Accommodating Cooks with Low Vision

Posted by Kim Cordingly on May 6, 2016 under Accommodations, Employers, Products / Technology, Vendors | Comments are off for this article

By: Teresa Goddard, Lead Consultant – Sensory Team

Cooking and eating together are powerful ways of building relationships and creating a sense of community at work. Whether you are seeking to include an employee in cooking activities, or accommodating a food service employee with a vision impairment, there are many ways to make a kitchen more accessible to employees with vision impairments.

Some typical suggestions for accommodating cooks with low vision include the following:

  • Use measuring tools with large print, color coding or tactile marking, or modify existing measuring cups and spoons with customized markings.
  • Use knife guards or specialized tools such as vegetable peelers for cutting and peeling.
  • Use guards, cut proof gloves and other Personal Protective Equipment (PPE) as needed when handling or cleaning sharp objects.
  • Use measuring tools and cutting boards that contrast with the substance being measured or cut.
  • Use an ice cream scoop to measure cookie dough and place on a baking sheet.
  • Use parchment paper when baking to prevent sticking and simplify cleaning.
  • Use color coded prep bowls to keep track of ingredients that have been measured out.
  • Use liquid level indicators when pouring hot liquids.
  • Use talking thermometers and timers.
  • Use oven mitts when handling pots and pans.
  • Use extra-long oven mitts, oven rack grabbers, and oven rack guards for oven tasks.
  • Use magnifiers, bar code readers, or Optical Character Reading (OCR) technology to access information on labels.
  • Avoid placing pots, pans, and bowls directly on slippery or slick surfaces.
  • Use pot stabilizers for safer pouring and ladling.
  • Use boil control discs to prevent boil overs.
  • Make a plan for how to effectively clean and sanitize cooking area, dishes and utensils.
  • Use a talking calculator when modifying, halving, or multiplying a recipe.
  • Consider induction cooktops for increased safety when practical.
  • Modify lighting according to need. Some individuals need more lighting or task lighting, other may need lower light levels, filtering of light sources, or an alternate type of light source.
  • Use dial type controls, which may be easier to modify/memorize.
  • Use tactile marking or color coding to mark important buttons.
  • Try magnification or hand held OCR to better access digital displays.
  • Use a talking oven thermometer to verify oven temperature.
  • Digitize inventory and temperature logs as needed for improved accessibility.
  • Use fluorescent tape to mark routes of travel and tips of stairs.
  • Seek customized recommendations and individualized assistive technology (AT), occupational therapy (OT), or vision rehabilitation therapy (VRT) assessments when appropriate.

Visit the JAN Website for more information on low vison cooking aids.

The American Foundation for the Blind offers information on modified tools and methods for safe cooking for individuals with low or no vision.

Many tools that may be useful to a cook, chef, or baker with low vision can be found at vendors of standard and commercial kitchen supplies. There are however some vendors with specialized products for individuals with low vision that include kitchen aids. Examples of these types of low vision aids for cooking tasks can be found here, here, and here.

You can link here to information on talking thermometers.

JAN’s Website includes information on talking bar code scanners and talking scales.

For highly specialized cooking and baking tasks, scientific instruments designed for use by individuals who are blind may be helpful.

If you would like to discuss specific accommodation situations in more detail, we invite you to contact JAN directly.

 

 

Tips for Starting a Food Related Small Business

Posted by Kim Cordingly on April 15, 2016 under Accommodations, Entrepreneurship / Self Employment, Products / Technology | Comments are off for this article

By: Kim Cordingly, Lead Consultant – Self-Employment Team

Many JAN customers contact us with an interest in starting a food related business.

Below is a sample of the type of food businesses we have been contacted about:

  • Food truck or concession
  • Cottage food product (such as homemade jams, cookies, breads, and so on) –typically sold at a farmer’s market, local shop, or online
  • Catering service
  • Coffee/tea cart
  • Fruit/vegetable stand
  • Consumer supported agriculture (CSA) – subscribing to receive produce from a local farm throughout their growing season
  • Cupcake shop
  • Limited or full service restaurant or bakery

While the scale of planning requirements and applicable food laws and regulations involved for each of these businesses can be quite different, we’ve included below some general tips that can be instrumental in making any food related venture successful.

Tip 1: Take the time from the outset to research your business idea in the context of your local community and potential market

JAN is located in Morgantown, WV – a medium sized college town with a large public university and many coffee drinkers. Theoretically, opening a coffee shop seems like a sure bet in a town like this. Yet over the years, many coffee shops have come and gone, while a small number have endured. Why? Bad coffee? No parking? Too pricey? If you are considering opening a coffee shop, an important step is to map this market – both historically and now. Which markets are being filled and which are not? What makes what you will offer different, better, cheaper or more desirable? I remember when it was considered to be a competitive edge to have Wifi access. Now this is available in almost any coffee shop, fast food restaurant, or bookstore. My point is that whatever your business idea – even before you embark on a formal business or marketing planning process – get to know your local community and potential market well.

