other health benefits to ensure timely and appropriate case man-agement
resources, and proactively support treatment adherence
and healing.
Health benefit plans are intended to promote better health, so
proven cancer prevention and management techniques such as
screening or targeted education should be an integral part of their
design. To improve cost-effectiveness and yield the greatest bene-fit,
employers could consider making these resources available on
the basis of health risk and medical need.
2. Disability
While an increasing number of employees may be able to work
through their cancer treatment, many will need to go on one or
more leaves of varying duration, depending upon a multitude of
factors such as type of cancer and treatment plan, the employ-ee’s
job and overall health. Studies indicate that about 60 per cent
of cancer survivors can return to work: adequate, well-managed
sick leave and disability benefits will help. Cancer-specific pro-tocols,
based on clinically validated information and guidelines,
should be an essential part of overall disability case management.
This may include partial disability benefits. Ensure that disability
case managers are trained to actively manage cancer cases; oth-erwise,
external expertise should be engaged, especially for more
complex cases.
Given the often-significant emotional burden of cancer,
short-term and long-term disability protocols should include psy-chological
and social supports. Operational coordination with an
EAP provider can help triage the need for additional psychological
feature
CREATE
REASONABLE
EXPECTATIONS
Studies indicate that factors such
as higher age, lower education,
lower incomes, more complex
treatment, chemotherapy
and physically demanding
occupations are more likely to
frustrate return to work.
services. A critical element of psychosocial support is the role
of managers and co-workers. Providing training and support
will help the team better manage the employee’s absence and
accommodation.
Employer discussions with cancer patients, and often their
health providers, should occur as early as possible to build trust
and establish the needs of both parties. A validated test of work
ability that includes physical demands and cognitive functions
will help assess the employee’s expectation of recovery and per-ception
of work ability and self-efficacy, and ensure everyone has
reasonable expectations. By law and good practice, employers
should establish a written accommodation plan. It should be flex-ible
enough to allow the employee to work when able, taking into
account the many factors that influence success.
3. Caregivers
The burden of disease on caregivers has been well documented
recently. Caregivers often miss as much work time as do cancer
patients, and sometimes more. Moreover, there is a significant pre-senteeism
burden on caregivers, who often bear the main burden
of finding information, and generally advocating with health sys-tem
stakeholders on behalf of the patient. The role of caregivers
and the attendant burden and impact on their work and quali-ty
of life is still not well recognized by society. Perhaps as a result,
beyond legislated leaves, employers often lack defined policies in
this area.
Employers should ensure that caregivers are made aware of
support resources, such as EAP, and consider caregivers’ needs
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