In-Home Care: Multiple Sclerosis (MS)

Posted in Articles, In-home Care: Diseases and Conditions on January 11th, 2010 | Comments Off

In-Home Care: Multiple Sclerosis (MS)

What is MS?

Multiple Sclerosis is one of the most common chronic neurological diseases, inflicting damage to the central nervous system, brain and spinal cord. 400,000 people are affected nationwide, and when viewed globally is somewhere above the 2.5 million mark. It could potentially strike any person of any age, but the onset is more likely to occur between ages 20 and 50. Genetics play a role in determining who gets the disease, but it’s not known to what extent. If someone has a sibling or parent with MS, chances are significantly higher that they will contract the disease. MS is more likely to develop in people who live in colder climates, and women are twice as likely as men to be diagnosed. While studies are still being conducted, it is not certain what is the specific cause of the disease. What is known is that it is a defect within a person’s immune system.

When a person has a functional immune system, certain infection fighting cells will attack foreign bodies to prevent illness. When MS develops, these cells begin to attack healthy nerve cells in the person’s body as through they were an infection. Nerve cells work in a chain-like fashion. When a person touches something hot, the nerves send a signal that travels from one nerve to the next all the way to the brain where the information is processed and returned to the nerves with instructions on how the body should react to this particular stimulus. MS is detrimental because it breaks the connections in the nerves, resulting in “faulty wiring”. Some people compare the effects of MS to a flickering light bulb due to bad circuitry. In the case of MS, the circuitry problem occurs because the infection fighting cells destroy the fatty layer that surrounds the nerve cells, called the myelin. This layer creates a buffer between each nerve cell, allowing for signals to be transmitted throughout the nervous system. With this layer destroyed, the signals are interrupted. This nerve loss is referred to as demyelination. People who loose this type of nerve function typically experience it in many locations throughout their central nervous system. This is the “multiple” part of the disease’s title. “Sclerosis” refers to the scar tissue that blocks messages and signals between nerves and muscles. Unfortunately at this time there is no cure, so treatment focuses on remission and stopping the attacks from occurring.

What are the symptoms of MS?

  • Visual: The Optic Nerve is a common area for inflation. Haziness, blurred vision, serious visual impairment are results. Visual symptoms often lessen or disappear after a period of weeks. Blindness in MS is rare.
  • Movement: Difficulty controlling the strength and precision of movements. Holding things is a problem and balance and coordination my be impaired (ataxia)
  • Sensory problems: Numbness, tingling and sensitivity to heat and cold
  • Bladder/Bowel function: Problems with control, urinary tract infections
  • Cognition issues: May cause problems with memory loss and concentration. Mood swings ranging from depression to euphoria are common. Affects 50% of patients with MS
  • Fatigue: Mild to severe fatigue and weakness

Additionally, patients may experience tremors and slurred speech as a result of blockages.

What type of care does a MS patient need?

Symptoms are different for the varying types of the disease, therefore care practices will depend on the patient’s condition. The three most common types are:

Relapsing Remitting MS: Clearly defined flare-ups (relapses) with some amount of recovery between. Affects 80% of MS patients.

Secondary Progressive MS: Flare-ups and remissions are quite common. More continuous loss of physical and cognitive functions takes over, flare-ups become less common. 50% of people with Relapsing Remitting MS develop this within 10 yrs of diagnosis.

Primary Progressive MS: No flare-ups, but over years there is gradual loss of physical and cognitive functions. 10% of MS patients have this.

Depending on the severity of the situation, a live-in caregiver may be needed. If no one in the patient’s family can do this, then one or more caregivers will need to be hired.

For people with MS, caregivers are very important because they can notice new symptoms or recognize when existing symptoms become worse. Several medications help to reduce the symptoms of MS, so a doctor visit is in order if a relapse has occurred. The caregiver should be sure to ask the doctor which medicines are best for the patient’s symptoms. Medical treatment should begin immediately upon diagnosis because this is when the medicines will benefit the patient the most. There will probably be several doctor trips, so it is a good idea for the caregiver to keep a medical log in order to keep events, lists of medicines taken and treatments in order. This should be brought to every doctor visit to ensure that the patient’s needs are being met.

Most medicines that treat MS must be injected. This can be daunting for both caregiver and patient, so treatments should be discussed with all involved. If the caregiver is not comfortable administering an injection or the patient is squeamish about needles, these problems need to be addressed to the doctor.

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