Tip 2: Start small, test your ideas, then scale up

You have a dream of opening a small storefront bakery selling breads, cakes, muffins, and pies. You’ve been baking your whole life and inherited a number of wonderful family recipes you’d like to use. But where to start? Even with a small shop, the initial costs appear daunting – rent, commercial cooking equipment, baking ingredients, insurance, advertising, and so on. If you’ve ever watched the Food Network TV show Cupcake Wars, you may have noticed some of these expert bakers do not have their own storefront shops yet. They are either making their products in their home; in a rented commercial kitchen space; at a culinary incubator; as a business within an already established business; or another creative arrangement. The reason for this is it gives the entrepreneur the chance to start small and test their product ideas without the huge capital investment. This also gives you the chance to build up a client base, establish local business and financial relationships, and then scale up your operation. For example, you might begin by investing in a booth at the local farmer’s market and sell baked goods there. Further down the road, you might advertise at the booth being available to cater parties and special events. You might also make an arrangement to sell baked goods at the local food coop or coffee shops. Through this process, you are collecting data about what works and what doesn’t – what types of muffins are most popular — refining not only recipes but your own vision for your future storefront bakery.

Tip 3: Learn the state and local regulations and laws that apply to your food business

Producing food products commercially whether in a food truck, home kitchen, or restaurant are governed by strict laws and regulations that ensure sanitary standards and the safety of products sold to customers. You need to know what laws and regulations will apply to your business. Some businesses may require special permits – such as those operating a food truck or a business in the home. Organizations such as a local your Small Business Development Center, a Women’s Business Center, or your state extension service are often a good place to start. Your state Department of Agriculture will also have information about food related businesses. Many will also have guides about starting a food related business such as this one available for food entrepreneurs in Pennsylvania.

Some states have passed Cottage Food Laws, which Harvard University’s Food Law and Policy Clinic defines in its publication Cottage Food Laws in the United States (2013) as:

At their most basic, cottage food laws permit the inhome production and sale of nonpotentially hazardous foods. As of the publication of this report, fortytwo states had some sort of cottage food law, and nine states, including Washington, D.C., did not.  Although more than twothirds of states have cottage food laws, there is no uniformity among the laws. Some states restrict homebased food processing activities to a very narrow category of processors (such as onfarm only). Others cap allowable sales at a low amount, such that inhome processing activities can only be a hobby and not a viable business or launching pad for a more traditional food processing business. Some cottage food laws are relatively easy to find in the states’ laws and have clear requirements, while other states’ cottage food laws are difficult to find and may not clearly state the requirements for a cottage food operation. 

These laws will vary by state, but may also be guided by additional regulations at the city level, such as these in the City of Chicago. You will need to do your research to find out what laws, regulations, or permits will apply to your business.

Tip 4: Build any needed accommodations into the design of your business and test them out

This tip is certainly not exclusive to a food business, but can be very important particularly with accommodations that involve food related work environments such as kitchens, food trucks, shops, or farmer’s markets, as examples. JAN consultants can suggest specific accommodation examples and products, but some potential examples in the food industry may include:

From the JAN’s Searchable Online Accommodation Resource (SOAR):

Gripping or Pinching Tools or Objects – This could apply to cooking utensils such ergonomic knives; reachers to eliminate bending; or specialized baking equipment.
Sitting – This could include anti-fatigue mats for those who need to need to be on their feet all day; headsets that free up hands for cooking; or copyholders that could also hold recipes.
Moving, Carrying, or Lifting Materials or People – Lifting devices to move large food products; motorized carts for use when catering; or eating aids.

Food related business ideas are increasingly popular for JAN customers. We’ve highlighted a few tips that can help in the development of these types of businesses. For more specific information about becoming a food entrepreneur, contact JAN directly and we would be happy to put together individualized resources for you.

Fonts for Readers with Dyslexia

Posted by Kim Cordingly on under Accommodations, Organizations, Products / Technology | Comments are off for this article

By: Melanie Whetzel, Lead Consultants – Cognitive/Neurological Team

While some of you may be familiar with the two dyslexia fonts highlighted below, many may not be aware of the specifics of how they can assist as reading improvement tools. Several of our JAN staff learned more about these fonts while attending the 2016 CSUN Conference — 31st Annual International Technology and Persons with Disabilities Conference held at California State University Northridge in San Diego a couple of weeks ago.

