Developing an accurate prognosis for an individual MS patient is notoriously difficult owing to the multitude of variables including: age of onset, clinical type of disease, nervous system pathways involved, attack frequency, patient ability to compensate and patient comorbidities. The majority of patients experience MS as an incrementally disabling disease that evolves over decades. Most can expect a nearly normal lifespan with a cause of death similar to the general population.
While some patients will maintain independance, those whose disability cannot be managed at home may need
placement in an assisted living center or skilled nursing facility. The National Multiple Sclerosis Society states that "only about 5–10% of the MS population requires chronic nursing home care .
In general, MS nursing home residents are:
The National Multiple Sclerosis Society suggests that "A neuropsychology consult can be invaluable in defining the cognitive issue(s) and working with staff and the resident to compensate for it. Impairment of judgment, planning and organizational function may have an impact on the safety of operating wheelchairs, especially power-operated wheelchairs or scooters. An occupational therapist should be consulted to address issues of safe driving for individuals with MS who are experiencing cognitive problems."
As patients with MS age,
age-associated changes may complicate the management of MS patients in facilities
primarily designed for aging adults. Other chronic illnesses such as osteoporosis,
stroke, and diabetes may compound the management of these patients. Shared
with attendant care, group residences, and adult day treatment centers are
potential settings where independent living can be promoted and nursing home
for persons with severe MS can be delayed.
National Multiple Sclerosis Society (2010). Nursing Home Care of Individuals with Multiple Sclerosis. Guidelines and Recommendations for Quality Care.
Palmer A.J., van der Mei I., Taylor B.V., Clarke P.M., Simpson S. Jr., Ahmad H. (2019) Multiple Sclerosis Journal. First Published February 26, 2019
Zurawski J., Glanz B., Chua A., Lokhande H., Rotstein D., Weiner H., Engler D., Chitnis T., Healy B.C .(2019) Time between expanded disability status scale (EDSS) scores. Multiple Sclerosis and Related Disorders. 30:98-103