At a late stage of the Huntington’s disease the patient loses the ability to drive. Generally a person values his capability to drive as a sign of competence that helps him to remain independent. Loss of driving ability comes as a blow to the patient.
Smoking can become a problem. Due to personality changes and boredom may cause the patient to become an excessive smoker. Due to difficulty in judgment and impairment of voluntary movements, the act of smoking may become unsafe for the patient. There may be a need to establish a smoking schedule and other safety measures such as avoiding smoking in bed and in rooms with rugs from safety point of view.
Sleep disturbance is a usual complaint of the patient with this disease. This can be due to depression or mood disorder. If mood disorder is treated, this can improve sleep related problem. Patients who are inactive and have nothing to do have their sleep cycle disturbed and they take a nap most of the day and are wide awake in the night. It is necessary to maintain a sleeping schedule to be followed. The restlessness in their sleep is attributed to involuntary movement at night. The patient is unaware of such movements.
It creates disability in patients. Patient may have to seek retirement as the disease progresses. The actual difficulty is to do with organization, flexibility and mental information processing. But the patient may appear as careless, lazy and irritable at work. If the employer is informed about the nature of the problem, he can get some help at the work place. The individual may not show signs of disability but specific tests directed to identify the disease related defects may reveal this condition.
End of life issues need to be discussed with the patient and other members of the family before the patient loses his ability to communicate.
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