When caring for a client with MS, you must be aware of the 3 most common symptoms. Managing these symptoms will help improve your client’s quality of life.
Having MS can cause one to become “incontinent.” This is where one loses the ability to control when they pass urine. MS can also prevent one’s bladder from emptying fully, which can lead to a Urinary Tract Infection (UTI). If you are worried that your client with MS may have a UTI, here are some signs to look out for:
The person has a burning sensation when passing urine
They need to visit the toilet more than usual
They cannot pass urine even if they feel like they need to
When they go to pass urine, only a little bit comes out
If they have a bad, fish-like smell
Their urine is cloudy, dark, or has blood in it
The person has a fever, chills, aches, or feels tired
If you notice your client has any of the symptoms above, it is important that you act fast. The best thing to do is take a sample of their urine and take it to your General Practitioner (GP) within an hour. If you are not able to do this, you can call the District Nurse (DN) and they will come out and test the urine. If the UTI test is positive, then you GP or DN can prescribe your client the antibiotics they require. If left untreated, the infection can spread to the kidneys and infect the blood causing Sepsis, which is a life-threatening condition that occurs when the body has a negative response to an infection.
To reduce the chances of your client getting a UTI, make sure they:
Drink 1.5 – 2 litres of water each day
Keep their catheter clean
Replace catheter bags regularly (leg bag each week, night bag each day)
Make sure you always have fresh catheter bags stocked up
MS can cause complications with the bowels that can lead to constipation. Having constipation means your client will be unable to have a bowel movement. They may also strain when trying to go to the loo, have some bloating, and if they are able to have a bowel movement, their stool (poo) will be hard. If your client is experiencing constipation, you can try and relieve the symptoms by:
Giving them an abdominal (stomach) massage.
Establishing a toileting routine that suits your client e.g., an hour after breakfast or after a hot drink
Getting a raised toilet seat or a stool, as having your knees higher than your hips with your feet apart can make having a bowel movement easier.
“Inserting a finger” (only do this if you have been taught by a qualified healthcare professional)
Keeping a diary of their bowel movement’s frequency, appearance, consistency and so on.
If you need guidance on how to describe your client’s bowel movements to a GP,MS nurse, or other medical staff, download the “Bristol Stools Chart” from the internet. It breaks down bowel movements into types e.g., types 1 and 2 bowel movements are like separate, hard nuts and usually indicate constipation, while types 5 and 6 are like soft blobs with clear cut edges and usually indicate diarrhoea.
Pressure ulcers, also known as pressure sores or bed sores, happen after one stays in the same position for too long. If your client spends a lot of time in a wheelchair or bed, they could be at risk as it results in a lack of blood flow to the parts of the body that have contact with an inanimate object (e.g., a chair or a bed)or another part of the body. Friction from moving or being moved can also cause pressure sores. The best way to prevent pressure sores are:
If your client has lost all mobility, it is important to change their sitting or lying position anywhere from every 15 – 30 minutes.
If your client’s wet themselves, change them as soon as possible as dampness can accelerate the production of pressure sores. If they wet themselves regularly, invest in some absorbent pads.
If your client is bed-bound, change their position every 2 hours or use an air-filled mattress. Put pillows or leg lifters under their legs to mitigate the weight on them.
If your client develops a pressure sore, do not fret as a pressure sore can occur with even the most through care. There are also many ways to treat and ease the pain of pressure sores and these are as follows:
You can use specially designed dressings to protect pressure sores and speedup the healing process. An example is hydrocolloid dressings that contains a gel to encourage the growth of new skin cells. Other dressing are available, but gauze is not recommended for prevention or treatment.
Barrier creams can be used to protect skin that has been damaged by incontinence.
Make sure their diet contains enough protein, vitamins, and water to help speedup the healing process.
In more severe cases where the sore is infected, antibiotics may be prescribed to help with treatment.
We hope this information on the 3 main symptoms of MS and how to manage them will help you care for your client with MS.
If you are concerned by the severity of any of the above symptoms, please contact your GP or DN to assess the symptoms and provide appropriate treatment.