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This paper explores the progression of motor neurone disease (MND) in order to outline the complex needs and care requirements with respect to symptoms, suffering, grief and loss, and the potential for early referral to palliative care to ameliorate the impact of the disease. MND is a neurological disorder affecting motor neurones and the muscles under voluntary control, leading to deteriorating function of mobility, swallowing, speech and respiration. The person with MND has to constantly adapt to multiple losses and increasing paralysis, which affects them emotionally, physically, psychologically and spiritually. Ultimately they will die from respiratory failure. Palliative care can provide symptom management, comfort and care to the person, their carers and family, and help to ameliorate the distress and impact of a devastating illness. Their multidisciplinary team is able to provide holistic care and resources that can enhance the quality of life and assist with grief and loss as well as provide bereavement support for those affected. [ABSTRACT FROM AUTHOR]