Meditation is a way to relax and revitalize both mind and body, and can be practised in many ways. Technically, meditation is deliberately entering into an inner silence and stillness for a certain period of time, usually fifteen to twenty minutes. It has been practised over the centuries by many different cultures and in many different ways. Referring to the results of researching meditation in his book The Relaxation Responses, (Avon Books, N.Y.), Dr. Herbert Benson writes that meditation creates an overall awareness of relaxation and a feeling of well-being. Breathing and heart rate slow down, blood pressure drops, and there is an increase of healing alpha waves from the brain. In other words, meditation can reduce stress, and relax muscles.

Meditation techniques can be divided into two categories. One type of meditation involves concentrating on something, such as your breathing, a candle flame, a crucifix, even rolling surf, while peacefully and silently repeating a mantra, a special word or sound. Any word that contributes to inner peacefulness can work. The other type of meditation also involves repeating a mantra, but the objective is to relax your mind entirely. When thoughts come into your mind, you try to relax, observe the thoughts and let them flow, without participating in the thought process. For most people, this takes practice.

Before starting to meditate it is usually best to let other people in your house know that you don't want to be disturbed for 20 minutes. Many meditation teachers suggest that, for the best results, meditation should be done twice a day, for about twenty minutes, with your eyes closed. When you think about 20 minutes is up, gently open your eyes and look at your watch. Two common problems for those new to meditation are being unable to relax as their minds are so full of thoughts and/or when they are finally relaxed, they fall asleep.

It takes daily practice and time to develop the ability to achieve a state of conscious relaxation. Sometimes quiet, peaceful music can help the mind calm down, but in later phases of meditation that may be too distracting.

There are several other techniques to help clear the mind, and achieve a state of relaxation, including music therapy and visualization therapy. Books on this subject can provide patients with knowledge of these techniques, instructions, exercises and many hours of quiet pleasure.

Because vitamins, herbs and other so-called complementary or alternative medicines have become so popular over the last few years, it is appropriate to say a few things about these potential remedies in the context of research. People with ALS can be particularly attracted to these remedies either because drug trials so far have been unsuccessful, or because of the perception that alternative medicines are natural.

While extensive research is done for pharmaceutical drugs, virtually no research has been done on alternative medicines with the exception of vitamins, which have been extensively researched. On the other hand many alternative medicines have been used by some cultures for hundreds and even thousands of years. Stories circulate about people who have been cured by these medicines. Also, it is well known that animal and plant by-products have provided the basis for many successful drugs. Unfortunately, the hundreds of millions of dollars required to thoroughly test pharmaceutical medicines are not available to test alternative medicines. Scientifically, very little is known about the effect of alternative medicines on the human body.

If you are considering alternative medicines, here are some points to keep in mind.

Medicines that come from nature are in fact drugs, and can be harmful, particularly in large doses. Different individuals have different tolerance levels for drugs, including so-called natural remedies. There are many products from nature that are in fact poisonous.

Alternative medicines are not regulated. The consumer is subject to domestic and foreign manufacturers who could dilute the strength, or change the composition of their products without disclosing this information on their labels.

If you want more information about these types of medicines, you should discuss your options with professionals such as your family doctor, pharmacist, and naturopathic and homeopathic doctors. Be careful: some people with ALS have been enticed by false claims into spending many thousands of dollars on alternative medicines and therapies.

Death is something most of us would prefer not to talk about. How we deal with death can be deeply affected by our cultural values. Some cultures view death as a welcomed spiritual transition. Others believe that death and rebirth are a continual process. During our lives, the cells in our bodies die at an ever-increasing rate, while at the same time our learning, intelligence and spiritual awareness can continue to grow.

As your physical activity decreases, you will have more time to think about and to become at peace with death.

Even though we may be uncomfortable talking about death, important and inevitable decisions will have to be made. It is best to discuss and plan for these decisions well before death is near.

Practical Planning
As ALS progresses, there are a lot of practical problems to deal with and arrangements to be made. At some point someone has to deal with financial changes, tax issues, insurance, a will and funeral arrangements, as well as distribution of assets and belongings. It is often difficult for a family to talk openly about these practical matters.

You can usually make it much easier for your family if you bring up these subjects, and see to it that appropriate planning and action are taken. Inadequate communication and planning of these practical concerns could force family members to make decisions without knowing your wishes, and could also cause unnecessary financial hardship.

Dying at Home
Most people with ALS would prefer to die in the peace of their own home. You should communicate this wish to your family while you are still able to do so. Factors that might not make dying at home possible include your family's financial or emotional inability to cope, caregiver burnout, respiratory problems or insufficient home care services. Remember, calling 911 will bring a medical team obligated to keep you alive, including artificial life support that you may not want. Some provinces may have a death at home policy which allows bypassing of calling 911. There will be forms to complete. Please check with your regional ALS Unit.

Instructions in a Power of Attorney and Living Will should help to ensure that you are treated according to your wishes.