Multiple sclerosis is a lifelong, potentially disabling disease of the central nervous system that affects the white matter tracts of the central nervous system in a sporadic and unpredictable manner. The disease produces inflammation and demyelination of the white matter, as well as varying amounts of damage and destruction to the underlying axon. The onset of disease is most often in early adulthood. Individuals experience a myriad of symptoms with likely progression of disability over time. Symptoms may include fatigue, visual disturbances, sensory changes, incoordination, pain, tremor, elimination dysfunction, and cognitive impairment. Symptoms usually occur as relapses early in the disease, or as symptoms that appear over 24–48 hours and recede to some extent over weeks to months. After a decade or so, many individuals experience fewer relapses, but in their place is a slow progression of MS symptoms that often leads to increased functional disability over time. A small percentage of patients will experience progression from the onset of the disease and experience progressive mobility impairment over time.
MS invades every aspect of life, and patients as well as families can be severely affected. Patients and families experience a sense of loss, both real and perceived. The disease can adversely impact the roles of provider, spouse, parent, friend, and employee. There are emotional consequences of the disease as well as physical ones. As the disease is one for life, individuals and families will have multiple needs throughout their lives. They will need emotional support, education, symptom management, adaptation to changes, adaptive equipment, supportive care, and perhaps even end of life care.
Nursing is a critical element in meeting the multiple needs of the MS patient and family. MS nurses have evolved from home-based care providers giving support to the disabled person to certified MS nurses and advanced practice nurses who must be well educated in the disease process and the available treatments. In addition, MS nurses must be sensitive to and supportive of the emotional needs of those affected by the disease. MS nurses must provide appropriate education regarding the disease process, treatment regimes, symptom management, and community resources.
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