Cancer Can Be Beaten. We all know the slogan. About two out of every five Canadians are likely to develop cancer in their lifetime, and about 62% of cancer patients will return to work following successful cancer treatment.
Employees coming back to work after cancer treatments describe a variety of challenges that employers may not be aware of/or consider in their return-to-work accommodations:
COGNITIVE
“Brain Fog” is the common term used by patients to refer to changes in thinking that can occur following cancer treatment, including decreased memory, reduced attention and concentration, problem finding words, and difficulty thinking through and solving problems.
PHYSICAL
Fatigue is the most frequently reported side-effect. Also, some employees have reduced mobility due to surgery and may need their physical workspace adapted. There is also the practical consideration of medical follow-up, and the need for time away from work for medical appointments
EMOTIONAL
For some employees, the “roller coaster” that started on the day of their diagnosis, continues. Fear, anxiety or depression may impact how they handle various situations and how they see themselves. They may be living with the fear of relapse. Subsequent depression often goes undiagnosed. Cancer is a life-transforming experience and it is natural to re-evaluate one’s life after a traumatic event. Some are eager to return to full hours and/or duties, while others wish to spend less time working. Some do not wish to return to work at all, but must because of the financial constraints. Others may choose a completely new career path.
FINANCES
Time away from work for cancer treatment can have a serious financial impact, even for employees who received income from employer or government-based programs. Cancer has been associated with an average of 12 percent decrease in wages, with many experiencing a significant financial decrease. Due to this, many employees are compelled to return to before they feel emotionally or physically ready.
It is common for small and mid-sized companies to not offer Short -Term Disability Leave (STD) or have access to Employee Assistance Plans (EAPs). This leaves those who require short-term leave to rely on employment insurance (EI), unused vacation or sick leave, or the generosity of their employer. The Report Card on Cancer in Canada, shows that the cost of cancer-related drugs is rising at 35% per year. Employees can experience additional financial strain as they may struggle to pay for prescription drugs that are not fully covered or not covered at all by their benefits plan.
In a recent survey, the majority of employers indicated that they were concerned when an employee’s ability to work was affected by cancer, but most said this was not a human resources issue they were actively focused on. The survey also showed that the level of support tended to increase with tenure and seniority, with the employer’s ability to backfill the position and for employees with a history of strong performance. Support tended to decrease for work that was physically demanding, for hourly and part-time workers, and if the management team was extremely cost driven.
EMPLOYER’S ROLE
Many factors affect successful management of a situation when an employee’s capacity to work is affected by a disease such as cancer, including the nature of the employee’s illness, the type of work, the size of the organization, the flexibility of managers and employees, the culture in the workplace, the employee’s willingness to return, the manager’s willingness to make things work, and the financial and organizational constraints of the employer.
According to Canadian Partnership Against Cancer, their recommendations to employers include:
- Facilitate and provide training sessions for human resources managers. Employers need to act as holistic supporters that can coordinate and reassure patients about the financial and practical aspects of the cancer diagnosis. By being as proactive and supportive as possible, employers can assist with stress reduction and provide emotional support, as well as directing the employee to resources that may be available to them.
- Develop educational materials for managers and employees. Undertake a communication program to raise the profile and importance of being prepared. Compile and provide online access to a list and description of corporate and community services that could assist managers and employees during the diagnosis, treatment and return-to-work process. Many benefit providers and EAPs have helpful website resources that can be accessed, but few employees are aware of these resources. As well, the Canadian Cancer Society has a variety of informational resources that can be accessed. Managers can be provided with guides on how to manage the return-to-work process, as well as guides on managing workload and staff morale when the employee is away, and how/what to communicate to the employee when they are away. (Note some insurance companies have these already developed)
- Assess the extent to which inadequate financial support impedes a successful return-to-work process in your workplace. Employee benefits vary widely, but most employers provide some sort of protection—such as disability and other income protection—through group benefits coverage.
- Employers may consider providing a cancer support benefit which can serve as insurance for both the employee and the employer by clearing a potential path to recovery and return to work. This benefit may cover access to external professionals with expertise in accommodation and the development of return-to-work plans, such as a highly trained oncology nurse that may be accessible both by telephone and electronically.
- Group critical illness (CI) insurance is designed to assist those who survive a critical illness by paying a lump sum benefit to the beneficiary, to use at their discretion. This benefit can provide much needed financial assistance to cope with unforeseen expenses, allowing the employee to focus on recovery.
- Access to Personal Financial Planners may help the employee understand their financial state and help to put a plan together to pay off debts or budget for expenses due to continued treatment and time away from work.
- Accommodation. Employers have to reasonably accommodate changes, such as changes in work hours or duties, to help the employee do their job after cancer treatment. However, employers do not have to make changes that would be overly costly or disruptive.
- With many treatments, such as chemotherapy, employees may be prone to mental exhaustion, making some jobs difficult to carry out. Be open to accommodate modified duties and reduced hours and understand that an employee may have to get used to limiting their tasks, losing a bit of control or sharing job duties with others. On their return, employees might feel awkward or out of place, and some might be insecure in their ability to do their job as competently or as quickly as they once did.
- Accommodation is easier when the organization is well staffed, with part-time staff who can absorb more hours, and with several employees being able to perform the same task. Sometimes there needs to be a corporate attitude shift to an approach that is more creative, collaborative and flexible. The prevalent attitude should be, “We have invested in you, how can we help?” It is important to have a good understanding of the employee’s capabilities, medical condition, treatment and side effects and this is only possible when working in an environment of trust, and as a team-approach.
It changes lives, impacts families and hinders workplace productivity. However, as our treatment plans become more successful and more people return back to their workplace, it is essential that companies become more prepared to assist in this process.
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Road Map To Disability Management
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