What are the 4 Stages for PSP?

What are the 4 Stages for PSP?

It has been said there are four stages, but because there is so little research they are a guideline only.

Many people experience some stage four symptoms at stage one or overlap stages. Some never experience certain symptoms and then others can experience ones not listed. The impact it has on each individual varies dramatically.

 

Progressive Supranuclear Palsy (PSP) is a rare neurodegenerative disorder that affects movement, balance, vision, speech, and cognitive function. The disease progresses slowly over time, and its symptoms typically become more severe as the disease advances. While not everyone with PSP experiences the same symptoms or progression, there are generally four recognized stages of PSP:

  1. Early stage: In the early stage of PSP, individuals may experience symptoms such as difficulty with balance and coordination, changes in gait, and problems with eye movement. These symptoms may be subtle and easily dismissed as normal aging or a different condition.

  2. Mid-stage: In the mid-stage of PSP, symptoms become more pronounced and can include falls, speech and swallowing difficulties, and cognitive impairment such as problems with memory and executive function. Depression and apathy are also common.

  3. Advanced stage: In the advanced stage of PSP, individuals may become wheelchair-bound and require assistance with daily activities such as eating, dressing, and bathing. Symptoms such as rigidity, spasticity, and involuntary movements become more severe.

  4. End-of-life stage: In the end-of-life stage of PSP, individuals may be bedridden and require around-the-clock care. They may have difficulty swallowing, become more susceptible to infections, and experience other complications related to the progression of the disease.

It's important to note that not everyone with PSP will experience all of these stages, and the progression of the disease can vary widely from person to person. Additionally, some individuals may experience rapid progression, while others may experience a slower course of the disease.

 

Here is the four stages below in more detail;

 

Early stage:
May present via the fracture clinic, falls services, eye specialist or speech and language therapist. The early stage typically spans years 0-1.

> Ambulant.
> Occasional falls.
> Unsteadiness and poor balance.
> Possible visual problems affecting ability to read.
> Voice changes, for example reduced volume.
> Mood changes.
> Reduced socializing.
> Changes in mood and behavior, including apathy and anxiety.

Mid stage:
Many people reach this stage before diagnosis. Consider discussing advance care planning and advance decisions to refuse treatment. Consider referral to palliative care services. The mid stage typically spans years 2-3.

> Ambulant with aids.
> High risk of falls and injury.
> Visual problems affecting self-care abilities, for example eating and walking as unable to move eyes to see.
> Speech increasingly unintelligible.
> Inability to initiate conversation.
> Impulsivity (risky or impulsive behavior).
> Apathy.
> Dysphagia.
> High level of supervision required.
> Increasingly socially withdrawn.

Advanced stage:
Patients should be on GP palliative care register and have access to specialist palliative care.
The advanced stage typically spans years 3-6.

> Mobility significantly compromised, probably chair bound requiring a wheelchair for mobility.
> Significant visual problems.
> Significant muscle stiffness.
> Significant communication problems, but probably still able to understand.
> High risk of aspiration and pneumonia as a result of dysphagia.
> Pain.
> Increasing periods of sleepiness.
> Incontinence.
> Severely withdrawn socially.
> Dependent for most or all aspects of care.

End of life stage:
This stage is difficult to detect, but may be indicated by reduced levels of consciousness, inability to eat or drink, acute infection, a fall or major fracture, and rapid and significant weight loss. The end of life stage typically spans 6-8 weeks.

> Severe impairments and disabilities.
> Rapid and marked deterioration in condition.
> Decisions with regard to treatment interventions may be required, considering an individual’s previously expressed wishes (advance decisions to refuse treatment).

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PSP Decals Progressive Supranuclear Palsy
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79 comments

May father Was PSP patient last 3 year but this time is bad wridden any help and suggestion in this matter he was completely bad rest and no conssiousness

PANKAJBHAI JIVRAJBHAI PATEL

I have been care giver for ML for 18 months . She was diagnosed with PSP about 4 years ago. My friend seems to be progressing rather slowly. She walks with assistance , she is independent with meals, however she does have bouts of slight choking which is cleared independently. I assist with bathing and dressing. ML has a good sense of humour and likes to laugh. She rides her stationary bike and likes to go out in the community. ML has a slight gaze however no difficulty with speech other than decreased volume at times. ML had stem cell treatment in June of 2023 which has definitely benefited her. Some symptoms seem sporadic ie, dragging her left foot. We take things one day at a time.

Karen

Our best friend has been diagnosed with PSP. It seems to be progressing rapidly…onset of symptoms happened shortly after recent injections. My sister in law is helping him get Emergency SSI Disability. She is licensed in NC & TN. It’s a crappy Gov system but it’s all there is. At least she has access to the system to help people faster than they can on their own. She gets funded by Social Security, not you. Look her up & reach out if you need help.

Rinker Disability Law
423-839-0025
Her name is Dana—- tell her her sister in law Kate mentioned her.

Praying for all involved——this is a horrid disease.

Kate Neely

My brother in law has been diagnosed with PsP , he is 61. His speech is slurred and he is bed ridden now. He has been going through this for about 2 years. He had to stop working over 1 year ago and is still waiting to be approved for disability. The system is broke , it is terrible my sister is having to spend the last years of her husbands life fighting on the phone with disability and lawyers. Please any help. We are in NC.

Donna

My brother in law has been dia

Donna

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