It is often this area of early intervention and counselling in the rehabilitation process of MS that fails to attract the recognition it deserves. Rehabilitation practitioners in the MS field have often been disappointed with disability rating scales in both the inpatient and community settings as they do not sufficiently reflect this psychological effort. The degree of social and physical handicap a person experiences is dependent on many factors, most particularly the community and how it looks after the disabled. The wheelchair dependent person in the city today finds himself or herself in many ways trapped within the home. While the circumstances differ, both are handicapped.
Rehabilitation needs to extend itself to be an advocate for disabled people.
There is a need to improve community perceptions and work with governments to improve all areas of physical access, transport and communication for the disabled if we are to effectively influence handicap. There is no simple answer to this question but as a priority the whole team must work well together. The team must be multilevel and multidisciplinary. It involves a high standard of medical management of impairments such as infections, comorbid conditions, spasticity and pain. There must be good formal and informal communication on goals, objectives and outcomes.