Questions and Answers
Responses are provided as general educational resources and should not be interpreted as diagnoses, prognoses, or treatment suggestions. Information and perspectives represent the views of the individual author(s); Can Do Multiple Sclerosis is not responsible for the accuracy or currency of the responses. Readers should consult with their healthcare team.
My husband is having open heart surgery next week and I am concerned about being able to keep myself capable of being his caretaker during recovery. I feel selfish for asking, but any suggestions on what I can do to be the best for him.
Roz Kalb, PhD
Can Do MS Senior Programs Consultant
Taking care of yourself is not selfish – in fact it’s an essential part of being a good care partner. Just as the flight attendant reminds us to put on our own oxygen mask first before helping another person, care partners need to keep themselves healthy and rested in order to provide optimal care and support. Try to build time into your day for adequate sleep and rest, physical activity or exercise, and healthy meals.
This may be challenging depending on your husband’s needs, but perhaps you can ask a friend or relative to be on call for your husband while you take some time for these important activities. You may also find that you need support and comfort for yourself, so don’t hesitate to reach out to your support network when you need a chat or a hug. If you find yourself feeling stressed and anxious, make use of strategies that have provided stress relief in the past – perhaps listening to music, keeping a journal, taking time for prayer or meditation. Each person’s needs are different, as are the strategies that help a person feel better.
You mentioned wanting to do the best for your husband. My other recommendation is to have a conversation before the surgery about how you can best help and support him while also taking care of yourself. As his needs change over the next days and week, be sure to check in with one another to see how you’re each doing and to tweak your help and assistance as needed. I hope the surgery goes well and that your husband recovers as quickly as possible.
Can Do MS has several resources on its website devoted to help us care for our support partners, including this webinar on Caring for Carers.
Where should I start if I’m feeling varying levels of depression?
Roz Kalb, PhD
Can Do MS Senior Programs Consultant
The best place to start is a conversation with your healthcare provider. I would suggest making a list of the symptoms and changes you have experienced and the ways they have been impacting your daily activities and quality of life. This will help you start the conversation. If you live with a partner, he or she might be able to offer helpful observations of your mood and its impact on daily life.
Your healthcare provider will be able to offer a depression screening or refer you to a mental health professional who can offer a full evaluation. The mental health professional will also be to describe the kind(s) of treatment strategies that would be most helpful for you.
If you would prefer to have a depression screen before you talk with your healthcare professional, you can access a free, confidential, online screening at. Once you answer the screening questions, this website gives you a report that you can print and take to your healthcare provider.
If you have difficulty getting a referral to a mental health provider to assist you, you can contact a National MS Society MS Navigator® (1-800-344-4867) to request the names of mental health professionals in your area who are familiar with MS. You are taking an important step toward feeling better and taking charge of your emotional well-being. Life is challenging enough without the added weight and pain of depression. I wish you the best.
For more information about depression in MS, please check out these resources:
My son wants to visit me, but I’m not sure if it’s safe with the coronavirus. How do I tell him not to visit without hurting his feelings?
Roz Kalb, PhD - Senior Programs Consultant
I think this may be a question that lots of families are dealing with right now. We all miss one another and feel anxious about our loved ones’ well-being. Having two grown children myself, I know that we miss being able to be together and take care of each other. However, the guidelines for health and safety right now are very clear – the way we can protect ourselves and others most effectively is by staying put where we are so that we don’t inadvertently carry the virus from place to place.
Since the elderly seem to be the most vulnerable to COVID-19, it is particularly important for those of us who are over 60 to remain in our homes without visits from others. I would urge you and your son to connect virtually through one of the many available platforms, such as FaceTime, Zoom, or Skype. That will allow your son to see and talk with you, both to confirm that you are OK and to get the comfort of talking with his mother during this time of crisis. You can support each other and feeling very connected, even if it’s virtual. Setting up a regular time to connect can be fun and comforting for both of you.
This may be difficult for your son to hear, so you’ll want to make sure you are communicating clearly and empathetically. The Can Do MS Coronavirus and You has some Communication Tips, and this webinar and library article focuses on communicating with family.
