Saturday, February 5, 2011

Alzheimer’s Disease and Employment Issues

Recently, in the media, the son of former president Ronald Reagan, Ron Reagan claims that his father experienced the onset of Alzheimer’s while in office. If this claim is true, being afflicted with a serious impairment that disrupts memory and mental function, Ronald Reagan having knowledge of this affliction should have resigned his office. At 69, Reagan was the oldest man ever elected to the White House.

Early Alzheimers (known more fully as Early Onset Alzheimer's Disease) refers to a person showing signs of the disease before the age of 65. It is not considered rare but it is an uncommon occurrence of the disease when it strikes before the age of 65. In fact, only 5 to 10 percent of those diagnosed are younger than 65 years old. Alzheimer's Association of the United States defines Alzheimer's Disease as: "ultimately fatal, disorder in which certain types of nerve cells in particular areas of the brain degenerate and die for unknown reasons."

Dementia is usually considered a condition of older people and is not expected in younger people.  When a person under age 65 goes to a doctor with symptoms of dementia, the doctor may not even think of dementia as a possibility or may not know how to diagnose it. As a result, getting an accurate diagnosis can be a long, difficult, and frustrating process.

People with dementia who are in paid employment may find that memory problems eventually start to interfere with their ability to carry out their duties. Difficulties with concentration, flexibility and abstract thought can also interfere with a person’s ability to function normally in their profession. This can be embarrassing and stressful. Many people try to hide their difficulties from their colleagues and bosses and worry about their financial future. Some work overtime in an attempt to solve the problem, whereas others take their worries or work home. Often, the only solution seems to be to resign.

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Tips for consideration for the person with Early Onset Alzheimer’s

  • If you are experiencing problems at work which you suspect may be associated with dementia, it is important to consult a doctor especially if you drive or operate machinery.
  • Medication exists for Alzheimer’s disease which for many people temporarily slows down the progression of the disease and reduces some of the symptoms. This could help you to cope for longer at work.
  • Another reason to consult your doctor is to obtain a certificate of incapacity to work (if and when this becomes necessary). This might enable you to stop working without this affecting your pension rights or leading to a reduction in earnings, particularly if you are nearing retirement.
  • Having discussed the issue with your doctor, continue working for as long as you feel able.
  • Another option is to consider early retirement or a less demanding position.
  • At some point, it may be necessary to talk to your union or employer about your diagnosis.
  • It is also a good idea to talk to your colleagues about your difficulties and to explain a little bit about dementia so that they can understand you better and know what to expect.
  • If you are a younger person with dementia and have financial commitments (e.g. a mortgage), it would be worthwhile discussing the issue of how to deal with this should you leave your job.

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Tips for consideration for the manager whose employee may have Early Onset Alzheimer’s

If you are a manager with an employee in their 50's whose performance has fallen below your acceptable benchmarks, you normally would counsel them to see why their performance has fallen. This is normal good business practice. However, The Family and Medical Leave Act of 1993 (FMLA) for the United States requires larger employers to provide employees job-protected unpaid leave due to a serious health condition which can extend to include care for family members.

Short-term memory loss is an early symptom of Alzheimer’s. Initially, memory problems may show up as forgetting appointments, repeating anecdotes, confusion, misplacing things and trouble finding the right word in conversation. Eventually people tend to get an official diagnosis when the impairment is to the point where no one can ignore it anymore. The forgetfulness has gone beyond names and phone numbers to include meetings, key decisions and reiterating and rehashing decisions that have already been made.

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However, memory loss isn’t the only warning sign. Others include difficulty with technology and new tasks, and personality changes such as becoming more withdrawn and less talkative. In some cases, people may become irritable or agitated, or may start to behave inappropriately.

These signs often become noticeable in the workplace before anywhere else. However, employees can often manage their symptoms in the early stages of the disease. As the workforce ages, the number of people working with early symptoms of dementia is likely to grow.

