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Understanding and Treating Psychosocial Barriers


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                                          © 2013 Griswold International, LLC
What is Multiple Sclerosis (MS)?

Multiple Sclerosis (MS) is a chronic, often disabling
disease that attacks the central nervous system
(CNS), which is made up of the brain, spinal cord,
and optic nerves.
Symptoms may be mild, such as numbness in the
limbs, or severe, such as paralysis or loss of vision.
The progress, severity, and specific symptoms of
MS are unpredictable and vary from one person to
another. Today, new treatments and advances in
research are giving new hope to people affected by
the disease.


                                  National MS Society
                                  www.nationalmssociety.org

                                                              © 2013 Griswold International, LLC
“The quality of life in
   patients with MS is not solely
       determined by physical
     disability, but rather by the
 level of social support, living area,
   depression, level of education,
employment, fatigue and religiosity…
  we suggest that these should be
 evaluated in every patient with MS
     as they may be modified by
       targeted interventions.”

          (Yamout et al, 2013)




                                         © 2013 Griswold International, LLC
 “Depression
                                        and MS”
                                                          “Newbie with
                      “Anxiety or                          questions”
                      MS...Scared”

Subjects
Matter
Patient discussion
board subjects
uncover “invisible”
symptoms


                                                                    “Am I
                                                                  just crazy?”
                       “Scared of
                        romance”

                                      “Taking meds
                                     through airport
                                        security?”
                                                       © 2013 Griswold International, LLC
Shifting the Focus
from Medical
to Psychosocial




                     © 2013 Griswold International, LLC
Psychosocial factors are predictors
of quality of life in MS
                                     Values, Emotions,
                                   Beliefs, and Attitudes
 Surrounding                      Anxiety, depression, uncertainty, fear,
 Environment                                 anger, isolation
   Financial issues,
competing needs, access
   to care/services




                                                Knowledge
                                            Understanding of MS and
                                              how to self-manage
    Support
    Network
   Awareness and
   access to family,
    friends, peers,
       advocacy
                               Self-Efficacy
                           Confidence in diagnosis, care
                            team, treatment, ability to
                              manage MS/treatment


                                                        © 2013 Griswold International, LLC
Highlighting a disconnect between
    Patients and Prescribers
       Prescriber                                                   Patient
Primary focus on managing                                 Primary focus on managing
physical symptoms with                                    psychosocial (“Invisible”)
medication due to time                                    symptoms yet reluctant to
limitations                                               discuss with their prescriber
• Numbness or weakness in one or                          • Overwhelmed with diagnosis
  more limbs                                              • Overloaded by amount of information
• Partial or complete loss of                               they are given
  central vision                                          • Depression due to isolation and
• Double vision or blurring of vision      Disconnect       mounting losses
• Tingling or pain in parts of your body     Medical      • Fear and uncertainty about the future
• Electric-shock sensations that occur
  with certain head movements
                                               vs.        • Loss of roles: parent, spouse, worker,
                                                            active member of society
• Tremor, lack of coordination or          Psychosocial   • Impact on family and relationships
  unsteady gait                                           • Concern about financial issues
• Slurred speech                                          • Difficulty with activities of daily living
• Fatigue                                                 • Travel concerns
• Dizziness




                                                                             © 2013 Griswold International, LLC
Bring on the Healthcare Extenders!:
Professionals who focus primarily on psychosocial issues


                                                     Nurse
                   PT/OT/Speech                   (RN, LPN, APN)



      Pharmacist                                                   Advocacy




     Griswold                                                          Government
    Home Care                                                           Agencies




          Family/Friends                                     Discharge Planner


                                   Counselor,
                                  Social Worker

                                                                      © 2013 Griswold International, LLC
MS Non-Medical Toolkit Solutions

        Videos

Mood Changes and MS: Understanding Depression – National MS Society: http://bit.ly/Z0gmob
Mood Changes and MS: Managing Anxiety – National MS Society: http://bit.ly/X7yxIY
Career Crossroads: Employment and MS Part 1 – National MS Society: http://bit.ly/Z0gyni
MS in a Personal Relationship – National MS Society: http://bit.ly/YbkkuU


