ABSTRACT
This study is aimed at reviewing both the rehabilitative program and the role of the home visit physician regarding ALS patients living at home. Seven ALS patients were chosen as subjects for this study. Two of these patients required a mechanical ventilation system and nutritional support such as gastrostomy or central venous infusion, and all patients were found to be totally dependent on their physical care for activities of daily living. Although home visit rehabilitation services were planned for 5 of the patients, it was found that the individual rehabilitation needs of each patient differed depending on the progression of the ALS or the patient's impairment, the level of care that can be given, public support system usage, and the patient's acceptance of their ALS. Cooperation between family members and multidisciplinary care members was essential for effective daily management of the medical and rehabilitation needs of these patients. The home visit physician should provide appropriate care from the viewpoint of the patient's life, based on the decisions of the patient and their family.