The multiple sclerosis (MS) team of caregivers generally
consists of:
Neurologists
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 multiple sclerosis. Ideally, it is helpful if the neurologist is affiliated with an MS center, research facility, or a teaching hospital. The neurologists at the Mellen Center specialize in the diagnosis and treatment of multiple sclerosis and related disorders.
Neurologists:
- Diagnose MS
- Make recommendations for treatment, testing, and symptom management
- Are available to answer your medical questions, sign forms, fill prescriptions, and provide help with disability-related issues
- May initiate courses of care for MS including disease modifying therapies, treatment for attacks, symptom management, and referral to other members of the team for treatment and counseling
A consulting neurologist makes recommendations to your local doctor or neurologist for treatment, testing, and symptom management.
Rehabilitation Specialists (Physiatrists)
At the Mellen Center rehabilitation specialists work closely with the neurologists and other team members to provide high quality rehabilitation services to people with multiple sclerosis as well as to other patients with disorders causing spasticity, balance disorders, and leg weakness. The physiatrists evaluate patients for treatment needs, develop plans of care, and monitor their progress. They are involved in treating patients using Baclofen pumps and Botox injections. They are involved in research using new rehabilitative devices to improve movement. They oversee the provision of physical therapy and occupational therapy at the Mellen Center. At the Mellen Center rehabilitation is fully integrated into the care of the patient.
Advanced Practice Clinicians
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.
Physician assistants are specialists that undergo a specific training program to enable them to work with physicians in an area of clinical practice. Together, APNs and physician assistants can be considered advanced practice clinicians and are an integral part of the Mellen Center’s health care team.
Working independently and in collaboration with a doctor, advanced practice clinicians are able to provide a wide variety of services.
APCs 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
Neuroradiologists
At the Mellen Center we have integrated neuroradiology into the care fabric of our center. Our neuroradiologists provide us with state of the art imaging, using the latest in MRI technology to allow us the best evaluation of the brain and spinal cord. Our neuroradiologists are at the forefront of their field in terms of research and imaging technology. They are based in the Mellen Center so that there is a constant interplay between the clinicians and the radiologists at the center. Because MRI imaging is so key to the diagnosis and management of MS, we believe that having neuroradiologists on site allow us to do the best work we can to care for our patients.
Neuropsychologists
Measuring and evaluating the cognitive and emotional state of people with MS is often an important part of MS care. At the Mellen Center we use neuropsychologists to do a detailed evaluation of cognitive function when it becomes clear that problems in this area are interfering with the patients life or the relationship with family or employers. Such information helps guide out counseling, therapy, and sometimes our medical treatment. It also helps us guide patients and families better in their care decision making.
Social Workers
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 of 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
Psychologists
Psychologists are available to help people with MS cope with the cognitive, emotional, and interpersonal aspects of the disease. They offer:
- Psychological evaluation of emotional and interpersonal problems
- Individual psychological counseling sessions to reduce emotional distress and improve stress management skills
- Group psychological 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 Therapists
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, following an accurate assessment of each patient’s current level of functional performance
- 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 Therapists
Physical therapists are available to assess muscle strength, flexibility, coordination, balance, endurance, walking ability, and mobility. They specialize in:
- Improving function and 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 Specialists
A satisfying work life is as important to the person with MS as to anyone. For people with MS, finding work that matches their skills, interests, and abilities can be especially challenging.
- 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 Dietitians
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 Pathologists
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.
- 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
