caregiver with older man with ALS

The Stages of ALS

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Amyotrophic Lateral Sclerosis, Also Referred to as Lou Gehrig’s Disease or Motor Neuron Disease

It is important to note that although there are broad, general stages of ALS, individuals progress through the stages of ALS in different ways and in different timeframes. A person can move very quickly through the stages, or have frequent plateaus and progress slowly, or any combination thereof.

Early Stages

  • Symptoms may be limited to a single region of the body
  • Mild symptoms may affect more than one region
  • For some people, the muscles for speaking, swallowing or breathing are the first to be affected

Muscles characterized by:

  • Weak and soft or stiff, tight and spastic
  • Cramping and twitching
  • Atrophy (loss of muscle mass)

Possible symptoms:

  • Fatigue
  • Poor balance
  • Slurred words
  • Weak grip
  • Tripping when walking

Middle Stages

  • Some muscles are paralyzed, while others are weakened or unaffected
  • Symptoms become more widespread
  • Twitching may continue

Muscles characterized by:

  • Muscles characterized by: contractures from unused muscles—joints become rigid, painful and may become deformed

Possible symptoms:

  • Difficulty standing on one’s own
  • Difficulty eating and swallowing—causing choking
  • Finding it hard to breathe, especially when lying down
  • Some people in this stage experience bouts of uncontrolled and inappropriate laughing or crying called the pseudobulbar affect (PBA)

Late Stages

  • The person with ALS is unable to care for his or her own needs
  • Speech may no longer be possible
  • Eating and drinking by mouth aren’t possible

Muscles characterized by:

  • Paralyzation of most voluntary muscles
  • A severe compromise in the ability to move air in and out of the lungs, causing fatigue, fuzzy thinking, headaches and susceptibility to pneumonia
  • Severely limited mobility

The person’s needs and the role of the caregiver will change as the disease progresses. Discuss any questions you may have about care requirements and options with a physician.

CareWorks Health Services is skilled at caring for individuals with ALS, allowing them to remain safe and comfortable in their own homes throughout the stages of the disease. We can also guide families through the stages of care and recommend assistive devices for each stage. Contact us at (949) 876-5529 to learn more about our in-home care services.