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In my work as a visiting nurse in Ontario I was always especially touched by the Multiple Sclerosis (MS) clients I met. Usually when I met folks with MS they were in advanced stages of the disease and needed help to stay at home with their families. Since MS typically strikes young adults as they begin families and careers they have unique challenges trying to live with MS and at the same time cope with family responsibilities.
What is Multiple Sclerosis (MS)?
When it comes to understanding, preventing and treating chronic diseases, MS ranks among the most challenging. The word ?multiple? is apt in more ways than one.
MS is a chronic disease affecting the brain and spinal cord which make up the central nervous system (CNS). In the CNS a substance called myelin covers and protects the nerves. Myelin also helps to send messages between the brain and spinal cord and other parts of the body. In MS inflammation damages the myelin and also over time the nerves are damaged. The damage causes scarring called sclerosis. The scarring blocks the ability of the nerves to send messages.
People with MS experience one of four disease courses ? relapsing remitting, primary progressive, secondary progressive and progressive relapsing. Each can be mild, moderate or severe.
How common is MS?
MS is the most common cause of disability affecting the brain and spinal cord in young adults. The disease affects over 2.5 million people around the world. It is most common among people living in colder climates, urban areas and those of higher socioeconomic groups. It is twice as common in women as it is in men. It most often strikes people aged 20 to 40. MS is particularly common in temperate climates. Canada has one of the highest rates of MS in the world.
Signs and Symptoms
Since MS affects the Central Nervous System the symptoms are many and they vary.
- Blurred or double vision
- Burning sensation, feeling of ?pins and needles?, numbness in arms or legs
- Weakness, difficulty walking, loss of balance, trembling, inability to move limbs
- Bladder problems ? urgent need to urinate, incontinence, bladder infections
- Bowel problems ?constipation, incontinence
- Fatigue ? exhaustion at any time of the day
- Difficulty swallowing
- Difficulty speaking
- Mood swings
- Inability to control emotions
Treatment
Many healthcare professionals are involved in the treatment of MS. There is no cure for MS but there are goals for treatment. The treatment goals are to: shorten length of time symptoms last; reduce the damage done to the client?s functioning as a result of severe reappearance of symptoms. Many treatments are available ? like drugs, physical and occupational therapy, exercise and rest ? that can ease symptoms and delay the disease?s progression. Medication and other treatment measures help to slow down the disease progress or help to manage the symptoms. Rarely do any two patients respond in the same way to a given therapy. Trial and error is the name of the game, experts say, because it is often not possible to know in advance what will work best for individual patients.
Safety
Safety is a major concern for MS patients. The signs and symptoms of MS make it more likely that accidents, such as a fall or burn, can happen.
When caring for those with MS who remain in their own home some considerations are:
-????????? How difficult is it for the patient to use the stairs?
-????????? Are there hazards that pose risk for falls? Loose rugs? Uneven floors?
-????????? Is the lighting sufficient?
-????????? Is there an easy exit for emergencies?
-????????? Is there clutter that could cause tripping?
-????????? Are there handrails present?
-????????? Is the client safe when bathing?
-????????? Is it safe for the patient to do the cooking?
A full environmental and fall risk assessment should be done by the health care organization providing service. This will ensure preventative measures are in place to minimize risk.
There are health care organizations and MS support groups in most communities and they can provide supportive information and direction for resources. If you or your loved one would like to access more resources on MS contact the following:
MS Society of Canada at 416-922-6065 or email at www.mssociety.ca
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