Multiple sclerosis

Occupational therapy can enable people with Multiple Sclerosis remain independent by managing fatigue and mobility issue

Joanne was a woman in her forties who had been diagnosed with multiple sclerosis (MS) for a number of years

She lived with her husband and two teenage children.  Unfortunately, Joanne’s mobility had declined rapidly and she needed to use a wheelchair. She was physically able to move between her wheelchair and chair, but did not always do this safely and had had a number of falls. Joanne’s main problem however was fatigue: she became exhausted easily and spent much of the day lying on the sofa.  She felt unhappy about this as she believed she was letting her children down. The occupational therapy intervention centred around:

• improving her physical safety
• helping her to manage her fatigue more effectively
• improving her self esteem
   

Joanne was taught how to transfer safely between her wheelchair and her chair, bed, toilet and stair lift, and given opportunities to practice.She was asked to keep an activity and fatigue diary to find out if any patterns emerged. It seemed that Joanne tended to be overactive when she did have some energy but then needed to rest for several days when she became over-tired.  She worked with the OT to set a more regular routine, incorporating short and regular periods of rest between activities.  Although Joanne found it difficult to stick to a regular routine (she found it boring!) she could see that the amount she was able to do in a day was slowly increasing. 
 
Joanne worked with the occupational therapist to set herself some goals which centred around improving her relationship with her children and making a bigger contribution to the household.  After working with the occupational therapist, Joanne could move around her house safely and could do certain household tasks such as laundry and meal preparation. She used the family evening meal to chat with her children (previously she had been too tired to do this) and had been on some short shopping trips with her daughter.