- The client/caregiver can define amyotrophic lateral sclerosis or Lou Gehrig disease.
- It is a motor neuron disease affecting nerves of brain and/or spinal cord with progressive degeneration.
- Death frequently occurs from respiratory failure in 2 to 5 years.
- The onset of the disease usually occurs in middle age.
- The client/caregiver can list signs and symptoms of disease.
- Muscle weakness and atrophy
- Cramping
- Incoordination of hand and fingers
- Slurred speech
- Loss of reflexes
- Difficulty swallowing
- Fatigue
- Spasticity of muscles
- The client/caregiver can list measures to promote independence and maintain muscle strength.
- Participate in physical and occupational therapy as ordered.
- Plan activities with rest periods to avoid overexertion.
- Use adaptive devices to promote independence in activities of daily living.
- Use assistive devices to promote mobility (i.e., wheelchair, lift chair, and walker).
- The client/caregiver can list measures to meet nutritional needs due to difficulty swallowing.
- Adjust diet consistency as needed.
- Use a high-calorie, high-protein diet.
- Allow ample time for eating.
- Sit in upright position to eat, and do not lie down after eating.
- Discuss use of feeding tube when unable to take food by mouth.
- Keep suction equipment nearby.
- Weigh weekly.
- The client/caregiver can list measures to promote communications.
- Speech therapy
- Communication boards or alternative methods of communication
- Cognitive abilities are not altered.
- Encourage client to participate in plan of care and urge expressing feeling to condition.
- Encourage client to plan for future, such as advance directives, living will, and hospice.
- The client/caregiver can list measures to avoid complications.
- Avoid people with upper-respiratory infections to prevent infection.
- Provide good skin care and positioning to prevent breakdown.
- Provide good oral care.
- The client/caregiver can state possible complications.
- Respiratory infection
- Respiratory failure
- Use of mechanical ventilation
- Injury
- Aspiration pneumonia
Resources
ALS Associationwww.alsa.org
National Institute of Neurological Disorders and Strokewww.ninds.nih.gov/disorders/amyotrophiclateralsclerosis
Support groups for client and caregiver
Agencies for help in provision of home care
Sources of financial assistance
Counseling
References
Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.Cohen, B. J., & Taylor, J. J. (2005). Memmler’s the human body in health and disease (10th ed.). Philadelphia: Lippincott Williams & Wilkins.Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Credits
Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com