Managing multiple sclerosis at work

Symptoms

Multiple sclerosis or MS is an incurable disease of the central nervous system that inflames the protective sheath or myelin which surrounds the nerves and causes plaques or lesions to appear. It can cause interruptions in the way the nerves of the brain, spinal cord and optic nerves send messages to the associated muscles.
As multiple sclerosis is unpredictable, the symptoms and progression of the condition vary from person to person and may involve remissions, relapses and periods of minimal symptoms. Symptoms are diverse and can be any combination of five major health problems including:

motor control - muscular spasms and problems with weakness, coordination, balance and functioning of the arms and legs, including mobility difficulties
fatigue - including heat sensitivity
other neurological symptoms - including vertigo, pins and needles, changes to speech, neuralgia and vision disturbances
neuropsychological symptoms - including depression and cognitive difficulties such as reduced concentration and memory
altered bladder and bowel function

The type, degree and progression of symptoms will vary among people and some symptoms may fluctuate with triggering factors such as heat, cold or stress. Some people may be seriously disabled and others may have two or three relapses and then remain symptom free for the rest of their lives. The progress of the disease is unpredictable.

Workplace adjustments and solutions

As symptoms and restrictions are unique to each person with MS, a flexible approach and supportive environment is needed at work. A person’s symptoms and job duties should be reviewed to identify any changes in work equipment or work role that may help to maintain independence at work. The following examples are possible adjustments that may be helpful at work:

Activities of daily living

allow use of a personal attendant at work
allow use of a service animal at work
make sure the toilet and kitchen facilities are accessible for mobility aids and wheelchairs
ensure workstation is located close to the restroom
allow longer breaks or more frequent short breaks and consider whether work can be done from home
provide access to a refrigerator as some people with MS have difficulty regulating body temperature and may need to use cooling products

Cognitive impairment

provide written job instructions where possible
prioritise job assignments
allow flexible working hours
allow periodic rest periods to readjust
provide memory aids like schedulers and organisers
minimise distractions
allow a self-paced workload
reduce job stress
provide more structure

Fatigue or weakness

reduce or eliminate physical exertion and workplace stress
schedule periodic rest breaks away from the workstation
allow a flexible work schedule and flexible use of leave
allow work from home
use ergonomic workstation design
use of a scooter or other mobility aid if a person needs to walk as part of their job.

Fine motor impairment

use ergonomic workstation design
provide alternative computer access such as voice recognition software
provide forearm supports for computer use
provide pen grips for writing
provide a page turner

Gross motor impairment

modify the worksite to make it wheelchair accessible, for example ensure hallways are clear and alter desk height for leg clearance
provide accessible parking close to the worksite entrance
provide an accessible entrance such as the use of an automatic opening door
provide an accessible bathroom - consider door widths, access, use of rails, location of the hand basin as well as the soap dispenser and dryer or towels
provide an accessible kitchen and or break room - consider a kettle on a kettle tipper or use of an urn, as well as ensuring microwave and tea making facilities are at an accessible height
provide wheelchair accessible route of travel to other work areas used by the employee

Heat sensitivity

adjust worksite temperature such as blocking direct sunlight though windows
use cooling vest or other cooling clothing
use air conditioners and fans at the workstation
allow flexible scheduling and use of leave time
allow work from home during hot weather

Speech impairment

provide speech amplification, speech enhancement or other communication device
use written communication such as email or an iPad for notetaking
modify work role so that it does not require a lot of communicating by talking
allow periodic rest breaks

Vision impairment

magnify written material
provide large print material
control screen glare by adding a screen filter to the computer
ensure office lighting meets Australian standards and use extra task lighting where required
allow frequent rest breaks

Support Services

The Employment Assistance Fund is available to assist with funding for equipment or modifications to the workplace that enable eligible individuals with a disability to carry out their work.