HR practitioners are looking for ways to get ahead of the wave of rising benefit costs and declining employee retention. These two factors come together in the management of arthritis, a musculoskeletal condition that is a leading cause of chronic impairment and disability.
Don Russell, who has been with Ontario Power Generation (OPG) for 34 years, is an example of how adjusting work to the physical capacity of an individual can help retain a highly skilled employee. Diagnosed with rheumatoid arthritis in 1991, Russell has continued to work as an authorized nuclear operator for the past 17 years.
“In 1991, I was in bad shape. I could barely move and my whole body hurt. I had problems walking, getting up and down stairs and sitting for any length of time,” he says. “I was lucky I had an employer that allowed me to continue to work.”
With the right medications and time off work to recuperate, Russell gradually improved. His employer was open to a proposal to work at home, setting up a computer for him long before telecommuting was common. Once he was back at work, Russell was given a motorized cart to get around the large plant. His manager recognized shift work was taking a toll on Russell and made adjustments to his work schedule.
“The pain was affecting my sleep,” says Russell. “I thought it would go away but my manager went to bat for me and I have worked days ever since.”
Elfie Bennett is another OPG employee who has benefited from an active disability management program. Bennett suffers from osteoarthritis in her knees. She was able to manage with medications for a dozen years but ultimately had surgery on both knees. She was off work for three months.
“The company health programs were so helpful,” says Bennett. “I didn’t lose pay and the rehabilitation costs were covered. Once I was back, the nursing team did an assessment and came up with a plan for reduced work for the first couple of months, phasing into full-time work. The ergonomics team set up a desk that allowed me to be pain free. I find that I have to stay on top of the pain because once it starts hurting it seems to spread everywhere.”
Bennett is a specialist in nuclear operations and her current role is section manager in outages at OPG. Since her surgery, OPG has adjusted her work to focus more on strategic planning and less on immediate execution. This allows Bennett to do more work at a desk.
The on-site OPG fitness centre was another factor in Bennett’s recovery.
“I could go in before or after work, and keep at it every day. A kinesiologist at OPG put a program together for me. I had hired a personal trainer after the surgery and I overdid it. With the company fitness instructor I was able to gradually get back to the point where now I can do anything, including a five-kilometre walk.”
What is arthritis?
Arthritis is a complex of diseases involving joint inflammation and degeneration. The two most commonly known forms are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is associated with injury and advancing age, while rheumatoid arthritis can occur at any time. Both forms of arthritis are associated with pain, stiffness, reduced mobility and changes in mechanical functioning.
“When people complain about sore knees, swollen hands, aching feet or lower back pain, they are often describing a form of arthritis,” says Mary Bell, head of rheumatology at Sunnybrook Health Sciences Centre in Toronto. “Most people do not recognize their symptoms as a sign of arthritis. Men, in particular, assume they have an injury that will get better on its own.”
People should be encouraged to get these symptoms checked out medically rather than waiting and toughing it out, says Bell. That’s because intervention and proper supports can help people with arthritis live a normal life and continue to engage actively in work and leisure activities.
Working with arthritis
It can take a certain amount of trial and error to find the right mix of supports for people with arthritis. Physiotherapy, occupational therapy and counselling help manage disease symptoms and psychosocial impacts.
HR professionals and ergonomists can address on-the-job stressors through better work site and job design. As both a source and conduit for information, HR practitioners are pivotal in matching the workplace components of an individual’s particular health management plan to job requirements.
“I do not have one patient who has used a diagnosis of arthritis as an excuse to go on disability or avoid work,” says Bell. “On the contrary, people are concerned about continuing as normal a life as possible, including maintaining an active career. The support of employers can make a real difference in positive outcomes as people adjust to their diagnosis. The benefit to the workplace is that trained staff can continue to make a positive contribution.”
Communication between the workplace, the benefits carrier and health-care providers is very important to moving forward, says Bell. The employer should be realistic about what the job entails. The employee should be involved in describing the physical challenges she faces, says Bell, and let the health-care team know about the “real” workplace environment.
Employers also need to be creative in thinking about work. If a particular task is occasional and presents a problem for the person with arthritis, then why not assign that work elsewhere, says Bell. For daily tasks that are central to the job, look for opportunities to modify the work using new technology and ergonomic adjustments that make it easier. Changes to the workplace such as push-button door openers and lever faucets will help not only the person with arthritis, but also other workers and members of the public.
The strategic design of an employee benefits program will help workers with arthritis maintain their productivity. Attention to workplace wellness and safe work practices can help reduce the factors that lead to joint damage, a precursor for some types of arthritis.
A drug plan for prescription medications, assistance with physiotherapy or occupational therapy and counselling on lifestyle changes will help employees follow through on their health-care instructions. Employer flexibility in the design and delivery of work can make a major difference to the health outcomes of workers dealing with arthritis, says Bell.
OPG has an on-site fitness centre staffed with qualified instructors at two locations. The maintenance of a healthy body weight, cardiovascular fitness, and strength and physical endurance training pay dividends in employee health over time. The loss of as little as 10 pounds in weight can reduce stress on the knees by four times that amount, and cut the incidence of joint replacement by as much as 25 per cent.
For more information about arthritis, visit the Arthritis Society’s website at
. There is a range of resources for employers and employees under the “program and resources” tab.
Susan Singh is a Toronto-based freelance writer and author of Performance Management in the Public Sector and HR Manager’s Guide to Applied HR Strategy, both published by Carswell, a Thomson Reuters business.