Hi Catherine,
Your reply to the above topic was brilliant and I will be keeping it for reference on any other chronic condition as an aide memoir.  Thank you.
Jackie Morris


From: Catherine Tye <[log in to unmask]>
To: [log in to unmask]
Sent: Wednesday, 16 May 2012, 21:58
Subject: [OCC-HEALTH] Re Dementia advice

Hi Jane,

Firstly, I have to admit to knowing little about dementia as such but to some degree the label is less important - it is more about how it affects him and his performance at work at present (worry not about the future now - we can rarely objectively advise on that for a long-term degenerative disease such as this.) The stereotypical 'picture' in his, his manager's and/or HR's mind may be of an older person with memory problems - probably not very helpful!

Like any other health problem that affects or has the potential to affect work performance the employer/OH would need to use a risk assessment to demonstrate the decision making process. With my safety hat on - as a trainer, when I teach higher risk topics like - managing asbestos, legionella, working at heights where giving the wrong teaching advice could lead to a student doing the wrong thing with potentially catastrophic consequences, you would never rely just on the spoken word. The trainer has a responsibility to provide sources, references and handouts plus the learner has a responsibility here to study and read them too.

You have not said exactly how his dementia affects him on a day to day basis (memory, decision-making, comprehension, logical argument etc); whether any changes in his performance at work whilst teaching, marking or in meetings has been noticed and whether he is going to start medication to prevent/slow further deterioration. He may not be as 'sharp' as before but compare to others like me, who has to write everything down and he may still be way ahead of others and that doesn't stop him (or me!!) from being a darn good tutor - I just think differently and have to record carefully, form good habits and not 'rely' on my memory (less stressful anyway!)
   
Is he - an expert in his topic? Passionate about it? Long-term memory less or not affected? Been teaching for years?
If yes, then he is likely to know his topic inside out and therefore initially may have less problems than is assumed. From my perspective what needs 'managing' is how the verbal message in the classroom is backed up by written literature or self-directed study (verbally, written, electronically.) If he uses PowerPoint then these slides can be checked by another competent person and if made available to students including key points etc in the notes as a backup then the risk has potentially been managed. The students may have learning contracts to commit to doing the study!

In any learning environment there are always good and not so good tutors, more experienced and 'new' lecturers, elements that are supposed to be covered get missed or covered so briefly that the individual has to go away and study anyway. Then there are the formative and summative assignments and exams which are as much an indicator of the teaching input as the student's study dedication/ability! Are these double-marked? If a trainer/lecturers students score badly then something is amiss and that would reviewed accordingly as per an organisations QA procedures. Observation/peer review by colleagues although stressful, may reassure. If assignments not double-marked then the organisation could sample 10% for example (could be viewed as a reasonable adjustment under the Equality Act) and 360 degree feedback from students can help identify any early problems. Informal internal buddy or mentor maybe useful.

The difficulty may be with learning and recall of new or fast-changing technology, new design software or upgrades and when teaching new topics but being able to do that may be no different to anyone else. If he has short-term memory problems then initially these can be helped through planning, prompts and technology (mind-mapping software - links/exports to Powerpoint, Outlook and Word etc, Dictaphone, voice recognition (in my experience uses a different thought process to thinking then typing) e.g. if he can verbalise but struggles to get thoughts typed up or loses his track) but he has to get in the habit of using them - again just like anyone else and best to learn sooner rather than later before he has further problems! If the lecture objectives are reviewed briefly with students at end of session to confirm that those topics have been covered, or if not direction for self-directed study is given then the risk is reduced and your chap is reassured and has an audit trail that can be reviewed by his manager.

If you don't have it already then information from the assessment tests may be useful (OT, clinical psychologist, specialist etc) detailing how his dementia affects him from an objective perspective and can identify over time whether he is actually physiologically deteriorating or whether it his perception. Then there is the subjective and useful information that might be obtained (with his permission) from colleagues or spouse/partner.

Within the Uni you may have a disability advisor you can ask for technology advice, access to educational software licenses and as importantly robust training!

Spiritually, a chap of his age (approaching a BIG 0 as in 60) is viewed to be moving towards a later 'stage' of life and has the life experience and wisdom of the 'Elders.' He may be seeing his friends/siblings experiencing poor physical health and possibly some deaths. For a lecturer to 'loose' his mind and worse to be aware of it may be considered by him to be the ultimate betrayal of his body. However, the mental agility required of a lecturer may also provide him with the skills and knowledge to adjust somewhat positively to his changing mental function and future challenges.

A psychotherapist friend of mine recommends a book written by Ram Dass - Still here: Embracing aging, changing and dying. Ram Dass was an academic psychologist and Harvard lecturer who pioneered in psychedelics(!) He had a near fatal stroke whilst on a lecture tour. It is good at tying the physical world reality to the spiritual, as well as society's expectations. Psychological support for learning coping strategies and grieving for his previous good health may be beneficial at some point.

The above thoughts if documented alongside other advice within a risk assessment format - will give an indication of potential risk level (short-term, medium-term and long-term). Those then deemed applicable can be considered further, trialled then formally reviewed etc. If this is completed then you may have the evidence required to prove his competence and robust performance, protect the interests of the individual and the organisation from an Equality perspective and longer-term if his performance suffers or he deteriorates, robust evidence for ill-health capability and if appropriate ill-health retirement.

End of ramble! Good luck and all the best for the chap concerned (feel free to share this email with him),
Kind regards,
Catherine


Catherine Tye RN SPOH PgDipOSH
Health, Safety and Wellbeing Practitioner
email: [log in to unmask] | www.harmonyhealthandwellbeing.com

Date:    Tue, 15 May 2012 15:37:02 +0100
From:    Jane Gould
Subject: Dementia advice

Hello List,

I am after advice please read on;

Employee who although not in a safety critical role is a senior lecturer in aeronautics which involves the teaching of students in aircraft design/maintenance and also some theoretical teaching to pilots. The lecturer(only late 50s) has been diagnosed with early onset dementia- Advice first  thought of was memory aids, slower pace, work supervised- but  is that enough? I think may be not as potential for critical information not being taught correctly could parts be missed , would crucial quality be compromised etc. The poor man is devastated with diagnosis, implications for his role anyone any experience or advice I could send his way?
Thanks

Jane

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