Support systems and services are available to enable people with MS to continue employment as long as they are productive and desire to work.

Many people with MS leave the labour force because of the symptoms of the disease, such as fatigue, functional disability, and cognitive impairment. Leaving the workforce can have a major effect on family income as well as an individual’s selfesteem. Some people with MS could continue to work if employers provide assistance and restructure their work.

A wide range of accommodations or adaptations are possible, including part-time work, additional breaks in the work day, working only mornings, reducing the room temperature, changing work tasks, telecommuting, reducing travel, providing ramps, providing offices near restrooms, and others. Governments and social service providers can contribute by providing vocational rehabilitation and training programmes.

For those people with MS who do leave the labour force, substitute activities are important to sustain a sense of purpose in life. Examples include voluntary activities, creative arts, serving as MS peer counsellors, assisting with MS Society or MS centre administration or advocacy efforts, pursuing further education, and others.

7.1. Services must be available to allow people with MS to continue employment as long as they are productive and desire to work. Ref 3,6,9,12,13,15,17,19,20,25-28,30,35,42,46-48,56,59,65-67,124,152,165, 186-189

7.2. Employers must provide job modifications and other adaptations or accommodations to enable people with MS to continue working. Employers must be educated about the nature and symptoms of MS, and how job modifications can often enable people with MS to remain productive employees for many years. Ref 3,9,12,13,15,17,19,20,26-28,35,37,38,42,46,47,56,65-67,124,152,165,186-189

7.3. Employers should provide time off for family members and other informal care-givers to accommodate the unexpected needs of people with MS. Employers should be educated about the roles of family members in treating and managing acute exacerbations and symptoms of MS. Ref 3,13,15,19,28,37,47,189

7.4. Vocational rehabilitation and training services must be available to help people with MS return or stay in the labour force, if desired. Ref 3,6,12,13,26-28,35,42,46,47,65-67,124,152,186,187

7.5. When people with MS do retire from paid employment, they must be provided counselling and encouragement to develop alternative, voluntary activities that can fill the void often left by the loss of work. The transition out of paid employment is to be planned well in advance to ensure people with MS receive all of the services to which they are entitled, to prepare for alternate occupations or activities, and to avoid the stress that may accompany abrupt, unplanned transitions from work to retirement. Ref 3,8,20,21,25,37,42,189