The Team Approach
The process of diagnosis can be a long and stressful journey, often taking multiple rounds of tests and visiting multiple doctors. Ultimately, a confirmed diagnosis of MS is a life-altering event that affects each person in different ways.
Sometimes the complexity of treating multiple symptoms and concerns can overwhelm a single physician.
At the MS Center, we embrace the team approach for coordination of resources and therapies in a timely and cost-effective manner has been well received at MS centers nationally.
What is so special about the "multi-disciplinary" team?
A comprehensive care model aims to reduce disability, maintain independence and enhance safety. Members of the treatment team concentrate on all aspects of the patient's needs including attention to emotional and social needs and promoting a wellness approach to living with a chronic neurological condition.
Counseling, education and support are important functions of the team, and comprehensive care is enhanced when the patient takes an active role in his or her care. This combination of individual initiative and group concern can strengthen hope, successfully address issues related to loss and life changes and aid adjustment to daily frustrations and new challenges.
What services are part of the multi-disciplinary team?
The structure and orientation of a comprehensive care team may vary depending upon the resources that are available and upon changing needs as the disease progresses. One thing is certain: our treatment is focused on living well with MS.
- Physical therapy: Address issues such as strengthening, endurance, flexibility, gait training, and fall prevention. In addition, the physical therapist who is educated in the limitations common to MS, can custom-tailor a home exercise program to maximize function and improve fatigue levels. The MS Center team of therapists can put together an appropriate program to be practiced at home or followed by a more local therapy group. Ultimately a positive experience with physical therapy depends a great deal upon getting appropriate and timely interventions which are mindful of the specific needs for temperature regulation and fatigue management.
- Occupational therapy: Therapists can help the patient and their family more effectively manage everyday activities at home and at work. They do so by assessing a work or home environment to optimize fatigue management and safety. Therapists also offer training in ways to compensate for cognitive changes, such as difficulty with recall, verbal fluency and recall, and multi-tasking. Many times, these tools make the difference in maintaining employment or school enrollment.
- Speech and swallowing evaluation: Specialists in communication can help address all aspects of communication, screening for language and cognitive changes for timely interventions, and evaluating swallowing problems which may occur as MS advances. A swallowing specialist can evaluate and treat problems using a combination of modified diet, altered swallowing techniques and exercises.
- Social Work: Focuses on the psychosocial aspects of MS. The counselor works closely with the Greater Northwest Chapter of the National MS Society to coordinate the following services: Assistance with obtaining and paying for prescription medications, transportation, housing, home care services, financial assistance, emotional support, workplace accommodations to help maintain employment, job search strategies, job skills retraining referrals, assistance with social security and long term disability applications, family medical leave.
- Neuropsychology: Between 45% and 65% of all people with MS experience problems with memory, attention, word-finding, problem-solving, or other cognitive functions as a symptom of the disease. These cognitive changes can vary considerably from one person to another, both in type and severity. There is very little relationship between the severity of physical symptoms and the severity of cognitive problems. One person may have severe physical symptoms but no problems with cognition. Another person may be very physically fit but have severe problems with thinking and remembering.
The Neuropsychologist is trained to evaluate cognitive (thinking) skills by employing tests to identify and measure cognitive strengths and weaknesses. Based on findings from these tests, the psychologist can recommend a treatment plan aimed to enhance cognitive strengths. The Neuropsychologist also plays a key role working with school counselors to accommodate specific needs, such as a note-taking service and flexibility in timed tests or class schedules. For employed patients, the Neuropsychologist may help advise appropriate accommodations to the workplace and work schedule, as well as assist the patient in appropriate consideration of disability application.
- Nutritionists: Help with unwanted weight loss or weight gain, constipation, vitamin deficiency and supplementation, protein-related medication interactions and dehydration. They may also be able to recommend dietary changes to reduce swallowing problems.
- Community Leaders: The Greater Northwest Chapter of the National MS Society is a key partner in helping patients and their families identify wellness programs, including peer support, exercise, and formal stress management classes. Creative therapists in art, music, and recreation as well as spiritual counselors are important resources in a comprehensive wellness program.
Living with advanced MS
In the late stages of MS, the focus shifts to finding ways to optimize function and quality of life. While not all MS patients face loss of independence, some do. The MS Center's team approach can provide timely interventions to address changes in cognitive and physical function. The team social worker and neuropsychologist can help the patient and family gather information about home living arrangements such as assisted care, respite, adult day care and nursing home care.