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Alzheimer's Disease

Accommodation and Compliance: Alzheimer's Disease

About Alzheimer's Disease

Alzheimer's disease is a progressive brain disorder named for the German physician Alois Alzheimer who first described it in 1906. Alzheimer’s disease damages and eventually destroys brain cells, leading to loss of memory, thinking, and other brain functions. Alzheimer's is not a part of normal aging, but results from a complex pattern of abnormal changes. It usually develops slowly and gradually gets worse as more brain cells wither and die. Alzheimer's is fatal, and currently there is no cure. Alzheimer's disease is the most common type of dementia, a general term used to describe various diseases and conditions that damage brain cells. Symptoms of Alzheimer’s disease progress from mild forgetfulness to widespread brain impairment. Chemical and structural changes in the brain slowly destroy the ability to create, remember, learn, reason, and relate to others.

Early-stage Alzheimer’s is when the problems with memory, thinking, and concentration may begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal assistance with simple daily routines. However, at the time of diagnosis, an individual is not necessarily in the early-stage of the disease. The term early-onset or younger-onset refers to Alzheimer’s that occurs in persons under the age of 65. Younger-onset individuals may be employed or have children still living at home. Early-onset Alzheimer's has been known to develop between ages 30 and 40, but it is more common for someone in his or her 50s to have the disease.

JAN's Effective Accommodation Practices (EAP) Series: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.

Alzheimer's Disease and the Americans with Disabilities Act

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. 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. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Alzheimer's Disease

People with Alzheimer’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 Alzheimer’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:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training?

Helpful Hints for the Accommodation Process 

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.  

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.  
     

Accommodation Ideas:

Situations and Solutions:

Events Regarding Alzheimer's Disease