Multiple sclerosis (MS) is a progressive disease of the nervous system. It can cause a wide variety of symptoms, which may continue or worsen as the disease progresses. The most common symptoms include fatigue, walking difficulties, bowel and bladder disturbances, vision problems, changes in brain function, changes in sexual function, pain and depression or mood swings.
With diseases such as MS, for which there currently is no cure, palliative care expertise can help in all stages of the illness. A palliative approach offers help with symptoms, and help in anticipating and planning for issues and decisions that are likely to come up as the disease progresses. This ensures that a person’s wishes will be met at any stage of the disease. At the end-stage of MS, people commonly face some particular challenges.
The choice of where to care for someone with advanced MS depends on each person’s needs and available resources. Options may include home, hospice, personal care or nursing home, palliative care unit, or hospital. Where there are community-based resources, then care at home is often preferred by most patients and families. At times, the support needed may require care in a long-term facility. In such settings the person with MS may be far younger than other residents and have greater mental capacities. This can challenge the facility’s program resources, and can affect a person’s quality of life. A palliative care facility or hospice may be preferable at the end of life, if the person meets the criteria for these resources.