Both of the following fonts have been shown to be highly effective in improving reading skills for many people with dyslexia by helping to better differentiate between letters, aiding in the reading process.

Here’s a brief look at how they work:

Dyslexie uses a heavier, bolder line thickness that emphasizes the bottom of most letters. This anchors the letters and helps prevent substituting, rotating, and flipping of letters. The Dyslexie font is designed so that every letter has its own unique form. Some differences between the Dyslexie font and others are slanted lines, weighted bottoms, larger openings in the letters, such as a, e, and c. The ascending stems of letters like f and h have been made taller, as well as the descending tails of letters such as p, q, and y. The spacing between letters and words is increased to prevent crowding. The capital letters and punctuation marks are bolder so that it is easier to identify the beginning and ending of sentences.

OpenDyslexic is a font also created to increase readability for individuals with dyslexia. The typeface includes regular, bold, italic, and bold-italic styles. OpenDyslexic is created to help with some of the symptoms of dyslexia. Letters have heavily weighted bottoms to indicate direction. Readers are able to quickly figure out which part of the letter is down, aiding in letter recognition, and helping keep the brain from rotating them around. Consistently weighted bottoms can also help reinforce the line of text. The unique shapes of each letter can help prevent confusion through flipping and swapping. OpenDyslexic is being continually updated and improved based on input from users with dyslexia.

If you or someone you know has dyslexia, be sure to check out both Dyslexie and OpenDyslexic to see how effective they might be!

For information on Accommodation Ideas for Learning Disabilities, visit our JAN Website.

Spring Cleaning Your Workplace

Posted by Kim Cordingly on March 7, 2016 under Accommodations, Employers, General Information, Products / Technology | Comments are off for this article

By: Melanie Whetzel, Lead Consultant – Cognitive/Neurological Team

After the long, dark, and cold winter, we yearn for spring. We look forward to warmth, flowers, birdsong, and spending time outdoors. We also look forward to the opportunity to spring clean our homes, workspaces, and classrooms. What better time to get rid of clutter and lighten up? It would be a much easier task if it were one we kept up with throughout the year, but most of us find that difficult to do.

While for some of us messiness may be a routine annoyance, for employees with organizational difficulties as a result of attention deficit disorder (ADD), cognitive issues and/or fatigue due to cancer treatments, fibromyalgia, brain injury, multiple sclerosis (MS), or other impairments, creating and maintaining order may be especially challenging.

For those of you who work from home, you may find it even more difficult to keep up with the clutter in your work space. Maybe the fact that you don’t have co-workers who can see your mess makes it easier to let it go and let it grow! There is also the chance at home that items not belonging in your office have an easier time migrating there.

Regardless of whether you work in a classroom, an office, a cubicle, or a home office, reducing the disarray in your workspace may very well increase your sense of professionalism and productivity. Look to the following tips for help in organizing your workspace and reducing your clutter to a more manageable level.

  • Don’t become overwhelmed when you look at the area about to be cleaned. Take heart! Be brave!
  • Start from one side of the room, area, or desk and move in a path to the opposite side.
  • Remove rarely used tools and gadgets from your desk top and drawers. Place them in a storage area that is convenient for when you do need them. Label areas for easy retrieval.
  • Do you have books that you rarely use? Remove those to storage as well. If you haven’t used a particular book within the last 60-90 days, it is probably not something you need to have at your fingertips.
  • If you are a collector of whatnots and trinkets, consider limiting the number you display on your desk at a time. Put the others into storage and plan to rotate them in and out for a fresh new look.
  • If you have extra furniture in your space that is not needed, consider removing it. It may create more surface area that allows you to collect even more clutter.
  • Think about hanging photos of your family, sports teams, etc., on the walls instead of having them take up desk space.
  • If you have a mountain of paperwork, go through it with only three categories in mind: things to act on, things to file, and things to toss.
  • Color-code files to help identify them with ease.
  • Invest in stackable bins or trays for papers. Label them.
  • Use a bulletin or magnetic board to keep often-used items, schedules, or policies / procedures within eyesight. If you are a person who likes to collect photos, cards, or whatever, consider having one board for work use and one for personal use.
  • Have a trash can handy while opening mail. Toss absolutely everything that does not need to be responded to or remembered.
  • If your office recycles paper, have a tray handy for that. Take to the larger recycling area at least weekly.
  • Arrange the items on your desk and in your office according to how you use them. Your desk and surrounding office / cubicle space may look different if you are left-handed, for example.
  • Having an efficient usable workspace isn’t about it looking good, it’s more about the space being functional for you and your needs in your particular job.
  • Try to reserve 10 minutes at the end of each day to put things away, clear off your workspace, and prepare for the next day.

