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2. Assess functions

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 10 in getting ready to return to work:

Part of understanding work-related abilities in whether or not you are ready to return to work is in assessing your functions. Assessing functional abilities can begin with asking yourself about your physical, psychological, and cognitive strengths and challenges that may impact your ability to work. In some cases, completing self-assessment measures or having a professional assessment of your function may be helpful.

Drawing on a functional assessment will help you to establish your strengths, restrictions, and limitations. Assessment is very important to vocational rehabilitation planning because it can help to determine whether you can return to your former job (with or without accommodation) or whether you need to consider changing to another one.

Identifying early on and anticipating your maximum level of functioning in terms of your work ability will become important when the time comes to negotiate work accommodations or prepare for a job change as these usually take time. You may also want to consider reading the section on Cancer’s Impact on Work and Strategies to learn more about the potential physical, emotional, and mental challenges that can arise from common side effects linked to cancer and treatment and how to address them.

Assessing physical functioning

Cancer and its treatments may have an array of side effects that affect physical functioning. Understanding the impact of cancer and its treatment on your ability to work is valuable, and evaluating the possible needs for job accommodations, and further rehabilitation, particularly if your work is physically demanding. Consider if there are physical tasks you cannot do because of your cancer or treatments, and consider the limitation of these on your work ability.
Cancer-related fatigue, for example, is a common occurrence for those diagnosed with cancer, both during and after treatment, and this symptom can have implications on your tolerance to work. Click on this link for more information.

In preparation for a return to work, it can be helpful to self-assess your energy level. On this website, we have two helpful tools, the Cancer and Work Energizers and Drainers Tool and the Cancer and Work Fatigue Tracking Tool, same as mentioned above, that can help determine your work readiness and guide job accommodations.

These factors, your energy and fatigue over time need to be taken into account and addressed when preparing for your return to work. Sometimes it is not always easy to self-assess your physical abilities. Hence, a professional work focused physical/functional evaluations can be helpful.

For other ideas on how to assess your physical functions, see our section on assessing your physical abilities.

Psychological functioning

Following a cancer diagnosis, experiencing psychological challenges is common. Depressed mood and anxiety are common and can manifest at various times during the 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 (anxiety and depression) can reduce the risk of this being a barrier to returning to work. For ideas on how to assess psychological functioning, view our section on Psychological Assessment Tools.

If you find you are coping with distress, it is important to seek out or ask for a referral and help by a specialist in psychology and psychiatry for an evaluation and treatment in cancer treatment centres, health services, community organizations, workplaces, or funded privately by insurance providers.

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 with health care and insurance providers and employers.

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 chances of returning to work.

Next step:

Step 3: Understand job demands

Back to the list of return to work preparation steps