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consider the following patient case Mr Dinh Nguyen is an 83 year old widower who was diagnosed with Multiple Sclerosis (MS) six years ago

Mr Dinh Nguyen is an 83 year old widower who was diagnosed with Multiple Sclerosis (MS) six years ago. Four years ago he was diagnosed with osteoarthritis– which is now controlled on medication. The Nguyen’s migrated from Vietnam in 1976. Dinh lives alone in his own two story home where he has lived with his wife, Ngoc, until she died twelve months ago. Dinh has remained independent since then, however with his ongoing grief and increasing isolation he has noticed a marked decline in his health with ongoing worsening exacerbations of his MS. Dinh and Ngoc did not have children, thus Dinh has no immediate family. However, he has a brother, Bao and his family, living close by. Dinh, however does not want to involve them in his daily life as he does not want to be a bother to them Dinh has a small income from his self-managed superannuation and is careful with his money. This allows him some measure of financial independence, however, because of reduced investment returns, finances are now only just covering his expenses. He tries to go on a holiday once a year, but was unable to this year due to his altered mobility. Dinh has been experiencing some blurred vision, numbness in his face, and an “electric shock” type of feeling when he moves his head and neck, often travelling down his back and into his legs, impacting his movement and gait severely. This is making tasks such as cooking, showering, and dressing difficult, particularly bending down to do up his shoe laces. Dinh has also started to experience some episodes of urinary incontinence. Because Dinh perceives that his disease process is worsening, he is starting to wonder how he can face the uncertainty of his future.

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