Why is it advantageous to arrange for assistive devices through a specialized ALS center?
In ALS, very complex, rare, and costly assistive devices may be used. Certain assistive devices (e.g., orthoses) require custom manufacturing and fitting.
Expertise regarding the possibilities, new developments, medical needs, and limitations of available assistive devices is primarily found in specialized ALS centers, which in turn collaborate with ALS care networks.
It should not be underestimated that, when it comes to assistive devices (not just medications), further developments (new forms of complex electric wheelchair care and communication systems) as well as the introduction of new categories of assistive devices (such as arm robots and meal-preparation robots) must also be taken into account.
“Updates” to existing assistive devices and the introduction of new ones are preferably carried out at ALS centers. Years of experience in providing assistive devices is an important prerequisite for individualized, targeted, and effective assistive device provision.
When making decisions regarding assistive device provision, it is important to consider not only what is “technically feasible,” but also the social context and the individual course of the disease. Specialized neurologists on an ALS team have the experience to develop a proactive assistive device plan that anticipates the individual course of the disease (and the expected motor deficits).
In addition to their expertise regarding assistive device options and their individualized assessment of the course of the disease, ALS centers have significant experience with the application process for assistive devices. Specialized outpatient clinics ensure that there is appropriate medical justification and that cost-effectiveness (which is of crucial importance to health insurance companies) is taken into account.
From the perspective of the health insurance companies conducting the reviews, care provided at an ALS outpatient clinic is also helpful, as specialized medical care is expected to involve a high level of expertise in decision-making.