ARTICLE #12: Accommodation and Compliance Series: Employees with Parkinson's Disease
By Linda Carter Batiste, J.D.

Preface

Introduction | Information About | Americans with Disabilities Act | Accommodating Employees | Resources | References

Introduction

JAN's Accommodation and Compliance Series is designed to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). Each publication in the series addresses a specific medical condition and provides information about the condition, ADA information, accommodation ideas, and resources for additional information.

The Accommodation and Compliance Series is a starting point in the accommodation process and may not address every situation. Accommodations should be made on a case by case basis, considering each employee's individual limitations and accommodation needs. Employers are encouraged to contact JAN to discuss specific situations in more detail.

For information on assistive technology and other accommodation ideas, visit JAN's Searchable Online Accommodation Resource (SOAR) at http://www.jan.wvu.edu/soar .

Information about Parkinson's Disease

How prevalent is Parkinson's disease?

In the United States, it is estimated that 60,000 new cases of Parkinson's disease are diagnosed each year, joining the 1.5 million Americans who currently have Parkinson's disease. While the condition usually develops after the age of 65, 15% of those diagnosed are under 50. Parkinson's disease affects both men and women in almost equal numbers. It shows no social, ethnic, economic, or geographic boundaries (National Parkinson Foundation, n.d.).

What is Parkinson's disease?

Parkinson's disease is a chronic, progressive disorder of the central nervous system that belongs to a group of conditions called motor system disorders. Parkinson's is the direct result of the loss of cells in a section of the brain called the substantia nigra. Those cells produce dopamine, a chemical messenger responsible for transmitting signals within the brain. Loss of dopamine causes critical nerve cells in the brain, or neurons, to fire out of control, leaving patients unable to direct or control their movement in a normal manner (Michael J. Fox Foundation for Parkinson's Research, n.d.).

What are the symptoms of Parkinson's disease?

Symptoms of Parkinson's disease, which often appear gradually yet with increasing severity, may include tremors or trembling, difficulty maintaining balance and gait, rigidity or stiffness of the limbs and trunk, and general slowness of movement (also called bradykinesia). Patients may also eventually have difficulty walking, talking, or completing other simple tasks. The course of Parkinson's disease varies substantially. Some patients have relatively few troublesome symptoms for many years, while others have especially severe cases that leave them with little or no mobility in just a few years (Michael J. Fox Foundation for Parkinson's Research, n.d.).

What causes Parkinson's disease?

Scientists have not yet found the exact cause of Parkinson's disease. Most believe that it is a combination of genetic and environmental factors, but no definitive data exist (Michael J. Fox Foundation for Parkinson's Research, n.d.).

How is Parkinson's disease treated?

There are a number of effective medicines that help to ease the symptoms of Parkinson's disease. Most symptoms are caused by lack of dopamine. The medicines most commonly used will attempt to either replace or mimic dopamine, which improves the tremor, rigidity, and slowness associated with Parkinson's disease. Several new medicines are being studied that may slow the progression. Many promise to improve the lives of people with Parkinson's disease (National Parkinson Foundation, n.d.).

Parkinson's Disease and the Americans with Disabilities Act

Is Parkinson's disease a disability under the ADA?

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet (EEOC, 1992). Therefore, some people with Parkinson's disease will have a disability under the ADA and some will not.

A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having such an impairment (EEOC, 1992). For more information about how to determine whether a person has a disability under the ADA, visit http://www.jan.wvu.edu/corner/vol02iss04.htm .

Accommodating Employees with Parkinson's Disease

(Note: People with Parkinson's disease may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with Parkinson's disease will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.)

Questions to Consider:

1. What limitations is the employee with Parkinson's disease experiencing?

2. How do these limitations affect the employee and the employee's job performance?

3. What specific job tasks are problematic as a result of these limitations?

4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?

5. Has the employee with Parkinson's disease been consulted regarding possible accommodations?

6. Once accommodations are in place, would it be useful to meet with the employee with Parkinson's disease to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?

7. Do supervisory personnel and employees need training regarding Parkinson's disease?

Accommodation Ideas:

Large Blue Triangle BulletFine Motor Impairment:

Small Triangle Blue BulletImplement ergonomic workstation design
Small Triangle Blue Bullet Provide alternative computer access
Small Triangle Blue Bullet Provide alternative telephone access
Small Triangle Blue Bullet Provide arm supports
Small Triangle Blue Bullet Provide writing and grip aids
Small Triangle Blue Bullet Provide a page turner and a book holder
Small Triangle Blue Bullet Provide a note taker

Large Blue Triangle BulletGross Motor Impairment:

Small Triangle Blue BulletModify the work-site to make it accessible
Small Triangle Blue Bullet Provide parking close to the work-site
Small Triangle Blue Bullet Provide an accessible entrance
Small Triangle Blue Bullet Install automatic door openers
Small Triangle Blue Bullet Provide an accessible restroom and break room
Small Triangle Blue Bullet Provide an accessible route of travel to other work areas used by the employee
Small Triangle Blue Bullet Modify the workstation to make it accessible
Small Triangle Blue Bullet Adjust desk height if wheelchair or scooter is used
Small Triangle Blue Bullet Make sure materials and equipment are within reach range
Small Triangle Blue Bullet Move workstation close to other work areas, office equipment, and break rooms

Large Blue Triangle BulletFatigue/Weakness:

Small Triangle Blue BulletReduce or eliminate physical exertion and workplace stress
Small Triangle Blue BulletSchedule periodic rest breaks away from the workstation
Small Triangle Blue BulletAllow a flexible work schedule and flexible use of leave time
Small Triangle Blue BulletAllow work from home
Small Triangle Blue BulletImplement ergonomic workstation design
Small Triangle Blue BulletProvide a scooter or other mobility aid if walking cannot be reduced

