This book explores the palliative care needs of people with advanced amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease and related disorders, and assesses the impact of a new specialist palliative care service (SPCS) A mixed methods approach was adopted: - a qualitative needs assessment using in-depth interviews with patients and their family carers and focus groups of professionals involved in the care of this population. - a quantitative pilot-explorative randomized and controlled trial (RCT) to assess the impact of a new SPCS designed to meet the palliative care needs of the study population - using a waiting list methodology comparing the immediate provision of SPCS with standard care This research confirms the high prevalence of physical symptoms, psychosocial issues and spiritual themes for people severely affected by advanced neurodegenerative disorders and that these can be helped by specialist palliative care. The input of a SPCS caused a significant improvement of the individual quality of life of the patients and improved symptom control for pain, breathlessness, quality of sleep and intestinal symptoms compared to standard best care alone.