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Principles of ongoing management 

Principles of ongoing management
Chapter:
Principles of ongoing management
Author(s):

John Zajicek

, Jennifer Freeman

, and Bernadette Porter

DOI:
10.1093/med/9780198569831.003.0018
Page of

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date: 19 August 2019

Introduction 172

Adopting a rehabilitation approach 174

Guided self-management 176

Active involvement of the individual in treatment decisions 180

Comprehensive assessment of needs 182

The multiplicity of symptoms that may arise as a result of MS means that the physical, cognitive and psychosocial consequences are often wide-ranging, variable and complex. Because the disease evolves at differing rates over several decades, the needs of the individual will change over time, often quite suddenly and unexpectedly. These needs extend from the core medical parameters, and may include every facet of individual, family and community existence. Effective overall management of the individual therefore involves taking a long-term and proactive approach to management which begins from the point of diagnosis and continues throughout their lifetime. It requires an approach which acknowledges that this life-long disease requires a continuing relationship to be developed wherein the person with MS needs to be able to access services in a timely manner, as their needs change. Unfortunately surveys demonstrate that this contrasts starkly with the reality for many people whose experience of health and social care service input is overwhelmingly one of crises management wherein interventions are provided as a fragmented series of short term quick fixes....

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