Large Blue Triangle BulletSpeech Impairment:

Small Triangle Blue BulletProvide speech amplification, speech enhancement, or other communication device
Small Triangle Blue BulletUse written communication, such as email or fax
Small Triangle Blue BulletTransfer to a position that does not require a lot of communication
Small Triangle Blue BulletAllow flexible scheduling and flexible use of leave time
Small Triangle Blue BulletAllow periodic rest breaks

Large Blue Triangle BulletMedical Treatment Allowances:

Small Triangle Blue BulletProvide flexible schedules
Small Triangle Blue Bullet Provide flexible leave
Small Triangle Blue Bullet Allow a self-paced workload with flexible hours
Small Triangle Blue Bullet Allow employee to work from home
Small Triangle Blue Bullet Provide part-time work schedules

Large Blue Triangle BulletDepression and Anxiety:

Small Triangle Blue BulletReduce distractions in work environment
Small Triangle Blue Bullet Provide to-do lists and written instructions
Small Triangle Blue Bullet Remind employee of important deadlines and meetings
Small Triangle Blue Bullet Allow time off for counseling
Small Triangle Blue Bullet Provide clear expectations of responsibilities and consequences
Small Triangle Blue Bullet Provide sensitivity training to co-workers
Small Triangle Blue Bullet Allow breaks to use stress management techniques
Small Triangle Blue Bullet Develop strategies to deal with work problems before they arise
Small Triangle Blue Bullet Allow telephone calls during work hours to doctors and others for support
Small Triangle Blue Bullet Provide information on counseling and employee assistance programs

Large Blue Triangle BulletCognitive Impairment:

Small Triangle Blue BulletProvide written job instructions when possible
Small Triangle Blue Bullet Prioritize job assignments
Small Triangle Blue Bullet Allow flexible work hours
Small Triangle Blue Bullet Allow periodic rest periods to reorient
Small Triangle Blue Bullet Provide memory aids, such as schedulers or organizers
Small Triangle Blue Bullet Minimize distractions
Small Triangle Blue Bullet Allow a self-paced workload
Small Triangle Blue Bullet Reduce job stress
Small Triangle Blue Bullet Provide more structure

Large Blue Triangle BulletActivities of Daily Living:

Small Triangle Blue BulletAllow use of a personal attendant at work
Small Triangle Blue Bullet Allow use of a service animal at work
Small Triangle Blue Bullet Make sure the facility is accessible
Small Triangle Blue Bullet Move workstation closer to the restroom
Small Triangle Blue Bullet Allow longer breaks
Small Triangle Blue Bullet Refer to appropriate community services
Small Triangle Blue Bullet Provide access to a refrigerator

Situations and Solutions:

A secretary with Parkinson's disease and hand tremors was having difficulty using a keyboard, writing, manipulating manuals, and filing. She was accommodated with a keyguard, typing aid, page turner, and open files.

A supervisor with Parkinson's disease was having difficulty managing fatigue. The employer provided a private rest area with a cot so the individual could take breaks throughout the day.

A file clerk with Parkinson's disease was having difficulty meeting the physical demands of the job, including walking between work areas, standing at filing cabinets, and carrying files. The individual was accommodated with a power scooter with a basket and a stand/lean stool.

A technician with Parkinson's disease was having difficulty concentrating. The employee's supervisor provided written job instructions when possible and allowed the individual to have periodic rest breaks. In addition, she was moved to a corner cubical where distractions were minimized with strategically placed baffles.

A customer service representative with Parkinson's disease was having difficulty manipulating his mouse, writing, standing to greet people, and communicating effectively. He was accommodated with a trackball, writing aid, stool with lift cushion, and speech amplification.

A technical consultant was having difficulty using the computer in the afternoons due to fatigue. He was accommodated with speech recognition and an ergonomic workstation.

An office assistant with tremors and fatigue caused by Parkinson's disease was having difficulty typing the number of words per minute required by her employer. The individual rearranged her workstation to reduce distractions and her employer offered flexible scheduling. Her word processing software was programmed with macros to reduce keystrokes and she was given speech recognition software.

A consultant with Parkinson's disease was having difficulty getting to work on time. He was accommodated with flexible scheduling so he could use public transportation.

A teacher with Parkinson's disease was having difficulty standing in front of the classroom to write on the board. The individual was accommodated with a scooter and a laptop and PC projector. She was then able to remain seated while using the computer and projector to display information to the class.

An engineer with Parkinson's disease was having difficulty concentrating and communicating. The individual was accommodated with a quiet office free from distractions. In addition, her supervisor implemented a policy of scheduled interruptions with written reminders and assignments. The individual was also provided with a communication device.

Products:

There are numerous products that can be used to accommodate people with limitations. JAN's Searchable Online Accommodation Resource (SOAR) at http://www.jan.wvu.edu/soar is designed to let users explore various accommodation options. Many product vendor lists are accessible through this system; however, upon request JAN provides these lists and many more that are not available on the Web site. Contact JAN directly if you have specific accommodation situations, are looking for products, need vendor information, or are seeking a referral.

Resources

References

Equal Employment Opportunity Commission. (1992). A technical assistance manual on the employment provisions (title I) of the Americans with Disabilities Act. Retrieved April 29, 2005, from http://www.jan.wvu.edu/links/ADAtam1.html

Michael J. Fox Foundation for Parkinson's Research. (n.d.). About Parkinson's. Retrieved May 6, 2005, from http://www.michaeljfox.org/parkinsons/index.php

National Parkinson Foundation. (n.d.). About Parkinson disease. Retrieved May 6, 2005, from http://www.parkinson.org/site/pp.asp?c=9dJFJLPwB&b=71125