By Heidi Godman
YOU MAY TAKE IT FOR granted that you can whip up a hot meal for one or dinner for the whole family. But for people with multiple sclerosis, cooking is one of the activities that often becomes challenging. “There’s a variety of different barriers someone may encounter that impacts the ability to cook,” says Rebecca Thomasson, an occupational therapist in the MS rehabilitation and wellness program at Shepherd Center in Atlanta.
The Challenge of MS
MS is an autoimmune disease that attacks the central nervous system – the brain, spinal cord and optic nerves. The damage caused by inflammation from MS makes it harder for nerves to communicate properly and leads to effects throughout the body. Common MS symptoms or related conditions include extreme fatigue and problems with cognition (slowed thinking skills or executive function), vision (blurry or double vision, or partial blindness), mood (depression and anxiety) and muscles (rigidity, weakness, lack of coordination, pain and neuropathy).
MS muscle complications can cause difficulty with fine motor skills (using hands and fingers) as well as trouble walking, maintaining balance and using one’s arms.
People with MS also have a tendency to overheat easily, which temporarily exacerbates MS symptoms.
MS in the Kitchen
MS challenges can make food preparation difficult, dangerous or even unfeasible. Here are some potential problems and fixes:
- Problem: Cognitive decline can make it hard to plan meals and determine which ingredients to buy.
- Fix: Use simple meal planning apps and choose meals with just a few ingredients or meals that are easy to prepare in a slow cooker.
- Problem: Disability may make it hard to get to a grocery store. Plus, walking or wheeling around the grocery store is exhausting for MS patients who tire easily.
- Fix: Ask a buddy to grocery shop with you or have groceries delivered to your home if the service is available and affordable.
- Problem: Cooking is hard work and leads to fatigue.
- Fix: Conserve energy by sitting on a chair while you cook, and setting up your kitchen so that cooking tools and ingredients are within easy reach. Learn to transport several items at a time (on a rolling cart or a tray you attach to a walker). And take shortcuts: Buy chopped vegetables and don’t worry about making everything from scratch. “Cook the chicken, but use a boxed pasta dish on the side,” Thomasson says. Another idea is cooking in large quantities and freezing meals to eat later.
- Problem: Standing near a hot stove or oven can trigger heat intolerance.
- Fix: Thomasson suggests using a fan, sipping cold water or wearing a cooling vest – clothing with pockets for cold packs. “That extends the ability to perform the task by keeping the body temperature lower,” she explains.
- Problem: Standing for long periods may cause back pain.
- Fix: Sit frequently while cooking or wear a back brace for extra support.
- Problem: Trouble using your hands and fingers can make it tough to open packages, grip and lift a pot, hold a kitchen tool, strain boiling pasta or chop vegetables.
- Fix: Use a silicone strainer to remove cooked pasta from a pot of boiling water, and leave the water to cool on the stove. Use adaptive equipment, such as special scissors to open packages, cutting boards that brace food and enable one-handed chopping, gloves that make it easier to grip pot handles, or knives and peelers with handles that make them easier to hold. Those tools are available online and at medical supply stores.
- Problem: Vision trouble (especially problems with depth perception) may make it hard to see where pots and pans are sitting on a stove or the settings for knobs and buttons on a stove or oven. That could lead to spills and burns.
- Fix: Wear silicone cooking gloves to protect your hands. Use brightly colored or raised stickers on knobs or buttons so you can see and feel them. Use pot stabilizers to reduce the risk of knocking a pot over.
Adapting your kitchen and cooking skills on your own can be daunting. Occupational therapy may help.
The therapist can guide you through the whole process of cooking. Other experts may also get involved. “The speech therapist might work on the cognitive component of planning and executing tasks,” Thomasson says. “The PT would work on mobility skills. I might be the one who teaches about the grocery shopping. We even have a full kitchen with an oven, stove, refrigerator and table. So I have patients plan a meal and go to the grocery store. And we come back, cook a meal and go through whole task.”
Dealing With More Severe Issues
What if your MS is so advanced that you can no longer shop or cook for yourself? This poses a serious health risk. You may not be able to ensure you’re eating a diet rich in essential nutrients, which can lead to malnutrition.
You do have a few options for meals, however. One is asking friends and family for meal assistance. Another option – for those who can afford it – is hiring someone to do the cooking: a private duty care companion (for about $25 per hour) or a private chef (which can costs hundreds of dollars per week, plus the price of groceries). However, that’s pricey, and many people with advanced MS live on limited budgets.
Fortunately, some nonprofit groups can help. Meals On Wheels delivers low-cost and sometimes free meals. The number of meals you receive and your required financial contribution for each meal varies by chapter and may depend on your income level. Check with your local Meals On Wheels for information.
Some nonprofit groups that are part of the Food is Medicine Coalition also deliver free fresh meals. If you want, the food can be tailored to your individual medical needs.
One such group is Project Angel Heart in Denver. It provides free medically tailored meals to people coping with life-threatening or chronic disease that causes mobility issues like MS. Eligibility is usually based on a doctor’s referral that must be recertified every six months. “Two-thirds of our clients with MS are on regular diets, but a third have diet restrictions. Their food may need to be pre-chopped because they don’t have the ability to cut it themselves, and they are on gluten-free diets because gluten may have inflammatory properties,” says Erin Pulling, the group’s CEO.
That kind of nourishment makes a big difference to people struggling with serious health problems. “One of our clients with MS is a single mom with four children,” Pulling says. “She also has Addison’s disease, depression, anxiety and peripheral neuropathy. Getting around the kitchen to cook for her children has been almost impossible. The meals have been a lifesaver for her.”
Having nutritious meals helps improve health outcomes, lowers the cost of care and boosts patient satisfaction, according to the Food Is Medicine Coalition. And experts say that’s going to be the case whether you accept assistance from a nonprofit group or learn adaptive skills that allow you to cook for yourself and remain independent. Ultimately, a healthy diet will help you manage MS.