You can take charge and control your clutter by not allowing it to accumulate. Then when spring rolls around, you may be able to spend more time enjoying the flowers, the birds, and the outdoors!

 

JAN Goes to the ATIA Conference

Posted by Kim Cordingly on March 2, 2016 under Accommodations, JAN News, Organizations, Products / Technology | Comments are off for this article

By: Teresa Goddard, Lead Consultant — Sensory Team; Kelsey Lewis, Consultant — Cognitive/Neurological Team; Lisa Mathess, Senior Consultant — Motor Team

At the beginning of February, a few JAN consultants had the privilege to travel to sunny Orlando, Florida to attend the annual Assistive Technology Industry Association (ATIA) conference. All week, JAN was well represented with a booth in the exhibit hall along with consultants giving three presentations on a range of topics.

As part of the educational sessions, JAN offered a presentation titled Apps at Work: Accommodating Employees Effectively with Mobile Technology! showcasing a variety of mobile apps that could be used as part of, or as, a reasonable accommodation in the workplace. JAN talked about apps for limitations stemming from sensory, motor, cognitive, and psychiatric impairments.

JAN also gave a presentation on real-life situations and solutions from inquiries handled by our consultants regarding employees with multiple impairments and therefore various limitations. The presentation Multiple Impairments, Multiple Limitations: Accommodating Employees with Complex Needs was well received, as accommodation needs can be very complex and ever changing.

Finally, on the last day of the conference, JAN collaborated with alliance partner AbleData and presented on assistive technology options and accommodation ideas for employees with autoimmune disorders — Workplace Accommodations & AT for Individuals with Autoimmune Disorders.

The exhibit booth was visited by people from a variety of backgrounds, including educational professionals, rehabilitation professionals, students, employees with disabilities, and product manufacturers. Consultants discussed the various services offered at JAN and handed out publications and goodies to over 300 attendees.

If you’re interested in viewing the presentation PowerPoints, they are available on the JAN Website for download.

One of the things that we as JAN consultants enjoy most about attending conferences is visiting the booths of other service providers and vendors. Conference exhibit halls are a practical and hands-on way for us to keep up with the latest information on assistive technologies and disability services so that we can share up-to-date information with our consumers. This year, the ATIA exhibit hall showcased a wide variety of vendors and organizations. As usual, vendors of augmentative and alternative communication (AAC) devices and vision-related products were well represented. Due to the recent merger of Dynavox and Tobii, both of which are well known for their AAC devices and eye gaze systems, we were particularly interested to see how they would combine their product lines. We learned that the DynaWrite2.0, a speech-generating device particularly well suited to meet the needs of literate adults who need to be able to use a land line phone for work, had been discontinued. However, one of the Tobii DynaVox reps assured us that a similar product, the highly portable Lightwriter SL40 Connect, will continue to be available. The Lightwriter can be used to make mobile phone calls.

In addition to presenting for JAN, we were able to attend multiple educational sessions. One unique and entertaining session was called Music-Making = Differentiated Instruction and Unique Therapy Protocols, which featured a new [to us] product called Beamz. Beamz is a laser-based music device. It includes three prongs (shaped like a “W”) and laser beams running from each prong. Each laser acts as a different musical instrument that can be played with the stroke of a hand.

The Beamz device can link to IOS products, MAC, and PC, allowing users to view the corresponding instrument with a laser beam on the screen of their device. Users can choose among many genres, including country, hip hop, classical, and even nature sounds. In addition, users can choose to add their own musical twist to already-synced songs ranging from Beamz original compositions, to karaoke hits, and today’s latest radio jams.

Beamz is currently used in multiple settings including schools, geriatric and long-term care facilities, at home, and as a therapy/ rehabilitation tool. It is thought to improve cognition, socialization, and motivation through memory recall, improved communication, and “brain fitness.” Beamz also claims to help with fine and gross motor skills along with improving range of motion.

 

 

 

Baby It’s Cold…Inside

Posted by Kim Cordingly on December 21, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By Tracie DeFreitas, Lead Consultant — ADA Specialist

Lately, I’ve had that holiday tune, Baby It’s Cold Outside, melodically playing in my mind (imagine the Lady Gaga and Tony Bennet rendition). The song makes me smile and, ironically, warms my soul. Of course, it’s the holiday season and that means the song is playing everywhere we go. But, this isn’t the only reason I’ve had this catchy tune on my mind; JAN customers have me thinking of it as well. Now that winter has arrived, we’ve been hearing from employers who have questions about accommodating employees who are sensitive to cold temperatures. Interestingly though, the questions have been about the impact of exposure to cold indoor temperatures.

