Abstract
[Purpose] The purpose of this study was to consider how professional staff should support ALS patients in the process of decision making about the use of mechanical ventilation. We made a case analysis focusing on changes in the way of thinking of a patient resulting from interaction with family members and professional staff. [Methods] To gather data concerning the patient's feelings and interaction with others, the author visited the patient's home regularly and interviewed the patient, members of her family and professional support staff. [Results] There was a perceptual difference regarding the use of mechanical ventilation between the patient's family and professional staff. This gap was due to different points of view, with the patient and her family focusing on the current situation and professional staff on future developments. Differences due to information gaps could be rather easily resolved, while those due to a divergent sense of values were not easily dealt with. [Conclusion] Professional staff should take account of both types of differences when providing support. Besides giving accurate information, they need to encourage communication among family members including the patient in order to help them reach a consensus as a family.
