The purpose of this study was to gain an enhanced understanding of how people with multiple sclerosis (MS) experience their engagement in occupations. We interviewed 10 people and then analyzed the data gathered using the constant comparative method of grounded theory. The findings encompassed the core category “essentials of a constantly changing life,” showing that along a continuum of change, the participants experienced a decreasing engagement in occupations that forced them to continuously struggle to maintain engagement. This struggle changed them and required them to construct a different life than before. Our findings suggest that professionals working in MS rehabilitation need to broaden their repertoire of interventions relevant to conditions in clients’ social environment, with the intention of influencing those occupations that are individually most meaningful. Occupational therapists should focus on the client’s engagement in occupations and its consequences for the client’s life and self-identity.