Thermostat wars are a common ongoing battle in the office. You’ve experienced it, right? Co-workers stealthily sneaking around the corner, adjusting the heat up or down to their comfort level when no one else is watching. It’s probably fair to say that there is no particular temperature that is comfortable for everyone. The Occupational Safety and Health Administration (OSHA) does not regulate indoor workplace temperature but does recommend that temperatures be maintained in the range of 68-76° F. This range may be comfortable for many workers, but not all. Although this indoor temperature range is suggested, some workplaces maintain indoor temperatures (in cool and warm months) that fall well below 68° (I’ve heard as low as 61°), making it a frigid environment, particularly for those who are medically sensitive to cold temperatures.

Sensitivity to cold temperatures is a limitation associated with a number of impairments, including anemia, asthma, diabetes, Raynaud’s disease, rheumatoid arthritis, scleroderma, and thyroid disorders. Some individuals with these types of impairments experience joint pain, stiffness, or numbness in their extremities (i.e., hands, fingers, toes) in response to cold temperatures, while others experience difficulty breathing. Exposure to cold temperatures at work can cause these symptoms to flare-up, making it difficult for an affected employee to perform job duties. This can lead to a request for accommodation under the Americans with Disabilities Act (ADA).

One solution for dealing with the effects of the cold indoors is a small space heater to be used at an employee’s workstation. JAN Consultants are frequently asked if an employer has any obligation to provide a space heater as an accommodation for an employee who requests one due to a medical impairment. This isn’t about providing a space heater simply to improve personal comfort, but rather, to enable an employee to manage the impact of the cold on their impairment, and in-turn, performance. Some employers provide space heaters to employees for non-disability related reasons, or allow employees to bring their own heaters to work. But, is there a duty to provide a space heater as an accommodation under the ADA? Or, is a space heater a personal need item?

In situations where the temperature is extreme, it could possibly be argued that if the employer is creating a workplace barrier by maintaining an indoor temperature that 1) falls below the minimum suggested standard, and 2) has an adverse effect on an employee’s medical impairment and ability to perform job duties, then the employer may have some responsibility to provide a reasonable accommodation to eliminate that barrier – this could include providing a space heater. If a healthcare provider can confirm the existence of an impairment and that the extreme temperature of the work environment causes limitations that affect performance, then there will be medical justification for the accommodation.

The Equal Employment Opportunity Commission (EEOC) has stated that, in some situations, items that might otherwise be considered personal may be required as reasonable accommodations where they are required to meet job-related rather than personal needs (EEOC, 2002). While a space heater may seem like a personal need item, when it is needed to help an employee perform job duties effectively, it may be a reasonable accommodation. It often makes sense to err on the side of caution, do a risk analysis, and use common sense when considering accommodations. At a cost of about $30.00 for a small space heater, it may be difficult to demonstrate that this low-cost solution is not reasonable. And, it’s certainly a lot less expensive to provide the accommodation than to deal with a disability discrimination complaint alleging failure to provide a reasonable accommodation.

In addition to a space heater, there are other accommodations that might be considered to manage the cold indoors. Some ideas can be found on JAN’s AskJAN.org website under A-Z, by limitation, temperature sensitivity, but consider the following:

  • Adjust work-site temperature
  • Redirect or cover air vents using air deflectors or vent covers
  • Do not situate workstation under air vents, near cold windows, or near opening exterior doors
  • Move workstation to warmer area of building
  • Use window insulation, rubber weather sealing, heavy curtains, or shades on windows to reduce draft
  • Provide an enclosed workspace with separate temperature control
  • Allow use of heated blanket, heating pad, hand warmers, etc.
  • Modify dress code to allow wearing of layers, gloves, outerwear, etc.
  • Provide speech recognition software to limit keyboarding
  • Allow flexible scheduling
  • Allow flexible use of leave
  • Allow work from home or an alternate (warmer) location

Accommodation needs and situations vary. If you have a specific situation or question you’d like to discuss with a JAN consultant, we’ll be happy to assist you. Contact us directly or visit AskJAN.org.

Reference:

Equal Employment Opportunity Commission. (2002). Enforcement guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act. Retrieved from http://www.eeoc.gov/policy/docs/accommodation.html

Seasonal Affective Disorder (SAD) — More than Gray Skies in Winter

Posted by Kim Cordingly on November 23, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sarah Small, Consultant – Cognitive/Neurological Team

As I was driving on the interstate this past week, I couldn’t help but notice that most of the trees had lost their leaves. The beautiful reds, yellows, and oranges have slowly become bare branches. This, along with the slowly declining temperatures means one thing…winter is coming. Winter has its own excitement with the holidays and many traditions; however, at times it tends to bring with it feelings of dread. Winter means snow, ice, and for those of us in daylight savings time, shorter days. It’s easy to feel not ready and sad as the warm days leave us. But for some people, these feelings can be more intense than others.