        Tools                                                           Resources

MS Quality of Life Inventory: http://bit.ly/Ya0a7x                 MS Connections:
PlainTalk: A booklet about MS for families: http://bit.ly/ZLn3Pb   http://bit.ly/ZAeO5a
Clinical Practice Guidelines: http://bit.ly/XuId66                 Living with MS:
                                                                   http://bit.ly/Z0gXWT
                                                                   MS Learn Online:
                                                                   http://bit.ly/YseGDZ



                                                                           © 2013 Griswold International, LLC
Takeaways
Points to remember
   Quality of life for MS patients is directly related to
   psychosocial issues that are rarely addressed or
   discussed with prescribers

   Health care extenders can play a key role in helping to
   uncover these “invisible” symptoms and providing tools to
   overcome them


Join the conversation
   What best practices could you share on this topic?

   How helpful is this information? What other information would be helpful in the future?


                  GriswoldHomeCare.com/Blog



                                                                          © 2013 Griswold International, LLC
Thank you for viewing our presentation!

Brought to you by:                        Griswold Home Care offers access to affordable
                                          non-medical care options to assist your loved one.

                                                    CareAssure Screening System™
                                                    The Griswold Golden Rule: We only approve
                                                    caregivers we would trust in our own homes.


Extraordinary Home Care                             QuickCare Placement™
                                                    We give each family access to the most
at Affordable Rates Since 1982                      experienced caregivers available.

Griswold Home Care is committed to                  ValueCare Commitment™
being the best care service option for
                                                    Simple Rates. Unmatched Value. Our all-
non-medical home care. We refer only                inclusive rates are among the most affordable.
the most experienced, compassionate
caregivers in the industry to help each
client maintain the dignity, safety,             National 24x7 Care Line:
independence, and peace of mind they                 800-GRISWOLD
deserve – regardless of where they
call home.                                       GriswoldHomeCare.com

                                                                            © 2013 Griswold International, LLC
Sources
Yamout, B et. al. (2013)
Predictors of quality of life among multiple sclerosis patients: a comprehensive analysis; European
Journal of Neurology, DOI: 10.1111/ene.12046.
http://onlinelibrary.wiley.com/doi/10.1111/ene.12046/abstract

Healthboards.com
http://www.healthboards.com/boards/multiple-sclerosis/index425.html

National MS Society
http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/index.aspx




                                                                                © 2013 Griswold International, LLC

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The Invisible Side of MS – Understanding and Treating Psychosocial Barriers

