Challenges for a Nurse while Treating an ALS Patient

Amyotrophic Lateral Sclerosis (ALS) is a fatal disease. The cure of such an ailment has not been found yet. But the patient who suffers from such a disease knows from the beginning that he/she is going to die eventually. In such a situation they become often reluctant to live and fight on further. Consistent deterioration contributes to worsen the situation. When a patient suffers from this severe neuromuscular disorder, his family and loved ones suffer along with him as well. It is when a nurse has to take up the job of not only looking after the patient, but actually to lend the shoulder of support as well.

ALS is a neuromuscular disorder that results in degeneration of upper and lower motor neuron, resulting in muscular dis-balance. And the organs become limp with time. A patient and his family will need only supportive care that will help them to cope up with the situation somehow.

The patients become immobile gradually. In such cases, they should be looked after with special care by the nurse or the hospice staff who is well educated and trained to treat such cases. The nurse should concentrate on dealing with several problems separately. Here is a list of what a nurse can expect to come her way.


Communication is the bridge between two persons. It is the only way that helps us make ourselves understood by others. But as a disastrous outcome of ALS, the patient loses his ability to communicate. Though it is not a life threatening problem, yet it affects a patient emotionally - surely a frightening as well as frustrating condition. The nurse has to ensure that the patient never fails to communicate even if he loses the power to speak. Though the problem cannot be solved by medication, however, technology and a little patience can be of great help. Equipment to help such patients are widely available in the market.

  • If the breathing trouble is restraining to talk properly, there are equipment that will enhance a whisper to a fairly audible speech.

  • If paralysis of muscles prevents them to talk, they can take the help of electronic devices that are movable by hand, foot, and even eye sensor.

  • If every measure fails, the nurse or the caregiver can arrange a board or a multiple diagram in front of the patient’s eyes, so that he can point it out with eye movement or eye brow.

Respiratory Care

Since ALS is a neuromuscular disease, it causes dysfunctions in the muscles that help them to breath normally. As a result, patients of ALS often suffer from respiratory problems. While treating the patients of ALS, the nurse must have heard them complaining about the room being too stuffy and lack of air to breath properly. Especially when they wake up in the morning, they feel worse. Since in sleep, any normal person’s breathing becomes shallow. It is worse for ALS patients.

To help in such cases, as a nurse you need to do the following things,

  • Look out for breath shortness and gag reflex, chest expansion and swallowing rate.

  • Patients of ALS often fails to cough to clear their airway. It indicates their high need of support in the respiration system.

  • As the nurse, you need to assess what kind of support will help your patient.

  • To maintain a clear airway, you decide what your patient needs to use. It can be medication or oxygen.

  • To help the patient breath properly, you need to help him sit up or reposition him on the bed.


The patient faces problems in eating solid food during the advanced stages of ALS. The dysfunctions in the muscles prevent them from chewing and swallowing their food. That is why they often need external support of a feeding tube to eat.

But when an ALS patient suffers from respiratory problem, it becomes difficult for him to place the feeding tube, as it will result in obstacle. That is why a nurse should detect the appropriate time to insert the tube. That will help the patient to intake solid and liquid food. Due to shallow breathing and weight loss, the stomach changes its position and shifts nearer to the rib cage. That makes inserting the tube difficult. So, a nurse needs to take care and assess it properly.


  • ALS patients often suffer from problems of bowels. It is upon the nurse’s judgment how much medication, diet, fluid and laxatives are needed to make the process easier and less painful for the patient.

  • ALS patients suffer from excess salivation and drooling. It happens because of the obstruction to swallow. It also causes embarrassment too. And a nurse has to be attentive while the patient needs help.

  • Depression is another huge problem with ALS patients. As they realize that their life is doomed, they stop fighting. And that makes their life more miserable. What they need in such a situation is the support from the person who takes care of them. Being a nurse, it is your duty to support the patients emotionally, so that they can fight on.

A nurse’s job is different from that of any doctor. Doctors take care of the medication. But a nurse takes the full responsibility of a patient’s wellbeing. It’s needless to say that the job requires tremendous patience as well as expertise. Register in an institution where you can learn how to treat such cases with special care.

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