I’m finding myself more cautious and less trustworthy of people, e.g. I assume people are lying about not having COVID and hiding their invisible symptoms. Is this distrust normal?
Roz Kalb, PhD
Senior Programs Consultant
We are all having to be more cautious during this difficult time.
I think your best strategy is to worry less about whether other people have COVID and focus instead on doing everything you can to follow the guidelines from the Centers for Disease Control for optimizing your own safety. The fact is that the virus spreads in communities because many people have COVID without knowing it. They aren’t lying or hiding it, they simply don’t know they have contracted the virus because they have no symptoms. This means that we need to stay at home except for essential trips out – occasionally to the grocery store, for example – and otherwise isolating ourselves as best we can, washing our hands often and well, and making sure that we clean everything that comes into the house from the outside (our mail, clothing we wear when we go out, and so on. It is normal to be cautious but by taking the best possible care of yourself you can feel more secure.
The Pew Research Center recently published this article suggesting that the coronavirus is indeed impacting our social trust.
My husband & I stopped making love because it was uncomfortable with my PPMS and my bowel & bladder issues made intimacy seem impossible. I'm not sure what can be done…? If anything…? I feel like I'm cheating my husband from being intimate.
Linda Mona, PhD
Any time we use assistance for personal for daily activities (e.g., bowel and bladder care), we can feel detached from our bodies at times. We never dream that we would ever have someone assisting with those tasks. And, yet, that is what some of us are called to do. If your husband is the one assisting you with those tasks, it can be even more difficult.
It is best to find ways to clearly separate daily activity tasks from sexual intimacy. For example, if your husband assists with bowel and bladder care, leave a good chunk of time between those activities and sexual intimacy so that you are giving time for your roles to change.
Talk to him to see what he might be open to and try and create some special time together. Some people carve out a certain time every day (e.g., 7pm every other day). This could be a time to cut off electronics, hold hands, and talk. It only has to be 10 mins if you like.
The idea is that you need to prioritize time together to build up both emotional and physical intimacy. If you have an indwelling catheter, you can hold it aside during sexual activity or have sex in between changing the catheter if that is feasible.
Talk to your doctor (if you are comfortable) about what might be the best way to handle this situation. Sex and intimacy helps all of us feel connected to life. You deserve to fight for it! Eye gazing, hand holding, kissing, and anything else you enjoy can be explored again. Sex will be different living with disability but it does not necessarily mean it will be worse.
My husband seems to have lost the desire to be intimate due to loss of sensations caused by MS. What options do I have to be a better partner in the area of intimacy?
David Rintell, EdD
Can Do MS Programs Consultant
Changes in sensation is a common symptom of MS. A person with MS who is experiencing these changes in sensation should begin by letting their partner know that these changes are happening. Educate your partner and let them know that these changes are unpredictable.
You and your partner can work out a short-hand so you can let him know that "it is not a good time" for intimacy, to avoid unclear expectations. Remind your partner what you can do, which might include cuddling, enjoying activities or movies together, and other ways of feeling close. Intimacy really means closeness and honesty, and you can always be intimate in that way. When you are intimate, let your partner know if his touch is not feeling good for you. It may be what often is pleasurable at times, may be uncomfortable or even painful.
Your second step should be to schedule a meeting with your health care provider. Your HCP can look for biological reasons why you might have a loss of desire, which could include testing for hormone levels, and find out more about the changes in sensation you are experiencing. Your neurologist, urologist, or PCP may be able to offer some insights and perhaps a helpful intervention. Ask for a referral to a mental health professional who works with people experiencing challenges in sex and intimacy.
Third, some things you and your partner can do:
- Desire is always dependent on feelings of closeness, comfort, trust and affection. You and your partner can take more time to express these positive emotions toward each other. Desire sometimes arises from emotional feelings, not just physical feelings.
- Explore the areas where you do have sensation, and see if asking your partner to touch you in the right way in those areas helps you to become aroused and interested. An activity called "Body Mapping" or "Sensate Focus" might help. This activity is done when you and your partner can take time when there is no one else around, and with the agreement not to engage in intercourse as part of the activity. One of you spends time touching different areas of the body, and the partner being touched gives feedback about how the touch feels in that area, and whether the touch should be softer, lighter, harder, etc. Then switch and do the same for your partner.
