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If the symptoms persist and a cause is not determined, it is important to encourage the employee to confer with a specialist, such as a neurologist, geriatrician, or geriatric psychiatrist with experience in dementia.

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Early Onset Alzheimer's Disease in the Workplace

Major head injuries, diabetes, and heart disease are also linked with increased Alzheimer's disease diagnoses, so these conditions should be avoided or properly managed if they occur.

Joanne, a 54-year-old sales manager, was fired last week because of her declining performance during the past 18 months. She was arriving late to meetings with clients, missing report deadlines, and misplacing confidential company data. Prior to these issues, Joanne had a superior track record with the company, so her boss was especially disappointed in these changes. During her 15-year tenure with the organization, Joanne had won two awards, had been promoted three times, and was one of the highest earners in the organization. What happened to this star?

Unbeknownst to anyone, including Joanne, she was suffering from early onset Alzheimer's disease. Alzheimer's disease is generally considered an older person's illness, and usually that is true. But approximately 200,000 Americans suffer with the early onset type. Early onset Alzheimer's disease symptoms, by definition, manifest in patients before age 65 and can occur as early as the thirties and forties, but are most typically diagnosed during the fifties.

What Is Early Onset Alzheimer's Disease?
Early onset Alzheimer's disease is a type of permanent dementia for which there is currently no cure. Dementia symptoms consist of short-term memory loss, confusion, personality changes, poor judgment, and getting lost with familiar tasks and in familiar places. Those suffering with early onset Alzheimer's disease usually have been experiencing symptoms for a year or more by the time they seek a doctor's advice. Because dementia symptoms can be caused by a number of temporary conditions, many physicians correctly consider those first, particularly for those under age 65. Temporary causes of dementia can include significant stress, dehydration, infection, medication side effects, and drug or alcohol abuse.

Joanne may have assumed her problems arose simply because she was getting older. Although everyone has changes in the brain, including shorter reflex and reaction times, increased tip of the tongue moments, and mild forgetfulness, dementia symptoms are never part of the normal aging process. If Joanne had known about her condition, perhaps she would have remained employed. With a proper diagnosis, she may have had access to medications such as Aricept and Namenda that could have had minimized symptoms impeding her job performance. While these drugs are not a cure, they have certainly improved quality of life for many suffering with permanent dementia. Joanne also would have had the luxury of processing the diagnosis and preparing personally and professionally, instead of facing the humiliation and stress of a dismissal.

How Should an Employee Handle an Early Alzheimer's Disease Diagnosis?
Because Joanne had enjoyed more than a decade of success with her company, perhaps she may have had a candid discussion with her manager about her diagnosis if she had known. Maybe together, they would have determined a way for her to remain in her sales management position. If not, perhaps she could have been offered her another opportunity at the company that would be better suited to her health changes. If continuing with the company would not have been an option, most likely Joanne would have been eligible for some type of disability benefit. This would have protected her from immediately using her savings and retirement account for daily living expenses.

Protecting those assets for as long as possible with an early onset Alzheimer's disease diagnosis is critical because Joanne most likely will need to spend that on care expenses when her disease progresses. It is especially important to delay accessing the retirement account due to hefty early withdrawal penalties, given that she is still only 54 years old.

What can employees do to avoid Joanne's plight? All should be aware of their risk factors related to early onset Alzheimer's disease but should also keep in mind it is an infrequent condition. Only 5 percent of all Alzheimer's disease cases diagnosed are of the early onset nature.

What are the risk factors for early onset Alzheimer's disease? Clinical studies have determined that there are some genes associated with early onset Alzheimer's disease, so family history is a factor. Major head injuries, diabetes, and heart disease are also linked with increased Alzheimer's disease diagnoses, so these conditions should be avoided or properly managed if they occur.

What Can Employers Do?
First, an organization can facilitate a climate of trust about issues, health or otherwise, that may affect work performance. It is also important to investigate when a star employee like Joanne fails to meet expectations. Successful employees generally don't start falling off, especially after 15 years, unless something is very wrong. Joanne probably knew something was wrong with her, as most Alzheimer's disease sufferers do recognize changes in themselves, but may have been in denial.

When people are experiencing these symptoms in denial, a compassionate manager or human resources professional may be able to encourage the employee to seek help through Employee Assistance Programs or their group health insurance. If Joanne was suffering from a temporary dementia that could be cured or reversed, the company would have retained an excellent worker. Even in Joanne's case of suffering from permanent early onset Alzheimer's disease, the organization is in a better position to defend against a wrongful termination suit when it gives an employee the opportunity to seek help when a declining job performance may be the result of an illness or disability.

If the employee is not in denial and a trusting corporate culture exists, she might seek out her manager with her concerns about her ability to do her job. Patients experiencing such symptoms often appropriately begin by consulting with their primary care physician. But if the symptoms persist and a cause is not determined, it is important to encourage the employee to confer with a specialist, such as a neurologist, geriatrician, or geriatric psychiatrist with experience in dementia. Also, memory clinics and assessment centers are available in most major cities to assess and evaluate symptoms.

While early onset Alzheimer's disease can create havoc in the workplace for both employers and employees, it is fortunately a rare condition. When everyone in the workplace understands what to look for, it is easier to guide co-workers and subordinates who need help.

About the Author

Jennifer FitzPatrick, MSW, LCSW-C is an author, speaker, and educator. Founder of Jenerations Health Education, Inc., she has more than 20 years' experience in healthcare. Jennifer is a frequent speaker at national and regional conferences and was an Adjunct Instructor at Johns Hopkins University. Her new book, "Your 24/7 Older Parent," answers the prayers of those dealing with the care of an elderly parent. For more information on FitzPatrick's speaking, visit www.jenerationshealth.com.

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