Having dementia does not automatically mean that you are no longer fit for work. However, it may mean making changes to the way that you work. It is well evidenced that being in appropriate work is good for you. Working can improve physical and mental health and well-being. But what happens when health issues do arise?
The Equality Act 2010 (and the Disability Discrimination Act 1994 previously) outlines an employer’s responsibilities regarding individuals with disabilities – it is illegal to discriminate against someone as a result of their disability.
Recent changes now mean that the Act extends its provision not just to those with a disability but also to those who care for someone with a disability. There are specific criteria for being defined as disabled under the Act but progressive conditions like Dementia are covered from diagnosis.
The Act includes the following requirements;
Recruitment: Employers are no longer able to ask about a medical condition before they have made an offer of employment unless there are specific safety related standards (eg in the rail industry). Some occupations are excluded from this provision eg armed forces.
Reasonable Adjustments: In cases where an employee has a disability, the employer has a duty to make reasonable adjustments. This means considering making changes to a person’s job role that enables them to perform their work effectively and not be disadvantaged because of their disability. This can include workplace adaptations, changes of work task, changes to hours of work etc.
In some jobs, for example, where safety may be affected due to your symptoms, it is imperative that you inform your employer of your diagnosis and this may well be a contractual or statutory obligation (eg Armed Forces, or jobs including driving). For other types of jobs, you do not have to tell your employer if you don’t want to.
Whatever your job, informing your employer could help you get the right kind of support and can often be reassuring if you are worried about the employment consequences of your diagnosis. This can seem daunting but being open and honest if often the best approach. It is likely that your manager will not have dealt with an employee with dementia before and may need time to seek advice before they can advise you on the next steps.
If you have concerns regarding confidentiality, let your manager know. It is up to you if you want to talk to your colleagues about your diagnosis and will depend on your individual environment. Colleagues can often be a great support and, depending on local policies and procedures, advocate for you at meetings.
Many companies have access to Occupational Health services. These services are staffed with specialists who can assess an employee, liaise with the employee’s treating specialist and objectively advise the manager on next steps eg temporary adjustments to work. If your employer doesn’t suggest referral to Occupational Health, ask if they have access to these services and then ask to be referred.
Fit to Work – GP fit note
Sickness certification was changed several years ago from the “sick note” to the “fit note”. This gave GP’s the scope to give more information and advice on their certificates instead of simply sick or not. Your GP can now suggest adjustments to work or be more explanatory regarding your needs.
Access to Work
Access to Work is a specialist disability service delivered by Jobcentre Plus, which gives practical advice and support to disabled people, whether they are working, self employed or looking for employment. You can contact Access to Work via the above website or via Jobcentre Plus and their Disability Employment Advisors.
Your health condition must affect your ability to do a job or mean you have to pay work-related costs. For example, special computer equipment or travel costs because you can’t use public transport. Your mental health condition must affect your ability to do a job. It must also mean you need support to:
• start a new job
• reduce absence from work
• stay in work
Fit for Work
Fit for Work is a free advice service and helps employees stay in or return to work. It provides an occupational health assessment and general health and work advice to employees, employers and GPs. Fit for Work is in place to complement existing occupational health services provided by employers, to particularly benefit employers who have limited in-house occupational health services. The Fit to work website gives guidance and there is an advice line.
After talking to your employer and getting specialist advice, the next steps are assessing whether any adjustments are required to your job to ensure safety and performance. This may include your employer undertaking an individual risk assessment. This is an assessment that looks at how your condition affects your job and vice versa and identifies hazards and risks that may be affected by your condition. This then dictates decisions on how these risks can be mitigated against and what adjustments could be suitable.
As your condition changes, your risk assessment should be reviewed as your needs may change too. The word “reasonable” is used a lot when talking about adjustments. Whether something is “reasonable” is decided by your employer but they will be mindful of the Equality Act and its guidance regarding reasonableness. Keep the lines of communication open with you employer. Often a better understanding of a medical condition helps the employer give you the right support.
‘Gordon Waddell, A Kim Burton, Is Work Good For Your Health and Wellbeing? DWP, 2006’
Continuing to work whilst caring for a person with dementia can be a struggle but also very rewarding. Carers can feel isolated and giving up work can sometimes lead to financial difficulties and feelings of isolation. If you would like, or need, to continue to work, you could approach your employer to discuss your needs. Your employer may be able to change or reduce your working hours to help you attend appointments or offer flexibility.
There are some benefits available for carers looking after a person with dementia with substantial needs and support to help you stay in employment. Carers UK have a range of practical advice and guidance to support carers in work with requesting flexible changes to your hours and your rights.