Home: Specialty Centres: Rehabilitation Centre: Services & Clinics: Amyotrophic Lateral Sclerosis (ALS) Clinic

ALS Clinic

What Is ALS?

ALS - Amyotrophic lateral sclerosis, also called motor neuron disease or Lou Gehrig's disease - is a disease of the motor neurons in the spinal cord and lower brain which control the voluntary muscles of the body. As these motor neurons die, muscle power is progressively lost. The muscles affected and the order in which they are affected varies from one person to another. For some people with ALS, the muscles in the hands, shoulders and feet are the first to show weakness; for others, it is the muscles which control speech and swallowing. As the disease progresses, leg, arm trunk and breathing muscles become involved.

ALS affects six to seven people out of every 100,000. It is not a rare disease. The cause is unknown and there is no cure. However, with good management, a patient with ALS can be supported to maintain a good quality of life and retain control of decisions affecting his/her care.

Which Services Are Provided By The ALS Team?

The interdisciplinary team works with patient and caregivers to maintain the best possible level of function in all aspects of living. The team operates in multiple areas of function:

Mobility including walking, transfers, positioning, driving and related issues of environmental accessibility;
Self-care including personal care, activities of daily living and home-making;
Psychosocial status including emotional health and spiritual well-being;
Communication including both speaking and writing;
Nutrition including healthy eating and special needs;
Breathing including assessment and monitoring of lung functions and lung hygiene, as well as respiratory support.

In addition, caregiver needs and resources are supported and options for future care are discussed.

Central to care is ongoing monitoring of risk for change. ALS is a progressive, often rapidly progressive disease. It is essential to predict change, rather than assess change as it happens. Using an interactive risk tool, team members, together with each patient, anticipate change and intervene before a crisis occurs. With timely use of adaptive devices, strategies to prevent complications, education and environmental modifications, a patient can maintain good quality of life living with ALS.

Who are the members of the ALS team?

The core interdisciplinary team includes:

Physiatrist
Physical Therapist
Speech-Language Pathologist
Clinical Dietitian
Respiratory Therapist
Nurse Coordinator
Occupational Therapist
Social Worker
Chaplain

The core team works closely with other disciplines and agencies including:

Medical specialists
Orthotist
Psychologist
Rehabilitation engineer
ALS Society
Community Care Access Centre
Community palliative care programs

How are patients referred to the ALS Clinic?

The family physician or neurologist must refer patients who have never been seen at The Rehabilitation Centre, or who have not been seen in the previous twelve months.
The team's physiatrist assesses each patient.
Team assessment then follows, with priority given to the problems that the patient wants to address first.

Champlain District ALS Integrated Care Pathway (ICP)

An integrated care pathway (ICP) is a multidisciplinary outline of anticipated care. The ALS Integrated Care Pathway for the Champlain District tool presents an overview of the progression of ALS and identifies potential problems that might arise for the client and caregiver as the disease advances. It also offers a list of local resources which can be accessed to support clients with ALS at different stages of the disease. This anticipatory approach to care benefits clients and families by serving as a planning guide for service providers in securing appropriate resources and supports.

Links to ALS Web sites

ALS Society of Canada www.als.ca
ALS Society of Ontario www.alsont.ca