Accommodation and Compliance Series:
Employees with Parkinson's Disease
JAN’s Accommodation and Compliance Series is designed to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). Each publication in the series addresses a specific medical condition and provides information about the condition, ADA information, accommodation ideas, and resources for additional information.
The Accommodation and Compliance Series is a starting point in the accommodation process and may not address every situation. Accommodations should be made on a case by case basis, considering each employee’s individual limitations and accommodation needs. Employers are encouraged to contact JAN to discuss specific situations in more detail.
For information on assistive technology and other accommodation ideas, visit JAN's Searchable Online Accommodation Resource (SOAR) at http://AskJAN.org/soar.
How prevalent is Parkinson’s disease?
In the United States, it is estimated that 60,000 new cases of Parkinson’s disease are diagnosed each year, joining the 1.5 million Americans who currently have Parkinson’s disease. While the condition usually develops after the age of 65, 15% of those diagnosed are under 50. Parkinson’s disease affects both men and women in almost equal numbers. It shows no social, ethnic, economic, or geographic boundaries (National Parkinson Foundation, n.d.).
What is Parkinson's disease?
Parkinson's disease is a chronic, progressive disorder of the central nervous system that belongs to a group of conditions called motor system disorders. Parkinson's is the direct result of the loss of cells in a section of the brain called the substantia nigra. Those cells produce dopamine, a chemical messenger responsible for transmitting signals within the brain. Loss of dopamine causes critical nerve cells in the brain, or neurons, to fire out of control, leaving patients unable to direct or control their movement in a normal manner (Michael J. Fox Foundation for Parkinson's Research, 2007).
What are the symptoms of Parkinson's disease?
Symptoms of Parkinson's disease, which often appear gradually yet with increasing severity, may include tremors or trembling, difficulty maintaining balance and gait, rigidity or stiffness of the limbs and trunk, and general slowness of movement (also called bradykinesia). Patients may also eventually have difficulty walking, talking, or completing other simple tasks. The course of Parkinson's disease varies substantially. Some patients have relatively few troublesome symptoms for many years, while others have especially severe cases that leave them with little or no mobility in just a few years (Michael J. Fox Foundation for Parkinson's Research, 2007).
What causes Parkinson's disease?
Scientists have not yet found the exact cause of Parkinson's disease. Most believe that it is a combination of genetic and environmental factors, but no definitive data exist (Michael J. Fox Foundation for Parkinson's Research, 2007).
How is Parkinson's disease treated?
There are a number of effective medicines that help to ease the symptoms of Parkinson’s disease. Most symptoms are caused by lack of dopamine. The medicines most commonly used will attempt to either replace or mimic dopamine, which improves the tremor, rigidity, and slowness associated with Parkinson’s disease. Several new medicines are being studied that may slow the progression. Many promise to improve the lives of people with Parkinson’s disease (National Parkinson Foundation, n.d.).
Is Parkinson's disease a disability under the ADA?
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet (EEOC Regulations . . ., 2011). Therefore, some people with Parkinson's disease will have a disability under the ADA and some will not.
A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment (EEOC Regulations . . . , 2011). For more information about how to determine whether a person has a disability under the ADA, visit http://AskJAN.org/corner/vol05iss04.htm.
Note: People with Parkinson’s disease may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with Parkinson’s disease will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee with Parkinson’s disease experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee with Parkinson’s disease been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee with Parkinson’s disease to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training regarding Parkinson’s disease?