- Suggest to your partner that when intercourse does not feel like an option, that you cuddle, talk, and enjoy each other's presence. There is no couple who could not use more time cuddling.
- There are some good ways to increase sensation. There are new products which are lubricants which increase sensation. There are even products consisting of two different lubricants, one for each partner. When these lubricants meet, they react to each other and create more sensation for the users. There are many products, and if one doesn't work, it might be worthwhile to try another. One example is K-Y Yours and Mine - http://www.k-y.com/yours-mine-couples-lubricants.Many women and men utilize vibrators which increase sensation. There are many, many choices here. A good, reliable, and discreet source of vibrators are:
- http://www.mypleasure.com - A website which offers products for sale and a great education section, including a section on Sexuality and Disability, offering items for people with limited mobility and ergonomically designed sex toys. The site is very positive, appropriate, and is not porn. They offer $5.00 off for new customers. Enter the code: WELCMYP.
- http://www.goodvibes.com - Another positive sexuality online store, many toys plus much useful information.
- http://www.goaskalice.com - Sponsored by Columbia University, Frank answers about Sex, relationships, nutrition, and health
- Finally, experiment! Find out what else works. Does heat increase sensation? Cold? Does watching a chick flick, a sexy movie, or reading increase your interest and desire? If you find something helpful, use it. If you find something that makes the problem worse, avoid it.
Most people find solutions or work-arounds to sexual problems related to MS. We hope you will too.
For further information about sexuality in MS, download the excellent edition of MS in Focus from the Multiple Sclerosis International Federation, www.msif.org, at http://www.msif.org/about-us/communicating-ms/ms-in-focus-magazine/intimacy-and-sexuality.aspx.
Does breastfeeding or not having a menstrual period offer any protection against MS relapses?
Nurse Practitioner Response
Megan R. Weigel, DNP, ARNP-C, MSCN
Can Do MS Programs Consultant
Over the past few years, some of the leading researchers in the field of MS have been trying to answer this very question, and so far the results are conflicting. In 2015, a study in JAMA Neurology reported that women who EXCLUSIVELY breastfed for at least 2 months had a lesser risk of relapse in the first 6 months following delivery than women who breast and formula fed, or women who did not breastfeed at all. This study found that, once the mother stopped breastfeeding, the relapse rates return to expected. Here is a summary of that study: https://www.medicalnewstoday.com/articles/298961.php
I tell patients that exclusively breastfeeding means that you cannot even think about formula or look at it in the grocery store! Regarding amenorrhea (absence of a menstrual period), exclusive breastfeeding causes a woman to stop menstruating to a certain point. It is the hormonal changes that are likely protective. This is a great review article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757692/#B20
Bottom line is that the risks of postpartum relapses are much more related to the severity of your disease before pregnancy. If you were having frequent relapses even on disease modifying therapy, then you are more likely to relapse. If you have relapsing MS and your disease was quiet on disease modifying therapy prior to pregnancy, you are less likely to relapse. I recommend breastfeeding to women with controlled MS, and this often involves a long and honest talk about their desire and philosophy of child-rearing. It is very important to have a pregnancy and post-delivery plan. This includes discussing breastfeeding, restarting disease modifying therapy, and need (if any) for immediate postpartum therapies such as pulse steroids or IVIg. This is all based on the individual’s history of MS, and can’t be blanketed to a group.
For more information, the National MS Society has a website to News related to breastfeeding and MS: https://www.nationalmssociety.org/About-the-Society/News/Study-Finds-that-Breastfeeding-is-Associated-with
I read that couples with MS have a high divorce rate. How could a marriage counselor help my husband and I stay married and improve our relationship? Is there any research to prove that counseling can help people stay married?
Gayle Lewis, Ph.D., MSCS
Can Do MS Programs Consultant
For many reasons, MS can be stressful in a relationship. Whether or not this stress actually contributes to more divorces is unknown. While some studies show that over 70% of MS marriages end in divorce, it seems that the rate is more on par with the 50% divorce rate for the general population. Renowned MS psychologist and fellow Can Do MS Programs Consultant Roz Kalb believes "the divorce rate for MS couples may actually be lower due to a variety of reasons."
