The Impact of Multiple Sclerosis on Employment

The National Multiple Sclerosis Society (as cited in Bishop & Rumrill, 2015) states that the debilitating disease of multiple sclerosis (MS) impacts 2.3 million individuals around the world. This particular disease is considered chronic and typically worsens in severity over time, leading to an array of diverse symptoms that primarily diminish physical and cognitive abilities (Finlayson, Garcia, & Cho, 2008). As a result of these impaired abilities, employment is one of the most prominent areas of daily life impacted (Bishop & Rumrill, 2015). In fact, McFadden et al. (as cited in Bishop & Rumrill, 2015) affirms that merely 20% of individuals with MS maintain their employment positions for 10 years post-diagnosis. This circumstance is troubling for individuals with MS due to the fact that employment is a significant aspect of a prosperous and fulfilling life (Institute of Medicine as cited in Bishop & Rumrill, 2015). A thorough examination of the etiology and nature of deviation regarding MS will be conducted to identify how specific impairments are correlated to difficulties with employment maintenance.

Etiology and Nature of Deviation

MS is categorized as a disease of the central nervous system (CNS) marked by sporadic, repetitive occasions of inflammation (Lee & Dunn as cited in Bishop & Rumrill, 2015). In the beginning of disease onset, individuals with MS typically experience alternating periods of disease progression and regression (Cameron & Klein, 2010). However, as time elapses, some individuals with MS experience an increase in symptom severity as inflammation heightens (Cameron & Klein, 2010). The inflammation ultimately engenders demyelination of neuronal axons throughout various areas in the CNS including the brain, spinal cord, and optic nerves (Lee & Dunn as cited in Bishop & Rumrill, 2015). Myelin is composed of lipids and functions as an axonal covering that promotes enhanced speed and efficiency of electrical impulse conduction (Schapiro as cited in Bishop & Rumrill, 2015). When the myelin covering is diminished and damaged through the presence of inflammation, electrical impulses sent between communicating neurons decelerates (Bishop & Rumrill, 2015). As a consequence of this impulse deceleration, the communication of information between neurons loses efficiency and can ultimately obstruct an array of physical, cognitive, sensory, and psychological processes in the body (Schapiro as cited in Bishop & Rumrill, 2015).

The exact etiology of MS is not factually declared (Bishop & Rumrill, 2015). However, biological and environmental components present possible explanations regarding the likelihood of acquiring this disease (Bishop & Rumrill, 2015). In addition, the body’s immune system may also contribute to the development of MS (Pakenham as cited in Bishop & Rumrill, 2015). Pakenham (as cited in Bishop & Rumrill, 2015) states that individuals with MS tend to have immune system responses that trigger T cells to attack the myelin of axons in the CNS.

Impairment

The symptoms that manifest from MS fluctuate between impacted individuals (Herndon as cited in Bishop & Rumrill, 2015). Herndon (as cited in Bishop & Rumrill, 2015) explains that the reason for symptom diversity within this population involves the differences in location and severity of the CNS damage. For instance, damage to the frontal and parietal lobes of the brain typically lead to psychological issues, while damage to the brainstem and spinal cord engender diminished physical abilities of the bodily limbs (Fraser, Clemmons, & Bennett as cited in Bishop & Rumrill, 2015). Two prevalent impairments resulting from MS involve cognitive dysfunction and fatigue (Bishop & Rumrill, 2015). Chiaravalloti and DeLuca (as cited in Bishop & Rumrill, 2015) state that cognitive dysfunction is found in up to 70% of individuals who suffer from MS. Although the degree and type of cognitive dysfunction differs from person to person, typical problems include challenges with memory recollection, attentive abilities, and executive skills (Pakenham as cited in Bishop & Rumrill, 2015). Fatigue, on the other hand, is present in 92% of individuals with the condition of MS (The Multiple Sclerosis Coalition as cited in Bishop & Rumrill, 2015). The Multiple Sclerosis Council for Clinical Practice Guidelines (as cited in Andreasen, Stenager, & Dalgas, 2011) explains that the presence of fatigue results in the diminished ability to execute functional activities of daily life.

Therefore, individuals with MS who specifically possess cognitive impairments and fatigue struggle to preserve the physical and cognitive abilities required to execute employment duties and maintain occupational positions (Bishop & Rumrill, 2015). In addition, these particular individuals face environmental hinderances that cause the maintenance of employment to be challenging to an even greater degree (Duggan, Fagan, & Yateman as cited in Bishop & Rumrill, 2015). As a result of these impairments, employment positions can be lost (Bishop & Rumrill, 2015). This particular circumstance is difficult for this population since employment provides a sense of purpose, leads to essential social engagement, and secures financial means (Institute of Medicine as cited in Bishop & Rumrill, 2015). Both cognitive dysfunction and fatigue represent only two out of many MS impairments that can lead to the loss of employment (Bishop & Rumrill, 2015).

Conclusion

The globally-prevalent disease of MS leads to the diminishment of physical and cognitive abilities required to complete daily functional tasks (Finlayson, Garcia, & Cho, 2008). As a result of functional limitations, employment becomes challenging for this population to maintain (Bishop & Rumrill, 2015). This circumstance ultimately lessens the quality of life present within this particular population, eliminating an essential component of daily routine (Schiavolin et al. as cited in Bishop & Rumrill, 2015).

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