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Multiple Sclerosis (MS) is a progressive, immobilizing disease. The disabling effects of MS are the result of damage to the nerves of the brain and spinal cord. Normally, the nerves are covered by a fatty sheath called myelin, which works much like the insulation over electrical wires. MS causes the myelin to become inflamed and damaged. As a result, scar tissue develops—causing a disruption in the messages to and from the brain.

Because the scar tissue may develop in several different areas, symptoms of MS will vary between residents. The following are some nursing care measures for you to be aware of when working with MS residents:

Vision: Vision may be lost suddenly or over time, or residents may experience blurred or double vision. Visual impairment can increase the danger of falls. To prevent an accident, do not move furniture without the resident’s knowledge. Residents with vision problems will also need additional assistance with ADLs.

Communication problems: Residents with MS often have difficulty speaking and writing because of nerve damage and tremors. Nursing staff should try alternative methods of communication and report successful results to other staff members. Although a resident may have difficulty communicating, it does not mean he or she does not understand.

Skin integrity: Watch carefully for early signs of skin breakdown. Because of immobility, decreased sensory function, and incontinence, the skin is prone to breakdown. Follow standard procedures for prevention of pressure ulcers.

Changes in urinary and bowel patterns: Urinary and bowel retention and incontinence can occur as a result of muscle spasms. Keep accurate records and report changes in urinary and bowel patterns to your supervisor.

Anxiety and depression: Anxiety and depression are common in people with MS. The earlier the signs are reported, the quicker help can be obtained. If you observe symptoms of depression, don’t ignore them or attribute them to “sadness” about being ill. Depression and anxiety can be treated successfully with medication and counseling.

Residents with MS have varying degrees of disability. The nursing care provided should be geared toward each resident’s individual symptoms and conditions.