05/01/2014

Career and Chronic Illness

By Beth Lulgjuraj

Chronic illness impacts every aspect of a person’s life including their career (Beatty & Joffee, 2006). For some, it may seem almost impossible to continue working. At the same time, working can distract from health concerns and redirect focus on to something productive. It can boost self-esteem, enhance independence, and provide a sense of identity, belonging, and accomplishment. Similarly, dealing with a new diagnosis can be difficult. As career counselors, we can help clients face their challenges, make more informed decisions, redefine success, find work-life balance, and provide hope.

Here are a few notable challenges to process. Due to the complexity of these issues from a medical and counseling perspective, career services providers should follow ethical standards of referral as appropriate.

• Negative thinking

Identify and raise your clients’ awareness of their negative thoughts and process how such thinking affects their career decision-making. When teaching your client how to restructure their negative thoughts, ask them to state specific actions they can take to move beyond those thoughts.

• Feelings

Your client may feel as if s/he is losing their independence and/or sense of self. Feelings of anger, fear, sadness, isolation, guilt, frustration, anxiety, regret, and/or grief as well as a variety of other emotions can be expected. Process your clients’ feelings and determine whether a referral is needed.

• Support

Learn about your client’s support system. In addition to interacting with coworkers, friends, and family members, encourage your clients to connect with others diagnosed with similar conditions. Many chronic illness support groups, and forums, and blogs can be found online and often include topics related to working with a chronic illness. Your client may also consider asking their doctor if another patient would be willing to share their experiences persevering in the workplace despite a chronic illness.

• Stress Management

Stress exacerbates symptoms, so, it is important for clients to learn how to manage it. Career counselors can help by collaborating with clients to create unique career plans by breaking goals into manageable and attainable concrete steps. In addition, your client may be able to reduce stress in the workplace and/or while job searching by setting realistic goals, pacing themselves, and creating more structure. S/he may choose to take multiple minibreaks instead of one lunch break allowing him/her to engage in deep breathing or meditation. Discuss additional stress reduction techniques such as: massage, progressive muscle relaxation, yoga, guided imagery, and/or hypnosis. In addition, aerobic exercise has been known to reduce stress, anxiety, and depression.

• Work-life balance

To have a healthy work-life balance, clients may need to re-evaluate and adjust their work situations so their jobs are less stressful, less physically strenuous, and more compatible with their health condition. In some cases, individuals may choose to work less hours, or ask for flexible work arrangements such as flexible schedules, job sharing, telecommuting, or working from home. They may also consider trying to delegate unrealistic job duties to a coworker, making a career change, and/or volunteering as a way to continue their contribution in the workplace. As your client learns to adjust their work and life to their health condition, it may seem even more difficult to find work-life balance. Not only will they need to get rest, exercise, eat healthy, and follow their treatment plan, but they will also need to monitor their workload and know when to say no. It may help to reframe your clients’ definition of work-life success.

• Complexity of career decision making

Chronic illness adds to the complexity of career decision making. In addition to the challenges your client identifies, and those listed throughout this article, there are additional factors for your client to consider such as: job satisfaction, job demands, the disease’s progression rate, response to treatment, health insurance needs, and financial situation.

• Knowing their rights

  • Disclosure: Processing whether your client plans to disclose his/her condition, as well as when and how to do it can be helpful and decrease stress during the job search and on the job. Have your client share what they see as the costs and benefits of disclosing their condition to supervisors, coworkers, and/or prospective employers. S/he may consider whether the condition interferes with their ability to do their job, and if the symptoms can be managed. According to the Americans with Disabilities Act (ADA), an interviewer cannot inquire about a medical condition or withdraw an offer because of one. Keep in mind, talking to a supervisor about what they can still do, their limitations, and accommodations needed, may alleviate the employer’s concerns and help the client to continue working. If they choose to disclose, sharing a plan for what others can do if an emergency arises can also be helpful.

• Accommodations: According to the ADA, to receive accommodations the individual must disclose. The ADA requires organizations with 15 or more employees to make reasonable modifications that will enable individuals to perform the job duties and/or apply to positions. Inform your clients that their employer may not know very much about their illness and therefore, will not know the accommodations they need unless they specifically ask. The Job Accommodation Network, assists in determining accommodations and provides free consultations.

• Medical Leave: If individuals need time off work for a surgery or treatment, the Family Medical Leave Act allows them to take leave while continuing their health insurance and maintaining their current job duties.

In order to attain work-life satisfaction despite a chronic illness, clients must face many challenges and possibly redefine career success (Beatty & Joffee, 2006). If you are working with a client who has been diagnosed with a life altering condition, encourage them to continue looking for ways to pursue their career goals and maintain work-life balance.

Resources

Beatty, J. E., & Joffe, R. (2006). An overlooked dimension of diversity: The career effects of chronic illness. Organizational Dynamics, 35(2), pp. 182-195.

Chronic Illness Meetup Groups. Retrieved from http://chronicillness.meetup.com/

Counseling and Psychological Services at the University of Michigan. (2011). Progressive muscle relaxation. Retrieved from http://www.youtube.com/watch?v=KRUdkxQOqWM

HealingWell.com (2014). Retrieved from www.healingwell.com

Henshaw, H. (2012). Deep relaxation through guided imagery and relaxation music. Retrieved from http://www.youtube.com/watch?v=4BLlbmwMVto

Institute for Community Inclusion. National Center on Workforce and Disability/Adult. Disclosure of a non-apparent or hidden disability. Retrieved from http://www.onestops.info/print.php?article_id=107

Job Accommodation Network. Retrieved from askjan.org

MedlinePlus Trusted Health Information for You. (2014). Living with a chronic illness – dealing with feelings. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000601.htm

Moving Stillness Personal Fitness. (2011). Yoga at your desk or at work – sitting yoga poses and breathing. Retrieved from http://www.youtube.com/watch?v=Eo470b4SvlM

Peterson, G. W., Sampson, J. P., Jr., & Reardon, R. C., & Lenz, J. G. (2003). Core concepts of a cognitive approach to career development and services. Unpublished manuscript, Florida State University, Center for the Study of Technology in Counseling and Career Development, Tallahassee, FL. Retrieved from http://www.career.fsu.edu/techcenter/designing_career_services/basic_concepts/index.html

Sampson, J. P., Jr., Peterson, G. W., Lenz, J. G., Reardon, R. C., & Saunders, D. E. (1999). The use and development of the Career Thoughts Inventory. (Eric Document Reproduction Service No. ED 447 362). Retrieved from http://www.career.fsu.edu/documents/career%20thoughts%20inventory/Use%20and%20Development%20of%20CTI.htm

United States Department of Justice Civil Rights Division. Information and technical assistance on the Americans with Disabilities Act. Retrieved from www.ada.gov

United States Department of Labor. Wage and hour division. Family and Medical Leave Act. Retrieved from www.dol.gov/whd/fmla

Beth Lulgjuraj, M.S./Ed.S., National Certified Counselor, Distance Credentialed Counselor, has 10 years of higher education experience in career services and currently works as a Career Coach at the University of Phoenix. She has several years of experience working with individuals with special needs; she served as a disability liaison for seven years, was formerly a rehabilitation therapist, and was recently diagnosed with bilateral Meniere’s Syndrome. By working from home as a distance career counselor, she has found work-life balance even with a chronic illness. She may be reached at beth_kegler@yahoo.com.