[BIPAP-mask-ventilation in terminal amyotrophic lateral sclerosis (ALS)].

Amyotrophic lateral sclerosis (ALS) is a progressive, neuromuscular disease without any curative therapy at the moment. Non-invasive BIPAP-ventilation has proven to be helpful to cope with the increasing hypoventilation due to weakness in ventilatory muscles in ALS. If BIPAP-ventilation is well tolerated by the patient, it can be very helpful for symptom control in palliative homecare. In this case presentation we discuss how non-invasive ventilation can influence perception of dying at home and thereby quality of life of patients, caregivers and members of palliative teams. We will see that especially during this sensible terminal phase various questions and fears concerning the mechanically assisted ventilation may arise. These issues should be addressed in advance with careful attention and information. Members of palliative teams should therefore be provided with good training and regular supervision.