Reason for Services
What condition was Carrie diagnosed with?
Bulbar onset Amyotrophic Lateral Sclerosis (ALS).
What did Carrie do before retiring?
She retired early to help care for her grandchildren.
Where does Carrie live?
In a two-story home in a rural area with her husband.
What motor skills are most impacted by bulbar ALS?
Facial, jaw, and throat muscle control.
What is Carrie’s primary communication goal?
Maintain clear communication with her husband using a communication board.
What were Carrie’s initial symptoms?
Slurred speech, difficulty chewing, and swallowing.
What hobbies does Carrie enjoy?
Cycling, hiking, camping, and reading.
What accessibility challenge exists in Carrie’s home?
Master bedroom and bathroom are on the second floor.
What communication challenges does Carrie experience?
Slurred, strained speech and difficulty being understood.
What is a critical safety goal for Carrie?
Safely consume meals without choking.
What speech characteristics have changed for Carrie?
Hoarse, strained voice with difficulty forming words.
Why is communication critical to Carrie’s quality of life?
It enables her to maintain relationships and social activities.
Who is Carrie’s primary caregiver?
Her husband.
How does Carrie's impaired chewing affect her nutrition?
She may eat less due to fatigue or choking risks.
What emotional goal is important for Carrie?
Maintain social connections despite speech changes.
Why is safe swallowing a critical therapy focus?
To prevent aspiration and ensure adequate nutrition.
How might Carrie’s prior independence impact her rehab goals?
She may struggle emotionally with reliance on others for communication.
What family support is nearby?
Her daughter and son-in-law live five minutes away.
What adaptive strategy can help Carrie communicate?
Use of a communication board or voice amplifier.
What adaptive device may support Carrie’s communication?
Speech-generating device (SGD).
What is a major safety risk associated with bulbar ALS?
Choking due to impaired swallowing and reduced airway protection.
How can her interest in soap operas support therapy?
They can be used for language exercises and social interaction practice.
Why is clear communication with her husband important?
It reduces frustration and supports emotional connection.
How can therapy support her remaining abilities?
Energy conservation, safe swallowing techniques, and caregiver education.
Why is proactive planning important for Carrie’s future care?
ALS is progressive, and future changes in function are expected.