My mom has had MSA for 10 years. She's been in a nursing home for 4 years. It's the worst nightmare I could ever imagine. She is still fully aware and alert. She cannot move. She cannot eat. She lost her vocal ability 2 years ago. She can't write because she can't move her arms. The worst is sitting with her and not hearing her talk. We use a letter board. I don't know how she hasn't given up. She is my hero and inspiration.