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 Accommodation Solutions: 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 definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such 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:

What limitations is the employee 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?
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?
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.

By Limitation

Executive Functioning Deficits

Managing Time

Memory Loss

Organizing/Planning/Prioritizing

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

A finance manager with Alzheimer’s disease had difficulty learning new tasks and staying organized.

Her physician recommended disability retirement. Her employer took an integrated employment approach and carved out a position for her that had fewer responsibilities, but still allowed her to share her expertise with other employees.

Due to Alzheimer's disease, a project manager for an engineering firm was increasingly unable to keep track of and manage all of the individual components that were involved in the project.

After careful consideration, he spoke to his employer about the difficulties he was having and asked to be placed back into a team position where he would only be involved with one aspect of the project instead of coordinating the entire project. His employer agreed and as it was near to the end of the current project, felt that they could very easily do some restructuring and find a position for him on one of the teams.

A music teacher at a small high school was diagnosed with early-stage Alzheimer’s.

Through meeting with school administration and with help from her doctor, the teacher was able to remain in her position with increased support in the form of accommodations. With the help of a colleague, she was able to better organize her desk and files so that retrieval of information was much easier. Color-coding was used to help her better locate that information. She was also provided with a voice-activated recorder to help her remember verbal instructions and notes from meetings. At the current time, the accommodations were helping her keep her performance at a very high level.

A caller in his late forties contacted JAN to ask about job accommodations related to a recent diagnosis of early-onset Alzheimer’s.

The major difficulty he had been having was a compromised ability to find his way around the city. He drove a truck making deliveries and thought a GPS (global positioning system) would help him with the different directions and enable him to navigate the drive to specific locations. With information from his medical provider to substantiate the need for the accommodation, the caller submitted his request.

A human resources manager at a large university had recently been diagnosed with early-onset Alzheimer’s disease.

The diagnosis came as no surprise to the employee, as he had been struggling for some time with working the long hours involved in managing the tasks. He found that he needed progressively more time to complete tasks and that the same tasks were becoming increasingly more complex. His inability to perform the essential functions of the position prompted him to ask for an accommodation. He requested leave under the ADA so that he could contact his EAP and determine what benefits were available to him.