Declining neurological and cognitive functions
predispose patients to choking, aspiration,
and falls. Patients with BT are at high risk for skin
breakdown related to functional defi cits, immobility,
and weight gain secondary to steroid use
[ 13 ]. Patients may present with delayed wound
healing and/or wound infection as a result of steroid
treatment. With disease progression, leptomeningeal
disease, or spinal metastases, patients
may develop a neurogenic bowel and bladder and
become incontinent of urine and stool.