ALS (Amyotrophic Lateral Sclerosis/Lou Gehrig’s Disease) is a progressive
neuromuscular disease. It attacks motor neurons in the brain and spinal
cord which transmit signals to the voluntary muscles throughout the body.
When motor neurons die as a result of ALS, the ability of the brain to
control muscle movement is lost. Weakness spreads to all the voluntary
muscles and progresses to paralysis.
ALS does not affect sensory nerves so there is no loss of feeling in the
paralyzed areas. ALS only affects motor pathways in the brain so awareness,
thought and intelligence are not generally affected even after paralysis
makes it impossible for the patient to communicate.
ALS is a disease that has no cure and no medical treatment beyond supportive
care. Therefore the focus is on providing nursing care that helps the
patient and family cope with the ever increasing disability and deteriorating
breathing, maximizes communication, maintains comfort, and prevents further
complications of immobility.
The Progression of ALS
Most people with ALS experience their first weakness or spasticity in an
arm or leg. These symptoms usually progress and may soon involve the other
arm or leg. What is ALS weakness like to deal with? At first, the problems
will be fairly simple to manage. When the person with ALS first gets a
diagnosis, he will likely still be able to walk and use his arms and hands.
However, he may experience fatigue, loss of balance, and have difficulty
using his hands or trip when walking.
In this early stage of ALS, safety needs, around the house and outside
the home, are important. Slippery floors, scatter rugs and other hazards
should be eliminated, both at home and at work. A cane may provide stability
when weakness is mild. A brace that supports the foot and ankle can keep
a dragging foot from interfering with walking. He may need to use a wheelchair
for especially tiring excursions, such as going to a mall.
As weakness progresses, over several months or possibly years, a wheelchair
may become necessary most or all of the time. Many people with ALS say
the wheelchair is, at this stage, a welcome relief from the constant strain
of walking with weakened muscles and the fear of falling. The wheelchair
can be thought of as preserving, not decreasing, a persons mobility
As arm strength and hand muscles weaken as ALS progresses, other assistance
may be needed. Hand and wrist splints and specially adapted eating and
writing utensils can be helpful and can be obtained through your hospitals
physical or occupational therapy department or through specialty catalogs
or medical supply outlets.
Sometimes (in about a quarter of those with the disease), ALS starts in
the mouth and throat muscles, rather than in the limbs or trunk. In these
cases, the main problems are difficulty speaking, either in forming words
with the lips and tongue or producing sound from the vocal cords, or both.
There may be difficulty with chewing and swallowing food, posing a choking hazard.
No matter what part of the body is first affected by ALS, the disease eventually
involves the entire body, including the muscles involved in speech, swallowing
and breathing. What is ALS like in the final stages of the disease? In
the late stages of ALS, the affected person is totally paralyzed, and
providing care at home is multifaceted and demanding.
Download the What is ALS? PDF from Qualicare Franchise Corporation