Resilience and coping strategies in ALS patients and caregivers

The experience of living with amyotrophic lateral sclerosis (ALS) necessitates adaptation by the person living with ALS (PALS) and their caregiver. In the face of an incurable illness, many PALS and their caregivers report a significant decline in their physical and psychosocial-spiritual health, whereas others endure the illness with great fortitude and demonstrate positive adjustment and wellbeing. This heterogeneity in adjustment has led researchers to conjecture about why or how some people maintain their quality of life while others do not. Psychosocial processes that facilitate adjustment to ALS are coping and a variety of resilience factors including hope, optimism, social problem solving, spirituality and religiosity, and social support and relationship satisfaction. Therapeutic interventions that may foster resilience and coping in PALS and their caregivers include communication, dignity therapy, Buddhist psychology and mindfulness, social problem-solving therapy, constructivist grief therapy, and quality of life therapy (QOLT).