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Multiple Sclerosis (MS) Fatigue

Strategies to maximize your energy

​​​​​​​​​​​​​​​Maximizing your energy means doing things in the most​ efficient way so that you have enough energy for the activities you enjoy the most. It’s about using your energy wisely. Everyone can benefit from doing things to maximize their energy, but it’s an essential strategy for people living with MS.

There are many ways to maximize your energy. Three common ways are prioritization, planning, and pacing.

Prioritization

Prioritization means deciding what to spend your energy on during a day or week. The amount of energy you have is limited, so prioritizing how to use that energy will help you do the things that are most meaningful to you.

Prioritization involves asking:​

  • ​What do I need to do?
  • What do I want to do?
  • What can I ask someone else to do (delegate)?
  • What is not important?

After you have asked yourself these questions or talked about them with a support person, put your tasks and activities for the day or week in order of priority and write your to-do list. Your to-do list can include your top priorities, what you can do next, and what you might do only if you have energy left.

When you are setting your priority list for the day, try to have no more than 3 top priorities. Having more than that can make your list hard to manage.

Planning

Planning is an important part of managing fatigue and can be a good strategy to maximize your energy. Everyone may plan differently, but here are some ideas to help you find what might work best for you.

  • Schedule tasks in your to-do list, keeping in mind the time of day and your fatigue triggers.
  • Spread tasks out over time. Give yourself time for enough rest throughout the day.
  • Rotate between heavy and light tasks.
  • Predict when you might need to rest and plan your tasks around that. Plan to do your highest priority tasks when you are less fatigued.
  • Think about your day as a whole, like planning to make an easy dinner when you know you’ll have a busy day.
  • Plan over longer periods to find ways to balance your to-do list, like planning to hire a housekeeper one time per month.

Pacing

Pacing means expecting fatigue and resting before your fatigue gets worse. Resting can prevent fatigue and restore your energy levels. Resting doesn’t always mean sleeping or napping. Learn more about different kinds of rest and the different ways that you can rest.

A quick and easy way to pace is to schedule breaks before you need them. With pacing, you might do a little, then rest a little. Take several small breaks during an activity or task so that you can prevent a sharp decrease in your energy levels. Taking breaks before you are tired also keeps your energy levels higher than if you wait to rest until after the activity is done or after your energy levels are low.

You might feel pressured to push through a task and not rest until it is done. But studies on pacing show that your productivity stays the same, or can actually improve, if you take breaks compared to those who push through the task.

Another part of pacing involves switching from one type of task to another (rotating duties). For example, you can pace yourself by doing laundry, which is a physical task, and then sitting down to make an appointment, which is a thinking task.

Pacing takes planning, especially on a busy day. It’s helpful to know your limits and plan around that. You may also find it helpful to plan breaks first, then plan activities around the breaks. Remember that you also need breaks during cognitive, social, and mental tasks, like socializing with friends.

Your fatigue can change from day to day. On days where your energy is lower, you might feel an automatic cue to slow down or do less. But on days where your energy is higher, you need to be deliberate about pacing because otherwise you might overdo it and have an energy crash that takes a long time to recover from.

Delegation and asking for help

Delegation means giving certain tasks to others. This can help save your energy. This could mean that a family member, friend, or support person does tasks like home maintenance, carpooling to and from kids’ activities, meal planning and preparation, cleaning, or grocery shopping. If possible, you can also think about hiring help for these tasks, like scheduling a housekeeper, having groceries delivered, or using a landscaping company for outdoor chores.

Asking for and accepting help is a tough thing for anyone. Remember that it is OK to ask for help, and that asking for help can be considered a strategy to manage fatigue.

If you are a support person for someone living with MS, remember that they may not want to ask for help even if they would benefit. Sometimes offering to assist in a small way is helpful. As a support person, you are allowed to ask for help as well, especially if you are taking on additional duties.

