[Decentralised treatment of multiple sclerosis by the general practitioner, district nurse and relatives (author's...

Success of treatment obtained by hospital rehabilitation in patients with multiple sclerosis is frequently lost at home after a short time even if there is no new exacerbation of the disease. There is a lack of competent follow-up treatment which is largely identical with informed care and exercise, e.g. of bladder function. In severely handicapped multiple sclerosis patients investigated at home, nursing was mainly done by a family member in 88%. In order to prevent recurrence of decubital ulcers, cystopyelitis, and other handicaps, the most promising method seems training of relatives. This is best done with the help of district nurses who, however, in their turn, should be better trained in practical courses. Discharge letters from hospitals should not only be sent to the G.P. but detailed nursing instructions should also be sent to district nurses and relatives. For prevention of deterioration, home care prescribed and controlled by the G.P. and performed by relations should be attempted making use of existing legal support. Treatment of chronically handicapped patients should be presented in more detail in medical refresher courses.