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People diagnosed with dementia want to stay on the job as long as they can says Judith Plotkin, vice-president, strategic growth for Homewood Human Solutions. (Kevin Van Paassen/The Globe and Mail/Kevin Van Paassen/The Globe and Mail)
People diagnosed with dementia want to stay on the job as long as they can says Judith Plotkin, vice-president, strategic growth for Homewood Human Solutions. (Kevin Van Paassen/The Globe and Mail/Kevin Van Paassen/The Globe and Mail)

Mental Health

Staying on the job, when dementia hits Add to ...

Shortly after learning that she had early-onset Alzheimer’s disease, a university professor met with her supervisor to talk about how she could continue working while managing her condition, which is the most common form of dementia in Canada.

The professor’s well-meaning supervisor responded by assigning the professor to a lower-level class. But within a week, the school received several complaints from her new group of students and the professor, who was in her early fifties, had to leave her job.

“In trying to be helpful, the university put her in a position where she was having to learn new things and follow new directions rather than doing what she was already very familiar with,” said the professor’s husband, who asked that he and his wife not be identified.

“In hindsight, I know it was the wrong thing to do,” he said of the events of two years ago. “But at the time, neither we nor the administrators at her workplace knew the best way to respond.”

More than 500,000 Canadians have dementia – a number expected to increase to more than one million over the next 25 years, according to a 2010 report by the Alzheimer Society of Canada.

The disease, whose symptoms include declining memory, reasoning and judgment, is associated largely with advancing age, but can also be caused by pre-existing health conditions such as high blood pressure, obesity and stroke.

While dementia is more prevalent among the elderly, it can also affect the under-65 working group. About 71,000 Canadians who have dementia are under the age of 65.

And given the baby-boomer bulge, work places across the country are likely to see more cases of dementia, said David Harvey, chief of public policy and program initiatives at Alzheimer Society of Ontario in Toronto.

Corporate Canada is already feeling the economic impact of dementia, which resulted in about $3-billion in lost productivity and profits in 2008, according to the Alzheimer Society of Canada report. By 2038, these losses could more than double to roughly $6.8-billion.

“There are a growing number of older workers in the workplace,” Mr. Harvey said. “When you look at data from the U.S. Labour Force survey, you see that the number of workers over the age of 65 doubles in the first decade of this century, even before the first wave of baby boomers started to reach the age of 65, which was last year.”

Advances in medicine are leading to earlier diagnoses of dementia, years before symptoms of the disease start to appear, Mr. Harvey noted. At the same time, patients today have greater access to drugs that can slow down the onset of symptoms.

For employers, this could translate to more workers staying on the job after being diagnosed with dementia.

“People today are wanting to stay in the workplace longer, and that’s good because it helps them stay active, engaged and cognitively sharp,” said Judith Plotkin, vice-president, strategic growth for Homewood Human Solutions, which provides health and wellness programs.

“At the same time, we are seeing employers increasingly wanting to preserve the knowledge base in their company, which usually means retaining their highly experienced employees,” Ms. Plotkin said.

Under human rights laws, employers must accommodate workers with dementia, to the point where doing so would cause “undue hardship” to the company, said Hermie Abraham, a Toronto employment lawyer.

Depending on the employee’s dementia symptoms, this could mean changing things such as job duties or hours of work.

In small companies with only a few employees, accommodating a worker with dementia might not be easy – or at all possible, Ms. Abraham noted.

“But be careful how you proceed,” she cautions employers. “In smaller organizations that have no human resource department, sometimes the first knee-jerk reaction might be to terminate the employee, inadvertently creating liability for the company.”

Whether workers with dementia stay in their current role or switch to duties adapted to accommodate their symptoms, they can continue contributing to the workplace with the right strategies and adequate support, said Annette Gibbs, a Toronto-based vice-president of group life and disability claims for Sun Life Financial Inc.

For example, dementia symptoms often appear first thing in the morning or at the end of the day, so adjusting working hours might be a good strategy, she said.

Assigning a work buddy to an employee with dementia is also a good idea. But employers should take care to ensure the buddy is a proper fit; preferably it is someone who has worked closely with the employee.

People with early-stage dementia are generally able to work well in areas they’re already familiar with, “but suddenly changing their work patterns or introducing them to new tasks can really throw them off,” Ms. Gibbs said.

The university professor’s husband agrees. Being assigned to another class meant his wife had to learn a new curriculum, which put even more stress on her. “There were too many changes all at once,” he recalled.

Ms. Plotkin at Homewood urges employees with dementia who want to continue working to adopt strategies that will help them stay organized and track what they’re doing throughout the day. Strategies could include reminder notes and e-mail alerts for every task, and recording meetings and phone calls.

“If you’re giving a presentation, you may want to list all your talking points on a white board and check each one off as you go along,” she said.

Both employer and employee should agree to regular performance reviews, she added, to ensure the worker is meeting the requirements and targets of the modified job and to make adjustments where needed.

Safety is something employers need to be extra vigilant about when supporting an employee with dementia, Ms. Plotkin said. A worker who operates machinery, for example, might be better off moved to the mail room. And when it becomes clear that retaining a worker with dementia presents a risk not only to the worker but to others, including customers, the company should move to letting the employee go.

As companies face the prospect of seeing more workers with dementia, employers need to develop a more supportive culture for people with cognitive disabilities and mental health issues, said Mr. Harvey at the Alzheimer Society of Ontario.

Companies should train their managers and workers to understand various brain disorders, to recognize symptoms, and learn how best to respond.

“It’s important that we not automatically equate dementia with an absolute inability to perform work,” he stressed.

Mr. Harvey cited the case of a paint-store employee who learned she had dementia. Instead of letting her go for fear she might not be able to mix colours properly, the manager transferred her to reception duties, greeting customers and directing to them to other staff.

“She was able to perform adequately in that job for two years before making the decision to retire,” he said.

Special to The Globe and Mail

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