Case Management Services to Meet the Complex Needs of Patients with Multiple Sclerosis in the Community—The Successes and Challenges of a Unique Program from the National Multiple Sclerosis Society

Abstract

In spite of the therapies currently available to treat people with multiple sclerosis (MS), some individuals continue to experience physical, cognitive, and/or emotional changes over the course of the disease that severely compromise function, independence, safety, and quality of life. In addition, co-morbidities are common in people with MS, further impacting health and well-being, as well as the ability to manage their healthcare needs and cope with everyday life. The National MS Society’s Edward M Dowd Personal Advocate Program (which is one component of the National MS Society’s MS Navigator® Service) is designed to pick up where traditional neurologic care and Society MS Navigators cannot go—into patients’ home environments. This centrally administered program contracts with local professional case managers (most often nurses and social workers) to help stabilize individuals with multiple urgent care needs (for example, in cases of abuse or neglect, or inadequate food, housing or medical care, among others) while identifying and implementing longer-term, sustainable solutions leading to greater independence and quality of life. This article outlines the rationale and goals of the Society’s case management services, considers successful and unsuccessful outcomes that have occurred since the program’s inception, examines the factors that contribute to success or failure for any given patient, and describes future goals.