Mobility aids and the home with MS

The practical rule that follows is to plan around the bad days. A stick that is enough on a good morning may not be enough at five o'clock, when fatigue has built up and the house has warmed. Tell every professional who assesses you what the worst days look like and how often they come, rather than how you managed on the day of the visit. If the occupational therapist visits on a good day and hears only about that day, the house can end up fitted for the good days alone.

Fatigue is a large part of this. The MS Trust's page on walking difficulties explains that walking round a problem such as a dropped foot takes more effort, and that extra effort adds to fatigue. Building a day round MS fatigue covers pacing, and why the energy you spend walking in the morning is not available in the afternoon.

Heat matters as well. The MS Society says symptoms such as poor balance, weakness and fatigue can get worse while the body is warm and usually settle as it cools, and its page on the effects of temperature on MS has ideas for keeping cool, and heat sensitivity and MS sets out a plan for a hot day at home.

Neither of these is something to buy online and try. The MS Trust's page on foot drop says that if you are worried about your walking you should contact your MS nurse or neurologist, or ask the GP for a referral, so that a professional can assess it. A physiotherapist will also look at whatever else is making the foot drop worse, such as stiffness and spasms, and can give exercises for the ankle and foot. If getting to a clinic is hard on the bad days, physio at home covers physiotherapy in your own home.

The NICE guideline on MS in adults says people with MS and mobility problems should have access to an assessment to set their own goals and discuss how to reach them, usually with physiotherapists who have expertise in MS. The same guideline points clinicians to the NICE guidance on FES for drop foot. If you have not been offered a physiotherapy assessment, that is a fair thing to ask the MS nurse for.

A few changes at home help alongside either treatment. The MS Trust suggests shoes that fasten with laces or Velcro rather than slip-ons, which can loosen, and keeping the main routes through the house clear of rugs and trailing cables. Walking aids and how to choose covers sticks, frames and rollators, how they should be fitted, and who can lend one.

1. 1

   Ask to be referred

   GP, physio, OT or hospital

   The NHS says a GP, physiotherapist, occupational therapist or hospital staff can refer you to the local wheelchair service for an assessment. The MS nurse can start this too.
2. 2

   The wheelchair service assesses you

   Describe the worst days

   The service helps decide whether a wheelchair is needed and what type. Tell them how far you can walk on a bad day, how heat and fatigue change things, and where you will use the chair, including the car and the house.
3. 3

   Ask about a personal wheelchair budget

   A legal right for some people

   Since December 2019, people eligible for the local wheelchair service whose posture and mobility needs affect their wider health and care have a legal right to a personal wheelchair budget when they need a new chair. It can go towards a different chair from the one the service would provide.
4. 4

   If you buy one yourself

   No VAT

   Wheelchairs designed for a disabled person can be bought without VAT if you have a long-term illness such as MS. You confirm this in writing, and the supplier applies it.

MS raises a question the wheelchair service will want to hear about. A manual chair is lighter, folds into a car and works well for the good days when somebody can wheel themselves or be pushed a short way. On the bad days, pushing a manual chair takes exactly the energy that fatigue has used up, and a powered chair may be the only way of getting about independently. Explain both kinds of day at the assessment. The service decides what it provides, and a personal wheelchair budget, or the Motability Scheme, which lets some people use their benefits towards a powered wheelchair, may help with what it does not.

The NHS says mobility scooters are not generally available on the NHS. The NHS guide to walking aids, wheelchairs and mobility scooters covers each, and NHS England's page on personal wheelchair budgets explains what to expect from one. A wheelchair indoors changes the house as well, since doorways, turning space and the front step all matter, and the next section covers that.

To start, ask your council's adult social care team for a home assessment. You can do this online or by phone, and gov.uk has a page for applying for equipment for your home. The NHS guide to home adaptations says the assessment usually takes at least an hour and suggests having somebody with you to take notes. Tell the therapist everything you find difficult on the bad days, including small things such as opening a cupboard.