In terms of marriage counseling, it can be successful in strengthening relationships, but only if both partners come into counseling on the same page of wanting to preserve the marriage. If, on the other hand, each partner has different aims about whether or not to preserve the marriage, couples counseling alone cannot and does not have the power to reconnect the couple.
My biggest suggestions would be to communicate openly with your partner and to reach out to a mental health professional with experience working with couples living with MS (the National MS Society is the best resource to finding local support). If it is needed, there are family law attorneys that specialize in MS and other chronic conditions.
There are also many resources to understand and cope with the unique and very real impact that MS can have on a relationship. In addition to Roz's book, "MS: A Guide for Families," take a look at the following resources:
My son was diagnosed with MS four weeks ago. He is 30 years old and has a life ahead of him full of dreams. I am devastated and don't know how to deal with this. I have been pushing for him to have better nutrition, start an exercise program, and learn as much as he can about MS. Now, I feel maybe I am going too fast. I don't want to frustrate him or be the one that is constant reminder of his situation. I am pretty confused about how fast and how much should I help.
Roz Kalb, PhD
Can Do MS Programs Consultant Coordinator
I think your instinct is
correct -- your worries about your son's diagnosis may be causing you to
move a bit too fast. When young adults receive a diagnosis like this,
they need time to react, deal with the shock, and grieve over
this change in their lives.
Their initial reaction may be that “this changes everything” - including their present situation, as well as all of their dreams and plans for the future. Or, they may react in the opposite way - vowing not to let the MS interfere with anything. Of course, the realities of MS are somewhere in between. But each person needs to come to that realization in his or her own way. Not knowing your son at all, it's impossible for me to say what might be best for him. Some people cope by jumping in with both feet, trying to do everything and manage everything at once. This may be closer to your style than his. Others take more time to figure out how best to move ahead, which may be closer to his style than yours.
As parents, we
want to protect and care for our children no matter how old they are. We want
to try and make things better for them just the way we did when they were
small. Ultimately, however, your son needs to find his own way with his new
diagnosis, even if it's a different way than you would choose. When he's ready,
I hope that he will learn about the disease from his healthcare providers
(especially a neurologist with expertise in MS) and credible sources like Can
Do MS (cando-ms.org) and the National MS Society (nationalMSsociety.org), while starting treatment
with one of the approved disease-modifying therapies as quickly as possible.
There is now ample evidence that the sooner a person starts treatment, the more
effective it is in reducing relapses, lesions on MRI and disease progression.
If your son needs help finding a neurologist the National MS Society
(1-800-344-4867) can help him with referrals.
All of this may
take him a bit of time.
We know that
overall wellness - including a healthy, balanced diet, exercise, and stress
management - are important for all of us, including people with MS, but your
son may need time to come to these decisions on his own. In the meantime, I
would recommend that you let him know that you are there to support
him and to help in whatever way he needs. Let him be your guide. A psychologist that
specializes in MS can also be a valuable outlet for parents in your situation
by helping you develop strategies for your own grieving, coping, and
If he is open
and ready to hear about helpful resources for people with a recent
diagnosis, you can let him know about the following:
Power -- a learn-at-home series for those who are newly-diagnosis (www.nationalMSsociety.org/KIP)
that covers topics including treatment, working with your healthcare team,
employment, relationships, staying health, etc.
GPS for Your MS -- a webinar from Can Do MS (www.cando-ms.org/multiple-sclerosis-programs/webinar-series/gps-for-your-ms-1)
MS Path 2 Care -- a series presented by Can Do MS in partnership with Sanofi-Genzyme and the Society for Participatory Medicine (www.MSPath2Care.com)
Sometimes it is easier to get information and recommendations from someone other than one's parent! Please know that Can Do MS and the National MS Society also exist to support you -- so please don't hesitate to come back to us with more questions, or contact one of the Society's MS Navigators at 1-800-344-4867.
I feel very much alone in my MS world. I believe my husband wants to help and he does with "priorities," e.g. shopping, helping around the house, walking the dog. I need for him to treat me like his precious wife and remember the things that make me happy. I should be his priority; instead I always feel like a burden. How do I get him to recognize that chores should not be the only focus of the day?
