Multiple Sclerosis is a chronic, disabling and progressive neurodegenerative disease that affects the brain and the spinal cord. It is characterized as an autoimmune, inflammatory and demyelinating of the brain and spinal cord with progressive loss of neurons and axons. The National Multiple Sclerosis Society describes the disease as “…an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and the body”. It is not curable but there are some treatments available to provide comfort and quality of life.
The disease requires ongoing care and assistance in daily living. The average life expectancy is between 5 to 10 years lower than people who do not have MS. The progressive course of MS and the related functional damage significantly affects the person’s daily activities, autonomy and quality of life. Women are twice as likely to develop MS and it is more common in people of northern European descent. It affects people between the ages of 20 to 50 years and the average age at onset is 34.
(NOTE: Interested in learning more about Neurodegenerative Disorders? Checkout my Neurodegenerative Disorders on CEU Academy and try a FREE CEU today!)
Symptoms of Multiple Sclerosis
Symptoms of Multiple Sclerosis include pain that affects the muscles, nerves and joints. Spasms, stiffness, and muscle cramps are common. Tremors and sensory changes are also part of the clinical manifestations of this disease. Other problems that arise as the disease progresses include bowel and bladder incontinence, UTIs, and constipation. Difficulty swallowing and chewing become problematic. Speech difficulties eventually emerge. Problems with thinking, memory, anger, depression, mood swings, and anxiety are also common. If the individual is bedbound or restricted to a wheelchair, pressure sores are a risk.
Special Care Issues in Late Stage Multiple Sclerosis
Numerous services may be required to provide care and services to the individual with multiple sclerosis and can range from skilled nursing care to social services, assistance with daily activities, childcare, and rehabilitation services. Care can be delivered in a number of settings including at home, in the hospital, nursing homes, assisted living communities, and hospices. Early palliative care will eventually transition into the need for hospice care.
Effective palliative care can increase quality of life and appropriate hospice care can actually increase life expectancy in many cases. Pain and symptom management can be provided by skilled hospice professionals. Pain is something that does need special and ongoing attention because it will be a part of the clinical picture. There will also be a myriad of psychological and psychiatric issues to address. The issues of death and dying will eventually need to be addressed. Support will be necessary for both the individual and their family. Care will be delivered by a multidisciplinary team consisting of the physician, nurses, nursing assistants, social workers and case managers, OT, PT and speech therapists, dieticians, psychologists and psychiatrists and chaplains.
End Stage Multiple Sclerosis
At the end of the disease, palliative care will transition into hospice care, because the needs of the patient and family will be different. Hospice will be more prepared to take care of symptoms including fatigue, walking problems, bowel and bladder disturbances, changes in brain function, vision problems, pain, depression, anxiety, and mood swings. Hospice can help with these symptoms and assist in the anticipation and planning for issues and decisions that will arise as MS progresses to the point of death.
Honoring the individual’s wishes will become important. The patient and family will suffer and hospice will be uniquely able to handle these problems. Swallowing and eating will become problematic, as will communication, pain, spasms, respiratory function, infections, aspiration pneumonia, and falls. Suicide may be an issue that requires attention, as some individuals choose to take their lives rather than face the eventual decline that is so common with multiple sclerosis.
Final Words on Managing Multiple Sclerosis in Senior Care
I travel around speaking about this and that. I enjoy speaking. I love to be in front of people. It’s my jam. But, it does sadden me when I present topics like multiple sclerosis, Parkinson’s, Huntington’s, ALS, HIV, and other neurodegenerative diseases because there is no cure and the progression of these diseases is long and cruel. I hope that people diagnosed with these disorders receive the best care possible. I pray they receive palliative care until they require hospice. I also pray that hospice will deliver the most caring, sensitive and clinically superior care these people deserve and require.
(NOTE: Interested in learning more about Neurodegenerative Disorders? Checkout my Neurodegenerative Disorders on CEU Academy and try a FREE CEU today!)