The multiple sclerosis (MS) team of caregivers generally consists of:
- Neurologists
- Neuropsychologists
- Nurses
- Social workers
- Psychologists
- Occupational therapists
- Physical therapists
- Vocational rehabilitation specialists
- Registered dietitians
- Speech-language pathologists
What is each team member’s role in managing my MS?
Neurologist
A neurologist is a medical specialist trained to evaluate problems of the nervous system, including the symptoms of MS. Neurologists have an in-depth understanding of the central nervous system and how it is affected by MS. Ideally, a neurologist is affiliated with an MS center, research facility, or a teaching hospital. A neurologist’s role in managing MS includes:
- Diagnosing MS
- Making recommendations for treatment, testing, and symptom management
- Answering your medical questions
- Signing forms
- Filling prescriptions
- Providing help with disability-related issues
A consulting neurologist makes recommendations to your local doctor or neurologist for treatment, testing, and symptom management.
Neuropsychologist
Neuropsychologists specialize in managing memory, problem-solving, and other cognitive problems. They can evaluate and diagnose people with MS to help them seek the appropriate treatment. Neuropsychologists might offer cognitive rehabilitation exercises to improve memory, attention, information processing, and reasoning. All of these functions might become slowed due to a process called demyelination in the brain. (Demyelination is the destruction of the protective myelin sheath that surrounds the brain and spinal cord, causing a disruption or halting of signals normally transmitted throughout the central nervous system. The brain then becomes unable to send and receive messages.)
Nurse
Nurses possess a broad range of experience in advanced practice nursing, research, and treatment procedures.
Advanced practice nurses (APNs) are clinical nurse specialists, nurse practitioners, and registered nurses with additional education (certification or master's degree) and expertise in a specialty area or clinical practice.
Working independently and jointly with a doctor, APNs are able to provide a wide variety of services.
APNs who treat people with MS provide many health services including:
- Patient and family education about MS and related problems
- Ongoing assessment and management of MS symptoms
- Counseling on general health maintenance and wellness
- Information about medicines and monitoring side effects
- Education in the management of bowel, bladder, or other personal care issues
- Guidance in determining when change might be needed in the treatment plan
- Administration and monitoring of medicines according to treatment and research protocol
- Coordination of outpatient care with home care services
- Consultation to health team members as well as outside providers
- Speaking at community programs about MS and related topics
Social worker
Social workers provide personal support to people with MS and their families by offering:
- Short-term counseling and referrals for ongoing counseling
- Information about home care assistance services and assistive devices
- Recommendations for community resources, and local and national agencies that offer both information and support for people with MS and their families
- Financial resource information such as Social Security disability, supplemental security income, Medicaid, Waiver 4, and PASSPORT financial assistance programs
- Information about quality-of-life issues including living wills and durable power of attorney for health care
Psychologist
Psychologists are available to help people with MS cope with the cognitive, emotional, and interpersonal aspects of the disease. They offer:
- Evaluation of emotional and interpersonal problems
- Individual counseling sessions to reduce emotional distress and improve stress management skills
- Group counseling to develop strategies for coping with the illness and the resulting life changes
- Neuropsychological testing to determine if MS is affecting cognitive functions such as attention or memory
Occupational therapist
Occupational therapists analyze how MS affects the way people perform their daily tasks, help them learn new ways to do familiar activities, and prescribe proper seating as needed. Occupational therapists assist individuals in maximizing their level of functional independence. They offer:
- Individualized treatment through appropriate exercise and adaptive equipment, after assessing each patient’s current level of function
- Ongoing evaluation and appropriate treatment strategies to optimize the range of motion and muscle strength of patients’ upper extremities (arms and hands) to help them successfully complete activities of daily living such as dressing, eating, toileting, and bathing
Physical therapist
Physical therapists are available to assess muscle strength, flexibility, coordination, balance, endurance, walking ability, and mobility. They specialize in:
- Improving function
- Providing instruction on managing physical disabilities
- Recommending appropriate exercises to maintain flexibility, while preventing and reducing pain
- Providing instruction regarding the use of assistive devices, braces, or other mobility aids to maximize independence
Vocational rehabilitation specialist
A satisfying work life is as important to the person with MS as to persons not affected by MS. For people with MS, finding work that matches their skills, interests, and abilities can be especially challenging.
Vocational rehabilitation specialists assist individuals with:
- Recognizing their skills and abilities
- Exploring new careers
- Locating jobs
- Preparing for interviews
- Developing safe work sites
- Coping with work-related issues
- Learning the many resources available for making career choices
Assessing an individual’s needs is the first step in vocational rehabilitation. Information from the assessment helps the patient and the counselor make the best use of vocational services. During the initial interview, a counselor reviews the person’s educational, work, and medical histories and assesses any factors that might affect his or her ability to work. A vocational evaluation also measures the person’s general abilities, and specific needs and interests. After the consultation, the individual might be referred to other services or community resources.
Registered dietitian
Registered dietitians provide nutritional counseling through diet management to promote good nutrition while preventing malnutrition. They are available to:
- Assess each patient’s nutritional needs based upon the progression of the disease
- Recommend changes in each patient’s diet to assist in the treatment of MS
- Develop individual care plans for each patient to promote a good nutritional status
- If necessary, provide calorie and protein supplements to increase daily caloric and nutrient consumption
- Adapt the consistency of foods and liquids if swallowing becomes difficult
Speech-language pathologist
Speech-language pathologists can help people with MS maintain as many verbal communication skills as possible. They also teach techniques that conserve energy, including non-verbal communication.
The speech-language pathologists are available to:
- Evaluate and treat speech disorders and communication problems
- Assess swallowing problems to provide assistance with eating and drinking
- Recommend appropriate communication technologies to provide treatment that will aid in the success of daily activities
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/24/2007...#10439
