Webinar: Preventing Work Disability: Strategies and Resources You Can - - PowerPoint PPT Presentation
Webinar: Preventing Work Disability: Strategies and Resources You Can Use Presented by Saralynn Allaire, ScD, CRC-R ENACT: Center for Enhancing Activity and Participation among Presented by Saralynn Allaire, ScD, CRC-R Persons with
ENACT: Center for Enhancing Activity and Participation among Persons with Arthritis Visit us at bu.edu/enact Presented by Saralynn Allaire, ScD, CRC-R Associate Director, ENACT
1.
Define work disability
rheumatic conditions in particular
2.
Describe problem of work disability associated with arthritis
3.
Review effectiveness of strategies to reduce work disability
4.
Demonstrate use of one such strategy
5.
Discuss availability of strategies to promote job retention
No disclosures
Limitation in amount of work that can be done (part time work) Loss of promotions Being overqualified for job
Absenteeism Presenteeism
Costs:
Individuals and families Work disability among older workers ignored – time to
build up retirement savings
Work disabled persons with arthritis have lower self-
esteem, greater pain and depression
(MacKinnon,1992; Fifield,1991; Reisine, 2006)
Society Indirect costs attributable to arthritis in 2005 =
$42.8 bil
Social Security costs
More than 50% of people with arthritis in the US are
data])
30% have arthritis-attributable limitation in ability to
NHIS data], 2007)
The working life expectancy of Canadians with arthritis is
(Lacaille, 2001)
Medical treatment is limited for many forms of arthritis
Pharmaceutical treatment for rheumatoid and other highly
inflammatory forms of arthritis has improved in recent years
Evidence for its effect on work disability is mixed
Residual disease effects in those diagnosed before new
reatments available
Only 15% achieve excellent disease control
Disability pension programs, e.g., U.S. Social
Concerns about cost
Anti-discrimination legislation: The
Requires most employers to provide job
Job accommodation: Any change in the
US Health and Retirement Survey data
Use of a wide variety of job accommodations
extended employment tenure (Chirikos, 2000)
Job accommodation increased length of time
between onset of work limiting condition and application for disability pension (Burkhauser, 1999)
Among 581 participants with rheumatoid
Few employees with these conditions receive
63% of employed participants reported they
Individuals have to initiate the job
Many persons with chronic illnesses are not fully aware of how
their health affects their work
And are not familiar with disability issues and resources
And neither they nor their employers are familiar with
Suggestion by a health professional to use the ADA was
Vocational rehabilitation intervention consists of: Services that are job or career oriented, and Health (or disability) related
Federal/state program available in all states Mandated to prioritize those with most severe
80% of those served unemployed and most have
Unemployed persons with musculoskeletal conditions in Alabama with desire to return to work
Randomized to receive services or not
At 1-2 years, participants receiving services were not more likely to return to work
At longer follow-up, they were 30% more likely to do so
* White, 1997, 2001
Large portions are employed at disease onset Many have considerable work experience
10 weekly group meetings: Topics discussed:
feelings about working; communication skills; stress and symptom management; job accommodations; employment rights and responsibilities; job finding skills
Non-controlled trial: 141 participants with a rheumatic condition all attended Job Raising Program (Allaire, 1997)
unemployed or employed
Employment increased from 26% to 41% at 6 months after program completion*
What helped – developed belief that could work
242 employed participants with form of arthritis or lupus
Randomized to receive job retention intervention or information only
Job retention intervention delivered in two 1.5 hour meetings with a rehabilitation counselor
Assessment of work problems and development of solutions
for problems (e.g., job accommodations)
Promotion of belief can work if problems addressed Information about ADA and disability-related employment
resources
Discussion of disclosure issues Planning for future job/career change or advancement
*Allaire, 2003
0.5 0.6 0.7 0.8 0.9 1 1.1 6 12 18 24 30 36 42 48 54 Percent Remaining Employed Months from Randomization Printed Materials
Log rank Test P=0.03 Vocational Rehabilitation Vocational rehabilitation
122 122* 120 111 107 100 78 57 Printed
materials only
120 118 105 94 86 81 71 52 117
Training program focused on solving work-related
Work-related problems were explored and clarified Communication at work was addressed Solutions were developed and realized
122 employed participants with chronic illnesses followed
Results: Significant improvement in self-efficacy for
No difference in job maintenance
*Varekamp et al., 2010
Randomized controlled trial pilot studies in 4 states Interventions mix of health care and vocational
People with diabetes in Hawaii
Medication therapy management/education from pharmacists Setting and maintaining work, health and personal goals with
a life coach
110 experimental group participants reported high
*Schneider et al., 2011
Good evidence that intervening prior to job loss is
Job accommodation and problem solving/ goal
Conducted using Work Experience Survey (WES)
Structured interview tool (paper form) For persons with wide variety of impairments/ health
Assesses disability-related work-site/ job/ employer
Facilitates development of solutions for identified barriers
In person or phone administration by a “rehabilitation
30-60 minutes
Some may prevent a person from doing his/ her job More often, a person can do job tasks, but experiences
1-2 Roessler et al., 1995; Allaire et al, 2000
In Allaire studies, WES amended to include off work-site health- work problems noted by people with arthritis, e.g., commuting
Adapted from the Work Experience Survey for persons with rheumatic conditions – WES-RC (Allaire & Keysor, 2009)
Major differences between WES-RC and Work Experience Survey:
WES-RC has more comprehensive list of barriers Tailored for persons with rheumatic conditions
(video – look at WES-RC)
Few people with chronic illnesses receive job retention
Is WES-RC administration alone sufficient? Can a broad variety of “Rehabilitation professionals”
Physical and occupational therapists? Handbook of solutions developed Employee assistance personnel? Non-professionals/life coaches?
Limitation in ability to work is major problem for many persons with rheumatic conditions
Job retention intervention (provided prior to job loss) is effective
Currently little job retention vocational rehabilitation intervention is available
Occupational and physical therapists and others may be able to help fill this gap
By helping people reduce their health-related work
barriers
www.disability.gov
Job Accommodation Network (JAN)
www.jan.wvu.edu
Americans with Disabilities Act (ADA) Technical Assistance Program
www.adata.org; 1-800-949-4232
Arthritis Foundation online brochure, ‘Arthritis in the Workplace’
www.arthritis.org/resources
National Multiple Sclerosis Society online brochure, ‘The Win-Win Approach to Reasonable Accommodation’
www.nationalmssociety.org/Brochures
Public Vocational Rehabilitation Program
www.jan.wvu.edu/SBSES/VOCREHAB.htm