Gayle R. Lewis, Ph.D., MSCS
Can Do MS Programs Consultant
It’s so difficult to be given a diagnosis that erodes your sense of control over your body and life, and even more so when you feel that the lens through which your partners sees you has changed so drastically- to be made to feel “special” because he takes on daily chores that perhaps you no longer can do yourself vs. feeling “precious” because of the love and connection you have with and for each other. Hard at this might be, the only way for him to understand this distinction – and to realize what you perceive to be his “focus of the day” – is to communicate with him openly, honestly, and specifically.
I’m not sure what it is that is making you feel like a burden or what is making it challenging for you to communicate your needs and desires. Maybe you have tried communicating and “it hasn’t worked.” Maybe you are frightened to bring this topic up, as many people can be when they feel vulnerable. It is very important for you and your husband to set aside a dedicated time, where you both feel safe and undistracted, so you both can talk about your concerns –remember, your husband will also have very real and valid concerns that he may (or may not) want to share. Be ready to listen and understand where he is coming from. It’s vital that you be honest and that you allow your husband the time to be honest, as well.
Most importantly, this cannot be a one-off situation. Things won’t change by having just one conversation. Repetition is needed, reminding is needed- but the reminding must be in ways that you both can tolerate and that doesn’t make you feel like you’re nagging or being a burden. Your needs matter a great deal – make sure YOU know that. It will come across in the way you let your husband know.
I hope this provides some comfort that you are not alone in your feelings – they are very common. At the same time, change requires conscious adaptations in the ways you think and act. All of this is much easier said than done. That’s why I highly recommend couples therapy with a psychologist/counselor experienced in MS. I would also recommend that you and your husband find support groups to work through some of your issues.
I also recommend continuing to learn as much as you can about communication and the emotional issues inherent with MS – for people living with the condition and support partners. Can Do MS has some wonderful resources, including:
As my MS advances, I feel like I’ve become more of a spectator and burden to others. My husband spends all his time worrying about me and caring for me. He deserves more than this, and I feel like I'm not deserving of the time that I impose on him and other people. How do I deal with the guilt of being a burden to my family?
Clinical Psychologist Response
Gayle Lewis, Ph.D., MSCS
Can Do MS Programs Consultant
Feeling that the people who support and care for you, in fact, see you as someone who, for lack of better terms, is a pain in the ass in their respective lives is certainly an awful feeling and an all-too-common burden for people living with MS and many other conditions. However, I would suggest that the actual burden you are creating is more profound from your subjective perception than it actually is to them.
My first question – do you have any actual evidence that your husband and family see you and experience you as a burden? Has anyone actually said so or alluded to this feeling? The most direct answer to your question on dealing with the guilt is to communicate your feelings honestly and openly to your family, and provide them with the opportunity to honestly and openly communicate their feelings with you. A therapist can help facilitate this dialogue.
Yes, dealing with MS as the patient IS a big responsibility, accompanied by many daily issues to be dealt with, on your own and vis-à-vis the assistance of others.
And, yes, the stress of daily assistance can take a physical and psychological toll on the caregiver, causing caregiver burden. Caregivers are often reluctant to ease their own burden and take care of themselves. However, early recognition of caregiver burden can help you and your loved ones determine appropriate interventions. Ultimately, your family loves you and they are invested in caring for each other. Focusing on “who deserves or doesn’t deserve” being part of this team is a zero-sum game. Instead, you can focus on the positives in the lives who have lead together and will continue to lead in the future. The National MS Society has actually found that MS can draw partners more closely together as they provide deeply satisfying care and meet the challenges of caring for a loved one with a chronic illness.
Without being too much of a sideline therapist who knows nothing about you except the worry I feel in your question, could it be that you are projecting your own self-hate and anger about what MS has taken away from you and complicated your life onto your husband and family members? In other words, are you assuming that they all feel taxed by your MS and its progression because you feel that way yourself?