Unfortunately, many supervisors lack the training to either recognize or compassionately respond to people who show signs of dementia.

Employers and their management staffs need to become sensitive and gain an understanding about early-onset Alzheimer’s/dementia. Applying a delicate balance, employers and supervisors need to be more alert to some of the early signs. Employers should try to avoid creating a stigma around the disease. They should try to create an environment of support for the employee and their family, like any other disease or illness.

Experts urge employers to train supervisors and offer education to the whole team to raise awareness on behalf of those who have the disease, their working caregivers and the workplace itself.

If you have a worker who you suspect may be showing signs of Alzheimer’s, sitting down with the person and expressing your concern in a non-judgmental fashion is the best way to deal with the possibility of the disease at first. Be specific about what you’ve observed. Ask if similar problems are happening at home. Do not accuse them of having the disease; ask them to see a doctor to obtain a medical evaluation and early detection from a specialist.

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Expect the employee to be on the defensive. They may think you intend to fire them if they are diagnosed with Alzheimer’s/dementia.

Employers should remember their legal duty to accommodate and prevent workplace harassment and discrimination based on the grounds of disability and age.

Alzheimer’s/dementia are diseases that would fit the definition of disability under the law. Thus, as long as workers can continue to perform their work with “reasonable accommodation”, then they should not lose their jobs.

In addition, Alzheimer’s is not recognized as part of aging. However, most people associate Alzheimer’s with very old and frail seniors; this is called a stigma or a stereotype. The fact is the early-onset Alzheimer’s disease can strike a person in his or her mid-50s. Thus, discrimination and harassment based on age because a person has or is perceived to have Alzheimer’s/dementia is against the law.

Early diagnosis is the key for both the individual and the employer. According the Alzheimer Association, there is a period of time when employees with dementia will be able to transfer the knowledge they have to their successors, “rather than have them drop out of the workplace and take all the historical knowledge and skill sets.”

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Top Reasons Why Detection of Early Alzheimer’s is important for the manager and employee:
  1. Most employers, if they knew their previously reliable employee was suffering from Early Onset Alzheimer's Disease, could possibly give them a smaller workload while still allowing them to work and rearrange their finances accordingly.
  2. Most employers would be willing to work with the employee that was diagnosed because this allows them to work together to get the employee's employment issues sorted out for when the employee can no longer work. This would include getting professional advice and obtaining a copy of the Alzheimer's Association's Money Matters from their local Alzheimer's Association office.
  3. It allows the employer and employee diagnosed with Early Onset of Alzheimer's disease to explore the possibility of early retirement, which of course depends on the employer and what type of work the employee is involved in.
  4. If the employee is involved in equipment operations or other areas where it could be dangerous, an employer that knows of the Early Alzheimer’s diagnosis could take steps to keep the employee and others safe.
  5. It allows the employer and employee together to begin making the necessary arrangements for when the time comes that he or she is no longer able to work including reduced hours of work.
  6. If an employer knew of the Early Alzheimer’s diagnosis, they certainly would not fire the employee, because firstly, it may be illegal and secondly they may be able to keep an excellent employee by modifying their duties to better suit their capability.
  7. The employer could help family members of the employee find professional help with various insurance policies and other financial obligations that will become necessary.
  8. The employer can also help arrange for the second opinion from his insurance company's medical representatives which will likely be required to ensure it truly is Early Onset Alzheimer's disease because an accurate diagnosis is critical at this stage.
  9. Many people at the age of 50 are in the prime of their careers and to suddenly be stricken with the early onset is frightening and terrifying for both the person with the disease and their family members. Hiding the diagnosis from your employer is never a good idea, because they may mistake your illness as slacking off on the job, when nothing could be further from the truth.
  10. A person should not fear telling their employer of the diagnosis because under the law, they cannot just fire the person, but accommodations can be made in order to lessen the load of the employee so he or she may continue working.

Sources and Additional Information:

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