Seasonal Affective Disorder (SAD) is a form of depression that comes and goes with the change in seasons. SAD is most common in the winter months starting in the beginning of fall and peaking in December, January, and February (Mental Health America).

Common symptoms include:

  • Irritability and stress intolerance
  • Decreased energy
  • Oversleeping
  • Fatigue
  • Changes in weight
  • Difficulty concentrating
  • Changes in appetite
  • Decreased interest in daily activities, sex, and social interactions
  • Feelings of hopelessness or worthlessness

While the cause of SAD is unknown, it is believed that the reduced level of sunlight during the winter months disrupts the body’s internal clock (circadian rhythm), as well as the body’s levels of serotonin and melatonin (Mayo Clinic). This can impact sleep patterns as well as mood.

According to the Mayo Clinic, there are certain factors that increase an individual’s risk for SAD. These risk factors include:

  • Being female
  • Age – onset typically between the ages of 18 and 30
  • Family history of SAD
  • Having depression or bipolar disorder
  • Living far north or south of the equator- it is said to be rare in those who live within 30 degrees of the equator

Treatment for SAD can include prescription medications that fall within the same family of drugs that help treat depression. These types of drugs are typically non-sedative selective serotonin reuptake inhibitor (SSRI) drugs.

Another type of treatment is phototherapy. This type of therapy includes exposure to high intensity bright lights such as sun lamps or sun boxes. These forms of light are often portable and can easily be placed on a desk or table in a work area. They also can be used at home to simulate natural light and help reduce fatigue and feelings of depression.

Additional information regarding SAD as well as a variety of light products can be found at this Consultants’ Corner.

JAN also offers information on accommodating individuals with various types of depression in the workplace — Accommodation Ideas for Depression.

While the winter months can bog us down with gray skies and cold weather, make sure to find time these next few months for things you enjoy. Whether it’s spending time with family and friends, planning a ski trip, or curling up on the couch with a good book and some hot chocolate, don’t forget to take time for yourself. Spring will be here before we know it!

Resources:

Mayo Clinic – Seasonal Affective Disorder (SAD)

Mental Health America – Seasonal Affective Disorder (SAD)

 

 

Work After Breast Cancer

Posted by Kim Cordingly on October 16, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant – Motor Team

One of the most positive things about more people surviving breast cancer, and cancer diagnoses in general, is that life after a diagnosis goes on, including one’s work life. Many are able to continue working through treatment, while others choose to focus on treatment and then return to work. Often less recognized is that while a clinical diagnosis is made on a specific date, and various treatments are done on specific dates, the side effects may linger on for weeks, months, and sometimes years.

Cancer, as many oncologists say, is a lifelong, chronic condition. For some this may be a direct result of the disease process, while for others it may be the result of side effects from necessary, but often potent, treatment protocols.

Just like with any other chronic condition, people who have had breast cancer can be fantastic employees. Some return to work and continue on as they did prior to their diagnosis. Others may need accommodations to be the best employee they can be.

The following are some potential areas of accommodation that may assist someone who has had a diagnosis of breast cancer:

Need for ongoing medical treatment, follow-up appointments, and monitoring:

  1. Allow for a flexible schedule
  2. Allow employee to telework
  3. Allow for additional leave time

Need for an ergonomically adjusted workspace due to lifting restrictions, pain management, and so on:

  1. Provide workspace adjustments to desk height, monitor height, chair, arm support, and reach ranges for equipment and materials
  2. Provide ergonomically appropriate tools
  3. Allow for breaks from repetitive tasks
  4. Modify workspace layout to avoid tasks done over the head
  5. Allow time for physical movement to help circulation

Need for supports with cognitive processing:

  1. Allow for self-paced workload
  2. Adjust supervisory method to allow for prompting, adjusting instructional or management method, breaking large tasks into smaller tasks
  3. Allow for one task to be completed before the next is presented

Need to manage fatigue:

  1. Allow for periodic rest breaks
  2. Allow for a modified schedule
  3. Redesign workspace to bring all necessary materials within easy reach range
  4. Limit physical exertion required
  5. Move workspace closer to door, break room, or restroom
  6. Provide personal mobility device to maneuver around workspace without exerting more effort
  7. Allow telework from home and remote access to meetings

While wearing pink brings awareness to the needs of those who are living with or have survived breast cancer, providing accommodations concretely changes the lives of those who are affected, as well as strengthening the business as a whole.

