Karen Bailey is a 39 year old who was diagnosed with remitting Multiple Sclerosis 4
Karen is married to Geoff, and they have 3 children aged 3, 5, and 9 years old
respectively. They live in their own home which is spread across two levels. Geoff is Karen’s
primary carer Geoff is a partner is an accountancy firm which involves a large amount of
interstate travel. He is often not able to get home before 7.00 PM of an evening.
Karen now needs to use a walking frame to maintain her level of ambulation and is
finding it increasingly difficult to mobilise easily. Karen’s sister, Lisa lives nearby and visits
often. Lisa is keen to be involved in looking after her sister; however Karen doesn’t want Lisa
to see the extent of her condition or her lack of independence.
Karen continues to look after the children on a daily basis, however some afternoons
Karen finds this more difficult than others. Karen is finding that it is harder and harder to
remain positive about her changing condition.
Karen has always enjoyed reading, however due to deteriorating eyesight and weaker
arm muscles, Karen is no longer able to focus on the text or hold the book. Lisa has arranged
some talking books for Karen, however increasingly the concentration required to use these
has become too tiring.
Geoff is struggling with the joint responsibilities of work and increasing role in
Karen’s care. He goes into the office later in the morning after assisting her with a shower;
however this results in him coming home later in the evening. He has indicated that he feels
increasingly powerless in this situation and is concerned about what the future holds for
Only discuss one or two points on nursing implications but this is not the main priority, main
priority is the above question
Psychosocial Impact of Multiple Sclerosis
Psychosocial Impact of Multiple Sclerosis on Lisa
Lisa, on the other hand is having a stressful life. It really saddens her to see her sister
suffering. It becomes even more stressful for her to learn that her sister is rejecting any form
of aid she is providing despite her working hard to ensure that Karen tries to maintain her
quality of life. Koffman et al., (2013) enlighten that care givers of patients with multiple
sclerosis use different strategies to cope to their emotional functionality. Lisa has been forced
to change her routine. She is now updating herself on current research on the disorder and
attending support group meetings in search of how she can help her sister. For instance, Lisa
has gone out of her way and found out that Karen can use some audio books in satisfying her
desire to read that she has always had. However, it is frustrating for Lisa to learn that her
proud sister does not appreciate all that Lisa is doing. In fact, Lisa develops doubts on
whether she is listening to the books. This is quite stress for Lisa who now does not know
what she can really do to help her sister further. Moreover, there is a high likelihood for Lisa
to lose contacts her with her friends as she used so that she can concentrate on taking care of
her sister and the young kids.
Studies have indicated that about half care givers report of not being able to
communicate effectively with their loved ones with conversation about emotions,
medications, medical decisions, and other life difficulties (Hind et al., 2014; Uccelli et al.,
2013). For instance, Lisa does not know how she should approach Karen when she starts
having thoughts of stopping her medication and embarking on herbs. Lisa also develops fear
for Karen’s general health and physical decline as well as the fear that the disease is robbing
her friend’s vision.
Providing care for patients with multiple sclerosis is lonely and isolating especially
now that Karen starts to gradually lose her ability to communicate effectively (Hayter et al.,
2016). Lisa has been forced to improvise and find new ways of connecting with Karen with
on emotional level or regarding practical matters. Lisa feels saddened and sorry for her sister
due to the impact that the disease has on her. She does not like to see Karen a once competent
and hardworking lady being reduced to an extent that she can no longer clean her children as
she used to. Hopelessness is also affects Lisa who reports of lacking control or influence over
Karen’s situation. Hopelessness is aggravated further due to nonparticipation in care or
decision making. This is seen when she finds out that her sister is considering taking herbs
without letting her know despite her being there for Karen at all times. Lisa cannot also
continue performing her routine roles as she has been forced to reschedule and find time for
taking care of Karen.
Nurses are in a unique position of monitoring individuals such as Lisa and their
psychosocial care (Urden et al., 2013). For instance, nurses can build dialogue with patients
in order to understand how caregivers perceive their loved ones and how their relationships
with patients affect their decisions and their ability. The communication should use general
interactional skills to convey empathy and support. Nurses can also create an environment for
Lisa that makes her feel comfortable and safe to relate and communicate. This would play an
important role on Lisa as she relies on the nursing staff for the emotional journey she will be
Hayter, A. L., Salkovskis, P. M., Silber, E., & Morris, R. G. (2016). The impact of health
anxiety in patients with relapsing remitting multiple sclerosis: Misperception,
misattribution and quality of life. British Journal of Clinical Psychology.
Hind, D., Cotter, J., Thake, A., Bradburn, M., Cooper, C., Isaac, C., & House, A. (2014).
Cognitive behavioural therapy for the treatment of depression in people with multiple
sclerosis: a systematic review and meta-analysis. BMC psychiatry, 14(1), 1.
Koffman, J., Gao, W., Goddard, C., Burman, R., Jackson, D., Shaw, P., … & Higginson, I. J.
(2013). Progression, symptoms and psychosocial concerns among those severely
affected by multiple sclerosis: a mixed-methods cross-sectional study of black
Caribbean and white British people.PloS one, 8(10), e75431.
Uccelli, M. M., Traversa, S., Trojano, M., Viterbo, R. G., Ghezzi, A., & Signori, A. (2013).
Lack of information about multiple sclerosis in children can impact parents’ sense of
competency and satisfaction within the couple.Journal of the neurological
sciences, 324(1), 100-105.
Urden, L. D., Stacy, K. M., & Lough, M. E. (2013). Critical Care Nursing, Diagnosis and
Management, 7: Critical Care Nursing. Elsevier Health Sciences.