World Alzheimer's Month has been celebrated every September since its launch in 2012, to coincide with World Alzheimer's Awareness Day, which takes place on 21 September. The month is intended to bring greater awareness of the support available to those affected by dementia. We provide some practical steps for employers on how to proceed if an employee is affected by a dementia diagnosis, be that their own or a loved one's.

What is Alzheimer's?

Alzheimer's disease is a degenerative disease that causes the loss of cognitive ability and memory. It is the leading cause of dementia. There can be some confusion between dementia and Alzheimer's, but being aware of the difference between the two can help to understand the support that affected individuals may need.

Dementia refers to a general loss of cognitive functions, such as thinking, logic, memory and reasoning. It is a general term referring to the degeneration of brain function which may lead to additional symptoms such as emotional instability and changes in personality. Alzheimer's refers to a specific brain disorder which causes dementia. Alzheimer's is usually a late-onset illness which most commonly affects individuals in their mid-60s. Early-onset Alzheimer's, usually presenting between a person's 30s and 60s, is much rarer.

Whilst September is specifically the awareness month for the Alzheimer's Society, much of the focus is on supporting individuals affected by dementia more widely. As a result, this article focuses on the general support that could usefully be provided in the event of a dementia diagnosis. For more specific guidance on Alzheimer's, please see the Alzheimer's Society website.

What are the legal obligations for employers?

A dementia diagnosis would most likely constitute a disability under the Equality Act 2010 (the Act), meaning that employers are prohibited from discriminating against employees or job candidates because of their disability, both directly and indirectly. This means that individuals with dementia must be treated fairly and reasonable adjustments should be put in place to support them. Additionally, it is unlawful to discriminate against an individual because they have an association with someone who is disabled under the Act. Therefore, employees and job candidates who are carers for a person with dementia must also be treated fairly and have a right to reasonable adjustments where necessary and appropriate.

Aside from the legal responsibility, employers who support their employees through a dementia diagnosis are helping to create an inclusive workforce. That is recognised as an important factor in improving the quality of talent organisations are able to attract and retain, as well as increasing productivity.

What practical support might employers provide?

The types of support required by affected employees will vary depending on the stage of dementia from which they or their loved one are suffering. The three recognised stages are:

• Phase One: Supporting employees in the early stages of dementia;
• Phase Two: Ongoing support and management; and
• Phase Three: Leaving work.

During the first phase, the focus should be on facilitating a supportive working environment, where employees feel comfortable in opening up about any diagnosis of dementia. Line managers should be trained on how to have conversations about dementia (as well as other health conditions), including the need to:

• have conversations in a quiet, private space;
• be patient and understanding with the employee and acknowledge the difficulty in being honest about the subject matter;
• listen carefully to what the employee is saying;
• check that they have understood and ask questions to confirm;
• be supportive of the employee's decisions regarding their capacity to work, including how to support them in adjusting their role or, in some cases, leaving it; and
• ask the employee if there is any specific support that would aid them if they would like to continue working.

Phase two is likely to be the stage where employees will need reasonable adjustments to support them with their role. The open and understanding dialogue established during Phase One is key to ensuring that the right reasonable adjustments are put in place. It would also be useful to work with Occupational Health to ascertain the employee's capacity to continue with their role. If the employee has received a dementia diagnosis themselves, necessary reasonable adjustments may include:

• adjusted or reduced working hours;
• time off for appointments;
• increased capacity to work flexibly, including working from home where possible;
• adjusted productivity targets;
• more frequent rest breaks;
• extra time for proofreading work; and
• assistive technology to aid with drafting and reading.

It is important to have a collaborative dialogue and to understand that reasonable adjustments will look different for each employee. Dependent on the severity of symptoms, individuals may not need, or want, all or any of the reasonable adjustments suggested. For further guidance on how to support employees who are caring for an individual with dementia, and the reasonable adjustments they may require, please see our previous article on supporting carers.

Due to the nature of dementia, it is likely that the symptoms will eventually reach a stage where the individual no longer has capacity to work. It is crucial to be sensitive when considering this and to ensure that employees are not unduly pressured. A dignified exit and strategy should be agreed. Where possible, employers might also consider what post-employment support should be put in place. This may include offering the individual the opportunity to return to the organisation to volunteer or offering dementia-friendly retirement activities.

If you would like any further guidance on supporting employees who have been affected by a dementia diagnosis, please contact our PRM team.