How ALS Affects the Hierarchy of Needs

How ALS Affects the Hierarchy of Needs
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I’ve written before about how the world has been shrinking for my husband, Todd, and me. Some activities, such as going on vacation or visiting people in their homes, became too difficult, even before social distancing mandates, due to Todd’s worsening ALS symptoms.

But we still made an effort to get out. We went on family outings to hockey games. We went to church, where my daughter and I led preschool music every week. Todd went out to Applebee’s with his friends. I went to the gym every day. I was part of a local ukulele group that met once a week, and went caroling at a nursing home last Christmas.

Since March, all of those activities have come to an end, and our world is even smaller.

It’s hard to be stuck at home, because I’m an extrovert. I miss getting energized by being around others, but at the same time, I feel a sense of relief. I have been exhausted trying to maintain a sense of normalcy, getting out for activities while being a caregiver. Todd’s needs are extensive.

Todd has no sense of relief that he doesn’t get out anymore. He feels a sense of loss, like when he couldn’t squeeze a mustard bottle anymore. He has always wanted to maintain independence for as long as he could, because he felt as soon as he couldn’t do something, he would never do it again. He has come to expect gradual losses, but in March, there was a sudden loss to his social life. And now, even if life in our country returns to normal, he fears he won’t ever do those things again.

Psychologist Abraham Maslow laid out a hierarchy of needs model that starts with the most basic. The gist of his theory is that people’s basic needs take priority, and until those are met, folks aren’t able to pursue other needs to help them grow and reach their potential.

Basic needs are things like food, water, warmth, rest, safety, and security. I spend much of my day meeting those basic needs for our family by preparing meals and maintaining our home. I’d also add breathing and pain management to that list. Some days, Todd requires a lot of assistance from me to meet those needs, such as helping him clear his lungs.

I spend time addressing our kids’ growth beyond the basics — their school work, creative activities, social interactions, and opportunities to try different activities. I am “Taxi Mom,” so they can connect with friends and participate in extracurricular activities. Todd and I work to provide an encouraging home environment for them.

It has become increasingly difficult for Todd and me to meet needs beyond the basics. Maslow’s model recognizes that life experiences sometimes force people back to focusing on just meeting the basic needs.

And with that comes a sense of having life cut short, of us lacking the opportunity to grow. We piqued many of those other growth areas before ALS, so we feel the loss. Todd and I have our family, but our social connections are limited. He feels the loss of no longer having a sense of purpose through his work. I have a loss of sense of security with his health being so precarious.

Some days, we are caught in the minutiae of basic survival.

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Note: ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of ALS News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to ALS.

Kristin Neva is an author, mother of two, and caregiver for her husband, Todd, who was diagnosed with ALS in 2010 when he was 39 years old. Knowing they would need family support, they moved to Upper Michigan and built an accessible home on property next to Kristin’s childhood home. Kristin enjoys spending time outdoors, especially on the shore of Lake Superior in the summer. Todd no longer has use of his limbs, but he stays active working on projects on his computer using adaptive technology. They try to find joy in the midst of sorrow as Todd’s health declines.
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Kristin Neva is an author, mother of two, and caregiver for her husband, Todd, who was diagnosed with ALS in 2010 when he was 39 years old. Knowing they would need family support, they moved to Upper Michigan and built an accessible home on property next to Kristin’s childhood home. Kristin enjoys spending time outdoors, especially on the shore of Lake Superior in the summer. Todd no longer has use of his limbs, but he stays active working on projects on his computer using adaptive technology. They try to find joy in the midst of sorrow as Todd’s health declines.

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One comment

  1. Anne says:

    Kristen and Todd,
    Your love and courage and grit are blessings to those of us who live and have lived this struggle. But to quote you and not a behavioral science genius, you endure—- how? “Let’s just call it love.” Prayers that something so beautiful happens to your family today that you want to put it in a frame. 🙏❤️😘😀

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