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End of life: Wishes, values and symptoms, and their impact on quality of life and well-being 

End of life: Wishes, values and symptoms, and their impact on quality of life and well-being
Chapter:
End of life: Wishes, values and symptoms, and their impact on quality of life and well-being
Author(s):

David Oliver

DOI:
10.1093/med/9780198757726.003.0013
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date: 24 February 2020

The holistic assessment of the patient with ALS and their family will help to maximize the care as the disease progresses and the end of life approaches. This includes consideration of advance care planning, so that the person’s wishes are known if they lose capacity or communication late in the disease course. Discussion of ventilatory support, either by non-invasive ventilation or tracheostomy ventilation, is particularly important so that decisions are not made in a crisis situation. Although ventilatory support may improve quality of life (QoL) and length of survival, there may be increased dependency and continued disease progression. The recognition of the later stages of disease progression can allow further discussion and anticipation and preparation for end of life care—for patient, family, and professions—so that QoL is maximized until death.

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