For more information:

Accommodation Ideas for Cancer

EEOC Fact Sheet: Questions and Answers About Cancer in the Workplace and ADA

Healthcare Workers with Motor Impairments – Part 2

Posted by Kim Cordingly on August 18, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

In this final segment of the 2-part Blog on accommodations for healthcare workers with motor impairments, JAN Lead Consultant Elisabeth Simpson, MS., CRC, in collaboration with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, continues the discussion on some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the remaining four questions and offering resources and information on the topic.

Questions:

1) When a limited schedule is needed (e.g., 10 hour shift in place of a 12 hour shift), would allowing this for one nurse on a unit really be a hardship for the other nurses working?

The accommodation of a schedule modification, as well as modifications of a workplace policy regarding scheduling, are a couple of types of accommodations an employer would need to consider providing, absent undue hardship. The EEOC’s Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act (ADA) offers guidance on this area of accommodation that might be useful for an employer or individual to review.

According to Dr. Maheady, in some cases an employer may be able to limit an individual’s schedule without it posing a hardship. However, in most situations, nurses are working with limited staff and adding additional work can be problematic for various reasons. Safe staffing ratios are critical to patient care outcomes and allowing a nurse to leave early or come in late could impact safe staffing ratios.

Alternative options could be to consider accommodations that would enable an individual to work the hours required. This could include periodic breaks, modifying policies around eating and drinking, providing equipment, or restructuring a job to reallocate marginal functions. Reassignment may be necessary if accommodations would not be effective or would pose a hardship. This type of accommodation may also be necessary if an individual needs to limit hours to the extent at which they would be working part time rather than full time.

2) For medical professionals with upper extremity limitations, what are some alternative ways to place a catheter (male or female)? Is maintaining a sterile field ever a concern?

It depends on many factors (age of patient, patient’s condition, etc.). For males, in some instances, it is appropriate to have the patient assist while placing the catheter. Also, if teaching the patient to self-catheterize (or a family member), this is part of the teaching/learning process.

What would work best is to have a second person, possibly a nurses’ aid or family member, don gloves and assist. Then the individual can don gloves, clean the meatus, and insert the catheter. Dr. Maheady notes that, in her experience, many nurses ask for assistance, disabled or not.

3) How can a medical professional who uses a cane or mobility device address concerns around sterilizing the device?

In these situations, Dr. Maheady recommends that the Infection Control Department or designee should always be consulted. There may be specific infection control issues related to a facility or unit. Collaboration with all parties in determining effective solutions can help to speed up the process and ensure that policies and procedures around sterilization are kept in mind.

Concerns around cane or wheelchair use in sterile medical environments can be addressed by:

  • Having two wheelchairs available and keeping one chair in a sterile area. The individual could switch chairs in a dedicated area.
  • Using wheelchair tire covers.
  • Wheeling into the room with one pair of gloves and changing to a new pair of gloves before touching the patient.
  • Surgical gowns could also be used to cover exposed areas of the chair.
  • A long narrow plastic bag (like ones for wet umbrellas) could be used with a cane and taped around the cane to secure. Bags could be changed as needed.

It is important to note that in general patient care areas, nurses do not sterilize their shoes, sneakers or clogs. An employer would not want to unnecessarily impose more stringent rules or requirements for employees with disabilities as this could be a violation of the ADA.

4) When a patient lifting device is not available, what are some alternative options that a medical professional with a lifting restriction could consider?

This is another situation where job restructuring may be the most effective form of accommodation for individuals who have lifting restrictions and are working in healthcare positions that require them to lift. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as patient lifting techniques, individuals with a disabilities should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. For example, an individual could be permitted to ask for assistance when lifting a patient. Team lifting, or lift buddies, can also be a solution. However, there will still be risks associated with lifting patients and injuries can occur with any employee, not just those with restrictions. It is important to remember that team members have different strengths and body sizes and may contribute differently when lifting a patient.

Ultimately, if an individual is not able to lift patients even with accommodations, reassignment would need to be considered. Reassigning the individual to another unit (e.g., pediatrics, newborn nursery) where there is a vacant position could be explored.

JAN and Elisabeth would like to extend our appreciation to Dr. Maheady for her assistance in answering these common, but difficult questions related to healthcare workers with motor impairments. For assistance in determining accommodation options for individuals with motor impairments, JAN consultants are ready to assist!

Healthcare Workers with Motor Impairments

Posted by Kim Cordingly on July 1, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

According to the Bureau of Labor Statistics (2013), the health care and social assistance sector will account for almost a third of the projected job growth between 2012 and 2022. With 16,971,800 healthcare workers employed in the United States in 2012 (Bureau of Labor Statistics, 2013), accommodations for those with disabilities working, or planning to work in, the healthcare field is a timely topic to be discussing.

