Hello to all who have asked: What is End Stage MS or what are the stages of advanced MS, what is advanced MS, or what are the signs and symptoms of advanced MS, how do you know when a person is nearing the end of their life due to MS?   I am sorry to hear you have to be asking this question, but to help yourself and loved one, I do hope that you will look at the link below and print off that brochure and really read it and take the actions you need to help your loved one. It is not easy to face this and the information may be upsetting to you.    http://www.nationalmssociety.org/about-multiple-sclerosis/living-with-advanced-ms/index.aspx   On this page, please find the document listed below the main article and video, called "Advanced MS: a guide for families" . Print it off and refer to it often as things change.    Make sure you, the family, and all caregivers, and even doctors are aware of the signs. Make sure you and caregivers know when you need to call the Doctor or 911, and when to get more care, "palliative" or "hospice" care (both are end of life care to make the loved one comfortable and pain free). You may want to learn how to use a stethascope to monitor breathing problems   for those in the UK, there is a similar link: http://www.mssociety.org.uk/downloads/MS_Essentials_16_Support_for_people_severely_affected_by_MS_-_web.8df5f599.pdf   Read both, as each one has important info.   to read more about Palliative care:   http://www.mssociety.org.uk/about_ms/care_and_support/support_for_people_severely_affected_by_ms/palliative_care.html   signs: in addition to all the typical MS symptoms of stiffness and being bed or wheelchair bound, what makes it end stage is new or worsening problems with Breathing, Swallowing, talking, worsening bladder and bowel problems, having a permanent catheter, pain patches such as morphine or fentanyl patch, disoriented, lack of focus, crying out in the night, not sleeping through the night, needing more and more from you because they are uncomfortable, such a drink, repositioning, more pain medication. Changes in mental attitude, worsening depression...   You may be seeing these things now. Don't ignore it. You can help by seeking "palliative care" which means care that makes the person more comfortable and pain free. This is also what "hospice care" means. It's all you can really do for advanced MS, even if no one is calling it "end stage".  It could be weeks or months or tomorrow.