The purpose of this article is to explore some of the considerations and options for individuals who are living with ALS.  ALS – Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease, is a progressive neurological condition that leads to gradual decline in strength, respiratory function, and functional mobility.

When looking at the needs for home adaptations for individuals with ALS, it is important to consider components of flexibility and adaptation with the design of the home environment.  Adaptability is important for varied levels of accommodation for the individual, and certain considerations can be accounted for to maintain the highest level of independence for the individual as well as the family and caregivers of an individual living with ALS.

Bathroom modifications – options available for care in the home:  Even with considering adaptations and long term care of the individual with ALS, there are still a wide variety of options available.  For the individual who is able to manage fairly independently and well – adaptations such as grab bars, tub lifts, or tub cutouts may be good options to promote independence and safety in the bathroom.  Adaptation of the bathroom for an individual who more progressed and requires more care, may not require a complete bathroom remodel (though the options of a barrier free shower, or accessible walk in tub provide great solutions).  Installation of a ceiling lift system can provide easier and safer transfers to and from the bed, and can extend into the bathroom to allow easy transfers for toileting and bathing in the tub, or on a tub bench.

Entry to the home, and managing stairs – when looking at stair management options for the individual with ALS it is generally ideal to consider which option would work best without requiring transfers to and from a wheelchair.  An alternative to stair lifts include options including: ramping (for home entry), vertical platform lifts (for home entry or as an inside lift), inclined platform lifts, and home elevator systems.  Having a home accessibility consultation to determine the best option is important, as any of the above options involve a significant investment.

Environmental controls – in the advanced stages of ALS, there are many options for maintaining control of one’s environment with environmental controls.  Options for environmental access and control of one’s environment can stem from wheelchair controls that are integrated into the wheelchair controls (through a joystick, head array, or other controller), or through other external environmental control systems.  Through the use of environmental controls individuals are able to access components such as: automatic door openers, motorized window treatments, light controls, ceiling fans, television, phone, computers and other electronic devices.  This is significant in providing control for the individual with ALS to maintain independence and control of their own environment.  Technology has continued to advance and allow great opportunities for environmental controls.

This article was written by Rob Horkheimer, MPT, CEAC, CAPS, ECHM – accessibility specialist and owner of BILD – Bridgeway Independent Living Designs, LLC. BILD provides accessible home remodeling, construction, and lift/elevator installations, as well as accessibility consultations. Visit BILD online at: BILD is a Milwaukee based accessibility company serving: Wisconsin, Illinois, and the greater Chicago area.