Talking with patients about returning to work
It is important to talk with your patients well before they are ready to go back to work, particularly about how to address any challenges they may have. You can provide guidance to your patients about:
- expected recovery time
- whether or when they will be able to return to work
- restrictions or limitations that their employers may need to accommodate
- whether they will be able to return to their old jobs or may need to consider a career change
Planning ahead gives the employer time to prepare for the employee’s return, particularly if accommodations are needed. If the survivor is not able to return to their former job and needs vocational counselling or retraining, these also take considerable time.
Planning ahead also helps survivors minimize the time they need to wait before returning to work—and minimize lost income. If they anticipate having to change jobs, they have more time to find alternative work.
Here are some issues to discuss:
- Whether your patient has a job to return to: If yes, you and your patient can assess their job demands. This step will help you assess your patient’s work readiness.
- What you think is the survivor’s current work ability? What might delay the return to work and when it might happen? For help assessing work abilities, read our article assessing work abilities.
- How cancer and its treatment may affect your patient’s work abilities.
Assess, treat, refer or make recommendations for improving work ability
As a healthcare provider, you can help your patient improve their functioning by assessing, providing more treatment (symptom management), refer or make recommendations for services to improve workability. If you feel the following will help, refer your patient to:
- rehabilitation programs
- vocational rehabilitation
- psychologist, social worker or counsellor
- exercise programs
- other services you feel will help
If your patient has insurance coverage such as long-term disability, consider and recommend assessments, treatments and rehabilitation services the insurer would cover and which are the best options. Click here for guidance on communicating with insurance companies.
Ready to work soon?
If you feel your patient is close to being ready to work, give them as much information as possible about what limitations and restrictions they will have, so that they can pass the information on to their employer. This includes:
- Should they limit certain job tasks?
- How long can they work each day?
- How long before they can work full time?
- How will their work abilities change over time?
- How long before they can return to fully functioning?
In many cases, the employer or insurance company asks the treating physician to fill out forms about the patient’s work abilities and readiness to return. Based on these recommendations, the employer will determine whether a job is ready for the employee to return to and whether accommodations can be made.
If you find these questions too difficult to answer, you can refer your patient to the following for additional professional assessments of their work abilities:
- Occupational therapists, physiotherapists or kinesiologists who can perform functional capacity evaluations in the clinic or at the worksite.
- Neuropsychologists or occupational therapists specializing in neurology who can assess cognitive function, how cognitive limitations will affect work, and recommend coping strategies.
Monitor your patient’s progress
- Once the patient has started back on a return to work plan or attempting to stay at work or has resumed their former work hours and duties, it is still important to monitor their progress. Research has shown that while 62% return to work in the first year (Spelton, 2002), between 26%-53% of cancer survivors quit or lost their jobs over 72 months post diagnosis (Mehnert, 2010) which may suggest the need for more support with return to work and staying at work. For more information see Monitor progress after returning to work.
Helping your patient decide who gets to know about their cancer
Deciding whether to tell people at work about their cancer is each survivor’s individual decision. From the start, know that disclosure about cancer is not required. For example, after returning to work following treatment, survivors may choose to say only that they had health issues to attend to. However, disclosing or not can have pros and cons. To learn more, read who gets to know: how to exercise your power of “disclosure.”