- Implement ergonomic workstation design
- Provide arm supports
- Provide alternative computer access and a keyguard
- Provide alternative telephone access
- Provide writing and grip aids
- Provide a page turner and a book holder
- Provide a note taker
- Reduce walking or provide a scooter or other mobility aid
- Provide parking close to the work-site
- Provide an accessible entrance
- Install automatic door openers
- Provide an accessible route of travel to other work areas used by the employee
- Move workstation close to other work areas, office equipment, and break rooms
- Reduce or eliminate physical exertion and workplace stress
- Schedule periodic rest breaks away from the workstation
- Allow a flexible work schedule and flexible use of leave time
- Allow work from home
- Make sure materials and equipment are within reach range
- Provide speech amplification, speech enhancement, or other communication device
- Use written communication, such as email or fax
- Transfer to a position that does not require a lot of communication
- Allow periodic rest breaks
Medical Treatment Allowances:
- Provide flexible schedules
- Provide flexible leave
- Allow a self-paced workload with flexible hours
- Allow employee to work from home
- Provide part-time work schedules
Depression and Anxiety:
- Reduce distractions in work environment
- Provide to-do lists and written instructions
- Remind employee of important deadlines and meetings
- Allow time off for counseling
- Provide clear expectations of responsibilities and consequences
- Provide sensitivity training to co-workers
- Allow breaks to use stress management techniques
- Develop strategies to deal with work problems before they arise
- Allow telephone calls during work hours to doctors and others for support
- Provide information on counseling and employee assistance programs
- Provide written job instructions when possible with more structure
- Prioritize job assignments
- Allow flexible work hours
- Allow periodic rest breaks to reorient
- Provide memory aids, such as schedulers or organizers
- Minimize distractions
- Allow a self-paced workload
- Reduce job stress
Activities of Daily Living:
- Allow use of a personal attendant at work
- Allow use of a service animal at work
- Make sure the facility is accessible
- Move workstation closer to the restroom
- Allow longer breaks
- Refer to appropriate community services
Situations and Solutions:
A secretary with Parkinson’s disease and hand tremors was having difficulty using a keyboard, writing, manipulating manuals, and filing. She was accommodated with a keyguard, typing aid, page turner, and open files.
A supervisor with Parkinson’s disease was having difficulty managing fatigue. The employer provided a private rest area with a cot so the individual could take breaks throughout the day.
A file clerk with Parkinson’s disease was having difficulty meeting the physical demands of the job, including walking between work areas, standing at filing cabinets, and carrying files. The individual was accommodated with a power scooter with a basket and a stand/lean stool.
A technician with Parkinson’s disease was having difficulty concentrating. The employee's supervisor provided written job instructions when possible and allowed the individual to have periodic rest breaks. In addition, she was moved to a corner cubical where distractions were minimized with strategically placed baffles.
A customer service representative with Parkinson’s disease was having difficulty manipulating his mouse, writing, standing to greet people, and communicating effectively. He was accommodated with a trackball, writing aid, stool with lift cushion, and speech amplification.
A technical consultant was having difficulty using the computer in the afternoons due to fatigue. He was accommodated with speech recognition and an ergonomic workstation.
An office assistant with tremors and fatigue caused by Parkinson’s disease was having difficulty typing the number of words per minute required by her employer. The individual rearranged her workstation to reduce distractions and her employer offered flexible scheduling. Her word processing software was programmed with macros to reduce keystrokes and she was given speech recognition software.
A consultant with Parkinson’s disease was having difficulty getting to work on time. He was accommodated with flexible scheduling so he could use public transportation.
A teacher with Parkinson’s disease was having difficulty standing in front of the classroom to write on the board. The individual was accommodated with a scooter and a laptop and PC projector. She was then able to remain seated while using the computer and projector to display information to the class.
An engineer with Parkinson’s disease was having difficulty concentrating and communicating. The individual was accommodated with a quiet office free from distractions. In addition, her supervisor implemented a policy of scheduled interruptions with written reminders and assignments. The individual was also provided with a communication device.
There are numerous products that can be used to accommodate people with limitations. JAN's Searchable Online Accommodation Resource (SOAR) at http://AskJAN.org/soar is designed to let users explore various accommodation options. Many product vendor lists are accessible through this system; however, upon request JAN provides these lists and many more that are not available on the Web site. Contact JAN directly if you have specific accommodation situations, are looking for products, need vendor information, or are seeking a referral.
EEOC Regulations To Implement the Equal Employment Provisions of the Americans With Disabilities Act, as Amended, 29 C.F.R. § 1630 (2011).
Michael J. Fox Foundation for Parkinson's Research. (2011). About Parkinson's. Retrieved December 29, 2011, from https://www.michaeljfox.org/understanding-parkinsons/index.html
Parkinsons.cfm National Parkinson Foundation. (n.d.). About Parkinson's disease. Retrieved December 29, 2011, from http://www.parkinson.org/Parkinson-s-Disease/PD-101