With the over ten thousand calls JAN has received related to accommodations in healthcare settings, JAN consultants can offer a wealth of experience with accommodation situations. For healthcare workers with motor impairments such as carpal tunnel, back conditions, leg impairments, or arthritis, certain job duties – tasks such as lifting, carrying, moving, transferring, standing, walking, manipulating extremities, and positioning individuals for activities of daily living or physical therapy – may be difficult to perform without accommodations.

There are a variety of accommodation options that can be implemented in order for an employee to perform the essential functions of the job. Proper lifting techniques, lowering adjustable exam tables and equipment (low-lipped showers), ergonomic layouts for equipment (cranks and handles on beds and carts) and supplies (storing items at waist height, lowering bed rails when attending to patient needs, etc.), and team lifting are beneficial work site and procedural changes.

Still, accommodation situations in healthcare settings can be tricky or complicated. When this is the case, JAN consultants might turn to other experts in the field for assistance so that those contacting us for guidance are provided with the most beneficial and accurate information. For this two part blog, I collaborated with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, to discuss some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the first three questions and offering resources and information on the topic.

Questions:

1) For medical professionals with either a hand or arm amputation OR restrictions that limit the use of one hand, what are some alternative methods for giving injections? What about placing IV’s?

According to the Equal Employment Opportunity Commission (EEOC), a reasonable accommodation must be provided to enable a qualified employee with a disability to perform the essential functions of a job currently held. In general, an accommodation is any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities.

Job restructuring may be the most effective form of accommodation for individuals who have limited or no use of one hand and are working in healthcare positions that require them to perform injections, place IV’s, etc. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as placing an IV, an individual with a disability should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. Time to practice clinical skills or tasks may be needed as part of the accommodation.

A number of videos and articles are offered as an additional resource to support the work of those with motor impairments in healthcare settings:

Videos

Foreign object removal with prosthesis

Adult CPR with prosthesis

Nursing with the hand you are given

Disabled Nurse: Focus on abilities

Danielle’s story (nurse missing her lower arm)

A sequence of photos demonstrating the donning of sterile gloves with one hand can be found within the article: “Nursing with the Hand You Are Given

Articles and Book Chapters

In the book Leave No Nurse Behind: Nurses Working with Disabilities by Donna Maheady, Susan Fleming (nurse born missing her left hand) wrote a chapter about her journey.

In the book The Exceptional Nurse: Tales from the Trenches of Truly Resilient Nurses Working with Disabilities, edited by Donna Maheady, Connie Stallone Adleman wrote a chapter called “Loving Ourselves Exactly as We Are: Nursing after a Stroke.”

In the article “Missing a Limb but Not a Heart,” Carey Amsden, RN, discussed how she practiced performing certain job tasks with the use of one arm, such as starting an IV, and donning a sterile glove in nursing school and has been able to successfully work in the field of nursing.

2) For medical professionals who need to wear a brace or post-burn glove, how can concerns around sterility be addressed?

An employer may require as a qualification standard that an individual not pose a “direct threat” to the health or safety of the individual or others, if this standard is applied to all applicants for a particular job. Additionally, employers may comply with medical and safety requirements established under other Federal laws without violating the ADA.

However, an employer still has an obligation to consider whether there is a reasonable accommodation, consistent with the requirements of other Federal laws, which would not exclude individuals who can perform jobs safely. In situations where sterility is a concern, alternatives to standard practices should be explored with the individual.

One option could be for the employee to wear a sterile glove (perhaps a larger size), gown or drape over the brace or glove. In doing this, sterility would be addressed to the same standard that others would be held to.

It is also recommended that the Infection Control Department or designee be consulted. There may be specific infection control issues related to a particular facility or unit to consider.

3) Are there alternatives to taking a leave of absence during flu season for medical professionals who are not able to receive the flu vaccine?

Flu season, in some areas, can last a while and a leave of absence may not be feasible or could pose an undue hardship to the employer. Alternative options for accommodating those who are not able to receive the flu vaccine can include: allowing the employee to wearing a mask or protective gear, reassigning the employee to a position that does not require direct-patient contact, considering flu shot alternatives, modifying a policy if applicable and depending on state law, or allowing an extended leave and offering reassignment to a vacant position upon return. For more information, see the following article: “Vaccinating the Health-Care Workforce: State Law vs Institutional Requirements.”

Next month we will be exploring schedule modifications and specific work tasks, so stay tuned!

Resources:

Monthly Labor Review (2013). Bureau of Labor Statistics. Retrieved from http://www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022-1.htm