Let’s say this is the case….and/or that your loved ones DO feel burdened and overwhelmed by your MS…I would recommend individual therapy for both you and your husband, as well as couple’s therapy for the two of you to talk about these things in a safe space. Group therapy would also be helpful to share with others going through the same concerns/experiences and learn from their own helpful insights.
Again, this is cursory guidance as your situation requires individualized attention from a mental health professional. However, you have taken a great first step by recognizing your concerns and seeking information to cope. I hope you will continue to use Can Do MS as a resource. For more information, I would suggest watching this webinar on supporting family members and this webinar on relationship issues in MS. There is also a great video on coping and managing complex care needs in advanced MS.
Over the last few years, I have noticed a significant increase in my forgetfulness, disorganization, and clumsiness. At the same time, I have all but lost my sex drive. Are these symptoms “normal” for MS? I just need to figure out what is wrong with me! It’s like my doctor has given up; all they want to do is prescribe me more pills. Is there anything else that may work?
Pilar Poal, Ph.D.
Can Do MS Programs Consultant
Thank you for your questions. I can appreciate your frustration with your current symptoms and feeling that pharmacological support is not enough. These are common symptoms of MS, and they can at times be puzzling and disconcerting.
We know that brain lesions associated with MS can have an impact on cognitive functioning. While some of the current pharmacological therapies used for MS may slow the progression of cognitive changes, using compensatory strategies can reduce the impact of decreased memory and organizational skills on your daily life. If you have access to a smartphone or computer, there are many free programs that can assist with reminders, lists, logs, calendars, and other tools. However, basic paper planners or boards can also get the job done. My recommendation would be to keep it simple, find one or two tools that work for you that are easy to incorporate into your daily routines. For more tips on organization and overcoming forgetfulness, check out this Can Do MS webinar and article.
If you feel that your cognitive symptoms are worsening and significantly interfering with your daily life, you could discuss with your doctor the option of getting a referral for neuropsychological testing and cognitive rehabilitation.
Decreased coordination, which you describe as clumsiness, is a common symptom of MS and can be related to other MS symptoms, such as decreased balance, muscle weakness, spasticity, or fatigue. It may help to explore which ones are contributing the most to the decrease in your coordination. Then, you can develop a plan with a physical therapist to specifically target those areas. Note, however, that fatigue is likely to amplify these and other MS symptoms, so learning to pace yourself throughout the day and make adjustments when you identify the beginning signs of fatigue can be a helpful strategy.
Exercise may also help with your "clumsiness." Read this Can Do MS article for more information on the benefits of exercise on balance and coordination.
In regard to your concerns regarding sex drive, this is also a common consequence of MS and is associated with many factors. Sexual functioning can at times be directly affected by the neurological changes caused by MS. Other times, some MS symptoms such as spasticity, restricted movement, changes in sensation, bladder functioning, and fatigue can have an impact on sexual functioning. In addition, body-image, relationship concerns, and expectations can also affect sexual drive. A good place to start would be to communicate with your partner regarding your concerns about your decreased sexual desire and to enlist his/her support so that you can address them together. Exploring the impact that physical changes, relationship roles, fears, and expectations may be having on your sexual drive can help clarify what is happening and identify possible ways to address your concerns. In addition, it is important that you share with your partner what type of physical touch is pleasurable and what feels uncomfortable or painful.
Another recommendation would be to broaden the way you think about physical intimacy with your partner so that you can have more ways of being physically close to each other. Explore together what changes may help you get in touch with the more sensual parts of yourself and possible situational factors that may increase your sexual interest (i.e. location, time of the day, leading up activities, etc.) While fatigue and other physical symptoms of MS may, at times, affect your sexual desire, sharing your needs with each other and exploring new ways to be emotionally and physically intimate will promote closeness in your relationship and minimize the chances that your decreased sexual desire will create feelings of distance or resentment between you and your partner.
For more insights, please watch this Can Do MS webinar, "Keeping Your Relationship Alive: The Physical and Emotional Aspects of Intimacy in MS."
I am a caregiver of a 65yr old female with MS. I have noticed her recently becoming very weak and unable to move when using her walker. What should I do? Also, how I can help her exercise and stretch in light of these increasing mobility issues?
