Stage 5. The Late Stage of Multiple System Atrophy
In the final stage of Multiple System Atrophy, managing the symptoms becomes exceptionally challenging. This stage represents the most severe progression of the disease, where patients are typically fully dependent on caregivers for their daily care. The continuation of earlier symptoms combined with the emergence of new ones requires comprehensive and attentive care.
In stage five, patients with MSA often need help with all aspects of daily living. The severe loss of mobility and substantial physical constraints mean that patients are likely to need full-time assistance with tasks such as moving, bathing, dressing, and eating.
The extreme stiffness and rigidity that were once just hindrances may now leave the patient virtually immobilized. Some patients might also experience contractures – a condition where the muscles stiffen and shorten, limiting range of motion and causing discomfort or even pain.
The complete dependency on others can take a psychological toll on patients. They may struggle with feelings of loss, not just of their physical abilities, but also of their autonomy and self-sufficiency.
Offering psychological support, such as counselling or therapy, can be instrumental in helping patients cope during this difficult stage. It’s also important for caregivers to take care of their mental well-being, as the demands of caregiving can be emotionally taxing.
Autonomic dysfunction, which involves the disruption of bodily functions that are usually automatic, becomes extremely severe in the late stage of MSA. This dysfunction can lead to a variety of issues, from significant fluctuations in blood pressure to problems with body temperature regulation.
One of the most common manifestations of severe autonomic dysfunction is orthostatic hypotension, a form of low blood pressure that happens upon standing. It can cause dizziness, fainting, and falls, posing a significant risk to patient safety. Management strategies often involve lifestyle modifications, such as elevating the head of the bed and rising slowly, combined with medication to raise blood pressure levels. (5)