The free route is set in law. Under the charging regulations, a council cannot charge for aids and minor adaptations, and an adaptation counts as minor if it costs £1,000 or less. That covers grab rails, a second stair rail, a perching stool, a shower seat and a small ramp.

Bigger work goes through a Disabled Facilities Grant. In England it is worth up to £30,000, and it is means tested on household income and savings over £6,000, so the amount can be less. Gov.uk lists what it can pay for, including a stairlift, a level-access shower, widened doors and ramps, and an extension such as a downstairs bedroom. It does not affect any benefits you get. Wait for the council to approve the grant before any work starts, because gov.uk warns you might not get any grant if the work begins first.

MS makes the order of work matter. A change that fits how you walk this year may not fit in three years, so it is worth asking the therapist to plan with that in mind: a level-access shower rather than a bath lift, for example, or a doorway widened while the builders are there. Home adaptations that reduce the need for care goes through the process in general, and stairs, stairlifts and moving downstairs covers the choice about the stairs. If moving from bed to chair has become the hard part, transfers, hoists and when a visit needs two carers explains how a hoist is assessed and who pays for it.

1. 1

   The MS nurse

   The first call

   Tell the MS nurse when walking changes, and ask for referrals to physiotherapy, the orthotist or the wheelchair service. Ask when the yearly review is due, and bring a list of what has become harder.
2. 2

   The physiotherapist

   Walking, foot drop and exercise

   Assesses walking, balance and foot drop, and sets exercises. NICE says people with MS should be helped to keep exercising, for example through a physiotherapist with expertise in MS.
3. 3

   The occupational therapist

   The house and daily tasks

   Looks at washing, dressing, cooking and getting round the house, and recommends the equipment and adaptations in the table above. The council one is free.
4. 4

   Personal Independence Payment

   Not means tested

   PIP has a daily living part and a mobility part. In 2026/27 the mobility part is £30.30 or £80.00 a week, and the daily living part £76.70 or £114.60.
5. 5

   Access to Work, if you are working

   A grant, not a loan

   A government scheme that can pay for practical support at work, such as specialist equipment or the cost of getting to work if you cannot use public transport. It does not have to be paid back and does not affect other benefits.

A new PIP claim usually has to be made before State Pension age, and your savings and income make no difference to it. For MS the rule to understand is how often counts. Gov.uk says you must have difficulty with the tasks most of the time, which means more than half of the days over a twelve-month period. So describe the bad days, how long they last and how often they come, rather than an average day. PIP and care at home goes through the claim, and the gov.uk guide to PIP explains how to claim.

If you are working, Access to Work can help with what your employer does not have to provide, and MS and work covers telling your employer and asking for changes. It will not pay for the reasonable adjustments an employer must make by law, and the government guidance on reasonable adjustments explains those. The MS Trust and the MS Society are UK charities for people living with MS, and both run helplines.

Help from a carer on the bad daysSection titled Help%20from%20a%20carer%20on%20the%20bad%20days

Equipment makes tasks possible, and sometimes a person is needed as well: to be there for the shower, to get the shopping in, or to walk alongside on the way to an appointment. If you would like help on the bad days, you can search for carers near you and compare their rates. Carers on PrimeCarers charge £18 to £25 an hour with our fee included, typically £20, so two hours twice a week comes to £72 to £100. Through an agency the same four hours would be £112 to £140. Our pricing explains the fee.

PrimeCarers is an introductory service, not an agency or a care provider. Carers are self-employed, and you choose, interview and book them directly. Before a carer appears we check their identity and right to work, check an enhanced DBS (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 18 months, and interview them online. We do not check qualifications, training or references, so what a carer says about MS or about using equipment such as a hoist is their own account on their profile, for you to ask about. Every visit booked through PrimeCarers is insured, either by the carer's own policy or by cover PrimeCarers arranges where they do not hold one.