STAGES OF PROGRESSIVE SUPRANUCLEAR PALSY( PSP)
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 communicating, which can take a toll on them emotionally. Common symptoms of the advanced stage are: Motor Symptoms people may experience:
• Frequent falls
• Limited walking, especially without assistance
• Rigidity in neck, torso and limbs, which can be uncomfortable and make movement difficult Visual symptoms people may experience:
• Difficulty focusing on nearby objects because of eye movement issues
• Involuntary eyelid closure and difficulty opening them Speech and swallowing symptoms people may experience:
• Significantly slow, soft and slurred speech
• Increased difficulty with swallowing food and liquids 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, including multiple wakings at night to use the bathroom
• Possible bowel incontinence Impact on daily living:
• Assistance is required for most or all activities Treatment, care or resources people can utilize:
• 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
• Speech therapy for recommendations on devices and strategies that can help with communication
• At this stage, home health therapy may be more convenient than participating in outpatient physical, occupational and speech therapy
• 24-hour care may be required; if circumstances permit, this can be supplemented with professional caregivers, 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