Patients with ALS are constantly coping with changes in their physical condition. They may express fears about loss of control, loss of self-image, or loss of independence or express feelings of stigmatization, abandonment, or isolation. Having to give up the ability to function independently in a task can result in feelings of loss and grief. The nursing goal is to help the patient adapt with a sense of acceptance. If patients don't adapt, they may experience a sense of powerlessness.
Psychological distress is nine times more likely to hasten the disease.
The difficult process of losing independence can lead patients to behave in demanding ways, which in turn can provoke resentment in their families. Sometimes family members may feel powerless, which can lead to guilt and can result in overprotectiveness. This behavior can result in the patient's feeling even more helpless. The nurse can help patients maintain whatever control they do have by frequently assessing their physical status. Continued monitoring of the patient's physical status should be done by both the nurse and multidisciplinary team.