MS: thoughts about the future

None of us can tell what is going to happen in our future, however carefully we plan it, but when people are living with a long-term, progressive condition the future sometimes has a special kind of unpredictability. Living alongside somebody with a condition that can be physically debilitating sometimes makes even everyday life uncertain. In these circumstances the longer term future can look still more unknown.

People we spoke to sometimes talked positively about the future, for themselves or for their relative or friend who has Multiple Sclerosis (MS). David was looking forward to spending more time with his wife when the last of his children left home. Mully said her husband was ‘always at the forefront of new things’ so she was confident that they would find solutions to any problems they might encounter. Sarah said, ‘We don’t look to the negative future. What’s the point?’

Nick sees his brother leading a pretty full life, despite the disease and is relatively hopeful about his future.

Age at interview 30

Gender Male

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It can seem more appealing to plan for the short-term future or to live day to day, focusing on the here and now. Planning for daily life was very important to Dave: ‘If you’ve got Plan A you can change it. If you don’t have a plan, you’re in chaos.’ Several people talked about the importance of planning their holidays or their respite care.

Chez thinks it is easier to live life day to day rather than looking weeks into the future.

Age at interview 42

Gender Female

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All Daves plans are based on what his wife is able to do. He always has a back-up plan in case it all goes wrong.

Age at interview 73

Gender Male

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Karl and his partner only make plans for a year or two ahead because they don’t know how MS is going to affect her.

Age at interview 40

Gender Male

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Focusing on the here and now did not exclude looking further ahead. Chez and her husband were planning to move to a different part of the UK.

Chez thinks that moving to Wales will be a positive step because it is something her husband really wants to do. She is used to moving around and thinks the time is right for something different.

Age at interview 42

Gender Female

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Some of those we spoke to were worried or scared about the future. Nicola’s mum is still fairly independent but Nicola wonders ‘where it will end’ and thinks about how she will help her mum in years to come. Ann thinks about the impact MS might have on her young daughter’s plans to have a family and on her ability to work. Louise found her GP’s advice helpful: ‘Don’t worry what’s going to happen in two years, three years. Just work out what you need to do now and get on with it and things will work out.’ Betty, on the other hand, was very frightened about the future and how she would look after her partner. Mike thought that one of the reasons he focused on the here and now is that he is scared of what might be ahead.

Betty is scared stiff’ of the future, as it gets harder to look after her partner and he gets more depressed. She is not confident that shell be able to get the help she needs.

Age at interview 58

Gender Female

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Other people preferred to put thoughts of the longer term future to the back of their mind, saying they’d rather not think about it.

Kate hopes for the best, but she does worry about the future. Her husband doesn’t like to talk about it and she says that like a lot of people we shove it to the back of our minds.

Age at interview 75

Gender Female

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Louise would rather not think about a future in which her husband becomes more disabled.

Age at interview 49

Gender Female

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The future can seem particularly unpredictable when dealing with MS. ‘You just don’t know,’ Eric said; and Betty said very definitely, ‘You can’t plan for the future’. Ray gave this uncertainty a positive slant when he said, ‘We know that the illness is going to progress but without a crystal ball we don’t know how it’s going to progress. So if the next 30 years with it is the same as the last 30 years then we’ll be doing all right. We’ll think we’ve done reasonably well’.

Despite this unpredictability, some people anticipated that the progression of the condition would mean that they would need to have more equipment to help the person with MS. Eric could see that his life was likely to become more ‘restricted’ as his wife’s condition deteriorated.

For Jeff’s wife, MS is progressing slowly. She takes an active approach to exercise for strength and balance, but Jeff thinks there might come a time when they will need a hoist.

Age at interview 62

Gender Male

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Others were preparing their living accommodation for the future: Louise and her husband have decided, after putting it off for a few years, to change their bathroom; Mully and her husband have made their moorland house ‘watertight’ and are ready to make any other alterations they need; Morris’s dad is ‘all set up for the worst’ in a flat which has space for live-in carers if he should need them. Kay talked about taking one step at a time, but she was also looking to the future by including space for a mobility scooter, which her husband doesn’t need yet, in the design for landscaping their front garden.

Kay and her husband have different approaches to imagining the future, which causes some tension between them. She deals with this by focusing on specific, practical things which will make their life easier.

Age at interview 49

Gender Female

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For some people thinking about the future brought thoughts of their own death, or the death of their relative or friend with MS. Some older people worried about how their adult children with MS would manage without them if they should die first; Jean said she hadn’t talked about the future with her son because it was ‘too painful,’ but hoped that other family members would support him after her death. Morris has developed a bond with his dad through caring for him. He worries about how he will cope when ‘the inevitable’ happens and his dad dies.

After her recent experience of breast cancer, Ann thinks about who will support her daughter in the long-term future. At the moment they take things chunk by chunk, year by year.

Age at interview 55

Gender Female

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Norma was reassured by her children that they would support their brother if she should die: Everything will be done for him’, they said, It just won’t be you doing it.

Age at interview 70

Gender Female

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While not everyone had discussed the future some were ‘desperately trying to avoid’ the option of care home. Morris said his dad ‘hates the idea’, John Y is really worried about having to pay for residential care for his wife and Kate says she and her husband ‘obviously’ don’t want to have to move to a care home in their old age (they are in their 70s now, living independently). Betty rejected her friends’ advice to ‘put him in a home,’ but she said her health was getting worse and she didn’t know how long she could cope with looking after her partner.

John’s children are young adults now and he worries about how he will afford to help them financially if he has to pay for his wifes long term care.

Age at interview 55

Gender Male

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Patience, whose husband is already severely disabled, avoided fear of the future by deciding to live each day as it comes and to be optimistic. ‘I am positive about the future,’ she said. ‘We will never lack. We will never be in want’.

(Also see ‘Talking about end of life‘).

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