There are a number of ALS clinics across Canada that treat ALS through a team approach. In other communities, the same healthcare professionals are available as individuals or through homecare community programs. A variety of medical personnel can help you to cope with the limitations that the disease places upon you.

You can ask your primary doctor for referrals to these healthcare professionals if a specific problem needs to be addressed.

It is important that all of your primary caregivers meet with members of your healthcare team in order to be trained in the various helping techniques.

Your doctor's tasks may include the following:

• Explaining the diagnosis and possible progression of ALS;
• Making necessary referrals to, and mediating with, other healthcare providers.

Your doctor will refer you to a neurologist, a specialist in diseases of the nervous system who can confirm a diagnosis of ALS. Between them they will:

• outline types of treatment options available;
• encourage the setting of short-term goals;
• help you preserve a positive self and body image and maintain your morale;
• facilitate problem-solving by identifying specific needs and concerns and finding solutions.

A nurse clinician generally formulates nursing goals after analyzing assessment data, then draws up and implements a care plan. Other nursing functions may include the following:

• explaining terminology and techniques;
• teaching skills and providing demonstrations;
• evaluating skill levels and reviewing procedures;
• addressing questions and concerns;
• ensuring the comfort of people living with ALS;
• encouraging and promoting decision-making by the people with ALS and their families;
• liaising with community organizations;
• making referrals;
• limiting the development of complications;
• providing nursing interventions if problems arise.

The occupational therapist (OT) and the physical therapist/physiotherapist (PT) formulate management strategies that enable people with ALS to continue to carry out work and leisure activities in a safe and efficient manner. This is accomplished through the following:

• teaching;
• ongoing assessment/evaluation;
• ordering appropriate equipment in a timely manner;
• prevention of complications;
• utilization of community resources;
• provision of psychological support.

The OT is generally more concerned with fine-motor control and the application of movement to function. The OT's tasks may include the following:

• assessing fine-motor functional abilities (for example, hand use);
• evaluating positioning and seating requirements;
• assisting in choosing and accessing suitable augmentative mobility and communications strategies and any required assistive devices;
• giving instruction concerning exercise, positioning, correct body mechanics for lifting and transferring, and use of assistive devices to the person with ALS, family members, and caregivers;
• teaching energy conservation and time management techniques;
• making a home assessment.

The PT is generally more concerned with gross-motor function and anatomical impairments associated with abnormal movement. The PT's tasks may include the following:

• providing a detailed analysis of abnormal movement (for example, gait analysis);
• optimizing the person's strength, function, and comfort;
• designing and monitoring a therapeutic exercise regimen when appropriate;
• assisting with respiratory management;
• providing training in energy conservation and time management techniques;
• preventing needless purchases of unsuitable equipment;
• making a home assessment.

The physiatrist generally evaluates the extent of disability and functioning, and gauges the level of residual muscle function. On the basis of these findings, treatment plans may be designed. Other functions may include:

• recommending preventative and supportive treatment;
• preventing complications;
• determining which diagnostic tests are necessary;
• helping maintain maximum function;
• consulting with therapists concerning orthoses and equipment.