Research aspires to help employers and employees meet the challenges of mild cognitive impairment in the workplace

For 20 years, Rosemary Leslie suffered with an ever-deteriorating work life, without ever truly knowing the reason. A self-described Type A personality, with a master’s degree in engineering, she was having difficulty doing basic tasks in her job with the federal government. It became a struggle to work with spread sheets and data analysis. Her short term memory was slipping, causing her to re-do research that she had already done the previous day. And she had difficulty understanding what her supervisors were asking her.

“I was beating my head against the wall, wondering what’s wrong with me,” said Leslie in an interview from her Ottawa home.

She thought it might be an issue with the subject matter, so she changed to a different group. There was no improvement. She spoke to her family doctor and a psychiatrist, who focused on her struggles with anxiety, but nothing was working.

“I could scarcely function, I was so stressed,” she said.

Having received a couple of negative performance reviews, Leslie was on the verge of losing her job when a sympathetic representative of her union, someone with expertise in disability issues, suggested a neurological assessment.

The result was a revelation. After two decades of being misdiagnosed, Rosemary Leslie discovered she had mild cognitive impairment (MCI), a condition that causes problems with memory and thinking. The specialist who assessed her suspected that it may have been caused by a severe heart attack that Leslie suffered on her 32nd birthday in 1997.

Although some people with MCI may go on to develop Alzheimer’s disease or other forms of dementia, the symptoms are not as severe and people with the condition can continue to work, with appropriate accommodations.

That’s what happened for Leslie. She was switched into an administrative position that matched her capabilities and her life was changed for the better.

“The stress started melting off. Now I’m in a job that I really like where I feel like I’m contributing. It’s a total turnaround,” she said.

The risks of developing MCI increase as people age. It means that with an aging workforce and more of us choosing to stay on the job past the traditional retirement age, accommodating people with the condition is an emerging issue.

An AGE-WELL project titled Cog@Work aspires to help employers and employees adapt better to the challenges of MCI in the workplace.

“Ensuring that an organization is prepared for this is really important,” said Dr. Josephine McMurray, an Associate Professor at the Lazaridis School of Business & Economics at Wilfrid Laurier University who is the co-lead of Cog@Work and also an Associate Scientific Director at AGEWELL.

“As this is a non-visible disability, some employers don’t even know this is an issue,” she added.

Dr. McMurray is collaborating on Cog@Work with co-leads Dr. Arlene Astell, Director of the Dementia Aging Technology Engagement lab at the KITE Research Institute at University Health Network, and Dr. Jennifer Bo- ger, Adjunct Assistant Professor at the University of Waterloo.

The project is raising awareness about MCI, compiling information about work-related best practices, and developing policies and advice for building more accessible workplaces. In line with AGE-WELL’s mission, it is also nurturing the development of technologies that can support people with MCI so that they can continue to work. The Cog@Work website brings together an array of resources for easy access.

Dr. McMurray says that there is very little data on the prevalence of MCI in the workplace, so the evidence to date is anecdotal. Few managers have any idea of how to handle these kinds of situations, and how to navigate sensitive conversations with workers whose performance has changed. As a result, people can be fired or decide to retire early, she says.

Instead, MCI needs to be treated as a disability where accommodations can often be made to allow the worker to continue and contribute. Managers should not be expected to diagnose MCI, but rather to encourage a worker to seek professional help when performance on the job is affected, added Dr. McMurray.

“It’s a tough place to be doing research because it can be a difficult topic of discussion with employers,” said Dr. McMurray.

Fortunately, the project is benefiting from collaborations with some large employers who share a desire to create inclusive, accessible work environments for employees who identify with mild cognitive impairment or dementia. The overall goal is to improve employee experiences and enhance workplace accommodations through creative strategies for employers.

“Leaders require knowledge and understanding in order to identify the signs of someone living with MCI or dementia and be aware of the benefits and supports available. Often, they can be confused with other things such as performance issues rather than connecting the employee to the right supports,” said Lindsey Simpson, Director of Ability Management at Alberta Health Services (AHS).

Her team is actively working on reviewing existing policies and processes related to workplace accommodation with MCI in mind to help evolve best practices by participating in research with Cog@Work. They are drawing inspiration from the story of Roger Marple, an AHS employee based in Medicine Hat who developed early onset Alzheimer’s and feared he would have to quit a job he loved. Instead, an enlightened supervisor worked with him to develop a series of techniques, like sticky notes, alarms and cell phone reminders to compensate for his failing memory. The accommodations allowed Marple (who recently passed away) to extend his work life by two years.

Getting the right diagnosis and the appropriate accommodations made a profound difference for Rosemary Leslie.

“I plan to keep working as long as I am able, as long as I enjoy it and feel like I’m contributing,” she said.

She is also using her life experiences to assist the Cog@Work team, supporting their goal to help all employers find those kinds of solutions as they strive for workplaces that are inclusive and accessible.