Do cognitive issues make following instructions difficult

[Adriana]

Does anyone have cognitive issues from the MS that make it difficult to open hands, move legs or understand a basic request???

This is about a friend who has MS. She has really tried everyone's patience... she won't move or extend her right arm OR hand, she's not moving either of her legs and they are REALLY REALLY heavy to pick up, she's leaning to the right and has pushed herself to the front of the seat of her wheelchair coming close to pushing herself OFF the seat, which has an indention so she DOESN'T fall out,

when asked to open her hand and she opens her mouth, When asked to push herself upright in the chair and she pushed her butt even further up so she's "sitting" on her back...
Any suggestions??? Her neurologist is useless.

[agate]

Welcome, Adriana!

I'm sorry about your friend. It sounds as if she's having a very rough time with her MS.

You say her neurologist is useless. I hope that she isn't finding him/her useless. If she is, I hope that she can find another neurologist. A competent neurologist ought to be able to explain what is happening though there may not be any surefire remedy.

The right muscles and the right body parts may not move sometimes even though she may think they are--and actually she's moving some other body part. She probably has loss of sensation and may not be aware that she is opening her mouth when she's been asked to open her hand.

You say she won't move her arms or legs. She may be paralyzed to the point where she can't move them.

A little more compassion for her would be helpful. She can't help having MS, and it can do terrible things to people. Maybe you can help her to find some assistance in the form of home health aides because if she can't move her arms or legs, I'm not sure how she is dressing, eating, bathing, and doing other daily living activities.

[Adriana]

She is having a hard time coping with her disability. What I typed were her caregiver's words. She doesn't want to stretch or do her exercises so the question is, "is she faking it? or is it due to cognitive issues?"

[Howie]

It sounds to me to be more psychiatric issues than anything. She seems to be having a hard time accepting her disability, and unwilling to do what she can do to make the most of what she can do. You can't just give up, that doesn't make anything better.

You are a good friend to come here looking for help for your friend. But help has to start with her. Being ready to accept things, and build from there. I wish you both the very best.

[stillstANNding]

There are cognitive problems w MS. These include menory, word- finding, computing and others.

Faking is the last thing that I would think of. There's enough problems w MS w/o inventing new ones. There might be another problem going on.

I'd help her get evaluated by a competant MS specialist, neuro or internist as soon as possible.

Is she on any MS trestment? I am thinking of unusual side effects and secondary infections.

Thank you for caring about your friend. Please let us know what happens.
ANN

[agate]

It sounds as if you haven't observed your friend but have heard this information from her caregiver?

If your friend has a diagnosis of MS, it's unlikely she's faking, although she may be so frightened of what MS might do to her that she's talked herself into thinking she can't move some body parts. I haven't heard of this happening but there is such a thing as hysterical paralysis.

As others have said, this might be a psychiatric problem.

As stillstANNding said, an evaluation by a capable medical professional sounds like the best way to help her. Maybe you can persuade her to find and visit one.

You sound like a very caring friend.

[nuthatch]

MS affects everyone differently. I am affected on the right side of my body more than my left side. I also find my self leaning to the right because I cannot hold myself upright, it is especially bad when I am tired. It is very frustrating and uncomfortable. My husband tucks a small folded up throw blanket between me and the armrest of my wheelchair to shore me up and give me support. I cannot move my legs or feet either. I try to move my legs and toes and it feel like I am, but when I look, my toes are barely moving on my left foot only! Sometimes I think my legs/feet are in a position that, in reality, they are not in at all.

My point is, you're friend is most likely not "faking" a thing. It sounds likely that she is more severely affected by MS than most who can post here, and possibly differently and/or more severely affected than many with milder cases of MS and than what her caregiver has had experience with. All cases of MS are not the same and do not progress at the same rate.
It is my firm belief that all people should be treated with kindness, compassion, understanding, and loving encouragement.

