Disease Management

In-Home Care for Someone with ALS

ALS (Amyotrophic Lateral Sclerosis) also known as “Lou Gehrig’s Disease” is a neuromuscular disease which begins as muscle weakness and then slowly progress into total and complete paralysis throughout the entire body.  

The Allegiance Difference

Allegiance Home Health can assist you in managing and preventing many of the symptoms of ALS.  This is most often done with a multidisciplinary approach.  Some of the disciplines involved are Physical Therapy, Skilled Nursing, Occupational Therapy, Speech Therapy and Home Health Aide.  Our professional team will develop a personalized plan of care that is aimed at keeping our patients as mobile and as comfortable as possible in their home.

ALS patients utilize nursing and therapies to help in several ways:

  • Preventing muscle loss and weakness
  • Improving mobility and use of mobility devices
  • Pain management
  • Preventing pressure sores
  • Maintaining speech communication skills

Physical therapy is an essential part of supportive therapy for ALS sufferers.  Due to the progressive nature of the disease that results in increasing muscle weakness, physical therapy should be implemented as soon as possible to assist the client in maintaining independence in their home. There are several exercises, which can help with muscle strength and movement.  A physical therapist can also recommend exercises and stretching techniques to decrease muscle cramps, stiffness and contractures. The physical therapists will determine when braces or orthotics are needed for stability.   They will also recommend devices or tools to maximize your independence.  The therapist also provides training on the application or use of braces, orthotics or other medical devices.  The therapist will perform a home safety assessment of your home environment and provide recommendations including home modifications to minimize or eliminate any hazards in your home.

Skilled Nursing will instruct on medications and pain management strategies. Skin breakdown is another area of concern for someone with ALS.  Skilled Nursing will treat pressure sores (wounds) and assess the skin for other pressure areas and provide strategies to prevent skin breakdown.   Because of the progressive muscles weakness, the respiratory system is also affected.  Some of the interventions used are instruction of breathing exercises and the use of incentive spirometer to increase lung expansion and ease shortness of breath.  As the diseases progresses medical devices may be used to aid breathing.  Another problem related to effects of ALS is constipation.  This is as a result of progressive inability of trunk muscles to support normal posture to assist in defecation and slower bowel motility.
Nursing will instruct on sources of dietary fiber and other strategies to prevent constipation

Speech therapy will help maintain your communication.  The Speech therapist provides training on strategies that will assist you with communicating your needs to your family and significant others.
If speech is lost and you have no use of upper extremities, speech therapy will explore and recommend alternative methods of communication. Speech therapy will train on use of devices used for speech.   Because ALS affects the chewing and gag, cough and swallowing reflexes it places the person at risk for impaired nutritional status and aspiration.  Speech therapy will assess and monitor chewing, gag, cough and swallowing reflexes.  The Speech Therapist will educate on techniques for protecting the airway during meal time.

Our caring Home Health Aides can assist with other Activities of Daily Living such as ambulation, bathing, dressing, grooming, meal preparation, and assist with eating.  The Home Health Aide can also assist with Passive Range of Motion exercises as instructed by Physical Therapist or RN. 

About ALS or Lou Gehrig’s Disease

The cause of ALS is still unknown but a there is a higher incidence among people who have been exposed to agricultural chemicals and solvents. Individuals with ALS produce an excessive amount of a neurotransmitter called glutamate that clogs the synapse nerve cells preventing the transmission of neural impulses.  This clogging of the synapses causes death of these nerve cells resulting in muscle atrophy (shrinking) specifically to nerve cells in the brain and spinal cord that control voluntary movement.  The motor nerves that are attached to muscles gradually degenerate and die from lack of receiving nerve impulses and as a result of this nerve death, the muscles atrophy and waste away.   

Symptoms of ALS may include:

  • Tripping
  •  Stumbling and falling
  •  Loss of muscle control and strength in hands and arms
  •  Difficulty speaking
  •  Swallowing and/or breathing
  •  Chronic fatigue,
  •  Muscle twitching and/or cramping
  •  Drooling

The most common path of the disease is to weaken either the arms or legs.   ALS is not generally painful but some of the effects may be such as pressure sores, muscle cramps, joint contractions, constipation, burning eyes, swelling feet and muscle aches.

Let Us Help You Live Life Your Way

Living with ALS does not mean you cannot enjoy life.  Our team of skilled professionals of nurses, physical therapists, speech therapists and home health aides will develop with you a personalized plan of care that will assist you in achieving and maintaining maximum independence in the comfort of your home.  Our caring private duty staff will assist you with personal care such as bathing, dressing, meal preparation, eating and transferring. They will also assist you with maintaining your social activities whether it is taking you to the movies, out to lunch or shopping.

An ALS diagnosis effects the entire family. Call Allegiance Home Health and Rehab today to learn how we can treat the disease and care for you and your loved ones.