Amanda Rohrig, PT, DPT
Can Do MS Programs Consultant
Serving as a caregiver/support person for someone you love can be a truly joyful blessing that can offer many benefits to both parties. It is also a responsibility that, at times, have heavy tolls- physically, emotionally, and mentally- even though you feel proud of the role you play in your loved one’s life. You may find yourself experiencing a wide range of emotions as you adapt to the day-to day variability of this unpredictable disease. Knowing when to help and how to help when changes occur can be challenging. Despite your questions and concerns, please remember your attention and care make a huge difference!
First, I would recommend having an open conversation with the person for whom you are caring. Confirm that she is experiencing what you are observing. Then, potentially together, consult with her health care team (especially a physician or MS nurse) to determine if there are any appropriate and/or necessary changes that need to occur with the medical management of her MS, as well as a request for a prescription for physical therapy. A consultation with a physical therapist who understands MS can help to identify abilities and areas of improvements. For example, there may be alternative bracing or mobility devices in combination with specific exercises that may be helpful. Often, implementing some key fatigue management strategies or environmental changes can help, too. Most importantly, identifying when to help versus when to empower the person with MS to do an activity or exercise independently is key to strengthening mobility and for both of you to live well with MS.
In conclusion, seek that consultation with a physical therapist to help both of you learn to optimize exercise and mobility. In the meantime, consider education and investigation into some of the online resources from Can Do MS (there are some excellent webinars and articles pertaining to exercise, flexibility, and mobility are available on the CDMS website, www.mscando.org) and the National MS Society (www.nationalmssociety.org). I would encourage you to explore the Stretching for People with MS as well as the Stretching with a Helper for People with MS manuals from the National MS Society. These 2 resources would be appropriate to bring along to a physical therapy session. With the help of a PT, you and your loved one can identify and prioritize those that may be appropriate for your situation. Thank you for your question and best wishes for health, wellness, and happiness!
Finally, join me and renowned psychologist Roz Kalb, Ph.D., at the upcoming Can Do MS webinar on support partners. This free, interactive presentation will offer some great suggestions on the types of questions you are presenting here, and will connect to MS care experts that can provide support, as well as other caregivers going through similar situations. You can register for this webinar, broadcasting live at 8pm Eastern on Tuesday, October 11 (if you cannot attend live, the webinar will be archived and available to stream at your convenience), by completing this brief online form.
I am 67-years-old, and my husband is 74-years-old. I was diagnosed with a mild form of remitting multiple sclerosis in 2010. My husband was diagnosed with Alzheimer’s in 2013 and is an insulin-dependent diabetic II. How do I keep from being over stressed?
Clinical Psychologist Response
Rosalind Kalb, PhD
Can Do MS Programs Consultant
I’m so glad that you’ve reached out to Can Do MS for suggestions. You’re dealing with many different stressors, each of which can be a lot to handle. I think that the key to managing so many complicated issues is to make sure that you’re tapping all the resources that are available to help you; no one should feel that she or he has to do this alone.
I would start by thinking about the things that worry you the most, and tackle them one by one. So, for example, if you have financial concerns, make sure that you reach out to get some expert guidance. The National MS Society offers a free consultation with a financial planner, as well as ongoing assistance with questions/concerns. You can get information about this by calling 1-800-344-4867. If you are concerned about long-term care issues, or how to go about finding long-term care resources should the need arise, now is the time to start talking about your priorities and getting information about the available options – beginning with help in the home and extending to day programs, assisted living, as well as nursing homes. None of us make our best decisions when we’re in a crisis, so talking and planning today helps you feel more prepared and less vulnerable whatever the future brings. These are just two examples, but the point is that one good way to relieve stress is to identify the tools and strategies you can use to address the things that worry your most. Knowing that you have plans and strategies in place, can help you stop ruminating about “What if this happens? What if that happens?”
A second critical strategy is to make sure that you are getting the emotional support you need. Staying connected with family and friends is important. Too often, people tend to withdraw from others and become isolated just at the time when those connections are most important. In addition to maintaining your social support network, you may want to consider talking with a counselor with expertise in health and chronic illness issues. Talking through your concerns, identifying options and strategies, and getting support for yourself can help you feel less stressed and more empowered to deal with whatever occurs. By calling that same number at the National MS Society – 1-800-344-4867 – you can get the names of therapists in your area.
