Problems of patients with amyotrophic lateral sclerosis treated in an inpatient hospice: analysis of three clinical cases

Sclerosis lateralis amyotrophica (SLA) is a progressive and incurable neurodegenerative disorder leading to degeneration of motor neurons. In most cases, the disease begins with muscle atrophy and limb weakness. As the condition progresses, bulbar symptoms and dyspnea related to respiratory failure may develop. Sclerosis lateralis amyotrophica typically results in death within 3–5 years of diagnosis. Due to its progressive course, symptomatic treatment provided by palliative care services constitutes an essential component of care for patients in advanced stages of the disease. This analysis included clinical cases of patients admitted to an inpatient hospice in 2023 with a diagnosis of SLA (n = 3). Disease severity was assessed using the Polish version of the Sclerosis Lateralis Amyotrophica Functional Rating Scale-Revised (SLAFRS-R). The cases were analyzed and presented descriptively. All patients were male, with a mean age of 62 years. The average duration of hospice stay was 125 days. The mean SLAFRS-R score declined from 26.7 at admission to 9.7 at the end of hospice care. Two patients required transfer to hospital due to acute clinical deterioration (n = 2), while one patient died in the hospice as a result of progressive respiratory failure (n = 1). The findings indicate that the end-of-life course in SLA is highly variable. During this period, symptom burden increases and functional decline accelerates. Advance care planning should be an integral part of SLA management, as early decisions regar­ding emergency interventions help ensure care consistent with the patient’s preferences.