Coping with deterioration over years - multiple sclerosis

Abstract

Multiple sclerosis presents with a wide range of physical, mental and psychiatric symptoms. It is also a major cause of disability globally. Studies have demonstrated that patients living with MS often experience physical, mental, social, and spiritual suffering which significantly impacts their health and quality of life. Palliative care can help provide patients with relief from suffering by reducing pain and discomfort, providing emotional support, improving functional ability and quality of life, as well as addressing end-of-life and legacy issues. It is often unclear to physicians, and patients what elements of palliative care should be provided and when. One reason for this is the uncertainty that surrounds the progression of the disease, the wide range of symptoms, and the prognosis of the patient. As a result, patients are often poorly prepared to cope with the impact of new symptoms, disabilities, or loss of function. While little can be done about the uncertainty of MS, the adoption of a care model where palliative care is introduced early and provided alongside neurological care can help patients cope with the suffering experienced with MS. Specific triggers to intensify palliative care can be arranged while EDSS milestones can be used to revise the palliative care plan. Early introduction of palliative care can also allow physicians to gain a better sense of the patient's priorities and care preferences, which is important for the development of a care plan that allows them to achieve their goals, reduce suffering, and improve quality of life over the years.