The Intersection of Ventilator Support and Hospice in Late ALS Diagnosis

Authors

• J. Marco Cipriaso, MD, Thomas Jefferson University HospitalFollow
• Kenna Hawes, MD, Thomas Jefferson University HospitalFollow
• Margot Noyelle, MD, Thomas Jefferson University HospitalFollow
• Megan Cecchine, MD, Thomas Jefferson University HospitalFollow

Abstract

Amyotrophic lateral sclerosis (ALS) often leads to respiratory failure that can be treated with respiratory support in the form of tracheostomy plus invasive mechanical ventilation. It typically occurs late in the disease course, often allowing patients to adequately prepare by discussing their goals of care. We describe a case of a patient whose ALS was diagnosed after he had TMV initiated. As a result, the patient and family faced a daily decision on when to withdraw ventilator support, and he was unable to achieve his ultimate wish to die at home. We highlight this to recognize that serious illnesses with variable presentations can make end-of-life preparations difficult.

Recommended Citation

Cipriaso, MD, J. Marco; Hawes, MD, Kenna; Noyelle, MD, Margot; and Cecchine, MD, Megan (2026) "The Intersection of Ventilator Support and Hospice in Late ALS Diagnosis," The Medicine Forum: Vol. 27, Article 32.
Available at: https://jdc.jefferson.edu/tmf/vol27/iss1/32