[Sunshine]

This can definitely be due to MS. Remember, the disease affects the brain and spinal cord. Each person is a bit different depending in part on what part of the brain and spinal cord it affects.

My recommendation is to spend some time with her, see what you think, and the quality of her caretakers care. The problem may be the caregivers response to your friends disability. If she is lacking in basic skill and empathy, your friend may function even more poorly. I have seen that in patients with other types of chronic illness.

A good neuro can make a big difference, as well as a good friend, good caregiver and good physical therapist.

[Cat Dancer]

Does anyone have cognitive issues from the MS that make it difficult to open hands, move legs or understand a basic request???

This is about a friend who has MS. She has really tried everyone's patience... she won't move or extend her right arm OR hand, she's not moving either of her legs and they are REALLY REALLY heavy to pick up, she's leaning to the right and has pushed herself to the front of the seat of her wheelchair coming close to pushing herself OFF the seat, which has an indention so she DOESN'T fall out,

when asked to open her hand and she opens her mouth, When asked to push herself upright in the chair and she pushed her butt even further up so she's "sitting" on her back...
Any suggestions??? Her neurologist is useless.

Cognitive issues are those issues that are things like understanding, or being able to think quickly, or remembering, or things that affect the brain. It sounds to me like the only thing you're describing here that would be cognitive is the matter of what you say is "understand a basic request". But asking her to move a limb -- her arm, or hand, or leg -- and her not doing it isn't a matter of her not understanding the request, but may be that she *can't* move the limb! MS causes paralysis, weakness, loss of motor control. So while she may understand the request, she can't comply...she can't do it. She may be trying to do it .. her mind is saying, "hand, move!"...but the nerve impulses and muscles aren't working, so she can't.

If she is sliding in her seat so that she is, as you put is, "sitting on her back", it sounds like her trunk is involved -- MS weakens the muscles that keep a person upright, muscles in the back and butt and hips. When they're weak, it is extremely difficult to stay in a sitting position; you "slouch", and indeed can fall out of your chair. It's not that you WANT to do that..it's that you CAN'T keep upright, can't keep in an upright sitting position. You (or her caregiver) telling her to sit up won't help..again, she may well understand what you want of her..it's that her body can't do it. And if her legs are weak, or not working at all, she can't use them to push herself back into her chair. And if her arms are weak also, she can't use them to push herself back into her chair.

it sounds to me like her caregiver doesn't understand MS very well, and is expecting of her things that her MS has impaired her ability to do.

what are you expecting of her neurologist, that you call him/her useless? There is nothing the neuro can do about MS impairments. Once muscles and nerves are damaged or destroyed through MS, there is little a neuro can do. Sometimes function will return, but not always, and not always totally. She'll always experience some impairment, even with careful physical therapy. Medications a neuro might offer may help slow the progression, but they won't affect the symptoms either.

Rather than lose patience with your friend, you might spend some time learning all you can about MS, how it affects the nerves and muscles in a person, and what the meds might do to help. Then you can help your friend as she struggles with this disease, and help her caregivers give her better care.

[Jeanie Z]

:) Cat I agree with everything you said. No matter how hard I try I cannot move my left leg. Because the muscles in it are not used it swells since muscle action is what send fluid back up. I also have some cognitive issues remembering things. I'm glad you are trying to help your friend. We need all the support we can get as this is a very frustrating disease. Jeanie :)

[SuzE-Q]

Beautifully put, Cat!

And, as Jeanie discusses, the caregiver or friends can also help by rubbing or moving the affected limb to improve blood circulation and stimulate muscle stretches which often can lead to improvements and lessen swelling or problems due to poor circulation.

Finding gizmos that can offset some physical limitations can help too.

Engaging with the person, finding ways to help keep her mind active and neurons firing helps keep the connections strong.

Yes, it's important that caregivers and friends learn as much as possible to be able to support her and increase her quality of life, advocate for her where needed, and be a good, understanding friend.

I'm glad you sought out advice!