Multiple sclerosis (MS) is a chronic, frequently debilitating neurologic disease that affects young adults in the prime of their lives. Until recently, treatment focused on symptom management rather than on disease modification. Patients’ contacts with the health care system were limited to the diagnostic period, episodes of acute attacks, and periods of disease progression.
With the advent of disease-modifying agents, the focus of care in MS has changed from one of maintenance and crisis intervention to a more positive and proactive approach. The nurse working in the field of MS has emerged as an important member of the health care team, playing a vital role in the ongoing care of and interaction with patients and their families. Nursing care in MS is a collaborative effort whose goal is self-awareness and self-responsibility; its activities involve supporting a great deal of self-care by patients, families, and care partners.
The nurse working with MS patients is a care provider, facilitator, advocate, educator, counselor, and innovator. The challenges of the disease require many creative interventions in a wide variety of settings. The list of care needs is long and complex. Interventions range from instruction in the use of medications, both oral and injectable, to bowel and bladder management strategies, to the improvement of mobility. The dynamic nature of the disease, along with its psychosocial, economic, and physical implications, calls for ongoing skill development and up-to-date information on the part of the nurse interested in MS care.