How Occupational Therapy Can Help
Multiple Sclerosis (MS) is a complex and often unpredictable neurological condition that affects the central nervous system. It can bring about physical, emotional, and cognitive challenges that vary from person to person. For those living with MS, everyday tasks can become difficult and sometimes impossible without support. This is where occupational therapy plays a vital role—not only for individuals with MS but also for the caregivers who support them.
At its core, occupational therapy (OT) is about helping people participate in activities that bring meaning to their lives. For someone with MS, that might mean continuing to cook meals, managing work responsibilities, caring for children, or simply maintaining independence with self-care. Through personalized assessments, adaptive techniques, and ongoing support, occupational therapists help clients find new ways to live well, despite the potential limitations imposed by MS.
Understanding Multiple Sclerosis
MS is an autoimmune condition where the immune system attacks the protective covering (myelin) of nerves in the central nervous system. This disrupts communication between the brain and the rest of the body, leading to a wide variety of symptoms, such as:
- Muscle weakness or spasticity
- Fatigue
- Numbness or tingling
- Vision problems
- Balance and coordination issues
- Memory or cognitive difficulties
- Bladder and bowel dysfunction
MS can be relapsing-remitting, where symptoms flare and then partially or fully recover, or progressive, where symptoms steadily worsen over time. Because no two people with MS experience the condition in the same way, individualised care is essential.
How Occupational Therapy Supports People with MS
Occupational therapists (OTs) work collaboratively with individuals who have MS to promote independence, improve quality of life, and prevent unnecessary decline. Here’s how:
1. Energy Conservation and Fatigue Management
Fatigue is one of the most common and debilitating symptoms of MS. OTs teach energy-saving techniques that help clients manage their daily tasks without becoming exhausted. These might include:
- Prioritizing activities and tasks
- Planning rest breaks throughout the day
- Sitting while performing tasks (like brushing teeth or cooking)
- Using assistive devices to reduce physical strain
By learning to balance activity and rest, clients can maintain their independence longer and avoid burnout.
2. Home and Workplace Modifications
An OT can assess a person’s home or work environment to identify hazards or barriers to independence. Simple changes like installing grab bars in the bathroom, rearranging furniture for easier mobility, or recommending ergonomic office equipment can make a big difference in safety and comfort.
For individuals who use mobility aids like wheelchairs or walkers, occupational therapists ensure that the space is accessible and functional.
3. Fine Motor Skills and Hand Function
MS can cause weakness, tremors, or numbness in the hands, making daily tasks like buttoning clothes, writing, or using cutlery difficult. OTs provide exercises, adaptive tools, and techniques that help maintain or improve fine motor skills.
Tools like built-up handles, button hooks, or specially designed kitchen utensils can empower clients to continue doing tasks independently.
4. Cognitive Rehabilitation: Regaining and Adapting
Cognitive changes in MS—such as memory difficulties, slowed information processing, and reduced attention—can be frustrating and impact many areas of daily life. Occupational therapists address these challenges using both compensatory and restorative strategies.
Compensatory strategies help clients work around cognitive deficits using external tools or routines. These might include:
- Visual schedules or calendars
- Reminders and alarms
- Written checklists and task sequencing
- Environmental modifications to reduce distractions
However, cognitive rehab isn’t only about adapting to deficits—it’s also about rehabilitating and strengthening cognitive skills through targeted, repetitive practice. This restorative approach aims to improve function in specific cognitive areas through structured mental exercises and graded activities. For example:
- Memory training: Practicing memory recall, association techniques, and mental imagery
- Attention and concentration exercises: Activities that build sustained, selective, and divided attention, such as sorting tasks or reaction games
- Problem-solving and planning tasks: Puzzles, decision-making scenarios, or real-life planning activities to re-engage executive functions
- Computer-based cognitive rehab programs: Tailored software that offers evidence-based brain training modules
Occupational therapists may also incorporate dual-task training—engaging in physical and cognitive tasks —to mimic real-life demands and rebuild neural pathways.
Progress is often gradual, but with consistent engagement and therapist-guided practice, many clients experience improvement in cognitive clarity, confidence, and independence.
5. Emotional and Psychological Support
Living with a chronic illness like MS can be emotionally taxing. OTs provide not just physical strategies but also emotional support. They help clients build routines that include social connection, relaxation, and activities that bring joy and fulfilment.
While OTs do not provide psychotherapy, they often work as part of a multidisciplinary team that includes psychologists, counsellors, and other healthcare providers to ensure holistic support.
Supporting the Caregivers
MS doesn’t just affect the person with the diagnosis—it also impacts their family, friends, and caregivers. Occupational therapists extend their services to caregivers to ensure they are equipped, supported, and empowered to care in a way that promotes dignity, independence, and a strong sense of identity for the person with MS.
Education and Training
Caregivers often take on new and unfamiliar roles, which can feel overwhelming. Occupational therapists provide hands-on training to assist safely with daily activities like mobility, dressing, transfers, and bathing—reducing the risk of injury for the caregiver and the person living with MS.
Importantly, OTs educate caregivers on how to support independence, rather than taking over tasks prematurely. This includes:
- Encouraging the person with MS to perform as much of a task as possible, even if it takes longer
- Breaking tasks into manageable steps and allowing time for completion
- Using cueing and prompting instead of doing tasks for the individual
- Providing emotional encouragement while avoiding overprotection
By helping caregivers understand the “just right challenge”—a core concept in occupational therapy—therapists teach them to balance offering support and promoting autonomy. This helps the person with MS maintain their functional abilities for as long as possible and reinforces their identity as a capable, independent individual.
Promoting Identity and Purpose
MS can erode someone’s sense of self, especially if they begin to feel like a passive recipient of care. Occupational therapists work with caregivers to ensure the person’s interests, roles, and routines are preserved or adapted. Whether it’s continuing to manage household tasks, pursuing hobbies, or staying involved in social and family life, OTs help caregivers create environments and routines that affirm the person’s identity and self-worth.
Encouraging independence is not just about function—it’s about dignity, confidence, and purpose.
Emotional Support and Resources
Caring for someone with a chronic, unpredictable condition like MS can lead to caregiver stress, fatigue, and even burnout. Occupational therapists help caregivers identify early warning signs of emotional overload and connect them to appropriate support services. This may include:
- Respite care options
- Peer support groups
- Community resources and counselling referrals
- Mindfulness and stress management strategies
OTs often help caregivers develop sustainable routines that include time for self-care and personal interests—because healthy caregivers are essential to sustainable care.
Collaborative Planning and Communication
Occupational therapists promote collaborative care planning, involving caregivers as active members of the rehabilitation team. By aligning everyone around shared goals and values, they ensure that the care provided is respectful and consistent. Caregivers are also supported in navigating conversations about changing needs, transitions, and decision-making with compassion and clarity.
Occupational Therapy: A Lifelong Partner
As MS progresses, needs may change. Occupational therapy is not a one-time intervention but an ongoing partnership. An OT may work with someone during a flare-up, post-hospitalization, or when transitioning to new stages of life. From young adults diagnosed in their 20s to older adults facing mobility challenges, occupational therapy adapts to the client.
Because MS is unpredictable, having an OT involved means there’s always someone ready to help you problem-solve, adapt, and continue living with purpose.
Multiple Sclerosis can significantly alter a person’s life—but it doesn’t have to define it. With the right support, people with MS can continue to engage in the activities that matter most to them. Occupational therapists provide essential tools, strategies, and encouragement not just for those living with MS but also for the caregivers walking alongside them.