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2. Assess function

Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Step 2 of 11 in getting ready to return to work:

Part of understanding work-related abilities, whether or not someone is ready to return to work is assessing their function. Assessing functional abilities can begin with asking the cancer survivor about their physical, psychological, and cognitive strengths and challenges that may impact their ability to work. In some cases, asking the cancer survivor to complete self-assessment measures or having a professional assessment of their function may be helpful. Drawing up a functional assessment will help you to establish the survivor’s strengths, restrictions, and limitations. Identifying early on and anticipating the cancer survivor’s maximum level of functioning in terms of their work ability is very important because it can help to determine whether the cancer survivor can return to their former job (with or without accommodation) or whether they need to consider changing to another one. Anticipating the cancer survivor’s maximum level of functioning in terms of their work ability will become important when the time comes to negotiate accommodations or prepare for a job change. Read Cancer and its Impact to learn more about the potential physical, emotional, and mental challenges that can arise from common side effects linked to cancer and treatment.

Assessing physical functioning

Cancer and its treatments may have an array of side effects that affect physical functioning. Understanding their impact is very helpful in determining the survivors’ ability to work, need for accommodation and rehabilitation, particularly for employees in physically demanding jobs.

Cancer-related fatigue, for example, is a common occurrence for those diagnosed with cancer, both during and after treatment. (For more information see: Cancer and its impact on work: Fatigue).

In preparation for a return to work, it can be helpful for the cancer survivor to self-assess their energy levels. See two helpful tools (Fatigue Tracking and Energizers & Drainers) to help gauge work readiness and identify limitations that may require job accommodations. Gauging their work readiness could mean keeping track of how long they could do an activity in their day before feeling tired.

Just as job demands vary according to each job and worksite, physical abilities vary for each cancer survivor. These factors need to be taken into account and addressed when preparing the survivor to return to work. Work focused functional or physical capacity evaluations can also be very helpful in identifying workability, needs for job accommodations, and further rehabilitation. For other ideas on how to assess the physical functioning of a cancer survivor, see Assessing physical abilities.

Cognitive functioning

Cognitive functioning has been increasingly recognized as a work challenge for cancer survivors, particularly for those in mentally demanding jobs. Thought processing speed, finding the right words, remembering things, handling distractions, and multitasking can be harder for survivors who experience cognitive changes. The cancer survivor’s own perception of their cognitive challenges can also negatively impact their perceived readiness to return to work, and hence, these need to be addressed. Self-assessment tools such as the cognitive activities symptom at work can be helpful to start the
conversation about potential challenges at work. In some cases, referral to specialists such as neuropsychologists, neuro-specialized occupational therapists, and neuropsychiatrists can further clarify and address the challenges that might impact working. In cases where work focused professional assessments may not be available in the health care system, health care professionals can make recommendations to third party insurance holders (if they offer such services) to fund the assessment as this will likely increase the cancer survivor’s s chances of returning to work. 

Psychological functioning

Following a cancer diagnosis, experiencing psychological challenges is common. Depressed mood and anxiety are common and can manifest at various times during cancer screening, diagnosis, treatment, recurrence, and in the survivorship phase. Psychological distress, regardless of its degree, can negatively affect quality of life and potentially impede on a cancer survivor’s ability to work or return to work. Here is how one survivor so aptly expressed that:

Physically there was no reason I could not do an office job, like a cushy office job by most people’s description. But it was the head that was off, psychologically. I would not say [I was] destroyed, but I was not really in a good place to go back [to work] and start dealing with everything I knew would be there.

Early assessment and treatment of distress can reduce the risk of this being a barrier to returning to work. For ideas on how to assess psychological functioning, view our emotional assessment section information. You can also refer or make recommendations for cancer survivors who are in distress to access specialists in psychology and psychiatry for evaluation and treatment in cancer treatment centres, health services, community organizations, workplaces, or funded privately by insurance providers.

Next step:

Step 3: Understand job demands

Back to the list of return to work preparation steps