Jana, age 67, was diagnosed with multiple sclerosis in her mid-thirties. She has used a wheelchair for the past five years. Jana lives across the street from her daughter and son-in-law. They help with running errands, grocery shopping, and transporting Jana to her doctor’s appointments.
Jana had relapsing-remitting MS throughout her 30s and 40s, but she has now progressed to secondary-progressive MS. Her symptoms have worsened to the point where she is fatigued most of the day, finds it hard to concentrate on previously enjoyable activities, and relies on her wheelchair 70% of the time, even at home, to conserve her energy.
Jana recently fell when moving from her wheelchair to her bed. She would like more support to help with her activities of daily living, but she does not want to impose on her daughter.
WHAT IS MS?
Multiple sclerosis (MS) is an autoimmune disorder in which the immune system attacks the fatty coating on nerve cells in the brain, spinal cord, and optic nerves (nerves to the eyes). The immune system mistakes these healthy nerve cells for foreign invaders. The exact cause of MS is unknown.
A nerve cell has hundreds of extensions called dendrites that connect with hundreds of other nerve cells to carry electrical impulses to the cell body of the nerve cell. This information is integrated in the nerve cell body, and an electrical impulse is sent down another extension called an axon, which synapses (connects) with another nerve cell.
To speed up the transmission of these electrical impulses, axons have a fatty coating called myelin, which acts as an insulator. When the immune system destroys the myelin sheath that surrounds axons, the transmission of electrical impulses slows. The symptoms of MS will vary depending on which areas of the brain have damaged nerve cells. Scar tissue replaces the damaged nerve cells, giving rise to the term multiple sclerosis.