The third important strategy is to make sure you’re paying enough attention to your own health and wellness. When dealing with chronic illnesses of various kinds, it’s very easy to become so focused on the medical issues that you neglect your overall well-being. Taking time to do things you enjoy, attending to your medical and dental preventive care needs, taking care of your spiritual needs, and finding whatever stress management techniques work best for you are all essential components of wellness. If you don’t know what activities best relieve your stress, the therapist can help you identify them – whether it’s time with friends, prayer, meditation, a hobby, journaling, or time in your garden, or something else entirely. Building these activities into your life is like physical therapy for your mind – keeping you calmer and more balanced.
And last but certainly not least, exercise is a wonderful stress management technique that is also good for your emotional well-being, cognitive functioning, and overall health. A physical therapist can help you identify an exercise routine that fits your abilities and limitations – whether it’s walking, swimming, or anything other physical activity that appeals to you.
Taking time to attend to your own health and wellness is essential for relieving stress and will also help you be a more effective care partner for your husband. I wish you the very best.
As a support partner, I feel like I am unable to take care of my own needs and find myself too tired to focus on me. I want to be as supportive and available to my husband who has MS, but I sometimes feel jealous that no one is able to take care of me. More importantly, I find that I am unable to focus on myself to take care of my own well-being – physically, emotionally and mentally. What can I do to take control of my own health, while being an effective and caring support partner to my husband?
David Rintell, EdD
Can Do MS Programs Consultant
First, remember that if you do not care for yourself, it is likely that your effectiveness as a support partner will eventually be greatly reduced. If you keep in mind that care of the self and care of your partners are linked in this way, it reduces the competition for the attention of the care provider. Therefore, some focus on your own needs is a necessity and should not be overlooked.Thank you for posing this very important question. Many support partners feel torn between providing care for their partner (or family member) and looking after their own needs. And as you have pointed out, after providing care, a support partner often feels depleted and unable to do something health promoting for himself or herself. Here are some ideas which might be helpful to the many support partners who are wrestling with this dilemma.
Secondly, let’s look at the statement, “No one is able to take care of me.” Part of being an effective support partner is identifying possible sources of support for yourself. The first place to look is your partner, the person for whom you care. Although she or he may not be able to provide physical help, s/he can certainly provide emotional support of some type. Even a “thank you,” or a “how are you doing today?” can provide an emotional boost. We know, however, that people living with MS sometimes need to be very self-focused in order to get through the day, and such may be unaware of your need for emotional support. You can tell your partner or family member that you need recognition, acknowledgement and gratitude. You can ask for it. And, if supportive statements from your partner are rare, make sure to let him or her know how much they are appreciated.
There are other potential sources of nurture and care for support partners, but it does take some effort to locate them. You may start by letting your closest friends or family members know a bit more about your life situation. Yes, they should already know because it is right in front of them, but they do not know what you need unless you tell them. If you tell your close friends and family, it is likely that they will offer help. They will not know what type of help you need. Make a list of tasks that would help you replenish. Each task should take about an hour, and if a friend or family member does the task, it will give you an hour to look after yourself; rest, go to the gym, meet someone for coffee, etc. Make index cards, each with one task. When a friend or family members asks, “Is there anything I can do.” Give them a card. The card might say, “Visit Lois for an hour on Wednesday afternoons, so I can go to Water Aerobics.” It might be, “Take our clothes to the cleaners.” It could say, “Find someone to visit Fred during lunchtime, so you and I could go out to lunch, and I won’t worry about Fred being alone.”
These days, many family members live far away and can’t offer support in person. Write some tasks on your list that can be done from afar: Find resources, call your partner on the phone, pay for a cleaning service or a few hours for an aide. There are many ways that we can support each other from a distance.
Finally, remember that your needs are as important as the needs of the person you support. Perhaps you like to go out to the local coffee shop, but your partner does not like to be seen in public with her walker. It is OK to emphasize that both of your needs have to be addressed. Although your partner or family member has the symptoms of MS, you are both living with all of the challenges caused by MS.