Multiple Sclerosis (MS): The Healthcare Team -- WebMD

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To the Multiple Sclerosis Center

Multiple sclerosis is a complicated condition. If you have the disease, you will likely receive care from a variety of healthcare professionals, including:

Neurologists

Neurologists are doctors trained to diagnose and treat MS as well as many other diseases that affect the nerves. Neurologists have an in-depth understanding of the central nervous system and how it is affected by multiple sclerosis.

Neuropsychologists

Neuropsychologists specialize in memory, problem-solving, and other cognitive problems and can also diagnose MS. Neuropsychologists may also offer cognitive rehabilitation exercises to improve memory, attention, and information processing and reasoning.

Nurses

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, such as MS. Working independently and in collaboration with a doctor, APNs are able to provide a wide variety of services to people with MS, 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 medications and how to monitor side effects
• Education in the management of bowel, bladder, or other personal care issues
• Guidance in determining when change may be needed in the treatment plan
• Administration and monitoring of medications according to treatment protocol
• Coordination of outpatient care with home care services
• Consultation to healthcare team members as well as outside providers

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 MS.
• Financial resource information such as social security disability, supplemental security income, Medicaid, and other 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 problems.
• Individual counseling sessions to reduce emotional distress and improve stress management skills.
• Group counseling to develop strategies for coping with the illness and 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 by offering:

• Individualized treatment using appropriate exercise and adaptive equipment.
• Ongoing evaluation and treatments to optimize the range of motion and muscle strength of patients' 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:

• Ongoing evaluation and treatments to optimize range of motion.
• 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. 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

Registered Dietitians

Registered dietitians provide nutritional counseling through diet management to promote good nutrition. 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.

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 that will aid in daily activities.

Reviewed by the doctors at the Mellen Center for Multiple Sclerosis Research at The Cleveland Clinic.

Edited by Cynthia Haines, MD, WebMD, August 2005.