the disease need close supervision and are at higher risk of complications like big falls or infections. People in this stage often have a much more difficult time performing daily activities and communicating, which can take a toll on them emotionally. Common symptoms of the advanced stage are:
Motor Symptoms people may experience:
• Symptoms may start on the other side of the body not originally affected
• Frequent falls
• Limited walking, especially without assistance
• Loss of ability to perform manual tasks
• Muscle tightness and stiffness affecting multiple areas including neck and torso
• Involuntary jerking movements Speech and swallowing symptoms people may experience:
• Significantly softer and slurred speech, difficulty with articulation
• Increased difficulty with swallowing food and liquids, which can lead to choking Non-motor symptoms people may experience:
• Decreased ability to easily participate in conversations because of difficulties with voice and expressing words and organizing thoughts
• Urinary incontinence Impact on daily living:
• Assistance is required for most or all activities Treatment, care or resources people can utilize:
• At this stage, home health therapy may be more convenient than participating in outpatient physical, occupational and speech therapy
• Possible benefit from oral medications or botulinum toxin( Botox) injections to help with symptoms, such as muscle stiffness
• Working with physical and / or occupational therapy for adaptations to the home environment to support safety and daily functioning, such as toileting devices, lifts and adding foam to corners
• 24-hour care may be required; if circumstances permit, this can be supplemented with professional caregivers, or moving to an assisted living or skilled nursing facility; respite time is important for the well-being of care partners
• Close monitoring of swallowing function is important due to risk of choking and aspiration and likely need for changes to the consistency of food; it might be helpful to do another swallow evaluation to further understand the current level of swallowing function
• Make future healthcare decisions before they need to be made, such as designating a power of attorney and deciding on advanced directives like a do not resuscitate( DNR) order or a living will