Identifying and Assisting Employees with Cognitive Impairment | EAPA-SA

Cognitive decline is an issue that is gaining prominence in the workforce as more and more baby boomers delay retirement due to tougher economic conditions. The World Health Organization estimates that 35.6 million people worldwide suffer from early onset dementia and of these, 10 per cent are under 65 years of age and potentially still in the workplace. Early identification of cognitive decline is crucial for work health and safety, and assessment is vital for early intervention. 

What is cognitive impairment?

Cognitive impairment refers to an individual having memory and thinking problems. The cognitively impaired person may have difficulty with learning new things, concentrating, or making decisions that affect their daily life. The most common causes of cognitive impairment among older people are dementia and delirium.  Symptoms of Depression can mimic those of cognitive impairment and so it is often overlooked or misdiagnosed. 1

Mild Cognitive Impairment (MCI)

The term Mild Cognitive Impairment describes a set of symptoms, rather than a specific medical condition or disease. MCI symptoms usually include subtle problems with one or more of the following:

  • day-to-day memory;
  • planning;
  • language;
  • attention;
  • visuospatial skills (which give a person the ability to interpret objects and shapes).2

The main feature is deterioration, with an employee losing their ability to perform duties with the same degree of accuracy, efficiency and timeliness as previously. Bear in mind that cognitive decline can occur before the age of 65 – younger workers may also be at risk. 

Signs to look out for

  • Forgetting and trouble remembering tasks, instructions and appointments.
  • Limited learning and difficulty learning new material and role requirements.
  • An unawareness of making mistakes or having difficulties.
  • Disorientation: Becoming ‘lost’, or losing track of where they are or what they are doing.
  • Poor attention and lapses of concentration.
  • Avoiding responsibility, delegating work, recruiting help, requesting more time or input to complete work.
  • Anxiety, feeling overwhelmed, or stressed by task and role requirements.
  • Difficulties in word selection and poor verbal fluency.

These symptoms must describe a noticeable change from previous levels of functioning, and will often be recognised by the individual affected and those who know them. Problems that arise from MCI are usually not severe enough to interfere with the routines of daily life, but at work they can pose a risk to performance, judgment and decision-making.

Steps to take if you spot potential cognitive decline in an employee:

  • Employers should start by helping employees to get the right diagnosis and sorting out dementia from other problems that might present similar symptoms. Sensitively discuss the deterioration in the employee’s work capacity with the employee, and encourage them to see a medical practitioner.
  • Open dialogue is central to employers who are supporting a staff member with dementia, especially in relation to their roles and responsibilities. Once diagnosed, in consultation with the employee, look to modify duties that expose potential work health and safety issues.
  • Sharing a dementia diagnosis with colleagues is difficult. When an employee is ready to tell their colleagues, it is important that colleagues are well informed, and willing to help and support them. This will create the right environment for the employee with dementia to work as well as they can.
  • An EAP will definitely help provide support and advice, both for the employee and the employer.

For the employee, this will help in informing them where they can join support groups, what their legal rights are and how they can get external support.

  • An employee may need additional support with emotional issues. It is common to feel down or anxious when going through these changes, adjusting to new roles at work, and coping with stress. EAPs are ideal for providing counselling and, when the time comes, helping the employee with support and advice in their leaving employment.3 + 4