Reduce the number of tasks

Get rid of unnecessary tasks by thinking through what you need to do and looking for ways to make it easier. For example, you can reduce the number of trips you take up and down stairs by putting a basket on the stairs to collect items that need to go up or down. Or you can throw laundry down the stairs instead of carrying it down in a basket. When preparing meals, you can choose simpler recipes, use grocery delivery services if they are available, reduce the number of dishes you use to make clean up easier, and use the dishwasher as much as possible.

Ergonomics

Think about your posture and how you are doing tasks. Be mindful of your body’s posture and how you interact with different objects (ergonomics) to complete a task as efficiently as possible. Keep items that you use often within reach to avoid having to bend or reach. Keep heavy items close to you when you carry them. When possible, sit instead of stand, like using a shower chair while bathing or sitting on a stool while you cook. Sitting can take up to 25% less energy than standing.

Products, tools, and items to make tasks easier

Use tools and products to help make a task easier. This can include using a cart to move items around your home instead of carrying them, sliding items along the counter instead of lifting and carrying them, using utensils or pens with bigger handles if your hand strength is low, and using lightweight tools, including cookware, where possible. If possible, use an automatic or robotic vacuum cleaner for cleaning.

Cooking and eating when fatigued

Meal planning is an important part of healthy eating. Meal planning can help you manage your fatigue by saving energy, improving nutrition, helping you pace yourself, and reducing the stress of not knowing what to make for dinner.

If meal planning is new for you, start small by trying to plan 1 to 2 meals per week. Everyone can benefit from creating a list of simple recipes that can easily be made every week.

Apply the other MS fatigue management strategies to cooking and eating, too. Talk with your family, friends, and support people about what you find most fatiguing in meal planning and preparation. Then develop a plan for how to make these tasks easier. This could include having groceries delivered, asking for help to load and unload the dishwasher, having everything you need to cook within reach, sitting while you chop, and taking rest breaks.

Convenience foods can also help you maximize your energy. There are many nutritious foods that are already prepared. Use bagged salad, frozen or pre-cut vegetables, canned fish, canned beans, rotisserie chicken, shredded cheese, pre-marinated meat, chopped garlic, or quick-cooking grains.

Learn more about healthy eating despite your fatigue by registering for the free online class “Eating well when fatigued,” offered by the Alberta Health Services South Health Campus Wellness Centre. Find upcoming dates, registration details, and more information in the Wellness Centre Program Guide (PDF) (scroll down to the “Food, Nutrition, and Cooking” section of the guide).

Workplace modifications and accommodations

For people living with MS, fatigue is the most commonly reported symptom for leaving the workforce early. Talk to your healthcare provider, union representative, or human resources department about workplace modifications or accommodations that can help you remain successful at work, volunteering, or school.

Modifications are adjustments to daily tasks that you can make to be productive. In most cases, modifications do not require medical documentation as they are usually more informal. Examples include:

  • Using voice dictation software or note taking software
  • Asking colleagues to follow up by email instead of verbal responses
  • Automating processes at work where possible
  • Using a daytimer
  • Keeping to-do lists
  • Completing more demanding work tasks at the start of the day, when energy is higher

Accommodations are changes to certain rules, workplace cultures, and physical spaces to make sure they don’t have a negative effect on a person. Accommodations in the workplace and at school often require medical documentation. Some examples of accommodations that you can discuss with your employer to manage MS fatigue at work are:

  • Flexible hours of work and being able to pace yourself
  • Working from home
  • Using a stool or other supportive chair at work
  • Being able to take frequent rest breaks
  • Having a cot, couch, or chair in a quiet and private location for a rest period
  • Ergonomic workstation design

Accommodations that you can talk about with your teachers or administrators to manage fatigue at school can include:

  • More time to complete assignments
  • Recording classes (audio or video)

Remember that having reduced work hours or other accommodations does not necessarily mean that you’ll have more energy to do everyday activities or household tasks. Keep using different fatigue management strategies to find what works best for you. If you need support with accommodations, talk to your healthcare team.

Learn more about MS fatigue, work, and productivity.​


Current as of: September 14, 2023

Author: Calgary MS Program - Allied Health