  • 1. Understanding and Treating Psychosocial Barriers Brought to you by: © 2013 Griswold International, LLC
  • 2. What is Multiple Sclerosis (MS)? Multiple Sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another. Today, new treatments and advances in research are giving new hope to people affected by the disease. National MS Society www.nationalmssociety.org © 2013 Griswold International, LLC
  • 3. “The quality of life in patients with MS is not solely determined by physical disability, but rather by the level of social support, living area, depression, level of education, employment, fatigue and religiosity… we suggest that these should be evaluated in every patient with MS as they may be modified by targeted interventions.” (Yamout et al, 2013) © 2013 Griswold International, LLC
  • 4.  “Depression and MS” “Newbie with “Anxiety or questions” MS...Scared” Subjects Matter Patient discussion board subjects uncover “invisible” symptoms “Am I just crazy?”  “Scared of romance” “Taking meds through airport security?” © 2013 Griswold International, LLC
  • 5. Shifting the Focus from Medical to Psychosocial © 2013 Griswold International, LLC
  • 6. Psychosocial factors are predictors of quality of life in MS Values, Emotions, Beliefs, and Attitudes Surrounding Anxiety, depression, uncertainty, fear, Environment anger, isolation Financial issues, competing needs, access to care/services Knowledge Understanding of MS and how to self-manage Support Network Awareness and access to family, friends, peers, advocacy Self-Efficacy Confidence in diagnosis, care team, treatment, ability to manage MS/treatment © 2013 Griswold International, LLC
  • 7. Highlighting a disconnect between Patients and Prescribers Prescriber Patient Primary focus on managing Primary focus on managing physical symptoms with psychosocial (“Invisible”) medication due to time symptoms yet reluctant to limitations discuss with their prescriber • Numbness or weakness in one or • Overwhelmed with diagnosis more limbs • Overloaded by amount of information • Partial or complete loss of they are given central vision • Depression due to isolation and • Double vision or blurring of vision Disconnect mounting losses • Tingling or pain in parts of your body Medical • Fear and uncertainty about the future • Electric-shock sensations that occur with certain head movements vs. • Loss of roles: parent, spouse, worker, active member of society • Tremor, lack of coordination or Psychosocial • Impact on family and relationships unsteady gait • Concern about financial issues • Slurred speech • Difficulty with activities of daily living • Fatigue • Travel concerns • Dizziness © 2013 Griswold International, LLC
  • 8. Bring on the Healthcare Extenders!: Professionals who focus primarily on psychosocial issues Nurse PT/OT/Speech (RN, LPN, APN) Pharmacist Advocacy Griswold Government Home Care Agencies Family/Friends Discharge Planner Counselor, Social Worker © 2013 Griswold International, LLC
  • 9. MS Non-Medical Toolkit Solutions Videos Mood Changes and MS: Understanding Depression – National MS Society: http://bit.ly/Z0gmob Mood Changes and MS: Managing Anxiety – National MS Society: http://bit.ly/X7yxIY Career Crossroads: Employment and MS Part 1 – National MS Society: http://bit.ly/Z0gyni MS in a Personal Relationship – National MS Society: http://bit.ly/YbkkuU Tools Resources MS Quality of Life Inventory: http://bit.ly/Ya0a7x MS Connections: PlainTalk: A booklet about MS for families: http://bit.ly/ZLn3Pb http://bit.ly/ZAeO5a Clinical Practice Guidelines: http://bit.ly/XuId66 Living with MS: http://bit.ly/Z0gXWT MS Learn Online: http://bit.ly/YseGDZ © 2013 Griswold International, LLC
  • 10. Takeaways Points to remember Quality of life for MS patients is directly related to psychosocial issues that are rarely addressed or discussed with prescribers Health care extenders can play a key role in helping to uncover these “invisible” symptoms and providing tools to overcome them Join the conversation What best practices could you share on this topic? How helpful is this information? What other information would be helpful in the future? GriswoldHomeCare.com/Blog © 2013 Griswold International, LLC
  • 11. Thank you for viewing our presentation! Brought to you by: Griswold Home Care offers access to affordable non-medical care options to assist your loved one. CareAssure Screening System™ The Griswold Golden Rule: We only approve caregivers we would trust in our own homes. Extraordinary Home Care QuickCare Placement™ We give each family access to the most at Affordable Rates Since 1982 experienced caregivers available. Griswold Home Care is committed to ValueCare Commitment™ being the best care service option for Simple Rates. Unmatched Value. Our all- non-medical home care. We refer only inclusive rates are among the most affordable. the most experienced, compassionate caregivers in the industry to help each client maintain the dignity, safety, National 24x7 Care Line: independence, and peace of mind they 800-GRISWOLD deserve – regardless of where they call home. GriswoldHomeCare.com © 2013 Griswold International, LLC
  • 12. Sources Yamout, B et. al. (2013) Predictors of quality of life among multiple sclerosis patients: a comprehensive analysis; European Journal of Neurology, DOI: 10.1111/ene.12046. http://onlinelibrary.wiley.com/doi/10.1111/ene.12046/abstract Healthboards.com http://www.healthboards.com/boards/multiple-sclerosis/index425.html National MS Society http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/index.aspx © 2013 Griswold International, LLC