New suite of resources available to help employers better understand disease
For many, arthritis is seen as an old person’s disease. But arthritis can affect men and women in their prime working years — which is why it deserves a lot more attention in the form of awareness, education and accommodation.
On that note, the Arthritis Society has rolled out a suite of resources to help employers and employees better understand the disease.
There are many employers with staff affected by arthritis, and they may not be aware of it, says Sian Bevan, chief mission officer at the Arthritis Society in Toronto.
“It’s important to understand what accommodations they need around managing their chronic disease. I think that’s critical. And then the actual resources themselves, really around disclosure accommodations and making things as simple and straightforward for people.”
In the workplace context, arthritis is unpredictable and that’s a challenge, says Bevan. People may not know when a flareup is about to come — they might be OK one day but not the next.
“There are many different ways that arthritis impacts people, whether it relates to pain, physical abilities, fatigue,” she says.
It’s the daily challenge of managing the disease and working around what people are living with in terms of pain, fatigue and joint issues, says Kelly Lendvoy, vice-president of communications and public affairs at Arthritis Consumer Experts (ACE) in Vancouver.
“It’s not just disability, its productivity and it’s absenteeism.”
If the employee and employer work together in terms of chronic disease management, they’re going to start seeing positive results in terms of less absenteeism, more productivity and fewer mistakes, he says.
“There is a way out of this mire that we’re in right now [because] these costs are obviously not sustainable, not just for employers, but they’re not sustainable for public drug plans, private drug plans, etc. So, there’s light at the end of the tunnel, but still a lot more work to be done.”
Looking at the numbers
Arthritis is a chronic disease that affects six million Canadians, and with an aging population, that number is projected to reach nine million by 2040, says Bevan.
“It’s actually the most common chronic condition in the country, with one in five adults currently being affected,” she says. “Arthritis is one of the leading causes of workplace disabilities and causes limitations in the workplace.”
And it’s not just a disease of the elderly, says Bevan.
“The incidence of arthritis does go up over 65, though we see a good number of people in the population affected at a younger age — really in the prime of their lives when they’re trying to thrive in their careers.”
There are two main types of arthritis, the most common being osteoarthritis — where cartilage at the end of joints starts to wear down — and the more serious being inflammatory arthritis — an autoimmune disease where the body’s immune system attacks the joints. But there are more than 100 different types of the disease.
Risk factors include obesity, gender and previous injuries. And despite the commonality of the disease, there is no cure.
“One of the challenges is that arthritis is not just one disease. So, we’re talking about 100 different diseases and there’ll be different cures,” says Bevan.
Too often, people say, “Oh well, it’s just arthritis,” she says, and that can come from both patients and healthcare providers.
“One of the things that we are trying to do a much better job of is really increasing awareness of the severity of the disease because arthritis is a devastating disease for those who it affects.”
Treatment for arthritis can be very different, depending on whether its inflammatory versus osteoarthritis, says Cheryl McClellan, COO at the Arthritis Society. For the latter, therapeutic exercise, weight management and physical therapy are all important in treating the disease, along with certain drug options that help manage the symptoms.
“The kinds of drugs that people are taking are among the most expensive that are being covered either through public or private plans,” she says.
With inflammatory arthritis, there is no cure. And most of these employees who have it end up having to go on expensive bio-logics, says Lendvoy.
“All of a sudden, it becomes a major pressure on a drug and benefit plan for a plan sponsor.”
The best thing is if people can seek advice and treatment early, he says.
“The quicker they can get that diagnosis and the quicker they can get on treatment, in many cases, they won’t have to go on a biologic. That’s the window of opportunity. If they have to go on a biologic, there’s a very good chance that they’re going to be able to be back to work and productive within months of starting that therapy, but it’s really critical about timing.”
Also, there are disease-modifying antirheumatic drugs (DMARDs) to help, says Lendvoy.
“If we get that employee diagnosed early on, to treatment early, they’re going to be a positive contributor on the job, and [the employer is] going to be saving money in the long term.”
Among people living with arthritis, roughly 40 per cent require some degree of accommodation at work, says Douglas Emerson, senior manager of communications at the Arthritis Society.
And while HR departments might know this, managers may not be aware, he says.
“Employees themselves who are living with this disease may not themselves appreciate that it’s something that is actually protected under the AODA [Accessibility for Ontarians with Disabilities Act] that employers do have a responsibility to accommodate their needs and to have that conversation and provide those supports.
Overcoming people’s reluctance to discuss this disease is a real challenge, says Emerson. So, it’s about making cultural changes and creating a welcoming, supportive and understanding environment where employees feel comfortable to come forward.
“They don’t have to discuss their condition, but they can discuss their needs and find common ground with their manager and with their employer to accommodate those needs and improve their performance [and] improve the quality of life,” he says.
In terms of the actual workplace, it’s about structuring it so “that someone has the flexibility to be able to be productive and thrive and work in ways that don’t compound that disease,” says McLellan.
Employees with arthritis appreciate having more flexible work arrangements and more freedom or autonomy in how they do their job and organize their schedule, says Lendvoy.
“If you can allow these people to start or finish later — mornings are always really difficult because of the increased pain and stiffness,” he says. “Employers are [also] looking at split shifts, shorter consecutive hours and allowing that opportunity for rest.”
Employees with arthritis should also have the right to refuse overtime, he says, “especially when their disease is not well controlled, without being judged or prejudiced.”
Accommodation also means having the ability to take more breaks or be away from work for periods of time. Ergonomics are also beneficial, whether it’s a standing workstation, small modifications to the desk or wrist support at the keyboard, says McLellan.
“It’s very much tailored to the individual,” she says. “A lot of that is more about education and awareness and small modifications as opposed to anything that’s terribly onerous on the employer.”