The nurse is educating the family of a patient in the late stages of amyotrophic lateral sclerosis (ALS). Which information is most important for the nurse to include?

A. ALS primarily affects motor neurons, leading to muscle weakness and paralysis, but cognitive and mental functions usually remain intact. This is important for family understanding and care planning. B. The ability to swallow is often impaired in late stages due to muscle weakness. C. Breathing is affected as respiratory muscles weaken, which is a critical concern in ALS progression. D. Both upper and lower limb movements are typically affected as the disease advances, but cognitive status is a key point to clarify with families.