[Online Exclusive] Working with Epilepsy

By Carter Hammett

By learning about free tools, resources and technology available, career professionals will be better placed to advocate for clients with epilepsy

Here is a typical refrain from clients who find themselves in my office. An employee has epilepsy but has never disclosed their condition. They have always had a fairly good performance history when they have a seizure on the job. A well-managed, yet invisible disability quickly becomes “visible” and the employee becomes vulnerable in the process. Suddenly, there is an increase in worries about “performance on the job,” from superiors where no similar concerns existed before. Terms like “liability” and “concerns about productivity” enter the dialogue.

That is an unfortunate place to be for both employer and employee. Employers are concerned about productivity, absenteeism, accommodation costs and health and safety among other issues. Employees worry about discrimination, misunderstanding and accommodation and a host of other concerns. And they are frequently brought up as issues on both sides, especially by young graduates with epilepsy entering professional careers, unsure of whether to disclose their condition or not. Career professionals can play an important part in helping young graduates with epilepsy become more confident while helping them understand both their rights and how their disability might impact career choices.

The reality is, with a few exceptions, that most employees with epilepsy can do just about any job. There are a lot of successful actors, engineers and nurses living with epilepsy and some of them might be working with you.

Let’s first start with a few words about what epilepsy actually is. For the uninitiated, “epilepsy” is a chronic, neurological condition characterized by recurrent seizures. A seizure happens when abnormal electrical activity in the brain causes an involuntary change in the person’s awareness or behaviour. Epilepsy is diagnosed when a person has had two or more seizures that cannot be attributed to some other condition.

Anyone can develop epilepsy at any time during their life. Usually the cause is unknown, although it has been related to brain tumours, acquired brain injuries and infections. The condition is an “equal opportunity” disability affecting about 1 in 100 people from all cultures and ages.

Generally, there is virtually no difference in the performance between a worker with epilepsy and their non-disabled counterparts. Productivity is often equal to or better than employees without epilepsy and both workplace accidents and absenteeism are usually lower as well.

There’s always a few exceptions of course, and the usual reason given for discouraging certain careers is the risk of injury to the worker with epilepsy or the lives of others. Examples of this include but are not limited to: school bus driver, armed forces or pilot.

For other situations, it’s best to assess each case individually. Workplace accommodations will be determined by the employee’s seizure type, frequency and intensity. I always ask if a person owns their epilepsy or if their epilepsy owns them? In other words, how much knowledge and self-acceptance does the individual possess about their disability that can help guide employers to the best accommodations? Consider some key questions:

• What parts of the job are creating issues for the employee?

• How do these impact the employee’s performance?

• Can the job’s essential duties be performed? What accommodations has the employee identified?

• Are there possible side effects from medications to consider?

• Are there co-morbidities (conditions like dyslexia or attention deficit disorder that sometimes accompany epilepsy) that need to be addressed?

Job analysis

By placing emphasis on the job’s fundamental requirements and overall details, the position will become more accessible to the worker with epilepsy. One of the ways of doing this is performing a job analysis, which breaks a job into its essential functions. It also serves as a useful template for creating an accommodation plan. The first step should be to collect data on the following areas:

1. Duties and Tasks: The basic unit of a job is the performance of specific tasks and responsibilities. Data to be collected at this stage can include, effort, skill, equipment needs and standards among others. Questions to be asked include, “can specific elements of the job be reassigned or traded so the person can perform tasks more effectively?”

2. Environment: The physical layout of the workspace may present issues. Are the edges of desks and tables jagged or rounded? Can padding be placed on the floor? Is there glass around? All of these elements may have an impact on the physical requirements of the job. Is the environment hot? Cold? Noisy?

3. Tools: What tools are needed to effectively function on the job? These can include hardhats and work boots, but also assistive devices.

4. Relationships: This includes supervision given and received and the nature of the relationships with people inside and outside the workplace. Mentoring and coaching opportunities can also be helpful.

5. Requirements: What skills and abilities are needed to perform the job? What are the job’s minimum requirements? What are the performance expectations?

After these steps a list of accommodations are considered, including apps, coaching and environmental changes (including working from home and job carving as options) and implemented. The last phase is a review and follow up and opportunity to adjust accommodations that might not be effective.

Some seizure types require no accommodations at all. Others like tonic-clonic (grand mal) may mean that an employee will need sufficient time to recover from a seizure. The Job Accommodation Network suggests creating a private space for employees to regain their composure or possibly a place where a change of clothes can be stored.

Memory issues can be a tricky area for workers with epilepsy. Accommodations can include memory apps like Any.do task list, Remember the Milk or Evernote which can be tremendous assets for managing tasks and jogging the memory. Tried-and-true methods like chunking, which involves breaking tasks down into their step-by-step components can help reduce the risk of being overwhelmed in some workers with epilepsy. I like to recommend that the steps be placed on sticky notes and removed as each task is completed. This way the worker watches the workload shrink before their eyes. Most people carry phones these days but don’t think of utilizing the camera, notes, scheduling and voice notes features, all of which can have a great impact on enhancing a person’s productivity.

Perhaps you’ve noticed that a common thread running through these suggestions is how inexpensive they are to implement. Indeed, most of these ideas are either low cost-or-no cost, which busts another myth that the disability is expensive to accommodate. With diversity and inclusiveness, a key part of most employment and retention strategies these days, jobseekers need to feel confident they have skills and talents to bring added value to a pluralistic workforce. Career professionals should educate themselves about epilepsy so that they can play a vital role in reinforcing that message.

Carter Hammett is the Employment Services Manager with Epilepsy Toronto. He holds a Bachelor of Community Studies degree along with diplomas in journalism, social work and adult education. His work has appeared in National Post, Toronto Star and Toronto Sun, among others. He is the author of three books including Benchmarking: A Guide to Hiring and Managing Persons with Learning Disabilities (ALDER, 2005). He can be reached at carter@epilepsytoronto.org.