Falls
To avoid head injuries when falling, it is better to drop straight down, and not fall forward or backward. The best way to get up from a fall depends on what muscles you can still use. If you still have enough arm and hand strength, you can hold on to something firm, such as furniture, for example and pull yourself up and into a chair.

When you have fallen, the most important thing to do is to get help to sit in an upright position. The level of assistance needed will depend on the level of muscle weakness. You may need only some support while rising. Or you may need to be lifted from behind until you can push against the ground with your legs. Or you will need two people to assist you into a chair or wheelchair. It is important that caregivers not strain themselves, but make you comfortable until enough help is available. Ask your therapist to teach you and your caregivers the best method of recovering from falls.

Joint Pain
If you are unable to move yourself, you may spend too long in one position. This can be very uncomfortable for both the skin and the joints. Arrange for your helper to change your position every couple of hours throughout the day and to turn you at night. Some people with ALS improve their comfort in bed by using a sheepskin, egg crate foam, a satin bottom sheet or a vibrating air mattress. Your nurse or therapist can discuss the options with you and help you to decide what to try.

If you experience joint pain, discuss this with a doctor or physiotherapist.

Canes and Walkers
Most ALS patients will require a cane or walker sooner or later. The choice of a cane or walker should be made in consultation with your doctor and physiotherapist.

Orthotic Devices
Orthotic devices are aids that are attached to your body. They help to support your joints in certain positions when your muscles no longer can. Your doctor usually prescribes such devices, and your therapist will fit and instruct you in proper use of the aid.

Wheelchairs
Many people with ALS will find themselves in need of a wheelchair at some time. Some will use it only for long excursions outside the home, some for activities only and some people will spend most of their day in a wheelchair.

The decision about when to acquire a wheelchair is one that you will make with your doctor. If you always need another person to help you to rise from a chair, or if you stumble and fall a lot, or if you are fatigued when you walk a distance, a wheelchair could be useful. No one is eager to use a wheelchair and this is natural, but a wheelchair should be viewed as an opportunity to increase your independence and your ability to get around. It will also help you to conserve your energy.

All your caregivers should be instructed in safe and effective transferring techniques by professional healthcare providers as soon as possible. It is important that proper body mechanics be taught to decrease the risk of injury to both you and your caregiver.

If you have problems walking, or are in a wheelchair, telephone ahead to find out what accessible facilities are available. Some places are very accessible to the disabled, others are not. Be very specific about what your needs are – “accessible” means different things to different people.

Air Travel
Most airports provide wheelchairs that you can take to and from the plane. Make sure that the airline knows in advance that you require a wheelchair. If you need to be accompanied by an attendant, and have the appropriate document signed by a doctor, some airlines let an accompanying attendant fly at half-price. Airlines also provide other services for the disabled including special meals. When inquiring about reservations, it is also a good idea to make sure that the airline can accommodate your disability requirements.

As your mobility becomes more of a problem for family and other caregivers, please access the ALS Society nearest you. We are here to provide support and resources.