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June is Alzheimer's Awareness Month

Learn more about Alzheimer's disease and the accommodation process

From the desk of Melanie Whetzel, M.A., CBIS, Lead Consultant – Cognitive/Neurological Team


Many employers contact JAN to find out how to best handle situations where they don’t know what is specifically going on with an employee, but what they do know is that the employee is unable to do the job functions s/he has done in the past. Under the ADA, employers should not assume an employee has a disability or a medical condition, but many of these employers have known the employee in question for years and know what they have been capable of in the past. The employers come to realize that something has changed and that the change is progressive.

We encourage employers to handle performance issues as just that — performance issues — and then begin an interactive conversation with the employee. Sometimes employees will admit to the employer that they have noticed their abilities aren’t as sharp as they used to be, but other times employees aren’t aware or are unable to understand the extent of their inability to do their job tasks. This is where the employer can take steps to address the performance but also request medical information and family help to better understand what might be going on with an employee.

Memory problems are one of the first symptoms of Alzheimer’s disease. Symptoms of other medical conditions such as stroke, tumors, sleep disorders, Parkinson’s disease, side effects of medications, infections, and non-Alzheimer’s dementia may also cause problems with memory. Some of these conditions are treatable and some possibly reversible; so obtaining current and accurate medical information could be the first step in resolving the issues and determining what steps to take next.

Helpful Hints for the Accommodation Process

Employer:

  • A full conversation with the employee is vital for success. Keep an open mind about possible accommodations.
  • With assistance from the employee’s doctor, determine how quickly the disease may progress. This will help in ascertaining the long-term accommodations that may need to be made. As the disease progresses, job-related tasks will likely become more difficult to perform. Providing accommodations so that the employee is able to continue working as long as possible may help to preserve an income and independence, as well as increase self-esteem.
  • Encourage a support person or team, possibly a family member(s) familiar with the effects of the disease, to be part of the process. 
  • Monitor the employee’s performance to ensure the accommodations are effective. Some adjustments or changes in accommodations may be necessary. Keep in mind that a reassignment may become necessary in some situations. 

Employee:

  • Before your condition significantly affects your ability to effectively do your job, talk to your employer. A full conversation with your employer is vital for success. 
  • Familiarize yourself, your spouse, and/or caregiver with your benefits and contact the Employee Assistance Program (EAP), if available.
  • Explore your rights under the ADA. Contact JAN for assistance.
  • Encourage a support person or team, possibly a family member(s) familiar with the effects of the disease, to be part of the process.  

The following accommodations may be helpful. 

Memory:  

  • Provide a voice-activated recorder to record verbal instructions
  • Provide written information
  • Provide checklists
  • Prompt employee with verbal cues (reminders)
  • Post written or pictorial instructions on frequently-used machines or for routine procedures
  • Provide templates or forms to prompt for needed information
  • Remove marginal job functions to allow more focus on essential functions
  • Use color-coding to indicate important information
  • Extend training time when significant workplace changes occur

Organization:  

  • Minimize clutter
  • Color-code items or resources
  • Divide large tasks into multiple smaller tasks
  • Avoid re-organization of workspace
  • Label items or resources
  • Use symbols instead of words

Time Management/Completing Tasks:

  • Provide verbal prompts (reminders)
  • Provide written or symbolic reminders
  • Arrange materials in order of use
  • Use task list with numbers or symbols
  • Provide additional training or retraining as needed
  • Provide a timer and a recommended amount of time to complete tasks
  • Provide a watch with multiple settings
  • Rid desk or work area of clutter and items/materials not used

Difficulty Performing Job Duties:

  • Retain as many job tasks as possible that the employee is familiar with and proficient in
  • Remove marginal job functions to allow more focus on essential functions
  • Incorporate simpler tasks from other employees’ job descriptions
  • Consider a reduction in work hours
  • Alter when and/or how a job function is performed
  • Recognize that a reassignment to a position that better matches the skills and capabilities of the employee may be necessary

Situations and Solutions

A principal of an urban secondary school could no longer perform the duties required in the administration of such a large school. She was accommodated with a reassignment to a much smaller high school. She was provided with updated training in some of the select procedures she was having the most difficulty with, as well as color-coding of the problematic policies and procedures.  

An educational assistant was unable to initiate work throughout the day, but particularly at the start of the day. She had difficulty remembering tasks, as well as being distracted by the collection of knick-knacks and photos crowded on her desk. Her workspace, which was a little bit isolated, was moved to an area where she could be mentored. She was provided with a schedule of detailed tasks to perform at various points in the day, and with help, she cleared her desk of most of the clutter in order to help maintain concentration.

A lab tech was unable to follow procedures. His employer set up a system of checks, but it was taking the supervisor an inordinate amount of time to check the test results, many of which were found to have inaccurate results. A color-coded flowchart of steps was provided, as well as grouping like tests together so that he could do the same procedure multiple times. Color coding the testing procedures online helped the tech find and use them easier and more accurately than printed copies.

A sales manager with early onset Alzheimer’s was unable to navigate his travels, but he was still able to perform the duties of a sales position. As an accommodation, he was reassigned to a lower position that he was qualified for. The sales position required no travel, and the employee was able to make contacts by phone and emails, successfully performing the essential functions.

If you are working through a similar situation and need the assistance of a consultant, please feel free to contact JAN for a more individualized accommodation consultation.

individual with Alzheimer's disease